American Academy of Ophthalmology Web Site:
Original URL:

April 2004


For One and for All

Supply and Demand


For One and for All

I recently received information from the American Board of Ophthalmology regarding the change in status for recertification. To put it mildly, I can’t believe what is going on.

I am not against recertification. What is ridiculous is that it only applies to those ophthalmologists who were most recently educated (post-1992, I believe). The ABO newsletter states that older physicians cannot be forced to recertify because they were not given time-limited certification. They mention that recertification helps protect patients, and I believe that to be true.

But does this mean that the ABO wants to protect patients from young “incompetent” doctors—but not older ones? Does anyone believe that a 50-year-old doctor knows more outside of his/her specialty than a 40-year-old who was more recently trained? Do I remember as much of what I knew about general medicine as I did when I graduated from medical school about 10 years ago? No, only what I use in my practice today.

I would like the Academy to take a stand for fairness to all of its members and for patient protection. If the ABO won’t require recertification for older ophthalmologists, perhaps the Academy can require it for its membership. I seriously doubt anything will be done, as those in power in both the Academy and ABO are the ones who stand to “lose” by having to study, travel and pay for recertification. It is easy to spin the benefit of recertification when it doesn’t apply to you.

Steven R. Virata, MD
West Lafayette, Ind.
Ed: The ABO newsletter can be found at

Supply and Demand

I read the EyeNet Opinion by Ralph C. Lanciano Jr., DO, about the New Jersey Bill A3364 (“Saying ‘Optometry’s Not My Problem’ Means That You Have a Problem,” September). I would like to offer some insight from a newly graduated ophthalmologist who, with an optometrist for a father, grew up with significant exposure to the practice of optometry.

My father assures me that optometry’s push to increase the scope of practice comes from the optometry schools as justification for high tuition rates. His opinion is that most established optometrists, who don’t work with an ophthalmologist, do not have a strong interest in increasing their scope of practice. Many of these optometrists have profitable optical shops and coexist with the ophthalmologists in the community.

Newly graduated optometrists face a similar environment of perceived oversupply that new ophthalmologists face. It is not unreasonable that they utilize the trail that has been blazed, and compete head to head with general ophthalmologists.

While it is important to concern ourselves with the optometric community, it may be beneficial to examine our own profession. How can we increase society’s demand for the general ophthalmologist? I would suggest we decrease the supply. One of the arguments against the New Jersey bill was that increasing the optometric scope of practice was unjustified because of an oversupply of ophthalmologists. While the projections for the future suggest we need more ophthalmologists, I suggest that these projections were made without proper assessment of the future impact of optometry.

Recent attempts have been made by ophthalmologists to decrease the supply by undertaking fellowship training. How many fellowship-trained ophthalmologists practice exclusively in their subspecialty? I would imagine many still practice general ophthalmology and therefore have not impacted the supply.

An understanding of the motivations of the optometric community may allow us to peacefully coexist. However, we may need to analyze ways to promote society’s perception of the general ophthalmologist as the primary eye care provider.

Marc D. Hirsch, MD


In the February issue, page 13, the caption for the retinopathy of prematurity photo says that treatment is required in zone II or III. It should read zone I or II. EyeNet regrets the error.

Write to Us

Here’s how:
You can write to us at:
     Editors, EyeNet Magazine
     American Academy of Ophthalmology
     665 Beach Street
     San Francisco, CA 94109
     FAX 415-561-8533

EyeNet reserves the right to edit letters.