Medical Model

How We Built Diabetic Eyecare Services that Generate $1-2 Million Annually

By Danny P. Mathew, OD

July 20, 2022

Diabetes now affects 37.3 million Americans, according to the Centers for Disease Control and Prevention (CDC). That means around one-in-10 in the U.S. have diabetes. About one-in-five with diabetes don’t know they have it, the CDC reports.

The high incidence of diabetes, a disease that comes with the sight-threatening risk of diabetic retinopathy, means ODs have a huge opportunity to provide a valuable service to patients while significantly growing profitability.

Our practice currently consists of 30-40 percent of patients with diabetes, bringing in an annual revenue of around $1-2 million. That revenue is generated from services such as diabetic eye exams and the monitoring and treatment of diabetic eye diseases like cataracts and diabetic retinopathy.

Here is how our practice cares for diabetic patients, growing our patient volume and revenues in the process.

Post-Pandemic Diabetic Eyecare Needs
Our growth in this space has increased every year, but it grew exponentially after the pandemic. I attribute it to an overall increase in patients with diabetes in general, in addition to reduced exercise and poorer eating habits during the  pandemic lock-downs. In some cases, the pandemic also led to eyecare providers permanently closing their practices, which also reduced access.

Create a Diabetic Eyecare Referral Funnel
Most of the patients I see, who are living with diabetes, come from referrals from primary care providers (PCPs), endocrinologists, urgent care visits and other ODs. The rest are established patients recently diagnosed with diabetes.

We value referrals greatly, and we make sure those doctors know they are appreciated. It is important to our business to establish good relationships with the offices that refer patients our way. We do that by visiting in-person or by sending in small gifts or buying lunches for the staff of referring doctors. We’ve learned that, in addition to the doctor, it’s equally important for the referral office staff to know who we are.

It’s also important for the support staffs of referring doctors to know your own support staff. We schedule time for staff to introduce themselves or visit with other doctors in the area to make sure they know we’re here and that we offer services that can help preserve their patients’ sight.

Invest in Instrumentation that Allows You to Better Monitor Eye Health
The most helpful piece of equipment in our diabetic care is our optomap, which we purchased from Optos. The unit cost about $50,000, but was well worth it. It is a game-changer in following and treating our patients with diabetes. I’ve worked in two high-volume practices, and we paid both Optos units off in around a few months.

Editor’s Note: There are other wide-field imaging technologies to choose from. Other options include the EIDON Ultra-Widefield Module from iCare and the THUNDER Imager from Leica Microsystems, among others.

Ask Patients Targeted Questions in Exam Room
I start by asking every patient how they are feeling and if they have noticed any changes in their vision. For diagnosed patients living with diabetes, it’s also critical to ask if they have experienced neuropathy in their fingers or toes, and what their last blood sugar or A1C levels were. If I don’t already have the information on file, I also ask who the patient’s PCP or endocrinologist is, so I can communicate with them about the patient’s care.

Educate Patients So They Understand What’s at Stake
My team and I work with the patient to make sure they understand how diabetes affects the eyes and why they need extra testing.

I find it’s most valuable to show patients pictures of their own eye and educate them on what those images reveal to me about the state of their eye health. I then recommend we send the pictures to the patient’s other doctors to allow the entire care team to follow the patient’s eye health over time.

I also make sure my patients know diabetes is the leading cause of blindness in America. It’s important they really understand how serious diabetes-related eye diseases can be, and how important it is to come back for exams annually.

Along with the education I provide to patients in the exam room, I refer them to public resources, such as the Focus on Diabetes website. Focus on Diabetes is a public health initiative from the American Diabetes Association, VSP Vision Care and Regeneron, intended to help save sight for those at-risk of, or living with, diabetes. The site has informative fact sheets, podcasts and live interactive webinars.

Train Staff to Support the Diabetic Eyecare Services You Provide
Knowing what questions to ask the patient is key for staff so they can help get the patient to schedule both comprehensive and diabetic exams if needed – since a separate diabetic exam is needed for additional testing in those patients living with diabetes.

It is also extremely helpful to train staff so they are able to help the OD get referral information together, and to help write follow-up letters back to referral doctors and other care providers.

Danny P. Mathew, OD, practices at the Chu Eye Institute in Fort Worth, Texas. He practices with an emphasis on treatment and management of ocular disease and post-surgical co-management.

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