The Referral Relationships We Built that Generate Up to $1 Million Annually in Revenues

By Eric Rettig, OD

Feb. 23, 2022

The referral relationships you build with other healthcare practitioners are essential to care, and also can greatly increase profitability.

Approximately 20 percent of our patients are co-managed with other providers directly. This accounts for $800,000-$1,000,000 in annual revenues. The high revenue generation associated with our co-managed patients stems from return visits to our office for care and product purchases. Often, after a patient is seen for an acute issue, they come back to us for their routine eyecare and purchase glasses and/or contact lenses.

Here is how these relationships in our community have aided both our patients and practice, along with our approach for keeping these relationships going.

Identify Your Biggest Co-Management Opportunities
We co-manage with dozens of doctors across many different specialties, including several ophthalmologists and multiple primary care providers (PCPs) and physician’s assistants. We also have strong relationships with dermatology, plastics, neurology, rheumatology and endocrinology.

Diabetes is a huge area of co-management with other providers, probably our biggest cohort. Several PCP groups will send patients for diabetic exams if they are newly diagnosed or haven’t had their eyes checked in over a year.

Many dry eye patients have auto-immune issues, which we co-manage with rheumatologists. Many of these patients are also on hydroxychloroquine, which requires annual visual field and OCT testing. Both of these kinds of patients have helped to build the medical side of the practice.

Offer On-Call Emergency Eyecare Services & Let Other Healthcare Practitioners Know
In addition, we have relationships with local urgent-care/walk-in clinics, which grew because we offer 24-hour on-call services. Almost every day we get at least one call from these clinics for eye emergencies like foreign bodies, abrasions, hordeolums, infections and other issues requiring immediate attention. Having multiple providers in-office almost everyday enables us to see these patients immediately. It also keeps them out of crowded emergency rooms, which provides cost savings for the patient and their insurance.

Reach Out to Build Relationships With Frequent Information & Updates
We establish relationships with many other healthcare providers because we already have mutual patients. We are in a small community in central Pennsylvania, in which you inevitably find you have some of the same patients. We then build on those introductions that naturally happen by keeping in touch to provide information and updates about their patients.

We make sure they are aware of all the pathologies we can co-manage and keep these other doctors updated on their patients’ latest test results. Every co-managing doctor receives a letter from us detailing our findings. We have forms for many of these types of communications, which can be filled out quickly and are specific to the disease (diabetes, patient on hydroxychloroquine, etc.)

With doctors’ busy schedules, it is difficult to meet with other healthcare practitioners. However, we try to meet at least with the ophthalmologists we refer patients to for surgeries. This allows us time to talk about new methods or treatments they’ve adopted, and to make sure that we are co-managing with them appropriately.

Offer to Help Educate PCPs & Their Staffs on Common Eye Issues
The biggest step that you could take to build relationships with other healthcare providers is to visit large PCP groups and offer to educate their staff on common eye issues that should be referred to an eye doctor. ODs can also help by educating PCPs and other specialists that not every eye issue needs to be seen by an ophthalmologist, and, if it doesn’t require surgery, an optometrist is more than capable of handling any eye emergencies that come up in their practice.

Train Staff to Support Co-Management
Support staff needs to be trained to conduct additional testing that is required for patients, like those with diabetes or autoimmune conditions, who have been sent to us by other doctors. Staff also has to understand the right way to prepare documentation with test findings to send to the doctors we co-manage with. Staff in our office are responsible for scheduling the patients appropriately with us, including setting up appointments for the additional testing we may order. They have been trained on how to contact the offices of other healthcare practitioners to schedule appointments in their offices, as well.

With strong communication between offices, the patients you co-manage will be better off, and your practice will have a powerful springboard for growth and enhanced profitability.

Eric Rettig, OD, is a partner with Mountain View Eye, a Vision Source practice in Altoona, Penn. To contact him:


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