American Academy of Ophthalmology Web Site: www.aao.org
Employment of optometrists appears to have leveled off, according to data from Academy surveys.
“There are two underlying factors that may account for that trend,” said Harry A. Zink, MD, Academy secretary for Member Services.
“The increased reimbursement for office practice and decreased surgical reimbursement may have encouraged ophthalmologists to increase their own office practice. Consequently, ophthalmologists have less need for optometrists,” he said.
“Also, because practices are being squeezed by limited reimbursement and increasing overhead, ophthalmologists may be using techs rather than optometrists as a way to control costs.”
The Academy’s membership surveys also show that formal contracts between ophthalmologists and optometric networks have become less prevalent than they once were.
Caption: Eye M.D.s and Optometry. These data were collected from a large group of members and have an approximate sampling error of +/–3 percent.
For additional survey results, visit www.eyenetmagazine.org/archives and read about trends in physician satisfaction (January), Academy demographics (February) and practice problems (March).
“This may reflect the reduced reimbursements that are now available for cataract and refractive surgery,” said Dr. Zink.
“Lower reimbursements make comanagement less appealing to optometrists and more expensive for ophthalmologists.
“The bottom line of both trends is that ophthalmologists are transferring less patient care to alternative providers and are supplying those services themselves,” he said.
Next month: The Academy’s survey results track the rise and fall of managed care in ophthalmology.
Free Career Help for Young Eye M.D.s
Finishing a Residency or a Fellowship?
Visit Island Resort for Practice Tips
National Publicity for EyeCare America—Volunteers Needed
Nominate a Colleague for Carl Kupfer Award
$30,000 Fellowship in Disability Studies
Cataract, Refractive and Uveitis LEO Courses on CD-ROM
New Orleans Activities
New Orleans offers Joint Meeting attendees and their spouses an array of activities, which has made this destination very popular over the years. Vibrant neighborhoods, fine restaurants, music venues and excellent shopping opportunities—New Orleans has it all.
For more information, visit the New Orleans Visitors Bureau Web site at www.neworleanscvb.com or go to the Academy’s Web site at www.aao.org/meetings/annual_meeting and click “New Orleans 2004.”
Most visitors to the United States will require a visitor visa upon entry unless they are from a country participating in the Visa Waiver Program. In order for most international participants to attend the Joint Meeting, they will need to secure a visitors visa through the U.S. Department of State. Apply early to avoid unforeseen delays.
For detailed information, go online at www.unitedstatesvisas.gov.
Save These Dates for New Orleans 2004
Don’t forget to mark your calendar for the Joint Meeting of the Academy and the European Society of Ophthalmology (SOE). Circle the following dates:
Late May: The Advance Program will be mailed to Academy members. You can also access this information on the Academy’s Web site.
June 23: Registration and housing opens to Academy and AAOE members.
July 7: Registration and housing opens to nonmembers.
Oct. 22 to 23: Subspecialty Day meetings to include Glaucoma, Refractive Surgery and Retina.
Oct. 23 to 26: Joint Meeting.
For the most up-to-date information, visit www.aao.org/meetings/annual_meeting.
Surgery by surgeons is the standard of care in the United States—isn’t it? Not if you’re a veteran in the Department of Veterans Affairs health care system. In 2003, the VA allowed at least three optometrists to perform laser eye surgery at multiple VA hospitals, despite a 1998 pledge that only ophthalmologists would perform all eye surgery in those facilities.
Specifically, Oklahoma-licensed optometrists, until early this year, were credentialed and privileged to perform laser surgery within the VA system. But after the Academy intervened, VA undersecretary Robert Roswell imposed a temporary but immediate suspension of OD surgical privileges, pending a final decision by the department. A memorandum to all VA facility directors came in the wake of questions from House VA Committee members on the issue during a budget hearing early this year.
How did we get here? With 49 out of 50 states not authorizing optometrists to perform surgery, ophthalmologists and veterans alike scratch their heads and wonder how we got to this point.
The Academy’s challenge of optometric surgery began in the late 1990s when the Oklahoma Medical Board, with the support of the Academy, sued the Oklahoma Optometry Board over its decision to allow optometrists in that state to perform laser surgery.
In the fall of 1997, the court ruled that laser surgery was not within the ODs’ scope of practice.
Despite the win by the Academy and its medical allies, the state optometry lobby forced a bill through the state legislature that allowed optometrists to perform surgery.
The bill also prohibited state boards from suing one another, effectively paralyzing the medical board’s ability to stop the optometrists.
Since passage of the Oklahoma law in 1998, organized optometry has worked to expand its scope of practice into the surgical arena in other states. But the Academy has beat them back at every turn, defeating such attempts in 12 states, thanks in part to donations to the Surgical Scope Fund.
What you can do: A consistent component of the Academy’s winning strategy is the Surgical Scope Fund, which provides funds to help states derail optometric surgical scope expansion initiatives in states across the country
and at the federal level.
To donate to the Surgical Scope Fund, contact the Academy’s Washington Office by phone, 202-737-6662, or by e-mail, firstname.lastname@example.org.
Members at Large
State-to-State: Urging Residents to See the Big Picture
Two participants in the Academy’s 2003–2004 Leadership Development Program are encouraging residents to take an active role in both advocacy and organized medicine.
Jennifer H. Smith, MD, and Beth K. Bruening, MD, (representing the Illinois and Iowa state ophthalmological societies, respectively) talked with state societies about each supporting a resident at this month’s Mid-Year Forum in Washington, which incorporates Congressional Advocacy Day.
“This presents a unique opportunity to involve residents and get them excited about organized medicine—through both their state and national ophthalmology organizations. They can meet with congressional leaders alongside leaders in ophthalmology as well as participate in some of the cutting-edge discussions at the Mid-Year Forum,” said Dr. Smith.
Dr. Bruening added, “The Illinois and Iowa state societies led by example by sponsoring the participation of residents Dmitry Pyatetsky, MD, and Andrew P. Doan, MD, PhD, who are training at programs in Illinois and Iowa.” Dr. Pyatetsky, a second-year ophthalmology resident at Northwestern University, said, “During their training, residents often memorize a plethora of detail about a variety of diseases but often fail to learn the big picture of where ophthalmology stands in the health care system and the variety of forces that impact the way medicine is practiced. At the 2004 Mid-Year Forum, I hope to gain more insight on the direction ophthalmology is heading and, later, to share what I learned with other residents.”
For more information on the Mid-Year Forum and Advocacy Day, visit www.aao.org/myf.
Who’s in the News?
Joseph H. Calhoun, MD, offered advice on eye exams and described warning signs of pediatric eye problems in the December issue of MetroKids magazine (Philadelphia).
The IndUS Business Journal (Waltham, Mass.) interviewed Arun C. Gulani, MD, for an article in its December issue about the investigational implantation of artificial corneas.
Next month, the National Inventors Hall of Fame—which honors innovators who have changed society in significant and beneficial ways—will recognize Academy Laureate Charles D. Kelman, MD, for his role in transforming cataract surgery from a 10-day hospital stay into an outpatient procedure.