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March 2004

Academy Notebook

What’s Happening


Meeting Matters

For the Record

Washington Report

Members at Large

What’s Happening

Tackling Common Practice Problems
“The reality of decreasing margins from increasing practice costs and flat or decreasing reimbursement has become the major practice concern of Eye M.D.s,” said Harry A. Zink, MD, Academy secretary for Member Services, describing a survey of Academy members that was conducted in late 2003.

“The increasing malpractice crisis, which is affecting a majority of states with 50- to 200-percent increases in some states, is a major cause of the higher practice costs. While physicians have seen a decrease in problems with payment from managed care plans, decreased reimbursement continues to place increasing pressure on practices.”

Top Six Practice Problems

2003 Survey Results.

Caption: 2003 Survey results. When a large group of members was asked about 12 potential practice problems, these six issues were most frequently identified as being either “very” or “somewhat” serious problems. The other six issues were cost of malpractice insurance (61 percent), finding and retaining qualified staff (58 percent), uninsured patients and uncompensated care (51 percent), external review and limitations on clinical decisions (38 percent), obtaining malpractice insurance (31 percent) and staying abreast of new clinical trends and skills (20 percent).

Ophthalmology fights back. “Recently, organized medicine and the Academy blocked the draconian 4.5 percent decrease in Medicare and replaced it with a 1.5 percent increase,” said Dr. Zink.

“The necessity of addressing the malpractice crisis and the need for sustainable increases in Medicare reimbursements over the coming years makes it essential that ophthalmology’s voice be heard in Washington.”

What you can do. In the long term, the key to ensuring fair reimbursement is persuading Congress to fix Medicare’s sustainable growth rate flaw. “This year’s Academy Advocacy Day is an opportunity for Eye M.D.s to speak to their legislators and staff,” said Dr. Zink.

Register for Advocacy Day at by March 22. It takes place on April 21 and 22. No lobbying experience is needed.



Report CME Online
If you complete an Academy educational activity that carries CME credit (such as a BCSC section or a Clinical Skills video), you may now use the Academy’s online CME transcript service to report the credit you earned. You also can use this free member benefit to record CME credits that you earn outside the Academy. When you print your transcript, you will have a record of all your CME in one document.

To access your CME transcript and report credits earned, visit

Read Updated Policy Statement on Athletes’ Protective Eyewear
The Academy has collaborated with the American Academy of Pediatrics to publish a revised joint policy statement, Protective Eyewear for Young Athletes.

Because the eye-injury risk of a sport is proportional to the chance of the eye being impacted with sufficient energy to cause injury, the new statement recategorizes sports into high risk, moderate risk, low risk and eye safe. Baseball and basketball remain the sports associated with most eye injuries in athletes 5 to 24 years old.

In addition, the revised policy statement updates the information on protective eyewear options and recommendations, and for the first time provides information on protective eyewear certification.

To read the new statement, see this month’s issue of Ophthalmology or Pediatrics or visit and click “Policy Statements.”

Review the Latest Briefing on Confocal Microscopy
An Ophthalmic Technology Assessment, published in last month’s Ophthalmology, reviews the available evidence for the use of confocal microscopy in diagnosing infectious keratitis and corneal abnormalities and in refractive surgery.

Reprints of Confocal Microscopy (Product # 112047) cost $11 for members and $16 for nonmembers.

To buy reprints, visit or phone 415-561-8540.

Shopping for EMR? Know the Benefits, the Risks and the Options
The latest AAOE-sponsored audioconference, Electronic Medical Records: Your Guide to Successful Implementation, guides course participants through the process of determining what functions their practice will need in an EMR, how to find the system that best matches those criteria and how to implement that system successfully.

If you miss the audioconference—which takes place on Tuesday, March 9, from 11 a.m. to noon PST—you can purchase a recording of the proceedings. An audiotape or compact disc, together with the conference handouts, will cost $99 for AAOE members and $135 for all others.

For more information, visit

Meeting Matters

Last Call for Abstracts
The abstract submission deadline is April 13 for scientific exhibits, paper/posters and videos.

If you plan to submit a video, the Academy not only needs your abstract by April 13, but also must have your actual videotape no later than April 23.

Submissions for instruction courses and labs closed on Jan. 13.

Abstracts must be submitted online. Be sure to download the guidelines before making your submission.

For the abstract submitter and guidelines, go to and select “Scientific Program.” Any questions? E-mail the Academy’s Meetings Division at

Enjoy Highlights from Anaheim 2003
If you missed a particular session from the 2003 Subspecialty Day or Annual Meeting, you can catch the following highlights:

Posters online. Visit and select “Past Meetings” to view last year’s scientific posters.

Session audiotapes. Review an Anaheim presentation by ordering an audiotape online at

CD-ROMs. All five Subspecialty Day meetings—Glaucoma, Neuro-Ophthalmology, Refractive Surgery, Retina and Uveitis—along with Spotlight on Pseudophakic IOLs 2003: Where Are We Now? Where Are We Going? and Session Highlights AAO 2003 can be ordered online at

Save the Dates
Join your colleagues in New Orleans from Oct. 22 to 26 for Subspecialty Day (Oct. 22 to 23) and the Joint Meeting of the American Academy of Ophthalmology and the European Society of Ophthalmology (Oct. 23 to 26).

Additional future meeting locations and dates are:

Chicago (Oct. 15 to 18, 2005)
Las Vegas (Nov. 11 to 14, 2006)
New Orleans (Nov. 10 to 13, 2007)
Atlanta (Nov. 8 to 11, 2008)

For the Record

The board of trustees appointed William W. Culbertson, MD, to the Ethics Committee.

Washington Report

The Medicare Reform Bill: Fried or Foe?
The Medicare reform bill replaced a 4.5 percent cut in physician Medicare fees with a 1.5 percent increase. But there is much debate about what this bill really means for the big picture of medicine. What is certain is that anything can happen between now and its implementation in 2006.

HMOs and Pharmaceutical Companies. Some argue that HMOs and pharmaceutical companies are receiving a disproportionate share of the $400 billion over the next 10 years. Republicans smile and point to marketplace controls as a way to stabilize drug costs. Liberals frown and point to the increased funding for HMOs/private plans as a way to limit long-term governmental commitment to traditional fee-for-service Medicare. This means that, for the first time, ophthalmology will be vying with pharmaceuticals for our fair share of Medicare dollars. In the short term, physicians may be courted to participate in private plans and HMOs by higher reimbursements and incentives, only to be put under intense payment and coverage pressure within two years.

United Medicine Support. For sure, this bill enjoyed widespread support from medicine. Why? Because it provides a short-term fix to our fee crisis and buys us time to work with Congress on fixing the sustainable growth-rate formula —that maverick component of the Medicare update formula that results in automatic physician fee cuts. But the biggest reason: It was the only option on the table to prevent Medicare cuts from careening out of control to a 20 percent total cut by 2006. The new Medicare law is unlikely to stand as passed, and we will work for further refinements that are good for medicine.

Members at Large

State-to-State: Iraqi Surgeon Special Guest at Leadership Program
President of the Society of Iraqi Surgeons Quraish Al-Kasser, MD, was a special guest and presenter during the simultaneous sessions of the Academy’s Leadership Development Program and the Pan-American Association of Ophthalmology’s Curso de Liderazgo. Bernard Alpert, MD, who is collaborating on rebuilding Iraq’s health care system, and Assad Hassoun, MD, who was once Dr. Al-Kasser’s intern at Baghdad City Hospital and is now a liver transplant surgeon at California Pacific Medical Center, were also at the session, which took place in January in San Francisco.

Dr. Al-Kasser spoke about the current state of Iraqi medicine. Shortly after the fall of Baghdad, 90 percent of the capital’s hospitals were looted.

While there is still much work to do, he said he has great hope for the future. He wants to encourage partnerships between Iraqi and U.S. hospitals and he also hopes to get Iraqi medical students trained in the United States.

During his two-month stay in the United States, Dr. Al-Kasser acted as an unofficial ambassador of Iraqi medicine.

In December, he visited the White House to speak with President Bush on how to rebuild Iraq’s medical system.

He also addressed the American Medical Association’s House of Delegates shortly upon arriving in the country and received two standing ovations.

Daniel J. Briceland, MD, director of the Academy’s Leadership Development Program, noted that, “as one of the goals of the Academy and PAAO programs is to prepare and train these future leaders for leadership roles in their state, subspecialty and national societies, we are inspired by the plans Dr. Al-Kasser has to rebuild the health care system in Iraq and the partnerships he is forging between hospitals in Baghdad with hospitals in the United States.”

Participants in PAAO’s Curso—which is modeled after the Academy’s program —are nominated by national Latin and European ophthalmological societies. Curso participants (and their nominating societies) are as follows: Jose Manuel Benitez del Castillo Sanchez, MD, Spain; Fernando L. Colombo Rengel, MD, Venezuela; Jose Joaquin Flores Rivera, MD, El Salvador; Natalio J. Izquierdo, MD, Puerto Rico; Luis Oswaldo Izquierdo Villavicencio, MD, Peru; Miguel Angel Lopez Pimentel, MD, Dominican Republic; Paulo Henrique Morales, MD, Brazil; Eduardo Jose Gil Duarte Silva, MD, Portugal; Jose Luis Tovilla Canales, MD, Mexico; Gonzalo Vargas Diaz, MD, Chile; and Lihteh Wu, MD, Costa Rica.

In the Academy program, physicians are nominated by state, subspecialty and specialized interest societies. Current LDP participants (and their nominating societies) are as follows: Steven Awner, MD, New York State Ophthalmological Society; Barbara A. Blodi, MD, Macula Society; Beth K. Bruening, MD, Iowa Academy of Ophthalmology; Anna Luisa Di Lorenzo, MD, Michigan Ophthalmological Society; David W. Faber, MD, Utah Ophthalmological Society; Ravi D. Goel, MD, New Jersey Academy of Ophthalmology; Thomas Graul, MD, Nebraska Academy of Eye Physicians and Surgeons; Erich B. Groos Jr., MD, Tennessee Academy of Ophthalmology; Bryan J. Hammer, MD, South Dakota Academy of Ophthalmology; Paul Henry, MD, Arkansas Ophthalmological Society; Scott Limstrom, MD, Alaska State Ophthalmological Society; George Nardin, MD, Hawaii Ophthalmological Society; Mark Packer, MD, American Society of Catatract and Refractive Surgery; Joy Dixon Robinson, MD, Virginia Society of Ophthalmology; James F. Ronk, MD, Oklahoma Academy of Ophthalmology; Stefan Seregard, MD, European Ophthalmological Society; Jennifer H. Smith, MD, Illinois Association of Ophthalmology; Steven C. Thornquist, MD, Connecticut Society of Eye Physicians; and Russell N. Van Gelder, MD, PhD, American Uveitis Society.

For more on the LDP, visit

Who’s in the News
Andrew I. Caster, MD,
was quoted in the October 6, 2003 issue of USA Today on wavefront-guided LASIK.

USA Today interviewed Robert K. Maloney, MD, and Nathan Ravi, MD, on the topic of injectable gel as a replacement for aging or ailing lenses for an article that was published on Oct. 30.

Carmen A. Puliafito, MD, MBA, was quoted in the Nov. 17 issue of the Los Angeles Times on pegaptanib sodium (Macugen), the new drug that was developed to block neovascularization in exudative macular degeneration. Dr. Puliafito presented the clinical trial results at the Academy Annual Meeting.

New York City’s Memorial Sloan Kettering Cancer Center has appointed David H. Abramson, MD, as the full-time chief of the newly created Service in Ophthalmic Oncology in the Department of Surgery. “With this move, I believe that we will be able to offer ophthalmic oncology patients unprecedented resources in patient care, supportive and follow-up care and research,” he said.

Bernice Z. Brown, MD,
a pioneer in the field of ophthalmic plastic and reconstructive surgery and the first woman to be accepted as an ophthalmology resident at the University of Southern California, died on Dec. 24.

At the time of her death, Dr. Brown was a clinical professor of ophthalmology and fellowship director of ophthalmic plastic, orbital and reconstructive surgery at USC’s Doheny Eye Institute. She was also on the editorial board of EyeNet Magazine and the board of directors at the Doheny Eye Medical Group.

Dr. Brown was a founding member of Women in Ophthalmology and, in 1994, was elected president of the organization for a four-year term. She also served as president of the American Society of Ophthalmic Plastic and Reconstructive Surgeons (1990) and the California Academy of Ophthalmology (1990).

She was editor of the Journal of Ophthalmic Plastic and Reconstructive Surgery from 1997 to 1999.

Her many awards and honors include the Academy’s Senior Achievement Award, the ASOPRS’ Lester T. Jones Anatomy Award, the Doheny/USC Professional Association’s Distinguished Alumnus Award, the USC School of Medicine’s Alumnus of the Year Award and the WIO’s inaugural Suzanne Veronneau-Troutman Award.

A memorial fund at the Doheny Eye Institute will establish the Bernice Z. Brown, MD, Fellowship in Oculoplastics and Reconstructive Surgery. Contributions should be made payable to the Doheny Eye Institute and mailed to the Doheny Eye Institute Development Office, 1450 San Pablo Street, DEI-3050, Los Angeles, CA 90033.