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WHAT’S HAPPENING 

This Year’s Laureate: Dr. Sommer

The board of trustees is proud to announce the selection of Alfred Sommer, MD, MHS, as the recipient of the Laureate Recognition Award for 2011. Dr. Sommer is renowned worldwide for his continuing long-term research involving the cause, magnitude, consequences and control of vitamin A deficiency.

In a series of interventional trials conducted in Indonesia during the late 1970s, Dr. Sommer and his research team discovered that vitamin A deficiency was far more common than previously recognized. Their research also revealed that even mild vitamin A deficiency dramatically increased childhood mortality rates—primarily because this deficiency reduces resistance to infectious diseases, such as measles.

Parallel studies that Dr. Sommer organized with colleagues in Africa demonstrated that most cases of measles-associated pediatric blindness were also related to low vitamin A levels. To prove these observations definitively, he ran a number of large-scale, community-based randomized trials from 1983 through 1992 that demonstrated the link between even mild vitamin A deficiency and pediatric mortality.

Moving from science to practice, Dr. Sommer next showed that the debilitating consequences of vitamin A deficiency could be treated effectively and inexpensively with oral high-dose vitamin A supplementation—treatment that did not require a sterile injectable preparation.

As a result, the World Development Report declared vitamin A supplementation one of the most cost-effective of all health interventions. The latest research by Dr. Sommer shows that supplementing the diet of Nepalese women of childbearing age with vitamin A or beta-carotene reduced maternal mortality by an average of 45 percent and that newborn vitamin A supplementation reduced neonatal mortality by 20 percent.

Dr. Sommer is currently professor of epidemiology, international health and ophthalmology at Johns Hopkins University. He was dean of the Johns Hopkins Bloomberg School of Public Health from 1990 to 2005.

His research interests include outcomes assessment, child survival, epidemiology of visual disorders, glaucoma, vitamin A deficiency, blindness prevention strategies, cost-benefit analysis, the growing interface between medicine and public health, and clinical guidelines.

In recognition of his contributions to vision and world health, the Academy is pleased to present Dr. Sommer with its highest honor, the Laureate Recognition Award.

Be sure to check out EyeNet’s interview with Dr. Sommer in the Sunday/Monday/Tuesday edition of Academy News. The Academy’s onsite convention tabloid will be available throughout the Orange County Convention Center and the Exhibit Hall during this year’s Annual Meeting.

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LAUREATE OF THE AMERICAN ACADEMY OF OPHTHALMOLOGY:

ALFRED SOMMER, MD, MHS. The Laureate Recognition Award honors physicians who have made the most significant contributions to ophthalmology leading to the prevention of blindness and restoration of sight worldwide.

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TAKE NOTICE 

Ask the Ethicist: How to End the Physician-Patient Relationship

Q: One of my patients questions my every recommendation, is noncompliant in following my treatment suggestions, makes endless phone calls to my staff about the expense of the office visits, calls at the last minute to change appointment dates/times and has been verbally abusive to my staff. The situation is becoming intolerable. How can I dismiss this patient and regain professionalism in my office?

A: There is a simple remedy for this situation: documentation, documentation, documentation. Careful documentation of patient noncompliance, disruptive behavior, refusal to respect practice policies and so on should be kept in the patient’s record to serve as the rationale for termination of the physician-patient relationship if your actions are ever questioned. In addition, short memos to the record from your office staff regarding their experiences with the patient could be useful.

If you believe it’s in your (or the patient’s) best interests to terminate the relationship, notify the patient in writing and include the following information:

  • the reason(s) for the termination,
     
  • the effective date of the termination (usually 30 days from the date of the notification),
     
  • the names and contact information of other ophthalmologists in the area,
     
  • the offer to transfer patient records following receipt of a signed authorization and
     
  • the agreement to continue medical care for the 30-day time period.

Ensure that the letter and envelope are properly addressed and affix proper postage. As a general matter, the law has a presumption that a properly addressed letter with appropriate postage affixed to it is considered legally delivered once it is deposited into the mail. However, rather than relying on the legal presumption, it will make things easier (in the unlikely event of a lawsuit) if you have proof of delivery from the carrier; so if you wish, send the letter via any carrier that will document delivery. Because specific requirements for terminating physician-patient relationships may vary by state and malpractice carrier, it would be wise to discuss this situation with your attorney.

Allegations of patient abandonment can bring serious legal challenges to your practice and cost you time, money and energy better spent elsewhere. Abandonment can be defined as unilateral severance of the relationship by the doctor without acceptable notification while the patient is in need of medical treatment. In this situation, the physician may be liable for injuries affecting the patient as a result of termination of the relationship. Allegations of abandonment can only be considered against a physician who has a legal duty to treat a patient and fails to do so. The documentation noted above and the letter you send to the patient release you from that legal duty.

To submit a question for this column, contact the Ethics Committee staff at ethics@aao.org. To read the Code of Ethics, visit www.aao.org/about and choose “Ethics” and “Code of Ethics.”

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Take Advantage of AAOE’s Free Membership Category

If you started your residency this year, you should have received notification of your free membership in the American Academy of Ophthalmic Executives by now. Your member benefits include practice management e-newsletters and access to the AAOE’s listservs.

Who gets free AAOE membership? Academy members who are in residency, in fellowship training or in their first year of practice.

Just started your second year of practice? Ophthalmologists in their second year of practice can join for the discounted price of $145.

For more information, visit www.aao.org/joinaaoe.

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Academy Exhibit at ESCRS

The XXIX Congress of the European Society of Cataract and Refractive Surgeons (ESCRS) takes place Sept. 17 to 21 in Vienna, Austria. Stop by Booth #B119 to visit with the Academy and learn about new products, membership and the Annual Meeting in October.

For more information, visit www.aao.org/aao_exhibits.

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TAKE NOTICE. NEW OTA AND REVISED PPP SPOTLIGHT GLAUCOMA PROCEDURES AND CATARACT. Get information about the advantages and disadvantages of new glaucoma surgeries and devices, including the Fugo Blade, the Ex-Press mini glaucoma shunt, excimer laser trabeculotomy and more in the new Ophthalmic Technology Assessment: Novel Glaucoma Procedures. OTAs evaluate new and existing procedures, drugs and diagnostic screening tests for safety and clinical effectiveness. All 39 assessments are available as a free member benefit on the Ophthalmic News and Education (ONE) Network.

Also be sure to check out the revised Cataract in the Adult Eye Preferred Practice Pattern, available next month. PPPs are based on scientific data and expert consensus and are designed to assist clinicians in making decisions in treating specific conditions. All 18 PPPs are available for free on the ONE Network.

To access and download the Academy’s library of OTAs and PPPs, visit www.aao.org/one and choose “Practice Guidelines.”

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ACADEMY STORE 

Buy Four or More 2012 Coding Products and Save

AAOE’s 2012 coding products are now available for purchase in print, online and mobile versions. Take the guesswork out of coding and use AAOE’s ophthalmology-specific solutions to help you code confidently, competently and accurately. Save 10 percent when you buy four or more coding products.

To order, visit www.aao.org/codingproducts.

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Check Out the Downloadable Patient Education Videos Collection

All nine Academy patient education videos offered on DVD can now be downloaded in one collection (#057160V). Available in a variety of file formats for greater flexibility in educating patients, these videos offer the same high-quality production value and features as their DVD counterparts.

Topics include AMD, cataract surgery, diabetic retinopathy, dry eye, glaucoma, LASIK and wavefront. The collection also includes the two-volume Waiting Room series.

The collection is $1,420 for members and $1,920 for nonmembers.

To order, visit www.aao.org/patientvideos. Interested in personalizing these videos during the 2011 Annual Meeting in Orlando? E-mail patientinfo@aao.org or call 415-561-8549 to get more information or make an appointment.

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FOR THE RECORD 

Proposed Amendments to the 2011 Bylaws

The American Academy of Ophthalmology Board of Trustees recommends the following proposed amendments to the Academy Bylaws for consideration and adoption by voting fellows and members via official hybrid (mail and online) ballot to be forwarded to the voting fellows and members after the Annual Business Meeting on Sunday, Oct. 23, at the Orange County Convention Center in Orlando.

New language is underlined and deleted words and phrases are indicated by strike through. Only the affected portions of the current documents are printed below.

Board of Trustees statement: The Board of Trustees supports the creation of a new membership category for industry. Currently there is only one membership category, Associate Membership, for non-ophthalmologists and there is no differentiation between those who work in academic settings and those in industry. The addition of an Industry membership class will allow the Academy to distinguish between the two groups and charge different membership dues.

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ANNUAL BUSINESS MEETING : Notice is hereby given that the Annual Business Meeting of the American Academy of Ophthalmology will be held on Sunday, Oct. 23, in the Valencia Room at the Orange County Convention Center in Orlando, from 10 to 10:30 a.m.

  • The order of business shall be:
  • Call to order
  • Report of the president
  • Report of the EVP/CEO
  • Election of fellows and members
  • New business
  • Announcements and notices
  • Adjournment

As stated in the bylaws of the Academy, the order of business of each Annual Business Meeting may be amended by an affirmative vote of a majority of the voting fellows and members present and voting at the meeting.

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BYLAWS
Article I. Membership

1.01. Classes of Membership. There shall be the following classes of membership in the Academy: Active Fellows, Life Fellows, Honorary Fellows, Inactive Fellows, Active Osteopathic Fellows, Life Osteopathic Fellows, Inactive Osteopathic Fellows, Active Members, International Members, Associate Members, Industry Members, Life Members, Life International Members, Life Associate Members, Life Industry Members, Members-in-Training, International Members-in-Training, and Inactive Members.

1.12. Industry Members. A person who holds a degree of Doctor of Medicine, Doctor of Osteopathy, or Doctor of Veterinary Medicine or Doctor of Philosophy in science, and is engaged in full-time research in a science related to ophthalmology, shall be eligible for nomination to receive an invitation for membership as an Industry Member.

A person thought to be an eligible candidate for invitation may be nominated by two (2) Active or Life Fellows or Members, on the form prescribed by the Board of Trustees. If the Board of Trustees, in its sole discretion, determines that the candidate should be invited for membership as an Industry Member, an acceptance form prescribed by the Board of Trustees shall be furnished to the candidate. A certification attesting to the person’s continued satisfaction of all the requirements for eligibility for nomination to membership in that class shall be required annually.

1.1213. Life Members; Life International Members; Life Associate Members; Life Industry Members. A person who has been an Active Member, International Member, or Associate Member or Industry Member in good standing of the Academy or predecessor organizations for thirty-five (35) years, and whose license to practice medicine (if applicable) is valid and unrestricted at the end of that thirty-five (35) year period, is eligible to become a Life Member in the appropriate life category.

1.1516. Inactive Members. An Active Member, International Member, or Associate Member or Industry Member who is no longer engaged in the active practice of medicine (if applicable) by reason of disability or retirement, and whose license to practice medicine is valid and unrestricted at the time of disability or retirement, is eligible to become an Inactive Member.

1.1617. Membership Applications and Acceptance Forms. Each candidate for membership as an Active Fellow, an Active Osteopathic Fellow, an Active Member, an International Member, a Member-in-Training, or an International Member-in-Training shall file with the Executive Vice President the appropriate Academy membership application form, completed as prescribed thereon, and shall pay the application fee in effect at that time. Each person who has been nominated for invitation to become an Associate Member or an Industry Member, and who is furnished by or under the direction of the Board of Trustees the appropriate Academy membership acceptance form to accept membership in one of those classes, may accept the invitation by filing with the Executive Vice president the acceptance form, completed as prescribed thereon, and paying the fee in effect at that time. All information submitted on or with an application form, a nomination form, or an acceptance form shall be subject to review and verification by or under the supervision of the Board of Trustees.

1.1819. Transfers of Membership Class. The membership of a Fellow or Member who is eligible to become a Life Fellow, a Life Osteopathic Fellow, a Life Member, a Life International Member, or a Life Associate Member or a Life Industry Member in accordance with these Bylaws shall automatically be converted to membership in the respective Life membership class without any application, request, or other action by the Fellow or Member and without any recommendation, vote, or other approval by the Board of Trustees or the Voting Fellows and Members. A person who becomes a Life Fellow, a Life Osteopathic Fellow, a Life Member, a Life International Member, or a Life Associate Member or a Life Industry Member shall continue to have and enjoy all of the privileges and responsibilities associated with the person’s former membership class.

Board of Trustees statement: The Board of Trustees supports the creation of the International Trustee-at-Large positions. The board feels that the International Trustees-at-Large will offer an international perspective representative of its international members and will provide pertinent input during board discussions.

1.1920. Voting and Holding Office in the Academy. The only classes of membership entitled to vote on any matter or to attend any annual or special business meeting of the Academy shall be Active Fellows, Active Osteopathic Fellows, Life Fellows, Life Osteopathic Fellows, Active Members, and Life Members. Only Active Fellows, Active Osteopathic Fellows and Life Fellows shall be eligible for nomination, election, or appointment as an Elected or Appointed Officer or as a Trustee-at-Large of the Academy or as the Chair or Vice Chair of the Council, and only International Members, or those Fellows and Members who practice exclusively outside of the United States, shall be eligible for appointment as an International Trustee-at-Large.

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BYLAWS
Article III. Board of Trustees

3.02. Composition of the Board of Trustees. The Board of Trustees shall be composed of:

(a) the persons who are from time to time the Elected and Appointed Officers of the Academy referred to in Section 4.01 of these Bylaws;

(b) the most recent living Past President of the Academy able to serve on the Board of Trustees;

(c) the Chair of the Council;

(d) the Vice Chair of the Council;

(e) the Chair of the Academy Foundation Advisory Board;

(f) six (6) Trustees-at-Large;

(g) not more than two (2) International Trustees-at-Large; and

(g)(h) not more than three (3) Public Trustees.

Not more than one-fourth (1/4th) of the members of the Board of Trustees shall at the same time serve as officers or members of the governing board of any one (1) other ophthalmologic organization, other than an organization that is an affiliate or subsidiary of the Academy.

3.03. Terms.

(a) Each Elected Officer and Appointed Officer shall serve on the Board of Trustees for a term contemporaneous with the person’s tenure as an Elected Officer or an Appointed Officer in accordance with Article IV.

(b) Each Trustee-at-Large shall serve on the Board of Trustees for one (1) full term of four (4) years. A Trustee-at-Large shall be ineligible for re-election to the Board of Trustees for a second term as a Trustee-at-Large.

(c) The Chair of the Council shall serve on the Board of Trustees for one (1) full term of two (2) years, or for such shorter term as the person serves as Chair of the Council, and shall be ineligible for re-election to the Board of Trustees for a second term as Chair of the Council.

(d) The Vice Chair of the Council shall serve on the Board of Trustees for one (1) full term of two (2) years, or for such shorter term as the person serves as Vice Chair of the Council, and shall be ineligible for re-election to the Board of Trustees for a second term as Vice Chair of the Council.

(e) The Chair of the Academy Foundation Advisory Board shall serve on the Board of Trustees for one (1) full term of three (3) years, or for such shorter term as the person serves as Chair of the Academy Foundation Advisory Board, and shall be eligible for one additional three (3) year term.

(f) Each Public Trustee appointed by the Board of Trustees shall serve on the Board of Trustees for one (1) full term of three (3) years, except that the terms of the Public Trustees may be staggered by the Board of Trustees so that not all of the terms of Public Trustees expire in the same year. A Public Trustee shall be eligible for re-appointment to the Board of Trustees.

(g) Each International Trustee-at-Large appointed by the Board of Trustees shall serve on the Board of Trustees for one (1) full term of three (3) years, except that the terms of the International Trustees-at-Large may be staggered by the Board of Trustees so that the terms of the International Trustees-at-Large do not expire in the same year. An International Trustee-at-Large shall not be eligible for re-appointment to the Board of Trustees as an International Trustee-at-Large.

(g)(h) A person who serves on the Board of Trustees for less than one-half (1/2) of a full term shall not be considered to have served a full term for purposes of determining the person’s eligibility for continued service on or for re-election to the Board of Trustees. A person’s term as a Trustee on the Board of Trustees commences on whichever is applicable of January 1 of the calendar year following the year in which the person is elected to the Board of Trustees or the date on which the person automatically becomes an ex officio member of the Board of Trustees.

3.04. Duties and Responsibilities of Trustees.

(a) The Past President serving on the Board of Trustees, the Chair of the Council, the Vice Chair of the Council, the Chair of the Academy Foundation Advisory Board, and each Public Trustee shall have all of the duties and responsibilities as Trustees prescribed by these Bylaws and that the President or the Board of Trustees may determine.

(b) The Trustees-at-Large shall have all of the duties and responsibilities prescribed by these Bylaws and that the President or the Board of Trustees may determine; and in the event of vacancies in the Offices of both the President and President-Elect, for any reason, the most senior Trustee-at-Large, or in the absence or disability of that person, the second most senior Trustee-at-Large, shall assume the duties and responsibilities of the President for the unexpired term.

(c) Each Trustee shall be entitled to one (1) vote on all matters coming before the Board of Trustees, except as the contrary is provided in the Procedural Rules, and except further that only the Elected Officers, the Appointed Officers, the Past President serving on the Board of Trustees, the Trustees-at-Large, and the Chair and Vice Chair of the Council, and the Chair of the Academy Foundation Advisory Board Public Trustees and International Trustees-at-Large shall not be entitled to vote on matters involving matters of governance, rules, or procedures of the Academy or matters described in Section 5.03.

Board of Trustees statement: The Board of Trustees supports amending the Procedural Rules of the Bylaws to include online voting. This change will complete the bylaws changes begun in 2010 which added the online voting option.

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BYLAWS
Article II. Meetings and Vote of Fellows and Members

2.08. Procedural Rules, Parliamentary Authority, and Rules of Order. The Board of Trustees may from time to time adopt, revise or amend, subject to subsequent ratification by the Voting Fellows and Members, Procedural Rules that are not inconsistent with the Articles of Incorporation or these Bylaws relating to the presentation of papers at sessions of the Academy; notices of meetings of, quorum requirements for, and means of taking actions by the Board of Trustees, Secretariats, and committees; procedures applicable to contested elections for the positions of Elected Officers and Trustees-at-Large of the Academy and Chair and Vice Chair of the Council; procedures for voting by mail ballot or online voting for the election of persons to the positions of Elected Officers and Trustees-at-Large of the Academy and Chair and Vice Chair of the Council; procedures for voting by mail ballot or online voting on proposed amendments or revisions in the Academy’s Articles of Incorporation, these Bylaws, the Code of Ethics, or the Procedural Rules; and other matters that do not relate to the rights or responsibilities of Fellows or Members of the Academy. The deliberations of the Fellows and Members of the Academy, the Board of Trustees, the Council, and all committees shall be governed by the rules contained in the then-current edition of Robert’s Rules of Order Newly Revised in all cases in which those Rules are not inconsistent with the Articles of Incorporation, these Bylaws, the Procedural Rules, the Operational Procedures, customary practices, and procedures of the Academy.

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BOARD APPROVES NEW POLICY STATEMENT : The Academy Board of Trustees has voted to approve the new Differences in Education Between Optometrists and Ophthalmologists policy statement.

Policy statements are designed to make known the Academy’s position on an issue, and to educate on issues of concern. Statements are approved by the Academy Board of Trustees to ensure that they are in agreement with the principles and goals of the organization.

To read this policy and others, visit www.aao.org/about and click “Policy Statements.”

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D.C. REPORT 

D.C. REPORT : 2011 Annual Meeting Sessions

The year has shepherded in implementation of the far-reaching health care reform law, and the Academy is at work to protect and advance the interests of ophthalmology relative to it. And our profession’s challenges are not limited to Washington, D.C.; optometry is posing threats to patient safety in many states in 2011. Attend these free sessions at the 2011 Annual Meeting and discover how the Academy ensures that your voice is heard.

2011 SURGERY BY SURGEONS FORUM. The Surgery by Surgeons Forum highlights actions and trends by state legislatures and regulatory bodies. Registration for the fall Council meeting is required for the forum; attendance is limited to Academy members and invited guests. (Sunday, Oct. 23, 11:30 a.m. to 1 p.m., The Peabody)

2012 MEDICARE UPDATE. What changes can you expect from the Medicare program in 2012 and beyond? In addition to providing the latest Medicare news, ophthalmologist John S. McInnes, MD, the new director of outpatient services at CMS, will highlight the upcoming quality and value-based purchasing program for ambulatory surgery centers. Coding and payment changes for ophthalmic services will also be presented. (Sunday, Oct. 23, 12:15 to 1:45 p.m., Orange County Convention Center, Chapin Theater)

DIALOGUE WITH THE FDA: Introducing Newly Approved Drugs and Devices Into Your Practice. How do you incorporate the latest scientific breakthroughs into your practice? In this session, experts from the FDA will provide their insight on a variety of FDA-related ophthalmic issues. A question-and-answer period will follow. (Sunday, Oct. 23, 12:45 to 1:45 p.m., OCCC, W101b)

HEALTH SYSTEM REFORM, ROUND 2: Where Do We Go From Here? The 2011 American Medical Association Ophthalmology Section Council Symposium will feature AMA president Peter W. Carmel, MD, who will offer perspectives on health system reform’s impact on specialty care during his Parker Heath Lecture. (Monday, Oct. 24, 8:30 to 10 a.m., with the Parker Heath Lecture from 9:25 to 9:40 a.m., OCCC, W414ab)

EXCELLENCE IN VISION RESEARCH: Cutting-Edge Innovations in Veterans Affairs and the Department of Defense. In this free session, representatives from the Association for Research in Vision and Ophthalmology, the Association of Veterans Affairs Ophthalmologists and the Society of Military Ophthalmologists will discuss cutting-edge research taking place in the Department of Veterans Affairs and the Department of Defense. Sources and types of research funding will be highlighted. A question-and-answer period will follow. (Monday, Oct. 24, 12:15 to 1:45 p.m., OCCC, W101a)

Attend these free sessions and discover how the Academy ensures that your voice is heard.

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