Hard and Hopeful Lessons of Eye Care's Unpredictable Year

This is the first in a series of five blog posts that address risks, opportunities, and strategies in a new era of eye care.

2020 was supposed to be a great year for eye care—after all, 20/20 vision is one of the common, better-known goals of ophthalmic practice. Instead, it turned out to be a year that could be described as unpredictable—at best. 

A new reality: Economic vulnerability

Eye care practices experienced a supply-versus-demand roller coaster. Conditions in the ophthalmic marketplace varied greatly during the past year, depending upon geographic region and local severity of the COVID-19 pandemic.

Eye care subspecialties that rely heavily upon elective surgeries and procedures experienced the jolting reality of business risk. During the worst times of the pandemic, most eye care practices and ambulatory surgery centers (ASCs) closed their doors, except for urgent and emergent cases. 

Some shut down and reopened—only to have to close down again. Meanwhile, practices in some regions found opportunities for growth. Uncertainty became a hallmark of the business of office-based eye care. 

For professionals and staff who work in eye care, COVID-19 has been a learning experience. Many of us chose careers in this sector—in part, at least—because we perceived healthcare to offer stability and secure employment. Now, it’s become clear that the business of eye care is vulnerable to economic forces—as, of course, are many other sectors of the economy.

A questionable but necessary force

Telehealth emerged as a questionable, less familiar, but necessary force in eye care delivery. It offered a way to triage patients and provide some care during the pandemic. Perhaps most important, it offered a way to communicate with patients until they could be seen in person. 

Even as telehealth helped practices, it could never be a complete answer, given the necessity of looking into the eye. A question lingered in the minds of many clinicians as they did their best to provide care under lock-down conditions—when does non-emergent care become emergent?

Reopening: A time for fresh approaches

After closing doors and pushing back appointments and surgeries—the time finally came to reopen. But patients, staff, and doctors staff had to be kept safe. At this juncture, eye care practices had to be flexible and strategic. 

Social distancing is a challenge for eye-care specialties: many patients must be seen in a short timeframe. These patients must be moved into multiple rooms for testing or to wait for their eyes to become dilated. The demands of social distancing meant most practices could not immediately reopen to 100% capacity and some have not yet reach full capacity as of this writing.  

Eye care practices are showing themselves flexible in their response; for example, rearranging waiting rooms; asking patients to wait in their cars until called; modifying protocols for sanitizing rooms; and installing slit lamp breath shields and other protective barriers. Some practices are implementing a telehealth/office hybrid whereby the patients comes to the office for testing. Review and discussion of results occur remotely.  

For patients: The dangers of delayed care

Many patients delayed eye care. Some lost vision or medical insurance because of termination or furlough from work. Some people became fearful to go to offices for routine eye exams or follow-up appointments. Others felt it was okay to postpone eye care since they weren’t experiencing any symptoms. However, many ocular diseases do not show symptoms and patients may not be aware of warning signs. As patient volume returns, practices may need to deal with problems that, under pre-COVID circumstances, would have been avoided.

Lessons learned
Though 2020 was an unpredictable and difficult year, eye care practitioners and administrators learned some valuable lessons. Eye care professionals have long understood the importance finding ways to monitor patients remotely. In 2020, we received a crash course in how to implement telehealth effectively, when appropriate. We’ll be bettered prepared should another unforeseen event occur that disrupts normal business. 

Having confronted financial unpredictability, eye care practices learned the necessity of becoming nimble in responding to changes in the marketplace and more efficient in managing collections. Practice owners, executives, and administrators now have an opportunity to become more effective as business leaders as they seek to ensure a secure and profitable financial future for their organizations.

Perhaps most important, ophthalmic practice has shown itself to be resilient. We survived the storm.  Ophthalmologists, optometrists, technicians, practice administrators, and staff continue to work to improve vision and preserve sight. Delivering medical and surgical care, we enhance wellness and treat disease. Emerging out of a difficult and even tragic time, our work of preserving and enhancing one of life’s greatest gifts—eyesight—continues.