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Recent Corneal Central Island Medical Journal Articles...

Lasik Comanagement

Two doctors coordinating care can provide the best of both worlds, or the opportunity for miscommunications

Image of two doctors.  
Lasik comanagement is commonly when an optometrist provides pre-op and post-op care with an ophthalmologist providing surgery.  

Comanagement is the process of two or more independent healthcare professionals providing a patient's care. In most cases, this is when an optometrist provides the initial Lasik, Bladeless Lasik, PRK, LASEK, Epi-Lasik, RLE, or any refractive surgery  evaluation and care after the surgery with an ophthalmologist providing only the surgical component. Often the independent optometrist has been the patient's trusted eye care provider for years or the optometrist's office is more convenient to the patient. This can be especially valuable to patients who live in rural areas.

Long History of Comanagement

Comanagement has been around as long as there have been allied healthcare providers, surgical specialists, and surgical subspecialists; it really is not exclusive to eye care. Nurses and doctors are the prime example of comanagement. Chiropractors and orthopedists are another. Optometrists and ophthalmologists often coordinate and share the refractive surgery patient's care.

Check and Balance

When handled well, comanagement provides a check and balance between the patient and the surgeon, with an optometrist assisting the patient's questions and concerns. When handled poorly, comanagement can isolate the patient from the surgeon and potentially delay needed care.

It could easily be argued that the best person to handle all patient care is an ophthalmologist, but sometimes this is unrealistic. Even within an ophthalmologist's office optometrists, technicians, or allied personal perform certain procedures, such as refractions and visual fields

Industry Controversy

Comanagement is controversial. One of the areas of controversy is the financial arrangement between comanaging professionals and doctors. Some suggest that the fees a comanaging professional collects are little more than payment for a patient referral to a doctor. Of course an optometrist needs to be paid for the services provided, but it would be improper for that payment to exceed usual and customary fees for the scope of the services provided to the patient.

Pay Separately

We recommend that the patient separately pay the doctor for the surgical fees, the facility for the use of the laser, and the comanaging professional for the services being provided. In this manner, the patient has the opportunity to decide if the fees commensurate with the services.

Patient Preference

It is the patient's choice if comanagement is an acceptable manner to receive care or if care provided exclusively within the ophthalmologist's facility is more appropriate. If you choose to participate in a comanaged arrangement, be sure to choose your comanaging professional as carefully as you choose your doctor.

Looking For Best Lasik Surgeon?

If you are ready to choose a doctor to be evaluated for conventional or custom wavefront Lasik, Bladeless Lasik, PRK, or any refractive surgery procedure, we recommend you consider a doctor who has been evaluated and certified by the USAEyes nonprofit organization. Locate a USAEyes Evaluated & Certified Lasik Doctor.

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If this article did not fully answer your questions, use our free Ask Lasik Expert patient forum.

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