American Academy of Ophthalmology Web Site: www.aao.org
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May 2006

 
Academy Notebook
 
 

What's Happening

2006 Mid-Year Forum

Last month, more than 350 Eye M.D.s gathered in Washington, D.C., to question regulators, legislators and Academy leaders about some of ophthalmology's most critical issues. Topics discussed include:

  • Reimbursement? From SGR to P4P. Although Congress is finally acknowledging that the Sustainable Growth Rate is ultimately an unworkable basis for physician reimbursement, elimination of the formula is viewed by most insiders as too costly. Even rolling back the scheduled fee cuts annually is likely to include pay-for-performance as the price that providers must pay.
  • The Boomers Are Coming! If Congress and employers are reluctant to foot the bill for today's health care, what will happen as the growing health needs of the Baby Boomers cause costs to surge upward?

As chairman of the Academy's Task Force on Eye Care Delivery, Paul P. Lee, MD, JD, has been exploring opportunities for improved delivery of care in the face of mounting pressure to do more for less.

Humphrey J. F. Taylor, Academy public trustee and chairman of The Harris Poll, described key economic, political, demographic and social factors that will shape the future delivery of eye care.

Over the last 10 years, ophthalmologists have already made innovative adjustments in practice, said William L. Rich III, MD, the Academy's medical director of health policy. But they will have to be even more innovative over the next 30 years in order to deal with more patients, new technology and economic pressures.

Michael X. Repka, Academy secretary for Federal Affairs, outlined the statistical picture driving the anticipated spike in patient volume.

David W. Parke II, MD, the Academy's senior secretary for Ophthalmic Practice, urged practices to do more to measure practice productivity, in anticipation of the need for practices to increase capacity. Over the next 18 months, the Academy and AAOE will ask members to begin submitting practice data to a large, central database. This will allow Eye M.D.s to benchmark the productivity of their practice against comparable practices.

  • Quality in the Future. Thomas J. Liesegang, MD, Academy senior secretary for Clinical Education, opened a discussion that covered both surgical training and CMS efforts to determine, and then overcome, barriers to the delivery of quality care.

Thomas R. Russell, MD, the American College of Surgeons' executive director, discussed how surgical skills are taught and the role of wet labs, surgical simulation and apprenticeships in the acquisition of new surgical skills.

Michael Rapp, MD, JD, director of Quality Management at the CMS Office of Clinical Standards and Quality, described a CMS initiative to improve care. The agency has been thinking of itself as a public health agency with the financial leverage to effect changes in medical care delivery.

View the complete Mid-Year Forum Report. To listen to Podcasts from the Mid-Year Forum, listen here.

Advocacy Day
ADVOCACY DAY. Rep. Dan Boren (D-Okla.) welcomed Ann A. Warn, MD, MBA, and John A. Robinson, MD, (right) to his Capitol Hill office. They were among almost 250 Eye M.D.s who rallied in Washington on April 6 to lobby for their patients and their profession.


FYI

Take Part in the Eye Injury Snapshot Project, May 14???€š???‚??“21

Help to put the focus on eye injuries by participating in the Eye Injury Snapshot Project.

Both the Academy and the American Society of Ocular Trauma urge all ophthalmologists, ophthalmology residents and emergency room physicians to report every eye injury treated during the week of May14???€š???‚??“21.

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

Go Online for Spring's Current Insight

Current Insight is an online quarterly that provides concise, clinically based assessments of recent developments in ophthalmology. It is free to Academy members.

Every quarterly edition features nine articles, each covering a different subspecialty, and is published over the course of three months (three articles per month). This month's articles???€š???‚?covering pediatric ophthalmology, glaucoma and retina???€š???‚?will complete the Spring edition.

To read Current Insight's Spring edition, or the previously published Winter edition, visit aaophp.aao.org/current_insight/.

Membership Dues for 2006???€š???‚?A Reminder

Have you paid your 2006 membership dues? The Academy must receive your payment by June 1 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???€š???‚?Ophthalmology and EyeNet Magazine.

To renew your membership, you can pay your dues online at www.aao.org, by phone at 866-561-8558 (toll-free in the United States) or 415-561-8581, or by fax at 415-561-8575.

Register for the MOC Exam Review Course

The MOC Exam Review Course is designed for all Academy members who plan to take the American Board of Ophthalmology's (ABO) MOC examination. 

It can also serve as a useful update of clinical knowledge even for those who aren't taking the September exam. The course's curriculum will be based on the same content used by ABO to develop the exam questions.

The course will take place in the Chicago area, July 21???€š???‚??“23. Online registration closes on June 21.

To learn more, please visit www.aao.org/review_course.

Get Your Ethics CME

In the American Board of Ophthalmology's 10-year MOC cycle, diplomates must obtain an average of 30 Category 1 CME credits per year. Three of those credit hours must be in ethics.

The ABO's ethics requirement is designed to encourage ophthalmologists to recognize and resolve the ethical dilemmas that directly affect patient care. While there are no specific guidelines regarding courses that satisfy the ethics requirement, the course should contain the word ethics in the title or be designated as ethics by the sponsoring organization.

To assist members in completing this often hard-to-fulfill requirement, the Academy's ethics program offers:

  • courses at this year's Joint Meeting in Las Vegas
  • visiting lectures
  • both online and audio courses

For information on the Joint Meeting courses, check the Advance Program, which will be mailed to you in June. For details of the visiting lectures, or to buy courses, visit www.aao.org/member and select Ethics.???€š? Any questions? Please contact Mara Pearse Burke at ethics@aao.org.

AMGA Initiatives on Hypertension and Diabetes Management

The American Medical Group Association has provided 23 grants in support of two initiatives???€š???‚?one focusing on hypertension management and the other on diabetes care???€š???‚?that began in March and will run for 12 months. The grant recipients include medical groups, academic practices and independent practice associations. An additional 14 medical groups have been asked to participate on an unfunded basis.

Participants in the two initiatives will conduct their own quality improvement projects and use bimonthly conference calls to exchange their strategies and experiences.

The ultimate goal for both of these collaborative learning initiatives is to publish a compendium of best practices that can be shared with physician groups nationwide.

For more information, visit www.amga.org.


Academy Products

Help Your Ophthalmic Assistants Get Certified

The fourth edition of Ophthalmic Medical Assisting: An Independent Study Course is a 368-page, full-color book that is packed with practical information for your clinical and office staff.

Two of its chapters are new one covering refractive surgery concepts and procedures and the other focusing on key concepts of practice management and the rest have been updated.

The chapters also have been reorganized to establish a path for learning, with the student moving from concepts of ophthalmic science in the early chapters to practical techniques and office interactions in the later chapters.

Other enhancements include a glossary that incorporates new evidence-based information and ground-breaking technologies.

Successful completion of the accompanying open-book, multiple-choice Exam Booklet fulfills most requirements for the Certified Ophthalmic Assistant examination of the Joint Commission on Allied Health Personnel in Ophthalmology (JCAHPO).

You can buy both the text and the Examination together (#0211206) for $145, the text alone (#0211216) for $105 or the Examination alone (#0211226) for $60.

To buy OMA, visit www.aao.org/store or phone 866-561-8558 (toll-free in the United States) or 415-561-8540.

DVD for Patients Now Covers Multifocal and Accommodative IOLs

The Academy's Understanding Cataract Surgery DVD (#050103) has been updated with a brief discussion of multifocal and accommodative IOLs.

The DVD combines a physician's explanation with animated graphics and patient interviews to help your patients and their families understand what a cataract is and how it can be treated. With this information, they can develop realistic expectations about the surgery.

It costs $180 for members and $232 for nonmembers.

To view clips or to order, visit www.aao.org/store. You also can order by phone at 866-561-8558 (toll-free in the United States) or 415-561-8540.


Washington Report

Pay for Performance Is on the Horizon

With mid-term elections looming in early November, a short legislative year is making the complex debate on Medicare physician reimbursement even more difficult.

Top priorities. Ophthalmology's short-term priorities include derailing the 2007 physician pay cut. Longer-term priorities include reforming a Sustainable Growth Rate formula that, unless fixed, will cause cuts to medicine in each of the next nine years. In addition, with much talk in Congress of pay-for-performance, the Academy has mobilized to produce externally validated performance measures.

Working with the AMA to halt the 2007 pay cut. An AMA-led coalition is pushing to replace the January 2007 pay cut with the 2.8 percent positive update recommended by the Medicare Payment Advisory Committee, an independent panel that advises Congress on Medicare issues. The Academy is working with the coalition on a multistep solution to physician payment problems that will be presented to Congress.

Preparing performance measures. Recognizing that P4P's time has come, the Academy is making every effort to ensure that ophthalmology is ready to compete for financial differentials in a P4P system. Last year, the Academy worked with ophthalmic specialties to develop the first starter set???€š? of eight basic measures. The Academy is now playing a leadership role in the AMA's Physician Consortium for Performance Improvement, which was convened by the AMA to, among other things, identify and develop evidence-based clinical performance measures to enhance quality of patient care and foster accountability.???€š? The Eye Care Workgroup, with the Academy as the lead eye care organization, is developing measures this year on primary open-angle glaucoma, age-related macular degeneration, cataract and diabetic retinopathy.

Getting those measures validated. After using the Consortium's process to refine those measures, the Academy will submit them for validation to the National Quality Forum, a private, nonprofit membership organization that aims to develop a national consensus around healthcare quality measurement. Once the measures are validated, ophthalmology should be well-placed to participate in any P4P system???€š???‚?after all, when the CMS selected the first group of quality measures for its new Physicians Voluntary Reporting Program, it relied heavily on work done by the NQF.

Physician leadership. The Academy is fighting to preserve physician leadership in this process and to prevent multiple sets of quality measures from various private insurers and purchasers.


Meeting Matters

Get Ready to Reserve Your Hotel Room and Register for Las Vegas

2006 Joint Meeting housing and registration will open on the following dates:

  • June 28 for Academy and AAOE members
  • July 12 for nonmembers

Visit the Academy's Web site at www.aao.org to view hotel locations.

Check next month's EyeNet for a map of Las Vegas and a guide to its hotels.

Any questions? E-mail aao06housing@expovision.com or phone 866-774-0487 (toll-free within United States and Canada).

Coming Soon???€š???‚?The 2006 Advance Program

Keep a look out for the 2006 Advance Program, which will be mailed in early June to all Academy and AAOE members. It 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.

Also in June, complete abstract information, the participant index and general meeting information will be posted online at www.aao.org/annual_meeting.

International Attendees

Most visitors to the United States will require a visitor visa upon entry. For visa information and a letter of invitation, visit www.aao.org/annual_meeting and select Visitor Visas???€š? from the left hand navigation.

AAOE Offers Two Saturday Sessions

In addition to more than 100 hours of instruction course programming and 10 hours of select free events, the American Academy of Ophthalmic Executives is offering two Saturday sessions:

  • Strategic Planning for Executives has been designed to help practice administrators and physicians turn the challenges of the future into opportunities. A panel of administrators will evaluate trends, discuss methods to meet the needs of an aging population and help participants to recognize the impact of increased government scrutiny. Owing to the interactive nature of this program, attendance is limited. It includes lunch and takes place from 9:30 a.m. to 3:30 p.m.
  • AAOE Coding Camp will highlight the newest rules and regulations for documentation. With coverage on all subspecialties, participants will learn to code exams, consultations, special testing services and major and minor surgical procedures. It includes a continental breakfast and lunch, and takes place from 8 a.m. to 3:30 p.m.

Both events take place at the Venetian Hotel on Saturday, Nov. 11. Pricing for each events is as follows: earlybird price???€š???‚?$225, starting June 28 for AAOE and Academy members; advance price???€š???‚?$265, starting July 12 for nonmembers; and onsite price???€š???‚?$305.

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

Explore Nevada

With many attractions in and around Las Vegas, the city makes a great home base for a Nevada vacation.

The CCSN Planetarium & Observatory is open for public observing sessions on clear evenings. View the moon, planets, nebulae and star clusters. Educational performances take place on Fridays and Saturdays (www.ccsn.edu/planetarium).

Visit the Southern Nevada Zoological-Botanical Park and say hello to the last family of Barbary Apes in the United States. Or, join a desert ecotour and see ancient American Indian petroglyphs, visit a ghost town or look for extraterrestrial beings at Area 51 (www.lasvegaszoo.com).

The only complete skeleton of a fossilized ichthyosaur was excavated at what is now Berlin-Ichthyosaur State Park. View the remains of this creature, then visit the remains of Union, a mining camp near the ghost town of Berlin (parks.nv.gov/bi.htm).

The Hoover Dam is a National Historic Landmark and one of America's Seven Modern Civil Engineering Wonders. Built during the Depression, this Federal Works Project put thousands of unemployed back to work and was completed in just five years (www.usbr.gov/lc/hooverdam).


Members at Large

From Brazil to Austria U.S. Societies Are Meeting Their Twins???€š?

In the second year of a partnership between the Academy and the Pan American Association of Ophthalmology on a pilot twinning program, five U.S. state ophthalmology societies and one regional subspecialty society were paired with national Latin American societies. The twins???€š? delivered clinical sessions at February's World Ophthalmology Congress (WOC), which had approximately 12,000 attendees from 121 countries and took place in São Paulo, Brazil.

As a leader in the Vermont Ophthalmological Society (VOS), David A. Weinberg, MD, was quick to respond to the opportunity for the VOS to be involved. This provided a great chance to share knowledge and learn from our overseas colleagues,???€š? stated Dr. Weinberg, who coordinated the symposium titled The Modern Age of Ophthalmology with his counterpart from the Paraguayan Ophthalmological Society, Walter Martinez Gill, MD. Dr. Martinez Gill noted that, this twinning opportunity facilitates an exchange of ideas on improving eye care for our patients. The experiences gained from this unique opportunity are certainly rewarding???€š???‚?not only from a scientific standpoint, but from a social and cultural standpoint as well." Joining Drs. Weinberg and Martinez Gill as panelists in the VOS-Paraguayan pairing were Pablo Ciblis, MD, Daniel Sánchez Di Martino, MD, Jack A. Singer, MD, and Edward Wladis, MD.

The state ophthalmology societies of Colorado, Florida, Hawaii and North Carolina were twinned with the national ophthalmology societies of Costa Rica, Colombia, Brazil and Argentina, respectively, to present clinical sessions on a variety of topics at the WOC. In addition, the New England Oculoplastics Society was paired with the Pan American Oculoplastics Society to deliver a symposium entitled Diagnostic and Therapeutic Challenges in Oculoplastics.

The Academy, under the leadership of its international envoy Michael W. Brennan, MD, plans to continue the twinning program by promoting and facilitating clinical sessions at the European Society of Ophthalmology's (SOE) Congress, which will take place in Vienna, Austria, from June 9 to 12, 2007. U.S. state societies and European national societies will be twinned to develop clinical sessions. In addition, the SOE meeting will present an opportunity to expand the twinning effort by scheduling, for example, joint nonclinical sessions involving parallel U.S. and European certification boards, ophthalmology university professors and residency program directors associations. It's exciting to witness the synergy that has developed in the first two years of this effort. From the personal to the scientific, this experience has allowed for a cross-fertilization of ideas and significant social and intellectual opportunities. We hope to continue to improve on this program as we move forward,???€š? said Dr. Brennan.

People

On March 31, three physicians were honored at the Annual Meeting of the Washington Academy of Eye Physicians and Surgeons. Leonard B. Alenick, MD, received the WAEPS Lifetime Achievement Award, Arpenik Avakian, MD, PhD, received the Community Services for the Blind and Partially Sighted's 2006 In Focus Award and George N. Chin, MD, received the WAEPS Outstanding Humanitarian Service Award.

South Carolina Gov. Mark Sanford presented Hal H. Crosswell Jr., MD, with the state's highest civilian honor???€š???‚?the Order of the Palmetto???€š???‚?which is given in recognition of a lifetime of achievement and service to the Palmetto State.???€š? Gov. Sanford, drawing attention to Dr. Croswell's work both in his home state and in remote areas of Haiti, said that the physician had upheld the highest ideals of servant leadership.???€š?

In Oregon, retired ophthalmologist Gordon B. Leitch Jr., MD, is running for governor. He is one of eight candidates on the Republican ticket in the May 18 primary. To learn about his platform, visit www.leitch4govr.com.

Who's in the News

Fox News interviewed Steven V. L. Brown, MD, about the evolution of laser therapy for glaucoma. The news segment was broadcast nationally on Jan. 13 and was rebroadcast on Texas local news in late February.

The New York Times interviewed Eleanor E. Faye, MD, for a March 7 article on patients with low vision. Daily life becomes complicated when they are unable to read their mail, check price tags in stores, read nutritional information on food packages, drive, sew or travel alone,???€š? she said.

Charles E. Lyon, MD, was interviewed about Avastin by The Times, a Shreveport, La., newspaper. Following publication of the Jan. 3 article, the local ABC and CBS affiliates contacted him for news segments on the drug.

"Cases like this make me glad I'm in the profession," said Craig F. McCabe, MD, who was quoted in the March 13 edition of The Daily News Journal. Dr. McCabe was referring to an operation that he performed on an 11-year-old boy who had suffered a full-corneal laceration while playing at soldiers. The ophthalmologist took advantage of the FDA's compassionate-use exception to implant an Ophtec IOL.(The lens hadn't yet received the regulator's approval.) When the eye patch was removed, the boy opened his eye and teared up, saying, Momma, I can see,???€š? reported the Murfreesboro, Tenn., newspaper.