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April 2004

Academy Notebook

What’s Happening


Academy Store

Meeting Matters

Washington Report

Members at Large

What’s Happening

Trends in Practice: Eye M.D.s and Optometry

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.
Eye M.D.s and Optometry: survey results.
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 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.


Eye Injury Snapshot Project—May 17
The Academy is asking all practicing U.S. Academy members, ophthalmology residents and emergency room physicians to report every eye injury treated in a 24-hour period on May 17.

Once the data are gathered and analyzed, a media campaign will be built around it to help build awareness of eye injuries and to encourage better eye health and safety behavior.

The findings will be reported in a news release that will be distributed during Eye Injury Prevention Month in July 2004.

If successful, the Snapshot Project will become an annual event so longitudinal data can be obtained.

For more information, visit

Serve Your Colleagues
By volunteering to serve on a committee—and there are more than 50 to choose from—you can help to ensure that the Academy serves its members effectively.

Next month, the Academy will compile a registry of all volunteers. This registry will help the Academy’s president-elect and committee chairs when they draw up their committee selections for 2005. To be eligible, you must be a voting Fellow, Member or International Member.

To volunteer for committee service, visit Read each committee’s mission statement before indicating whether you are available to serve on it. To make sure you are considered for the 2005 committees, please register by the end of April.

New Code of Ethics for Technology Companies
The Advanced Medical Technology Association has updated its code of ethics for interactions between technology companies and health care professionals. Topics covered by the code include education, sales, gifts and charitable donations.

For more information, phone 202-783-8700, e-mail or visit

Free Career Help for Young Eye M.D.s
When it comes to launching a successful career in medicine, you’ll need more than clinical expertise to ensure that you are off to a flying start. To address the career issues that may not have come up during residency, the Academy developed a free online course.

Getting Your First Job in Ophthalmology will help you to evaluate practice opportunities, prepare for interviews, structure initial contracts and understand the basic financials of a practice. It includes 10 interactive quizzes.

For more information, visit

Finishing a Residency or a Fellowship?
f you are completing a training program this year, you should expect to see a Member Status and Training Update form in the mail in the coming weeks. This allows the Academy to know whether or not you will be continuing your training in 2005.

In order to keep your membership status up to date, please return this form no later than June 11.

If you have any questions, please contact Member Services by phone, 415-561-8581, or by e-mail,

Visit Island Resort for Practice Tips
This year, an administrator/ office manager program will be held in conjunction with the Southeast Regional Meeting from July 8 to 10 at Amelia Island, Fla.

Topics at the administrators program, organized by the American Academy of Ophthalmic Executives, will include Tools for Increasing Physician Referrals; Building Teamwork Through the Five Steps of Supervision; How
to Win Patients and Keep Them for Life; and What Every Administrator Must Know About Coding and Reimbursement.

To register for the administrators program, visit or phone 415-447-0369. For JCAHPO’s allied health program, phone 651-731-2944. For program registration and sponsorship information for the Southeast Regional Meeting—which is being sponsored by the Alabama,Georgia, Kentucky, North Carolina, South Carolina, Tennessee and West Virginia state societies—phone 919-833-3836 or e-mail For information about Amelia Island, visit

Healthy Vision Month: Promote Preventive Eye Care in May
In observance of May as Healthy Vision Month, the Academy urges Americans to take care of their eyes, as well as the eyes of their family members. Educate your community about the importance of appropriate eye screenings and examinations.

To promote Healthy Vision Month, visit and download free press releases, patient handouts (both English and Spanish), posters and more.

National Publicity for EyeCare America—Volunteers Needed
EyeCare America received national attention in the Jan. 4 issue of Parade Magazine and the Feb. 8 issue of USA Weekend Magazine. Each publication reaches approximately 45 million readers. This high-profile coverage generated thousands of calls to EyeCare America’s glaucoma help line.

On Feb. 17, the glaucoma program received further publicity when San Francisco’s CBS affiliate featured it in a prime time show called Evening Magazine. See the four-minute broadcast at select “Public Service Programs,” then “Glaucoma EyeCare” and scroll down to “Evening Magazine.”

To become an ECA volunteer, sign up online at or phone 877-887-6327.

Nominate a Colleague for Carl Kupfer Award
If you have a colleague who has played a substantial role in increasing access to eye care for a poor, underserved population, the Pan-American Association of Ophthalmology would like to hear from you.

Nominations for the $15,000 Carl Kupfer Award for Prevention of Blindness must be submitted to PAAO no later than Sept. 30. The award recipient will be expected to give a presentation on his or her work at the XXV Pan-American Congress of Ophthalmology, which takes place in Santiago, Chile, March 18 to 21, 2005.

For more information, visit

$30,000 Fellowship in Disability Studies
Applications are now being accepted for three full-time, nine-month postdoctoral residential Ed Roberts Fellowships. The program—which aims to train scholars, in any discipline, to be leaders in disability studies and rehabilitation research and mentorship—is funded by the National Institute on Disability and Rehabilitation Research. It is based at the University of California, Berkeley. Applications are due by Sept. 3.

For more information, e-mail Devva Kasnitz, PhD, at or

New Fiction
The authors of Blind-Sided took the basic elements of a good thriller—money laundering, murder and mayhem—and then upped the ante by adding the intrigue of an ophthalmic research project. Follow the project’s clinical coordinator around the streets of New Orleans as she tackles the mystery of the missing body parts.

To buy the novel, written by Janet Ferran, COT, and Monette Michaels, visit

Academy Store

Cataract, Refractive and Uveitis LEO Courses on CD-ROM
At the Academy’s Annual Meeting in Anaheim, leading subspecialists presented the latest developments in their field as part of the Lifelong Education for the Ophthalmologist (LEO) clinical update course series.

Those presentations are now available on CD-ROM. By clicking through these courses—which combine slides, text, video and audio exactly as originally presented—you can maintain competency without leaving your own office or home. High-quality image magnification and a rapid search function make these CD-ROMs a convenient resource for everyday use.

The Cataract LEO CD-ROM (Product #0212295) covers: wound construction; phaco chop techniques; new phaco technology; and the complications and surgical challenges of presbyopia, white cataract, poor zonular integrity, astigmatism, 4+ nuclear sclerotic cataract, small pupil, posterior capsular rupture/vitreous loss and phaco after refractive surgery.

The Refractive Management/Intervention LEO CD-ROM (#0212296) covers: demographics; diagnostics; myopic, mixed and hyperopic astigmatism; and surgery for presbyopia.

The Uveitis LEO CD-ROM (#0212297) covers: classification; clinical assessment; differential diagnosis; treatment; and surgery.

Each CD-ROM carries up to three hours of category 1 CME credit and costs $149 for members and $179 for nonmembers.

To order a CD-ROM, visit or phone Customer Service at 415-561-8540.

Meeting Matters

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 or go to the Academy’s Web site at and click “New Orleans 2004.”

International Attendees
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

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

Washington Report

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,

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

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.