This article was originally published in a sponsored newsletter.
Surgeons are always going to be challenged to balance procedure time with clinic availability. The mix of patients we see (mild to moderate vs. advanced patients) has a direct impact on this time. More of our schedule is consumed by severe patients, despite the fact that we primarily see patients in the mild-to-moderate category.
A study that followed patients for two years noted that those with severe glaucoma were in the office at a much higher rate than those with mild-to-moderate disease. This is not surprising; severe glaucoma patients often require closer follow-up and tend to need filters more often than mild-to-moderate patients, given the lower target IOPs in severe disease. However, this proportion of visits makes balancing time challenging. If I have 100 patients, 75 are mild-to-moderate cases, but 75 of my 100 office visits are earmarked for severe patients.
With the new interventional approach to managing glaucoma patients, surgeons will be in the OR more often and have less time in the clinic. Many surgeons, therefore, are looking for ways to minimize clinic volume to increase OR time. It's a catch-22 because severe patients really do need to be seen and treated by someone with extensive glaucoma management experience, unless they have been stable for years. Thankfully, mild-to-moderate patients do not always need to see me as much—or see me at all—if their pressures are at target and their glaucoma diagnostic testing is stable.
Finding time slots for these extra procedures has posed a challenge for my already overbooked daily schedule, but I have found tremendous value in utilizing my in-house associates, as well as other local eyecare providers, to help me manage my stable patients with mild-to-moderate disease.
With expanded co-management relationships, I have been able to isolate more time to focus on the new, proactive method of managing patients while being immediately available for my colleagues when direction is needed.
