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September 2004


Can’t Have It Both Ways

Fair and Relevant

Can’t Have It Both Ways
The decision by the Academy’s board of trustees to deny optometrists the privilege of attending its meetings was based on a Council Advisory Recommendation (CAR) I authored.

The Academy has drawn a line in the sand relative to surgery by nonsurgeons, and it recommends every ophthalmologist contribute significantly to its Surgical Scope Fund to fight optometrists’ initiatives.

Some ophthalmologists are encouraging the Academy to soften its position and let optometrists who are involved in low vision or contact lens work or who work for ophthalmologists have a special exemption to attend or participate in Academy-sponsored functions. In my mind and clearly in the minds of the Council members, you can’t have it both ways.

Either optometry changes its position on scope of practice initiatives or its agenda is counterproductive to ours.

Our goal is to assure U.S. citizens, veterans, the rich and poor, that when an eye surgeon is needed, that role will be filled by someone who has been through medical school and a residency training program in ophthalmology. Our interests are not territorial; they relate to quality of care.

If optometry changes its position—that is, if the American Optometric Association will formally state that it’s permanently dropping all efforts to enter the surgical and medical management of the eye and its adnexa—I would offer a follow-up CAR to instead urge the Council to encourage optometric attendance at Academy meetings. However, unless they do so, any softening of the Academy’s position relative to low vision or contact lens optometrists or optometrists employed by ophthalmologists is not in the best interests of either patients or the medical and surgical specialty of ophthalmology.

Philip C. Hessburg, MD
Grosse Pointe Park, Mich.

Ed: For the complete CAR, go to, select “The Council” and then click “Advisory Recommendations.”

Fair and Relevant
The following letter is in response to Dr. Michael S. Korenfeld’s letter “Speaking Out About MOC” (February).

The American Board of Ophthalmology (ABO) believes in the value of Maintenance of Certification (MOC) for all diplomates. It also recognizes the disparity between those diplomates who hold non-time-limited certificates and those who must recertify every 10 years.

Prior to 1992, the ABO issued certificates that didn’t have an expiration date and is legally constrained from imposing one now. The American Board of Medical Specialties (ABMS), the organization that mandated MOC for all 24 recognized medical specialty boards, holds that it’s the prerogative of individual boards to provide voluntary or mandatory recertification/MOC. However, a specialty board may not rescind an initial certificate unless a date of expiration was a condition of the original certification. Today, only time-limited certificates are issued by the 24 primary or conjoint boards.

While the ABO doesn’t require diplomates who hold non-time-limited certificates to participate in MOC, the ABO does encourage participation and is committed to recertification of all directors. Beginning in 2001, all new directors are required to recertify within two years of appointment. The eight directors appointed to
the Board since then have already recertified or are in the recertification process. The remaining nine directors are voluntarily entering the MOC process.

MOC is meant to assure that members of the profession continue their education, keep current in information and skill and practice in a contemporary manner. The intent of the process is to set goals that will guide all members of the profession as they strive to keep up-to-date. The ABO will continue to work with the ABMS, the American Academy of Ophthalmology, ABO diplomates and all members of the ophthalmic profession to ensure the MOC process is fair and relevant to the practice of ophthalmology.

Denis M. O’Day, MD
Executive Director,
American Board of Ophthalmology
Bala Cynwyd, Pa.

Julia Song, MD, should have been listed as the second author of “Postoperative Trabeculectomy Management” (Ophthalmic Pearls, April). EyeNet regrets the oversight.

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