The Optometric Minute

Building the Co-Management Relationship

Lori Landrio, OD, and Eric Donnenfeld, MD, FAAO, define the co-management relationship as one that is focused on delivering the best possible care and outcomes to patients. Mutual trust, good communication and complementary skill sets make it work to everyone’s advantage. THREE VIDEOS BELOW.


Build mutual trust. The co-management relationship works only if it benefits both sides. For the OD, that means being assured the patient will receive superb care—then be returned to the OD practice for continued care.  

Complement talents. Both ODs and MDs have individual strengths. Look to complement them for the benefit of the patient.

Benefit over time. It is best for the patient (and beneficial to both practices) when the patient stays in the lifetime cycle of care.  

Co-Management Lets Me Practice Full-Scale Optometry

For Lori Landrio, OD, of Merrick, NY, co-management is a means to practice full-scale optometry. She can confidently refer patients to specialists in cases where pathology must be addressed—and she is assured that she will continue to deliver care once they are returned for post-op or post-treatment care. Advances in electronic technology enhance the co-management relationship, she notes, as optical scans can be speedily transferred to the specialist. In choosing an MD to co-manage with, she looks for good communication that enhances the quality of care for her patients.


Referring to an MD–But Retaining My Patient for Care

Lori Landrio, OD, of Merrick, NY, refers patients to a network of ophthalmologists in her area for cataracts, corneal and retinal issues and laser vision correction. Referrals account for about 5-10 percent of her patient cases, she estimates, and having established referral relationships allows her patients to be seen by a specialist quickly and efficiently. Any referral relationship is based on mutual trust and the assurance that she will retain her patients and continue treating them. ODs should be aware of the value they bring to the referral relationship, in how they provide basic care and special services (e.g., CL fitting) when the MD often does not. Ultimately, there must be a shared concern for the patient to receive the best care possible.


How It Works: The Co-Management Relationship

Eric D. Donnenfeld, MD, FAAO, of Ophthalmic Consultants of Long Island, TLC Laser Eye Centers, in Garden City, NY, maintains co- management relationships with ODs who continually ask, as he does, “What’s best for the patient?” and, “How will the combined strengths of several doctors result in the best care and optimal outcomes?” Roles within the referral relationship are defined yet somewhat fluid to meet patient needs. Dr. Donnenfeld relies on the referring OD to provide insights into the patient’s health, based on the care the OD has given the patient over time. That continuum of care pays off: Dr. Donnenfeld performs cataract surgery on patients for whom he provided LVC years earlier–because the patients continued to be seen by the referring ODs. Today, the goals of health care reform provide compelling reasons for MDs and ODs to work together in co-management relationships to achieve even more superlative outcomes.


Lori Landrio, OD, owns an independent practice in Merrick, NY. To reach her:

Eric D. Donnenfeld, MD, FAAO, practices at Ophthalmic Consultants of Long Island, TLC Laser Eye Centers in Garden City. NY. In 2013, he was named president of the American Society of Cataract and Refractive Surgeons (ASCRS). To reach him:

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