How to get started in nursing home optometry?

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Optometric practice in the nursing home setting is not always very glamorous; however, there are many reasons optometrists might want to consider adding this specialty to their practice arsenal due to tremendous need.

This is a common question among new grads due to the changing landscape of healthcare along with the disruptive forces and entities putting pressure on eye care providers.

How much business knowledge is needed to open an optometry practice?

Many successful ODs have opened private practices without any business knowledge. The most basic business principle is that you need more money coming in than going out.

One misconception students have is that to be successful, one must have a wealth of business knowledge and efficient nursing optometry billing. This is not necessarily the case. Don’t confuse knowledge with experience. The difference is that knowledge can be gained prior to needing it and experience is what you get just after you needed it.

A lack of business knowledge is not a reason to dismiss the possibility of practice ownership. If you don’t have enough knowledge of business practices initially, that is something you can gain through a little studying as well as acquiring it over time.

The advantage we have today is the ability to gain this knowledge from so many entities, now more than ever before with all the resources readily available to us.

How to get started in nursing home optometry

After graduating from optometry; working as a part-time for an independent practice include visiting nursing homes as they provide vision, podiatry, audiology, and dentistry services to their residents. They provide all the equipment, support staff, scheduling and coordination with the nursing homes. All you have to do is show up, see patients, with minimal to no administrative work to do on your end.

Things to keep in mind

If you are not already a provider for medical insurance plans, your company will help assist in getting credentialed for the plans they will want you to take. You do not have to do any nursing optometry billing yourself as they will submit all claims based on the procedures you perform on each patient.

You will need to get familiar with the portable equipment. The equipment required to do a thorough exam consists of a standard eye chart, handheld tonometer, pachymeter, portable autorefractor, handheld slit lamp with a 90D lens, and a portable fundus camera.

How an average day goes

Expect to travel between 20 to 30 nursing homes during the year. Some are only a few minutes away from my home, but others are over two hours away. You will need to decide how far you are willing to drive as you may be asked to travel further. Typically you will set up in a conference room, and lighting control, chairs, equipment and so on can get tricky so you have to be ready to improvise with what you’re given.

The staff or your assistant will bring patients to you unless they are bed bound or cannot come to your room. Once they are dilated and ready, the exam goes pretty quickly, depending on the patient and their cognitive ability. Some residents are talkative and good history givers, whereas others are non-communicative or combative.

You will chart your exam notes on a laptop using EMR software, which includes a billing component. You will write orders for medications, order eyeglasses, refer to specialists for surgery or further testing. Your technician will print out your exam records and you will review any special notes with the staff of the home.

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