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Mid-Year Forum 2005

Last month’s Mid-Year Forum set a new attendance record, with 349 ophthalmologists gathering in Washington, D.C.

Held annually, the MYF provides Eye M.D.s with a venue for identifying and discussing the profession’s most critical issues. This year’s topics included:

  • Surgery by Surgeons. In the opening session, the Academy’s senior secretary for advocacy Randolph L. Johnston, MD, chaired a wide-ranging discussion on the attempts of nonphysicians to obtain surgical privileges. Last December, advocates for patient safety scored an important victory when the Veterans Administration ruled that only ophthalmologists should perform laser eye surgery in the VA health system. Ronald F. Conley, a past national commander of the American Legion, explained the critical role that Veterans Service Organizations played in influencing that decision. Wendy Der, legislative director to Rep. John Sullivan (R–Okla.), who had introduced the “Veterans Eye Treatment Safety Act of 2003,” vowed to reintroduce the legislation if the VA problem recurred. Meanwhile, Oklahoma’s decision to let optometrists perform eye surgery with scalpels raises new concerns. The presidents of Oklahoma’s osteopathic and state medical associations gave MYF attendees an update from the frontlines of the battle to reverse this law. Ann Warn, MD, MBA, president of the Oklahoma Academy of Ophthalmology, described the campaign to influence public opinion and efforts to support ophthalmology-friendly candidates in elections to the state senate and state house.
  • The Surgeon vs. the Technician. It has been proposed that nonmedical personnel can be trained in the technical skills to perform a procedure. If the medical profession doesn’t fight this development, it could lead to a piece-meal dismantling of the U.S. health care system. The Academy’s secretary for state affairs Cynthia A. Bradford, MD, chaired a panel that explored the differences between a surgeon and a technician. Thomas R. Russell, MD, FACS, the executive director of the American College of Surgeons outlined how the U.S. standards of credentialing, certifying and licensing had evolved. Richard P. Mills, MD, MPH, emeritus vice chairman of the profession’s ophthalmology residency review committee, and Nicholas J. Volpe, MD, residency program director at Scheie Eye Institute, described the surgical competencies that are instilled during residency. The panel discussed the differences in skills, knowledge, experience, attitude and philosophy that differentiate a surgeon from a technician, and the challenges of educating the public about those differences.
  • Pay for Performance (P4P). Currently, the buzz on Capitol Hill is that lawmakers plan to tie Medicare reimbursement to increased quality and efficiency. The Academy secretary for quality of care and knowledge base development Richard L. Abbott, MD, chaired a discussion of how the Academy plans to position ophthalmologists to receive the higher payment levels. Will such incentives improve quality or just serve to transfer dollars from surgery to primary care? Stuart Guterman, a researcher for the CMS, described what had been learned during pilot P4P schemes and explained the role that CMS would play if a P4P policy was adopted nationally. Kelly Cronin, the senior adviser to the DHHS’ national coordinator for health information technology said that federal support of data collection and health information interchange would underpin any P4P system. She said that the government is trying to facilitate implementation of electronic health records over the next 10 years. The panel discussed how CMS is exploring the link between quality and payment and how physician organizations are responding to the challenges presented.
  • Future Practice Patterns. Paul P. Lee, MD, JD, chaired a discussion of the challenges and opportunities that physicians should prepare for over the next 25 years. Humphrey J.F. Taylor, chairman of the Harris Poll and an Academy public trustee, shared his thoughts on the economic, political, demographic and social factors that will shape the future of eye care delivery. William L. Rich III, MD, the Academy’s medical director of health policy, described the factors that are influencing physician productivity. J. Leonard Lichtenfeld, MD, the deputy chief medical officer of the American Cancer Society, speculated on the future evolution of payment systems and provider compensation. David W. Parke II, MD, the Academy’s senior secretary for ophthalmic practice, discussed possible models for provision of eye care. Two members of the Academy’s task force on eye care delivery—Charlene Hsu Winges, MD, and Thomas P. Kidwell, MD—described Kaiser Permanente’s attempts to move toward a more patient-centered model of health care delivery, utilizing the Internet.

Resident Participation. Residents were well represented in D.C. Ophthalmology societies and training programs from 22 states sponsored almost 40 residents to participate in this year’s Mid-Year Forum:

  • Alabama: Steven Howell, MD
  • Arkansas: Matthew Margolis, DO, and Barbara McGowan, MD
  • California: Jasmine Hayes, MD, Pulin Shah, MD, and John Cason, MD
  • Georgia: Steven Bailey, MD
  • Illinois: Nick Patel, MD, and Mohammed Elmallah, MD
  • Iowa: Andrew Doan, MD, and Reid Longmuir, MD
  • Maryland: David Chia, MD, and Parag Parekh, MD
  • Massachussets: Cristiana Pieroni, MD
  • Michigan: Jeffrey Zink, MD and Ashish Sharma, MD
  • Minnesota: Aaron Holtebeck, MD
  • Nebraska: Shannon Cabrera, MD
  • New Jersey: Charles Duss, MD
  • New York: Eric Wolf, MD, Gregory Hofeldt, MD, and Danielle Ledoux, MD
  • North Carolina: David Gilbert, MD
  • Ohio: Terrence Doherty, MD, Kristopher Kelly, MD, and Richa Singh, MD
  • Oregon: Rebecca Amour, MD
  • Pennsylvania: Andrew Lam, MD, Seema Aggarwal, MD, Gil Binenbaum, MD, Nicole Fram, MD,  Shane Kim, MD, and Omesh Gupta, MD
  • Rhode Island: Howard Amiel, MD
  • Tennessee: Ronald Teed, MD
  • Texas: Aaron Miller, MD
  • Virginia: Daniel Simon, MD
  • West Virginia: Cristoforo Larzo, MD, and Brian Wood, MD

Want to sponsor a resident for the 2006 Mid-Year Forum? State ophthalmological societies and training programs that want to sponsor residents at next year’s Mid-Year Forum should contact the Academy’s director of ophthalmic society relations Gail Schmidt at gschmidt@aao.org.

“Surgery by Surgeons” Campaign Earns Key Win in New Mexico

Ophthalmology and its medical allies registered an important victory in March when they defeated a dangerous optometric surgery bill in New Mexico.

The bill would have authorized optometrists to perform surgical procedures with lasers, scalpels and needles, as well as prescribe any oral or injectable drug.

It passed the New Mexico House by a wide margin but was stopped in a Senate committee.

Members of the New Mexico Ophthalmological Society, led by president Ana G. Huaman, MD, were relentless in their efforts to educate state legislators about the risks of allowing nonphysicians to perform surgery. In addition, New Mexico residents were mobilized through the PR efforts of the New Mexico Medical Society and by a statewide advertising campaign supported by the Academy’s Surgical Scope Fund.

The Academy has worked hard to bring medicine together on “Surgery by Surgeons,” and today it stands united with the American Medical Association, American Osteopathic Association, American College of Surgeons and the American Society for Cataract and Refractive Surgery.

“This is a victory for patient safety not only in New Mexico but also across the nation,” said H. Dunbar Hoskins Jr., MD, Academy executive vice president. “It is a direct result of medicine’s collaborative efforts to preserve high-quality medical care in every state. And a powerful message has been sent to the Oklahoma legislature and its citizens: Oklahoma remains isolated as the only state in the nation that allows ODs to perform eye surgery, and ophthalmology has a winning strategy to bring Oklahoma back up to national medical standards.”

FYI

2005 Membership Dues—A Reminder

Have you paid your 2005 membership dues? The Academy must receive your payment by the end of June to guarantee that you continue to enjoy the many benefits of membership, which include uninterrupted delivery of the specialty’s leading peer-reviewed and clinical news publications—Ophthalmology and EyeNet Magazine.

To renew your membership, you can pay your dues online at www.aao.org or contact Member Services by phone, 888-393-3671 (toll-free) or 415-561-8581, or by fax, 415-561-8575.

Help the Academy Identify Current Trends

The Academy recently mailed a questionnaire to a representative sample of 4,000 Academy members. All responses are kept confidential.

If you receive a questionnaire, please respond. The data will help the Academy to identify trends that are likely to affect ophthalmologists.

Authors and Coauthors Sought for Evidence-Based Reports

The Cochrane Eyes and Vision Group is an international network of individuals working to prepare, maintain and promote access to systematic reviews of interventions to treat or prevent eye diseases or visual impairment.

This network is looking for volunteer authors and coauthors for topics ranging from bilberry supplements for glaucoma to interventions for ocular sarcoidosis.

For a list of topics and contact information, visit www.cochraneeyes.org.

Participate in the Eye Injury Snapshot Project

This year, partnering with the American Society of Ocular Trauma for a one-week period—May 15 to 22—the Academy is again asking all ophthalmologists, ophthalmology residents and emergency room physicians to report every eye injury treated.

Last year, nearly 600 physicians from across the country participated in the first annual Eye Injury Snapshot Project.

“We are hoping that what we learn from the Eye Injury Snapshot Projects will be used to build public awareness and educate the public about protecting eyes from injury,” said Paul Sternberg Jr., MD, the Academy’s secretary for communications.

For more information, visit www.aao.org/snapshot.

In May, Jules Stein Eye Institute Hosts “Eye Spy!” Exhibit

In honor of Healthy Vision Month, the Jules Stein Eye Institute at the University of California, Los Angeles, is hosting the Academy Foundation’s traveling exhibit “Eye Spy!” Created by the Museum of Vision in 2002, the exhibit explores how vision aids have been used as spy devices.

“Eye Spy!” is one of five traveling exhibits from the Museum of Vision. These exhibits can include artifacts or, like the display scheduled for the Jules Eye Institute, can consist of display panels on freestanding walls. There is no rental fee for these exhibits, but venues are asked to pay for shipping.

If you want to borrow an exhibit from the Museum of Vision, contact museum director Jenny Benjamin at 415-561-8502 or jbenjamin@aao.org.

AAOE Now Offers Three Listservs

In addition to E-Talk, the original listserv for members of the American Academy of Ophthalmic Executives, the AAOE has launched two additional listservs: E-Expert and E-Retina. 

E-Expert provides AAOE members free online access to moderated discussion topics led by experts in the field of practice management.

E-Retina provides AAOE members free online access to moderated discussions on topics of particular concern to retina practices.

For more information or to view a schedule of moderated discussions, visit www.aao.org/aaoe.

Academy Store

A CD-ROM of Ready-to-Use Policies and Procedures

Published by AMA Press, Medical Practice Policies and Procedures (#012175) is now available from the Academy.

The customizable policies and procedures in this collection were designed by practice managers and supervisors to monitor workplace rules and better manage staff.

They cover a wide variety of operational and financial areas that are specific to physician practices—from appointment scheduling to disaster planning.

The package includes the collection of policies and procedures in a three-ring binder and on CD-ROM. Medical Practice Policies and Procedures costs $125 for members; $150 for nonmembers.

You can buy this CD-ROM at www.aao.org/store.

Anti-VEGF Eye Fact Sheet for Your Patients

A new patient education eye fact sheet addressing anti-VEGF treatment for wet AMD is now available.

Anti-VEGF Treatment for AMD (#057052) provides an overview of AMD and wet AMD, discusses how anti-VEGF drugs are used as a treatment and how the treatment is administered to patients. It was sponsored in part by a grant from Genentech. The Eye Fact Sheet can be previewed online at www.aao.org/store.

A package of 25 eye fact sheets costs $9 for members; $11 for nonmembers.  

Meeting Matters

Get Ready to Reserve Your Hotel Room and Register for Chicago

2005 Annual Meeting housing and registration will open on the following dates:

  • June 29 for Academy and AAOE members
  • July 13 for nonmembers

You can go online to view hotel locations and descriptions, check room availability and, when registration opens, make hotel reservations. You can also download a housing form to fax or mail.

Check next month’s issue of EyeNet for a map of Chicago and a guide to its hotels.

For more information about the Annual Meeting or Subspecialty Day, visit www.aao.org/annual_meeting.

Check Your Mail for the 2005 Advance Program

Keep a look out for the 2005 Advance Program, which will be mailed in early June to all Academy and AAOE members and those nonmembers who have attended a meeting in the last three years. The Advance Program will include all registration forms, the hotel map and list, Subspecialty Day schedules and course information, including Breakfasts with the Experts, Instruction Courses, Skills Transfer Courses, Symposia, Special Meetings and Events and Spotlight Sessions.

Visit www.aao.org/annual_meeting for complete abstract information, a participant index and general meeting information.

If you do not receive a copy of the Advance Program by late June, send an e-mail to registration@aao.org.

Chicago Has It All

Chicago is a friendly and inviting city that offers visitors a wide array of dining, cultural and shopping attractions.

A trip to Chicago would not be complete without a visit to the Art Institute, a stroll down the Magnificent Mile or an evening listening to music in one of the city’s venerable nightclubs. Plan to spend time during this year’s Annual Meeting getting to know Chicago.

For more information about Chicago, visit Chicago’s Convention and Visitor’s Bureau Web site at www.meetinchicago.com.

Little Kids, Big Issues

Subspecialty Day welcomes pediatric ophthalmology to the 2005 lineup. 

In conjunction with the American Association for Pediatric Ophthalmology and Strabismus, this new meeting will cover the spectrum of pediatric eye disease, from new retinoblastoma treatments to pseudopapilledema, refractive surgery in children, management of retinopathy of prematurity and expanded use of superior oblique expanders. 

Program directors Benjamin H. Ticho, MD, and Marilyn B. Mets, MD, have developed an outstanding meeting.
 
When you register for the pediatric ophthalmology meeting (Oct. 15), you’ll be able to float between all six Subspecialty Day meetings that take place on that day.

For more information, visit www.aao.org/annual_meeting.

Washington Report

Reimbursement Too Low? Prove It

By participating in the CMS’ Five-Year Review of Work Values, you can help influence the reimbursement level for specific CPT codes, said Michael X. Repka, MD, the Academy’s secretary of Federal Affairs. This is an opportunity to improve the accuracy of the physician work component of the Resource-Based Relative Value Scale, which constitutes 53 percent of any code’s payment. But it is also a significant challenge to the medical community—a challenge that demands your involvement.

In a five-year review, CMS creates a list of codes it believes are overvalued or undervalued. It also seeks input from medical specialties in identifying undervalued codes. The list is then submitted to the RUC, a 24-physician panel that weighs the relative value of physician work involved in these procedures.

This year, CMS identified 14 “overvalued” ophthalmology codes for review, including YAG capsulotomy, cataract with IOL, vitrectomy with epiretinal membrane stripping, photodynamic therapy, laser panretinal photocoagulation, fundus photography, fluorescein angiography and visual fields. There is cause for alarm not just for the codes identified, but for all ophthalmology codes. “If the work value and time needed to provide cataract surgery are cut, it will negatively impact all other ophthalmic codes because of its effect on the practice expense methodology,” said Dr. Repka.

Also up for review are 15 undervalued codes submitted by the Academy. The Academy’s Health Policy Committee, with input from ophthalmic specialty societies, identified the 15 codes following a year of research.

The job of going before the RUC to argue ophthalmology’s case for the 29 codes (CMS’ 14, plus the Academy’s 15) goes to Dr. Repka, Trexler M. Topping, MD, Gregory P. Kwasny, MD, and Stephen A. Kamenetzky, MD, all of whom volunteer their time. It is a team that has an earned reputation of integrity and compiled an impressive record before the RUC, added Dr. Repka.

What You Can Do. This month, the Academy is sending out surveys on the 29 codes that are under review.

“If you receive a survey, it’s important that you take the time to carefully respond. Sit down, close the door and turn off the TV,” said Dr. Repka. “Without your input, we’ll have no basis on which to argue against cuts or to ask for an increase. It’s a data-driven, value-driven process—and it’s one that works.”

If you have any questions, or if you are interested in receiving a survey, contact DeChane Dorsey at surveys@aaodc.org or 202-737-6662.

Members At Large

Florida and Colombian Eye M.D.s Discuss Cataract Surgery

The Florida Society of Ophthalmology was one of 11 state ophthalmological societies to participate in a pilot program that twinned U.S. societies with national Latin American ophthalmological societies.

In March, the “twins” delivered symposia at the XXV Pan American Congress of Ophthalmology in Santiago, Chile. The Congress attracted approximately 3,000 attendees from around the world. Leaders of the Florida society joined their Colombian counterparts to present a joint symposium on the complications of cataract surgery. The audience learned how surgeons in geographically different locations manage similar, difficult problems.

FSO President Michael W. Stewart, MD, who coordinated the program with Colombian society president Juan Guillermo Ortega Jaramillo, MD, led off the symposium by stating his desire to “have a wonderful time learning from one another on what we do differently and take comfort in what we do similarly.” Luis Escaff, MD, Harold Freydell, MD and Felipe Vejarano, MD—all with the Colombian Society—also participated. Other panelists included FSO immediate past-president Gary B. Schemmer, MD, councilor Richard G. Shugarman, MD, and Clifford L. Salinger, MD. 

The FSO joined the state societies from California, Colorado, Hawaii, Michigan, New Mexico, North Carolina, Texas, Utah, Vermont and Washington, D.C., in this first-time twinning effort. Academy international envoy Michael W. Brennan, MD, stated his plans to “evaluate this effort to deliver an international exchange of ideas and improve the program for the XXVI Pan American Congress of Ophthalmology to be held from February 19 to 24, 2006, in Sao Paulo, Brazil. We are pleased with this year’s participation and hope to inspire additional societies to participate in Brazil.”

Who’s in the News

Richard E. Bensinger, MD, voiced his opinion about mandatory eye examinations for children’s eye exams in the Jan. 25 edition of the Sunnyvale Sun in Sunnyvale, Calif.

Russell J. Leavitt, MD, recently spent three weeks on a Mercy Ships floating hospital that was anchored at Monrovia, Liberia. This service work gives him a break from the “things that drive doctors crazy—insurance companies, government regulations and endless paperwork,” reported the March 8 edition of the Mail Tribune, a newspaper in southern Oregon. “It returns one to the reasons that one went into medicine in the first place. It’s just the doctor and the patient and everything else goes away,” he said.

Would prospective patients be interested in attending seminars that featured live surgery? T. Hunter Newsom, MD, thought so, and he built viewing rooms where seniors could watch cataract surgery via closed circuit television, reported the News-Sun, a newspaper in Sebring, Fla. The March 4 article described an afternoon of surgery that was observed by 90 seniors and 30 high school children.

The Las Vegas Sun interviewed Emil A. Stein, MD, for a Feb.18 article about the Southern Nevada Lions new eye care program. “Las Vegas has grown enough to support free eye care for the poor,” he said.

Isam J. Zakhour, MD, discussed trends in cataract surgery in the Feb. 1 edition of the Florence Morning News in Florence, S.C.

People

At the 50th anniversary celebrations of the Madurai Medical College, Madurai, India, Suryanarayanan Nagasubramanian, MBBS, PhD, was honored as a distinguished alumnus and was invited to deliver a guest lecture on “Logic, Science and Philosophy of Medicine.”

At its March 10 meeting, the Palm Beach Ophthalmological Society presented Emanuel Newmark, MD, with its “The Ophthalmologist of the Year” award.

David J. Palmer, MD, was recently appointed a councillor to the Chicago Ophthalmologic Society.

Passages

One of the most influential ophthalmologists of the 20th century died on Feb. 26. J. Donald M. Gass, MD, was 76.

His ability to correlate clinical and pathological findings in diseases of the retina and choroid and to interpret clinicopathologic processes have had an unparalleled contemporary impact on the approach to diagnosis and management of ocular diseases. “Don wrote the book on blinding macular diseases —not just literally, but figuratively,” said Denis M. O’Day, MD. “When he began his work in the early 1960s, the tools he had to work with were primitive or nonexistent, yet he opened up the field so effectively with his discoveries that it became attractive to a whole new cohort of other bright minds, many of whom he trained and who now continue his work.”

Dr. Gass had received many major awards, including the Herman Wacker Prize, the Lucien Howe Medal, the Helen Keller Prize and the Academy Laureate.

 

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