Co-Management

Share this Information with Other Doctors to Build Referrals & Grow Your Practice

By Feyi Aworunse, OD, FAAO

April 5, 2023

Sharing needed information with other healthcare providers enhances patient care while creating a powerful spark to help you grow your practice. Here is how my practice ensures that other doctors get exactly what they need from us, and give us what we need, to provide a high level of care and grow our patient base.

The Importance of Collaborating with Other Healthcare Practitioners
I work in a multidisciplinary outpatient setting, so coordination and collaboration is inherent to our practice model, when it comes to co-managing patient care. Because of this, I regularly collaborate with over 10 different providers across several specialties within and outside of the organization:

  • Ophthalmology: surgical management of cataracts and glaucoma, diabetic retinopathy and other ocular diseases requiring tertiary care.
  • Internal medicine: patients with diabetes, hypertension, general ocular/vision complaints
  • Endocrinology: diabetes, thyroid disorders
  • Rheumatology: Lupus, sarcoidosis, rheumatoid arthritis (due to ocular manifestations of these autoimmune conditions and long-term use of high-risk medications such as hydroxychloroquine)
  • Infectious diseases: HIV, tuberculosis
  • Neurology: headache disorders, idiopathic intracranial hypertension
  • Ear, Nose & Throat specialists (ENT): vertigo, vestibulo-ocular disorders
  • Maternal Fetal Medicine: pregnant patients with diabetes or hypertension

What Do Other Healthcare Providers Need to Know About You?
My clinic operates within a larger healthcare institution, with many referrals from other doctors happening organically. However, it is critical to build upon that relationship to understand what each provider or clinical area is capable of managing on behalf of the patient. As the first and only optometrist in the practice in many years, I made sure to communicate what my scope of practice was to referring providers. In an institution largely consisting of medical doctors, many did not know that optometrists are able to diagnose and manage many conditions before the patient requires tertiary or surgical management.

For the relationships outside of my practice, these doctors were initiated through networking with other providers at community events such as community health fairs, meetings, etc. By opening a discussion about what I do as an optometrist and how I can serve their patients, I have gotten countless referrals.

I have seized opportunities to meet with providers from different specialties and groups to discuss how we can best serve our patients and what we are able to offer in services and care. It is a great opportunity to put a face to a name and get a feel for the personality of the provider.

What Do I Send Doctors After Their Patient Visits Me?
I have a protocol of sending the following materials to referring doctors:

  • A thank you for the referral or continued care
  • Key findings or diagnoses related to the reason for referral or consult
  • Treatment initiation or the plan of care
  • Patient instructions and follow-up details
  • If it is an urgent consultation, I will relay information via phone.

If non-urgent, updates and exam summaries are sent via EHR or fax for their review. In both cases, exam documentation is sent promptly so that the referring provider can review my findings and make an informed decision about their plan of care, if it is dependent on my exam.

What Do Other Doctors Need to Know About Patients I Send to Them?
If I suspect, or am sure, about a particular diagnosis, I will outline that likely diagnosis in my consult request.

Based on this, the notes I receive usually include any tests or findings that either confirm or rule out the suspected diagnosis. Rarely do I receive consult notes that do not include what I request unless the reason for referral is not made explicitly clear or they completely fail to provide me with an exam summary.

When Do I Need to End a Relationship with a Referring Doctor?
There have been instances where I’ve had to end a relationship due to issues such as lack of communication between myself/my office and the provider/their office. Without clear communication, I am left to seek information from the patient regarding if and when they were seen and what the findings were. This breakdown in communication negatively impacts our goal of continuous care.

Also, I’m sure to ask my patients about their experience with the provider/clinic I refer them to, every time. This information provides me with insight into how my patient is treated, from the point they arrive for their appointment to the point that they complete their visit. If my patient informs me of any issues, I keep this in mind for future referrals and offer the patient an alternative option, if necessary.

In one instance, I referred a patient for an evaluation with an ophthalmology group. The patient’s appointment was scheduled prior to her departure from my office and she was given information about her time, date and location. The patient later realized she had a scheduling conflict and contacted the office she was referred to for rescheduling.

Unfortunately, she had a negative experience with the receptionist when she attempted to reschedule and later informed me of this. She made the decision to cancel her appointment completely and asked me for an alternative option. I referred her to a different group and she has completed her treatment and continues to follow-up without issue.

What Does the Patient Need to Know About Their Referral?
In our practice, we do our best to ensure the patient has the details of their referral appointment prior to leaving the office or within 24-48 hours, depending on urgency.

If we are unable to provide an appointment for the patient before they leave, they are informed of their plan of care and the importance of the referral. I emphasize that the referral is a continuation of their care and that I will be in communication with them and the provider along the way.

Feyi Aworunse, OD, FAAO, practices at the Eye Clinic at Nashville General Hospital at Meharry. To contact her: feyi.aworunse@gmail.com

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