SAN FRANCISCO — Here during the Integrated Ophthalmic Managed Eyecare Delivery program at the American Society of Cataract and Refractive Surgery annual meeting, Louis D. Nichamin, MD, said, “Comanagement and integration is here today,” but his rural Pennsylvania practice began comanaging in 1980.
“We comanaged before there was comanagement,” he said.
Louis D. Nichamin
An ophthalmologist founded Laurel Eye Clinic in 1973, and “in 1980 he added an optometrist out of necessity,” Nichamin said. “I joined in 1988, and now there are 10 offices and two ambulatory surgical centers that cover a better part of western and central Pennsylvania. We see 60,000 to 70,000 patients per year with four ophthalmologists and eight optometrists. We’re busy.”
Nichamin said that the surgeons see only medical-surgical patients, and the optometrists see all primary care, postops and medical follow-up.
“The surgeon schedule is heavily scrutinized,” he said. “I see all outside referrals, in-house medical-surgical problems beyond the scope of our staff optometrists, complications and patient requests. Optometrists see everyone else and take call – all walk-ins and all emergencies.”
Nichamin said the ophthalmologists in his practice train the staff optometrists as well as those in an outside referring network through continuing education events.
The practice is careful not to advertise its dispensary, “because we don’t want to step on the outside optometrists’ toes,” he added.