Allergy Season Must Be Coming……

While the weather hasn’t really gotten all that much warmer, the calendar says that it should be.  And the annual increase in drug rep calls promoting Rx allergy medications has spiked, the pollen counts must be getting ready to spike too!  I don’t mind the reps stopping in, especially when there’s something new to tell me about.  However, we’re fortunate to have some pretty good topical and oral allergy medications, and there’s nothing “strikingly new” on the market for this year’s season.  

Probably the best thing about these reps stopping in is the fact that they are dropping off coupons that patients can use to cap their co-pays and out of pocket expenses if they don’t have good drug coverage.  So, get ready, the allergy season is coming, I can tell from the drug reps presence, if not the actual change in the weather!

Dr. Warren

www.warreneyecarecenter.com

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I Have A Few Patients Like This

Fortunately, the vast majority of my patients are a joy to spend time with and help.  There are a few people in every “group” of people though who make things difficult.  From not showing up for appointments to repeatedly ignoring the advice that they’ve paid me for (or their insurance has paid me for, see my previous blog posts) to just having an overall negative attitude about the day and their life.  

I think that I do a pretty good job of insulating my emotions from these patients, but they do g

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et me down from time to time.  So, if you find your available appointment times limited to the first or last appointments of the day and no evenings, you may be one of these type of patients.

Otherwise, you can feel comfortable that I truly enjoy seeing you in the office!

Dr. Warren

www.warreneyecarecenter.com

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Who’s The Doctor’s Customer Anyway?

I was struck by this blog post, and by how hard I’ve been working to prevent this scenario from occurring in my office, with good success so far, but its a constant struggle.

Here’s an excerpt from the beginning of the blog post.  Its worth a few minutes to read the entire post.

You the patient are really not the customer of the physician. Since the insurer will determine whether and how much the physician will be paid for attending to your needs, you are largely a bystander in the relationship. The doctor’s customer has become the insurer.

As my patient’s know, I don’t want to get into a situation where I’m really working for the insurance company.   However, due to the power that they wield, its a constant fight to avoid just that situation.  From rules about what medications they will pay for to procedures and testing that they will or won’t pay for based on arcane and outdated information, I’m constantly having to think not only about what my patient needs from me, but also whether their insurance will cover the procedure or testing and if not, who can and will.

You can rest assured that I’m not going to give up this fight easily.

Dr. Warren

www.warreneyecarecenter.com

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What I’m Really Providing My Patients With

After practicing for over 21 years, I certainly haven’t “seen it all”, and whenever I think that I have, something or someone comes into the office that reminds me of that.  I actually really enjoy these patients and problems, they move me out of my comfort zone and really challenge my clinical thought process and decision making.   Most patients and their problems though fall within the “I’ve seen this many times” zone.   I still have many things to consider about these patients and its this thought and decision making process that is the real service that I provide my patients with.

All of the technology, office procedures and processes are all set up to provide me with the information that I need to make these decisions.  I’ve purchased technology and set up office procedures to streamline and shorten this process considerably, but in the end, I still have to filter all of the information and decide what the problem is and come up with a plan of attack to deal with it.  Whether its the farsighted 5 year old from yesterday who needs glasses to see easier (but not his entire Rx because he wouldn’t be able to adjust to it all at once), the 69 year old Glaucoma patient who has stable visual fields and anatomy but who’s pressure is too high even on his two glaucoma medications (one of which he may or may not have taken that day) or the 49 year old grocery store owner who “just” needs to use reading glasses to see up close.  Each patient presents a set of usually familiar problems and findings, and its my job to put the puzzle together for a solution.

I started thinking about this while sitting in my sons’ orthodontist’s office for 3 hours this morning as they had their braces removed and read this blog post on the topic.  I’m glad that they have wi-fi access so that I could write about it while the thought is fresh in my mind!  I have wi-fi available in the office, but we try to not keep our patients and their families in the office long enough to need the access!!

Dr. Warren

www.warreneyecarecenter.com

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My Least Favorite Part Of Practicing…….?

Easy, dealing with insurance companies, their policies, their processes etc.  Sure, they reduce payments for services too, but that’s not even close to the worst part of dealing with them.  Insurance companies make their money “in the middle” of the doctor patient relationship, and not just the financial aspect of the relationship.  

I had to make a tough decision last year, whether to continue to be a provider for one of the major national vision care plans.  I chose not to continue, knowing that I would definitely lose some patients because of the decision.  But I simply couldn’t continue to do business with them.  Their payments for services and products weren’t any better or worse than the other vision care program (VSP) that I continue to be a provide for.  But their policies and marketing to my patients were just not something that I could continue to deal with.  You see, this particular vision care plan is owned by the largest commercial optometric organization in the United States, Luxottica, who in turn owns LensCrafters, Pearle vision and several other companies.

This vision care plan does not have the ability to integrate with the software that my office staff uses (or with any other eye care practice software), requiring my staff to manually perform many processes, from looking up patient benefits to filing claims and orders and pricing optical orders.  This not only took up too much of my staff’s time, it also confused patients and wasted patient time waiting for information before, during and after their appointments.

This plan also would market to my patients, directing them to their own offices and optical sales locations.  So, besides being “not easy” to do business with, they were competing directly with me for MY patients.

I’ve also had to deal with medical insurance companies and their lies to patients when selling them coverage.  We’ve had a group of patients purchase/sign up for a “Medicare Advantage” plan who were told that “nothing will change” with regards to your doctor choices.  Sounds familiar, ‘eh?  But I digress.  Well, as I write this, I am not a provider for this plan, meaning that patients who saw me early this year assuming that they didn’t have to change anything, racked up bills in my office that their insurance company wouldn’t pay.  We don’t have the contract with the insurance company, the patients do.  Meaning that technically, the patients were responsible for these bills.  I chose to write off these charges and not collect the total amount from the patients, meaning that I got to work for nothing, and pay my staff to work at the same time.  We’re looking into being added to this plan’s panel, and if they will pay a reasonable amount for procedures provided, I’ll hopefully soon be a provider for this plan.

Can you see why doctors aren’t enamored with the business side of health care?  And this isn’t an ObamaCare issue, this is and has been “par for the course” activities in health care for a long time.  ObamaCare will just intensify the issues, potentially driving more and more doctors out of the “insurance business” when it comes to providing health care.

Dr. Warren

www.warreneyecarecenter.com

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Interested In New Contact Lens Technology?

If you have worn soft contact lenses before and would like to find out about newer lens designs and materials, drop me an email (jwarrenod@mac.com) and I’ll have the staff prepare a set of newer trials for you to try.  Lens design and material technology is constantly changing, opening up the possibility of successful lens wear to previously unsuccessful patients.  From bifocal lenses to astigmatism correcting lenses to lenses that you only wear once, there are many new and exciting contact lenses!

Dr. Warren

www.warreneyecarecenter.com

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News Articles About Nutritional Supplementation

While I don’t believe that nutritional supplementation is the answer to every health problem in the US, I do know that the science points to benefits for the prevention of eye diseases.  There has been lots of buzz in the main stream media about a new article that says that there’s no benefit to taking vitamins.  Here’s a link to one of the articles.

Until I see much, much more information and other studies (not just reviews of other articles) that suggest no benefit for the prevention of eye diseases, and other chronic conditions, I will continue to recommend moderate levels of nutritional supplementation to my patients.  There’s just too much other science not to do so.

Dr. Warren

www.warreneyecarecenter.com

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Falls Between Cataract Surgery

Here’s a link to a good article about the risk of falls between cataract surgeries.

This isn’t all that surprising when you think about it.  When patients are going to have cataract surgery on both eyes, the surgeries are typically scheduled 2-3 weeks apart.  After the first eye’s surgery, the patient’s previous eyeglass Rx is no longer appropriate so they either need to go without their glasses or wear their glasses, even though they may make the vision in their operated eye worse than no glasses.  A real Catch-22.  

I always try to minimize these risks for my patients, but it’s aways an issue.

Dr. Warren

www.warreneyecarecenter.com

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Impact of Affordable Care Act – Its Real, Its Here…

I read this opinion piece and it struck close to home.  All of these factors are going to be put between doctors and their patients.

The ACA (Obama Care) has placed more power in the hands of the insurance companies, is causing people to have to change their insurance plans and will also disrupt the doctor-patient relationship.   No matter what sound bites were uttered in the past few years….

You can rest assured that I am looking at ways to minimize these impacts on my patients and my practice.   Look for more here as things develop.

Dr. Warren

www.warreneyecarecenter.com

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