SOCIAL MEDIA AND OPHTHALMOLOGY

In July one of the largest private medical insurers in the UK announced that it would reduce the reimbursement for cataract surgery by 65 per cent at the end of that month. This should be taken in the context of the fact that there has been no increase in reimbursement for 20 years and therefore with inflation, the value has already dropped by three to four per cent per annum. In addition, private/self pay provision of cataract surgery in the UK is a low volume, premium service. The justification suggests that modern cataract surgery is of a lower skill and complexity than it used to be. We also should remind ourselves that the surgical fee doesn’t only pay for the surgeon’s time, but also runs the practice/business to support the patients. Unfortunately, the perception for many patients is that all fees will be covered by their insurers and that the contract is between insurer and provider (surgeon); in reality, it is between patient and surgeon.

The second outcome is to alter the referral pathway such that patients pass from the optometrist directly to the insurer who will then pass them to a selected group of hospitals for surgery. We are therefore drifting into managed care which many believe will ultimately result in a descent to the lowest common denominator; patients no longer have the choice they expect – people can pay €4,000 per annum for their insurance and therefore expect a premium service, and not to be part of a commoditised pathway. The insurers are, however, facing increasing costs as the breadth of healthcare in general increases with advancing technology. This presents a problem for patients, providers and third-party payers (insurers) of healthcare. A key to resolving these issues is communication, which is where social media potentially has an important role to play. (However, it should be noted that this is very distinct from collusion which is forbidden by competition law; each individual surgeon must make their own mind up as to how they interact with their patients/ customers.)

This month’s Cover Story looks at Social Media and how it impacts on the day-to-day working lives of ophthalmologists. This was one of the hot topics during the recent ESCRS Practice Development Workshops in Milan and it is a subject we will return to at the Practice Development Weekend which is being held in Dublin this month. As we point out in the Cover Story, the majority of ophthalmologists continue to rely on traditional methods to market their practices and communicate with colleagues, but Facebook, LinkedIn and You Tube are becoming increasingly important as our patients are getting more and more of their information online. I would also suggest that as we are using cutting-edge technology every day when we operate on our patients, they will also expect us to use the most advanced communication tools available, a process which we need to lead rather than be led. There may be concerns over privacy and ethics: Paul McGinn, a barrister in Dublin, Ireland and an editor of EuroTimes, points out, “the watchwords are the three Rs – read, reflect, and when in any doubt, refer the question to competent legal counsel.â€

Health services need a strong financial base to survive and provide the support that patients deserve. This is particularly relevant in ophthalmology where technological advancement has been stunning, and this is one of the reasons ESCRS is continuing to develop its Practice Development Programme. However, these advances need to be communicated to patients and all the other stakeholders. The popularity of the programme is such that between the Milan congress and the Dublin weekend, we will have presented five days of workshops and masterclasses. I would like to thank the members of ESCRS who have helped us develop the programme and also the professional marketing and communications consultants who have presented at our meetings. The programme up to now has been aimed at ophthalmologists and other healthcare professionals who are established in private practice or university or hospital settings.

Our mission for 2013 is to continue to target this group, but also to develop a new module aimed at younger ophthalmologists in training to prepare them for the business challenges which lie ahead as shown by the example at the beginning of this editorial.