One of the most popular aspects of this coverage has been the periodic survey of ECPs considering or offering vision rehabilitation.

To mark our 20th anniversary, we revisited 50 of the ECPs we had previously surveyed in order to measure changes in attitudes toward and opportunities in the category.

THEN AND NOW

To track those changes, we looked at ECP's previous responses to questions we asked in 2003, and then posed a few of those, as well as several new ones, to the same sampling again this year. Here are their responses, then and now, to just a few key questions.

Q. What prompted you to offer low vision services?
A. Differentiate my practice (60% 2006; 54% 2003); meet current patient needs (20% 2006; 5% 2003); social/moral obligation (15% 2006; 12% 2003); incremental revenue (10% 2006; n.a. 2003).   

Q. Looking back, was adding low vision a good decision?
A. 67% yes; 33% no.

Q. If yes, why?
A. Feel good (50% 2006; 48% 2003); patient benefit (30% 2006; 30% 2003); practice benefit (20% 2006; 14% 2003).

Q. If no, why?
A. Lack of referrals, specifically from ophthalmology; limited resources to resolve problems (e.g., coding and reimbursement); problems with integration into practice.

Q. Where do you currently receive continuing education in low vision rehabilitation?
A. 48% tradeshow seminars; 36% professional association seminars; 2% online.

Q. In what areas do you need more help to maximize your low vision rehabilitation practice?
A. 83% third party reimbursement and coding; 80% staff education and training; 75% marketing; 67% device dispensing protocols.

WHAT IT MEANS

The above represent only a few of the questions asked in the survey; but from that, we see three main trends.

■Now is the time. According to respondents, this is the right time to be adding vision rehabilitation services to a practice. More than 75 percent of those surveyed have added their low vision services within the last five years, and 50 percent within the last three. Conversely, we found a minority of ECPs leave the category within two years, citing difficulties in referrals as well as problems with staff training

■Need for help. Sixty five percent say an expert resource for ongoing support would be "very to extremely" helpful to facilitate entry into vision rehabilitation. Many respondents mentioned continued frustration in one or more areas where they recognized the need for help but in most cases said they couldn't locate such a resource.

■Times have changed. Several respondents mentioned observing a change in low vision patients in terms of accepting the doctor's recommendations for devices and training. Just as important, they report, is Medicare's recent (2002) decision to allow reimbursement for education and training incident to the physician's services.

Another recent survey found that as few as 10 percent of visually impaired persons are aware of low vision services. As one industry pundit puts it, "Literally millions of patients are waiting to see you, doctor."

One respondent told us he would love to see more of the many unserved patients who need his services, but that he constantly battles for referrals from ophthalmology. "We need a model," he says, "that involves the ophthalmologist in a way that breaks down the barriers to referrals and truly provides what is best for the patient."

Changing Profile

Here are three ways the profile of the low vision patient is changing.

1. Children of the depression are passing from the scene and being replaced by children of technology—a generation that expects solutions.

2. These new patients expect to live life to its fullest, strive to stay young, and are willing to spend money to attain those goals.

3. The Internet will educate patients about solutions that are available, and they will increasingly expect their ECP to discuss and provide them.