Collaborative care, referring to optometry and ophthalmology working in concert, has known advantages and benefits for both physicians and patients. From a physician standpoint, the collaborative care model affords each provider the opportunity to practice at their highest level and maximize their specialized skill set: The optometrist can function as the leader in the clinic, and the ophthalmologist can dedicate more time to using their surgical skills in the OR. Furthermore, this model can allow patients to access an elevated level of care because they are often seeing both an optometrist and an ophthalmologist, each of whom can share information and offer insight.
COLLABORATIVE CARE IN TRAINING
At our training site, Vance Thompson Vision in Sioux Falls, South Dakota, ophthalmology and optometry have worked in harmony since its inception. During the past decade, the practice has implemented an ophthalmology fellowship and an optometry residency with an emphasis on cataract, refractive, corneal, and glaucoma surgery and advanced anterior segment disease. The fellowship program is currently in its ninth year, and the residency program is in its sixth, with a recent expansion to two residents per year. The opportunity to train alongside ophthalmologists and optometrists simultaneously has enhanced our education and allowed us to experience firsthand the value of collaboration within patient care. Through our experience, we have come to appreciate that collaboration between optometrists and ophthalmologists is not only a benefit for patient care but also a tremendous advantage in education.
A UNIFIED APPROACH TO PATIENT CARE
Over the course of the training year, patients who are referred in with acute or emergent problems are evaluated and often shared by a fellow-resident team. In addition, we share call responsibilities and observe patients as a team. This is a valuable part of our training because we learn early in the year that, when a problem arises, we must directly collaborate and collectively form a plan for managing the patient. Because acute and emergent visits typically unveil unique pathology, these encounters represent excellent learning opportunities for us as a team.
Since the start of its ophthalmology fellowship, Vance Thompson Vision has run a “friends and family” program through which interested individuals may be scheduled for refractive surgery evaluations. Patients can sign up for refractive surgery at a reduced cost with the understanding that their procedure will be performed by the surgical fellow. This is a structured component within our training program that allows residents and fellows to work together exclusively. The optometry resident evaluates each patient and determines their candidacy for surgery. Then, collectively, the resident and fellow select the most suitable procedure (eg, LASIK, PRK, phakic IOL, etc.). Postoperatively, we see these patients together, and through these experiences, we have learned the importance of unified and consistent messaging. When patients hear the same phrasing from both the optometrist and ophthalmologist, it builds trust and assures them that we have their best interest in mind.
COLLABORATION OUTSIDE CLINIC
Beyond clinical responsibilities, we also collaborate to organize and lead quarterly journal clubs over the course of the year. The experience allows us to focus on a topic and collectively perform a literature review to select articles for discussion. These journal clubs, which bring together all the physicians in the organization, are excellent opportunities to review pertinent updates in the literature and observe how our colleagues interpret findings from selected studies.
CONCLUSION
Vance Thompson Vision is one of only a handful of practices in the country that offer both an ophthalmology fellowship and optometry residency. Our experience with this program has broadened our skills beyond clinical and surgical care and instilled the value of collaborating to deliver better patient care and a better patient experience. Furthermore, we have learned the value of thoughtful dialogue between providers and the importance of consistent messaging to the patient. As we enter the next stages of our careers, we are eager to join practices that recognize the value of collaboration in eye care.
