The other day, a longtime patient came in — and I can’t stop thinking about her.
She’s 57, with idiopathic intracranial hypertension (pseudotumor cerebri). For years, she’s been managed successfully by myself and her longtime neurologist with Diamox, OCT, imaging, weight management, and close follow-up. However, after seeing a different neurologist at a local university hospital due to insurance, she was immediately referred internally to neuro-ophthalmology within the same system. She was told she “never had pseudotumor, just anomalous optic nerves.”
In one sentence, years of treatment, trust, and teamwork were erased. I found myself needing to show her OCT comparisons to put her mind at ease. The other doctors were incorrect and incompetent in how they managed her. This is her OCT showing improved papilledema prior to seeing the university neuro group:
Her papilledema improved because her condition was being managed appropriately - not "anomalous optic nerves". The result? Confusion, mistrust, frustration — a breakdown in continuity of care.
This isn’t just one case. It is not uncommon and just one symptom of a dangerous problem. Consider...
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Corporate/retail optometry, the “refract and refer” model prioritizes throughput over patient relationships.
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Academic hospitals, rotating providers and siloed sub-specialists fracture care.
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Both models, continuity and communication, the key to effective medicine — is lost.
Continuity of care and communication shouldn't be a luxury, it is a necessity.
These types of scenarios fuel a call for change and add inspiration for my book, A Clinical Foundation for The Opthalmic Physician: Labs & Imaging for Primary Eye Care. It’s more than a high-yield clinical manual — it’s a call to action for a new specialty in medicine.
Inside, you’ll find...
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Definitions of Ophthalmic Medicine, Doctor of Ophthalmic Medicine - Ophthalmic Physician (OMD).
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Public health and legislative justifications with a proposal & petition to create a novel 2-year General Medicine residency program for Doctors of Optometry within Schools of Medicine.
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Real-world ROI secrets after decades practicing this integrative model providing surgical services in an OD owned & controlled practice -bottom line far beyond 20% co-management.
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Rationale & clear explanations of important labs and imaging necessary in primary eye care.
I invite you to read (or listen) to my complementary sample on Amazon. Available on Kindle, Audiobook, and Paperback release scheduled today.
Go to Amazon HERE:
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Join the Ophthalmic Physician Website, Community, & Book HERE:
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Read & Sign the Petition HERE:
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Do you have a patient story of lost continuity?...
"John"
John R. Martinelli, MD, OD, FAAO
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