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At least 919 records · Page 51Linked to original sources
PubMed1978

Eye care delivery in prepaid group practice.

This paper represents original research from the clinical implementation over a five-year period of eye care as a primary health care resource within the Medical Group of the Genesee Valley Group Health Association at the Joseph C. Wilson Health Center in Rochester, New York. The primary care delivered at this health maintenance organization has been organized in a multidisciplinary fashion with the doctor of optometry functioning as the primary eye care provider, and clinical administrator, and the ophthalmologist functioning as the medical and surgical consultative specialist. The data and information generated from this research represents four years of extensive clinical care delivered to a prepaid patient population in excess of 35,000 members.

Adolescent↗
PubMed1995

A comparison of TPA/DPA certification and access to care in North Carolina, Missouri, and Illinois.

BACKGROUND: The changing scope of optometric practice has had a large impact on the profession. Optometry has gone from a drugless profession to a profession that can use diagnostic pharmaceutical agents (DPAs) in every state and therapeutic pharmaceutical agents (TPAs) in 46 states. The intent of this study was to determine the influence that these legal variables exert on the scope of practice for optometrists in different states. METHODS: Optometrists in three states with varying statutes regulating the scope of practice were surveyed to determine if there were practice differences related to these state laws. RESULTS: In states with TPA usage, more optometrists accepted Medicare assignment and had hospital and nursing home privileges. Optometrists with TPA certification had, as a group, graduated more recently. Travel times for patients with conditions requiring treatment with therapeutic drugs were shorter in the states with TPA legislation. CONCLUSIONS: Access to care is enhanced for citizens of a state with optometric usage of therapeutic pharmaceutical agents.

Certification↗
PubMed1995

Community-oriented primary care programs.

BACKGROUND: Systems are being proposed by health planners in an effort to improve access to health care for the uninsured and underinsured, including the vulnerable and indigent populations. The lack of affordable and adequate health care for significant numbers of our citizens raises the potential for a serious economic crisis for our nation. Modern medicine has been more interested in developing high tech care for the well insured than in preventive and early intervention health care. While the development of this high technology is of great value and will be beneficial to many, it is out of financial reach for increasing numbers of individuals. As a nation we must reduce the demand for high priced medical care by providing a system that keeps people healthy or intervenes in their illness at a stage when less dramatic medical measures are able to restore them to health. To maintain a population that is healthy and productive in the school setting and in the work place, systems must be developed that reach out into the community with prevention-oriented health education programs and health care services at the primary care level. METHODS: A limited literature review was made in order to present to the optometric community the concept of Community Oriented Primary Care (COPC) as a cost-effective method of improving access to primary care services. RESULTS: The literature review demonstrated that Community Oriented Primary Care (COPC) as a health-oriented strategy brings the benefits of primary care closer to those in need. The history of the development of community oriented primary care services as a health delivery methodology, as well as the current utilization of the COPC concept, is presented in this paper. CONCLUSIONS: Optometry, as a provider of primary eye and vision care services should be included in these cost effective programs.

Community Health Services↗
PubMed1995

Musings of a Robert Wood Johnson health policy fellow.

BACKGROUND: Changes in national health policy affect all health care providers. To increase its understanding and involvement in health care development, in 1973, the medical profession, through the Institute of Medicine, developed a formal program--the Robert Wood Johnson (RWJ) Health Policy Fellowships Program--in the nation's capital. METHODS: Each year, since the mid-'70s, the RWJ Health Policy Fellowships Program provides "hands-on" health policy development experiences, to mid-career health professionals. Participants obtain an understanding of the health policy process at the national level, and an opportunity to contribute to the formulation of new policies and programs. RESULTS: The author describes his 1989-1990 RWJ Fellowship year. He reports that health professionals can and do contribute significantly in the development of national health policy. He also observes that there has been minimal participation by optometrists in the RWJ Health Policy Fellowship Program. During his fellowship, the author observed that the optometry profession was poorly understood and underrepresented at the national level. CONCLUSIONS: There is a need for direct optometric involvement in national health policy development. The RWJ Health Policy Fellowships Program provides exemplary policy experiences. This and alternative methods to increase optometric involvement and participation in health policy development, are discussed.

Fellowships and Scholarships↗
PubMed1994

Guideline development process for optometric care of the patient with diabetes mellitus. American Optometric Association.

BACKGROUND: The aim of this project was to develop a standard of optometric care for patients with diabetes mellitus in an effort to help the clinician bridge the gap between research and practice. These guidelines are intended to assist optometric practitioners in the prevention, diagnosis, treatment, management, and rehabilitation of their patients. The guidelines are based on the best available research and professional judgment regarding the effectiveness and appropriateness of optometric care and procedures. METHODS: This paper details the methodology used by the AOA's Clinical Guidelines Coordinating Committee, Consensus Panel and the Center for Vision Care Policy of the State College of Optometry, SUNY, to develop practice guidelines for patients with diabetes mellitus.

Diabetes Mellitus↗
PubMed1994

The perceived needs of practicing optometrists in geriatric continuing education.

BACKGROUND: A survey of American Optometric Association members in the states of Kentucky and Illinois was undertaken to determine the perceived need areas for continuing education in the field of optometric geriatrics and gerontology. METHOD: The membership was surveyed on which of a 23 possible courses were of the most interest and need. A total of 332 questionnaires were returned and analyzed. The respondents were largely younger practitioners (mean age 41) who had not taken a specific course in geriatrics during optometry school (56 percent). RESULTS: A large majority (79 percent) indicated that they would attend courses with geriatric content at regional and state continuing education. Courses with heavy optometric content were preferred over those with more general gerontology content. The most desired courses were in geriatric pharmacology and ocular disease. Coursework in medical epidemiology and systemic conditions affecting the older adult were the most needed in the area of general gerontology.

Adult↗
PubMed1976

A proposal for the inclusion of optometric vision care in Title XVIII of the Social Security Act.

The need to broaden the Medicare program to include the full scope of optometric vision care is discussed...particularly the need of the elderly for total vision care and how optometry helps to meet this need. This article is particularly timely inasmuch as the Congress is now considering AOA supported legislation (S.2020, H.R.2987, and many identical House bills) to accomplish this objective. Two dozen Senators and nearly 100 Representatives are currently cosponsoring these bills.

Aged↗
PubMed1994

The Council on Clinical Optometric Care (CCOC): The American Optometric Association's Institutional-Practice Reviewer 1967-1993.

BACKGROUND: For 26 years the CCOC served professional optometry as its institutional-practice reviewer. METHODS: The council used nine standards for accrediting clinical institutions. RESULTS: The benefits of the accreditation process were many, with improved patient care as its cornerstone. CONCLUSION: During its 26 year existence, the Council on Clinical Optometric Care (CCOC) had a major influence on the quality of optometric care.

Accreditation↗
PubMed1994

Informed consent in optometric institutions.

BACKGROUND: Modern bioethics has been traced to the interaction of advanced medical technology and the patient's rights movement. A fundamental principle of bioethics is the autonomy which allows patients to exercise personal judgment in their health decisions. The process used to exercise this choice is informed consent and its documentation is the consent form. METHODS: A survey was undertaken of the schools and colleges of optometry in order to learn more about patient autonomy in teaching institutions. RESULTS: Some institutions feel uncomfortable with the process of informed consent and use of the consent form. Research areas were most compliant. Contact lens and ocular disease clinics were compliant. CONCLUSIONS: Review of consent forms had little value in evaluating the ethics process and education taking place in clinics.

Consent Forms↗
PubMed1993

An optometric quality assurance program.

BACKGROUND: To be accredited by the Joint Commission on Accreditation of Health Care Organizations (JCAHO), a health care facility must have an ongoing quality assurance program. METHODS: In accordance with JCAHO Guidelines the Optometry Section at the Cleveland Veterans Administration Medical Center developed such a program as part of the Medical Center's hospital-wide ongoing quality assurance plan. RESULTS: The methodology used to develop a quality assurance program is outlined. A discussion of how specific clinical indicators are used to monitor performance and/or patient outcomes is presented. CONCLUSIONS: After the quality assurance monitoring period is completed the data is analyzed; if the outcome is unacceptable action must be taken to improve care. This dynamic process involves patient outcomes and enhances overall care.

Glaucoma↗
PubMed1993

Constraints to optometric practice in Third World countries.

BACKGROUND: Optometry, as a profession in the Third World countries, is in an underdeveloped stage and far from the ideal. Factors responsible for these include literacy level, and the low standard of economic, political, industrial as well as social development. METHODS: Comparisons of various aspects of selected countries bring these factors into clearer focus. RESULTS: Awareness of these problems will lead to possible solutions arising from recognition of need for proper orientation, a focus of interest, manpower, with professional and economic resources in the eye care delivery of the Third World. CONCLUSIONS: The ideal situation can be achieved only when the problems are well defined.

Aged↗
PubMed1993

Cataract: a critical problem in the developing world.

Cataract blindness is a major public health problem worldwide. Unlike other leading causes of blindness, cataract can be treated effectively with surgery. Demographic, social, and economic factors are important determinants of surgical treatment of this disorder in the developing world, resulting in the accumulation of very large numbers of unoperated cases. Because of many factors, the problem is really out of hand. In this paper, we try to raise awareness among optometrists of this major challenge. At the same time, because many individuals do not achieve good vision after surgery and because in most developing countries only one eye is operated upon, we emphasize the use of improved prognostic techniques to make the surgical outcome more predictable, avoiding nonproductive surgery and resultant disappointment on the part of all concerned. We feel optometry can play important roles in diagnosis, visual correction, and management of these patients, hopefully in cooperation with ophthalmic surgeons.

Blindness↗
PubMed1993

The impact of treatment of eye disease on optometric practice in Missouri.

This study attempts to determine the impact of the legal authorization to treat eye diseases on the practice of optometry in Missouri. Seventy-two percent of the therapeutic pharmaceutical agent (TPA) certified optometrists practicing in the state responded to a questionnaire in 1991. A majority of those responding prescribed every category of TPA except oral anti-histaminic agents. More than two-thirds have received registration numbers to prescribe controlled substances. The median number of therapeutic prescriptions written per year was 144. Disturbingly, most of the practitioners have never been visited in their offices by a drug company representative. Some have hospital privileges and only about one-fourth of the respondents have nursing home privileges.

Eye Diseases↗
PubMed1993

Rheumatologic disease and associated ocular manifestations.

BACKGROUND: Ocular involvement is a common manifestation of rheumatic disease. Recognition of associated systemic findings strengthens our diagnostic armamentarium. METHODS: The previous ophthalmic and medical literature was reviewed and synthesized into a focused review of rheumatoid arthritis, systemic lupus erythematosus, polyarteritis nodosa; the seronegative spondyloarthropathies, including ankylosing spondylitis, Reiter's syndrome, psoriatic arthritis, ulcerative colitis and Crohn's disease. RESULTS: New and improved diagnostic and therapeutic measures have added a great deal to our understanding of the ocular manifestations of rheumatologic disease and the systemic management of rheumatologic disease. CONCLUSIONS: Optometry can fill an important role in the health care of patients with rheumatologic disease. Regular optometric care and coordination with the patient's rheumatologist can significantly benefit the patient's care.

Arthritis, Reactive↗
PubMed1993

National Practitioner Data Bank.

Recently the federal government started keeping records relating to the conduct and competence of doctors. This article will discuss the National Practitioner Data Bank and how it relates to optometry. Potential problems are raised by the author while the need and benefits of such a program are left for future discussion.

Humans↗
PubMed1993

Establishment of comprehensive low vision services in Michigan.

The AOA Low Vision Section presented its distinguished service award to the Michigan Commission for the Blind during the Section's 10th anniversary celebration at the 95th AOA Congress in Montreal. A progressive low vision service delivery system has evolved in Michigan over the past 22 years with optometry identified as the provider of clinical low vision care. The development of this system is described as the relationship between the Michigan Optometric Association, Michigan Commission for the Blind, and other multidisciplinary agencies is explained. Strategies for serving the visually impaired pediatric, career/vocationally aged, elderly and multiply handicapped populations in Michigan are highlighted. This historical review offers ideas for future planning as optometric low vision services are integrated into other state programs.

Humans↗
PubMed1996

My fifty years in ophthalmic standards.

I believe that optometry has gained tremendously from its involvement in the standards process. It enables us to reach out and become involved with other disciplines with which we might not otherwise develop relationships. We learn from the process and from these other disciplines, and what we learn is brought into our professional database through the educational process. It is important that we contribute our knowledge and skills to the development of standards because it is a way in which we can show others what we know and also provide meaningful leadership. I have every reason to believe that our participation in standards will be as satisfying in the future as it has been in the past.

History, 20th Century↗
PubMed1996

Release of spectacle prescriptions: an update.

BACKGROUND: Due to the provisions of the Federal Trade Commission's prescription release rule, the patients of optometrists are entitled to a copy of the spectacle prescription following the examination. METHODS: The FTC rule and provisions of various state laws that regulate the release of information from medical records have been reviewed to determine the specific legal requirements that govern the release of spectacle prescriptions. RESULTS: Although the FTC rule does not require specific information to be included in a spectacle prescription, in 19 states specific information is required, and optometrists in all states should include such additional information as they believe will be necessary to ensure that patients receive the appropriate spectacles from a third-party dispenser. In addition, the laws of 29 states require optometrists to release copies or information from patient records on request from the patient, and in 3 states optometry practice acts or board rules require the release of copies of the spectacle prescription, thereby expanding the duty to patients beyond that required by the FTC rule. In states that do not have statutory provisions, court rulings must be consulted to determine the extent of an optometrist's obligation to provide prescription information from records to patients. CONCLUSIONS: These legal obligations should be observed when providing spectacle prescriptions or responding to requests for prescription information.

Eyeglasses↗