I studied optometry in Canada, and I currently practice in Florida, USA. By comparing my experiences of working in eye care in those two healthcare systems, I can clearly see how the relationship between ophthalmologists and optometrists differs in these two countries. Back in Canada, MD/OD collaboration was only just beginning, and it was only when I came to the States that I realized what this collaboration could and should look like. I was pleasantly surprised at the willingness of ophthalmologists to work with optometrists and their positive attitude to co-managing patients. The professions and their scopes are well defined here and doctors work together to achieve a common purpose.
In my practice, I have found the ability to refer patients to the best specialist in a particular area essential, and the referral system between ophthalmologists and optometrists seems to work very smoothly. I specialize in ocular surface disease and contact lens fitting, and I feel confident knowing that any cases outside the scope of my practice, such as glaucoma or retinal conditions, can be referred to my colleagues who focus on that particular area. Likewise, many ophthalmologists with patients who need specialized contact lenses will refer them to my practice.
Co-management of patients is of vital importance for both the patients’ wellbeing and for practice building. Patients with keratoconus or other corneal conditions that I refer to a corneal specialist, can then be referred back to me for continued care. There are many aspects of care that ophthalmologists could oversee, but given the limited time and resources they have, it may be more time- and cost-effective to refer those patients to optometric care. It is important to make sure that patients have a clear understanding of what each member of the healthcare team does – and why they are being referred to another specialist. In Florida, as in most US states, surgical procedures can and should only be performed by ophthalmologists. It is important to know one’s limitations, and regulations should clearly reflect that. When both professions can work together towards optimizing care and improving patients’ quality of life, amazing things can happen.
