EXPANSION OF THE SUCCESSFUL PESCATORE/ VISUALIZA EYE CLINIC MODEL THROUGHOUT LATIN AMERICA AND HAITI
The Pescatore/Visualiza eye clinics are a model for expansion in other countries.
Within 5 years after the Visualiza private eye clinic was transformed into a social service clinic for the poor and private pay wealthy patients alike,the clinic has increased the annual number of patients treated from 5,000 to 28,000.
Within three years through the support of the International Eye Foundation (IEF) the Visualiza clinic has become sustainable for all adult patients without need for outside funding.
Private practice eye clinic partners in 8 Latin American countries and Haiti have been identified for transformation into social service clinics using Visualiza as a model and teacher.
With a one-time $200,000 expansion plan per new eye clinic, each clinic is expected to become sustainable without outside funding within 3 years.
Each clinic is expected to increase productivity in treating poor patients by 500% within three years.
Background
A stable but inherently unjust equilibrium exists in eye care in developing countries causing exclusion, marginalization, or suffering of patients with eye disease and eye care providers who do not have the authority, autonomy, or resources to change the situation. Choices that patients have for eye care are an unaffordable private sector or an inherently inefficient and poor quality public system. Ophthalmologists’ and Optometrists’ choices are to stay in an inefficient, unproductive, and non-autonomous system; move out into a strictly private practice; or leave the country because they are unaware of how to develop a social enterprise practice.
According to the World Health Organization 90% of the burgeoning rates of blindness (37 million blind and 124 million with low vision) are occurring in developing countries. This problem can only be addressed when the quality of eye care is raised to the level that patients will seek, accept, and for those who can afford, be willing to pay for. Training more eye care professionals is needed, but addressing the root causes of inefficiency, poor quality, and under-utilization resulting from poor management
and lack of financial sustainability is critical.
Successful Strategies Demonstrated
To meet the growing demand for eye care in Latin America, eye hospitals and their donors mustincrease services to the poor, use existing resources more effectively, and become more accountable to their patients for the quality of care they provide. We simply cannot continue to provide funds to maintain “business as usual” where services are provided free and there’s never enough money to treat all who need care. Six years ago, the Volunteer Optometric Service to Humanity of Pennsylvania (VOSH/PA) and the International EyeFoundation (IEF) recognized that a paradigm shift was needed in the way we work because patients, nomatter how poor, will not seek care even when it’s free if they are not treated well and do not have a good visual outcome after surgery. Resources were directed to creating and supporting Visualiza, a social enterprise eye clinic, combining successful private practice and social services under one roof.
Visualiza’s results are dramatic and are now a model for Latin America. In 2002, Drs. Mariano and Nicolas Yee, ophthalmologist brothers, and Dr Kimberly Wiedman, optometrist, had a 2-room private practice in a shopping mall in Guatemala City. They were working one week each month at the Pescatore Eye Clinic in the Peten jungle and wanted to incorporate services for the poor into their private practice in the city but wondered how to afford it. They invited VOSH/PA and IEF to help and over the next 3 years, technical assistance and an investment of $210,000 created Visualiza and transformed their practice into a social enterprise. A social side was established with walk-in clinic, counselors, and sliding fee scale. In 2002 the Pescatore Clinic in the jungle and Visualiza in the city combined to form the Pescatore/Visualiza social enterprise. The increase in services from 2002 to 2007, with both clinics combined has been dramatic:
Outpatient exams increased from 4,996 to 28,078;
All surgeries increased from 1,903 to 5,163;
Cataract surgeries increased from 706 to 1,717;
Revenue increased from $160,000 to $1,064,122;
Visualiza’s initial goal of incorporating poor patients into their practice and becoming sustainable without the need of outside funding has been achieved. Approximately 80% of patients were subsidized by earned revenue with a staff of 50 employees including 6 opthamologists, 2 optometrists and two administrators. The Pescatore/Visualiza clinics perform an estimated 20% of Guatemala’s annual cataract surgery. This approach is well demonstrated in Guatemala and is being adapted at other eye clinics in the region. Eye clinics in Honduras and in El Salvador have recently implemented the socialenterprise strategy with similar levels of success. VOSH/PA and IEF plan on developing 15 new eye clinics in 8 Latin American countries and Haiti over the next five years envisioning a network of sustainable eye clinics based on the Visualiza model.
Planning and Transition Process
Transforming an eye clinic to become a social enterprise is based on identification of strong leadership, a champion, willing to take on the process. Clarifying ownership, legal authority, decision making authority, and purpose are crucial. A business plan and assessments are undertaken to determine feasibility, patient demand, service options, costing, pricing, and budgeting. Surgical and optical care to all ages is provided from the onset. The clinic itself must be well located, convenient to reach, with modern appearance, and able to accommodate patients and their caretakers in comfort. Renovation of rented space is a good option over expensive new construction. The clinic must have all required equipment, an operating theatre, be well staffed and supplied. In our experience, each clinic has its own unique characteristics.
The Campaign Purpose
Over the next five years VOSH/PA is seeking financial support to transform 15 additional eye clinics in the following countries:
El Salvador 2
Mexico 3
Guatemala 2
Nicaragua 1
Haiti 2
Paraguay 3
Honduras 2
Peru 2
$200,000 is needed to transform an existing private practice eye clinic into a social service enterprise. A total of $3 million is needed. The VOSH/PA commitment is $1.5 million which will be matched with $1.5 million of funding from IEF (International Eye Foundation.)As part of this initiative, Visualiza will serve as a Regional Demonstration Site for all new clinics. The unique opportunity to have practical, on-site, peer-to-peer interaction, coaching and training is the gold standard in encouraging new partners to undertake difficult changes and see for themselves the risk benefit.
Your Participation is Essential
Your heartfelt support and generosity is needed if we are to succeed in this campaign. Our campaign goal for the expansion phase of the campaign is $1.5 million.
The amount of your pledge is a matter only you can decide. This material was prepared to share our needs with you. The suggested gift plans are designed to help you respond generously by taking advantage of time payment methods. These are only suggestions, since you are encouraged to give according to your own circumstances.
