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Emerging Trends in Health Care Policy Pertaining to Optometric Clinical Education and Patient Care

November 25, 2007 by Charles F. Mullen
  • There will be a convergence of clinical services provided and community health care needs as expressed in the National Institutes of Health (NIH) Vision Objectives.
  • Growth in the volume of care provided to Medicare beneficiaries will increase significantly.
  • Optometry will eventually become a full participant in the federal programs Graduate Medical Education (GME) and the National Health Service Corps (NHSC) and other federal programs for patient services providers. Participation in these programs will likely require a separate clinical legal entity and collaboration with community-based health care programs and/or hospitals.
  • (GME) will provide significant funding to the clinical entity for the training of optometry students.
  • (NHSC) will provide loan repayment for optometry students assigned to Federally Qualified Community Health Centers (FQCHC) possibly beginning in their 4th year. Residents assigned to FQCHCs and optometrists who are employed by FQCHCs will also be eligible for educational loan repayment. The NHSC program will also fund resident stipends for community-based programs.
  • Schools and colleges of optometry will become proactive in influencing national and state health care policy.
  • There will be an increase in the number of optometrists pursuing careers in public health.
  • There will be an increase in the number of optometrists in federal policy making positions.
  • The National Rural Health Alliance (NRHA) and the National Association of Community Health Centers (NACHC) will support optometry’s legislative and regulatory initiatives.
    The Department of Veterans Affairs (VA) will contract with FQCHC’s to provide care to Veterans.
  • The Department of Defense (DOD) and the VA will significantly enhance capabilities in treating vision problems associated with Traumatic Brain Injury (TBI).

Filed Under: Emerging Trends and Issues

Emerging Trends in Optometric Clinical Programs Administration

November 25, 2007 by Charles F. Mullen
  • Quality assurance, risk management, compliance and accreditation of clinical facilities will become increasingly important.
  • There will be more proactive risk management and patient safety initiatives.
  • Quality of care assessment and peer review using published clinical practice guidelines as the benchmark will become the standard of assessment.
  • There will be more collaboration with community health care programs and an increased awareness of public health needs.
  • College affiliated clinical organizations will realize performance improvements in partnering with health center administrations in addressing common clinical practice and administrative issues by sharing of evidence-based best practices and then adapting them to their local environments.
  • Patient services revenue management from patient registration to coding and documentation to submission of charges to net collections will become increasingly important.
  • Comprehensive marketing programs consisting of public relations, advertising and direct sales will be essential to succeed in a competitive health care market.
  • Incentive-based compensation will become commonplace for attending staff and clinical administrators.
  • Accreditation groups and funding sources will set standards relating to academically affiliated clinical programs addressing public health needs.

Filed Under: Emerging Trends and Issues

Emerging Trends in Optometric Clinical Programs Governance

November 25, 2007 by Charles F. Mullen
  • Optometry colleges’ clinical programs will be reorganized into separate legal entities with their own governing boards and administrations. Creating a legal entity will provide for separation of risk – giving a degree of protection for College assets from risks associated with the provision of health care. For further information please read: Distinct and Separate Legal Structures for Clinical Programs of Schools and Colleges of Optometry
  • Schools and colleges will establish accounting models that differentiate clinical program capital and operating costs from the costs associated with clinical education.
  • Negotiated educational services payments will be made to the separately-organized clinical programs for educational services. The clinical entity will make administrative services payments to the school or college for any shared services.
  • The ability for soliciting funds will be improved as foundations, patients, alumni and others who do not support educational institutions will find patient care a worthy cause to support. Free care pools provided through various organizations will become available to the clinical organization.
  • Separation of the college and clinical programs Boards of Trustees/Directors and Administrations will facilitate the appointment of individuals with different skill sets appropriate to the mission, values and priorities of the respective organizations. Separation of the Boards and Administrations will encourage more focused attention to the priorities of the respective entities which are often different.

Filed Under: Emerging Trends and Issues

Testimony in Support of Senate Bill 1255, An Act Relative to the Modernization of Optometry

May 2, 2007 by Charles F. Mullen

I am Charles Mullen. I am a graduate of the University of Virginia and received my Doctor of Optometry degree from the New England College of Optometry. I have over 36 years of experience in optometric education at three institutions. I am the former President of the Illinois College of Optometry and former Director of the Department of Veterans Affairs Optometry Service, the largest optometric patient care and clinical training program in the Nation. Currently I serve on the Board of Trustees of the Pennsylvania College of Optometry and the Board of Directors of the New England Eye Institute. I am also an Adjunct Clinical Professor at the State University of New York.

My remarks today pertain to the impact that the current restriction on Massachusetts optometrists treating glaucoma has on the clinical education of students enrolled at the New England College of Optometry. From a national perspective, this restriction places the College and its faculty at a competitive disadvantage for the best and brightest applicants for admission. Upon learning of the restriction in the treatment of glaucoma, many highly qualified applicants and, for that matter, many highly qualified optometrists seeking a faculty appointment at the New England College of Optometry choose other Colleges of Optometry – simply because Massachusetts cannot offer the comprehensive opportunities they are seeking. No other optometry school across the country faces this problem.

Forty-nine states permit optometrists to treat glaucoma. It is now the national expectation; if not the standard. Students of the New England College of Optometry are expected upon graduation to be fully prepared to treat eye disease; including, the management of patients with glaucoma. Yet, without the ability to practice in Massachusetts, the New England College of optometry must seek training venues outside the Commonwealth or in federal facilities where the treatment of glaucoma is permitted. This is ironic given that Massachusetts is known to be a world leader in health care education. Forty-nine states and the federal system allow for optometrists to treat glaucoma, but the home state of one of the best optometry schools does not. Again, no other optometry school in the Nation is so limited.

Nationwide, optometrists provided $846 million in eye care services to Medicare beneficiaries in 2006. As the incidence of glaucoma increases with age and with the onset of the “baby boomer” retirement, graduates of the New England College must be fully prepared to meet the health care needs of the rapidly growing elderly population. This means they must be able to treat glaucoma.

I can assure you that optometric education and the profession of optometry are constantly evolving. Advances in the biomedical and visual sciences impact both the methods of treating patients and the methods of educating students. Given this quickly changing environment, it is essential that optometrists in Massachusetts be granted the authority to treat glaucoma – allowing both the New England College of Optometry and its students to remain competitive on a national level.

Thank you for the opportunity to testify before the Joint committee on Public Health. Accordingly, I respectfully request that this Committee release SB 1255 with a favorable report.

Testimony of Charles F. Mullen, O.D.
Delivered May 2, 2007

Filed Under: Federal and State Initiatives
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