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    Five secrets to success with co-management


    image courtesy of Dr. Chang


    3. Establish relationships based on best practices

    Dr. Chang“With co-management, you have to be really careful from a documentation standpoint,” said Daniel H. Chang, MD, who is in private practice at Empire Eye and Laser Center, Bakersfield, CA. To ensure thorough documentation, his practice uses a five-form process that includes consent for co-management, requiring signatures from the patient, surgeon, and co-managing optometrist.

    Prior to surgery, he sends a surgery appointment schedule to give the referral optometrist an idea of the anticipated course of treatment. After surgery, he sends a co-management operative report with relevant details about the surgery.

    After surgery, he documents appropriate transfer of care. When Dr. Chang examines the patient postoperatively and determines that he or she is doing well, he sends the transfer agreement to the optometrist, as well as a pre-labeled transfer response.

    This way, the optometrist can confirm that the patient returned for continued follow-up and report the postoperative findings from that visit.

    “These forms demonstrate an open communication between the surgeon and the co-managing optometrist,” he said.

    About 10% to 20% of his cases are co-managed. To enhance his collaborative relationship with community optometrists the decision was made not to include an optical shop at his new practice location. This reduces the concern from referring optometrists that he may not return their patients and may even represent unwelcome competition for spectacle sales.

    “We still have optical patients at our original location, and they remain a welcome part of our practice,” Dr. Chang said. “But referred surgical patients never know that we sell glasses.”

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