Low Vision
An inside look at low vision
By Stephanie K. De Long

In the August issue of EB, we presented a few findings of a low vision survey recently conducted exclusively for Eyecare Business. This month, we'll take a broader look at the results of this telephone and in-person survey.

Our goal was to find out how "general practice" optometrists who have been involved in low vision for two years or less now view the category. We surveyed 50 doctors who fit those criteria in interviews conducted by phone this spring and in person at last December's Academy of Optometry. To meet our criteria, each practice needed to have added low vision as an adjunct to an existing general practice within the last two years. And, it needed to be involved in dispensing devices as well as seeing low vision patients.

PHOTO COURTESY OF VISION ADVANTAGE INC

This is the second time Eyecare Business has conducted such a survey. The last time was in April 2001, and, as reported in our August column, there have been some definite changes from year to year--most importantly, a real increase of interest in the category.

In the 2001 survey, six out of 10 doctors surveyed reported their main reason for adding low vision was to set themselves apart by increasing their reach into the community. Only 18 percent said they added low vision primarily on the basis of immediately increasing revenues or reimbursement. While another 12 percent said they view providing low vision services as a social or moral obligation, six percent pointed to a personal or family experience that edged them into the field.

While practice differentiation is the major driver for doctors we interviewed this year (46 percent), the likelihood of soon obtaining more Medicare reimbursement for low vision is now a key motivator as well (34 percent). In fact, increased income and reimbursement were considered the major reasons for entering low vision by twice as many doctors this year as last. And, for the first time, several doctors said they were persuaded by their staffs to get involved in the category (four percent).

GETTING STARTED

One third of those surveyed said their initial planning involved both learning more about the category themselves as well as obtaining training for their staffs. We asked them where they obtained the training, and 32 percent said it was at vendor-sponsored seminars or as CE at a professional meeting. Another 24 percent said they took a course or courses at not-for-profit institutions or universities. And nearly 10 percent indicated they sought the expertise of a consultant.

Looking at their decision to add low vision to their practices, nearly all the ODs we surveyed agree it was a positive move. Though most said they view it as a long-term investment, especially when it comes to the profitability factor, almost all say they think it was the right decision to enter low vision now--before increased reimbursement pushes more of their peers into the specialty. So far, they say, it's more a way of differentiating themselves and of serving their community's needs. Here are the most frequently given answers to the question, "How has your investment in low vision paid off?"

• 32%..."It has set us apart"
• 22%..."It has increased business"
• 19%..."It's the right thing to do"

THE CHALLENGES

That's not to say low vision is without its challenges. Far from it. Almost everyone interviewed referred to the fact that caring for low vision patients is time-intensive for doctor and staff. Reimbursement remains an issue, though most of those interviewed believe that will change in the coming years.

But the biggest challenge, they said, is creating a business model that will make low vision economically feasible. Issues mentioned include managing chair and staff time, determining space allocations, and getting the right inventory mix. Several also mentioned models that include part-time staff and the sharing of a low vision specialist among multiple locations.

And, beyond the model itself, they said the challenge is to get the word out that help is available to those who present with low vision problems. That, they added, is a direct challenge for them and they stressed it is responsibility for every optometric practice, not just those offering low vision services.

Whether you're involved in the category or not, some of your patients will be. And, whatever your O, every eyecare practice and business will need to set procedures for low vision patients. Whether it's creating a referral strategy or offering services yourself, it is a decision you will have to face.