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Academy Fights for Children’s Eye Health
The Academy, along with the American Association for Pediatric Ophthalmology and Strabismus, the American Academy of Pediatrics and the American Academy of Family Physicians, is promoting screenings to detect vision problems in children.
New campaign launched. The Academy has recently launched the Visionary Benefit Campaign in an effort to provide the best possible health care for all children. “The Visionary Campaign is a dynamic effort to educate parents, the medical community and legislators about vision screening as a cost-effective way to ensure pediatric eye health,” said Catherine Cohen, Academy vice president for Governmental Affairs. “At a time when policy makers want to cut health care costs, vision screening presents an effective and cost-efficient solution.” The Academy has developed a tool kit to engage state Eye M.D. societies and campaign partners in the fight to increase vision screening and help them to reach out to target audiences. The campaign also includes two print ads: one directed at parenting magazines and the other to medical publications.
Campaigning in the states. The Academy is urging state legislatures to pass vision screening bills that would identify children who need full eye exams and call for federal funding to enhance state screening initiatives. “Our goal is to establish an effective system to screen children before they enter school and in targeted grades to identify and treat vision problems before they have a lasting impact on their lives,” said Michael X. Repka, MD, president of AAPOS. “We also want to clear up the misinformation that optometry has been spreading that comprehensive eye exams are the only effective manner to detect eye problems.”
State legislation. Since 2000, Connecticut, Massachusetts, Rhode Island, Wisconsin, Nebraska and Arkansas have enacted children’s vision screening bills. In addition, Mississippi, Oklahoma and California have all recently introduced vision screening legislation. And in North Carolina, the state superior court recently acted to halt a law requiring mandatory eye exams for kindergarteners. The Academy, the North Carolina Society of Eye Physicians and Surgeons and a coalition of education and medical groups are calling on the state’s General Assembly to repeal the law when it reconvenes later this year.
Campaigning on Capitol Hill. At the federal level, the Academy worked with Reps. Vito Fossella (R–N.Y.) and Sue Kelly (R–N.Y.) to introduce the “Children’s Access to Vision Care Act” (H.R. 2328). This bill complements efforts at the state level by providing $75 million in grants to states to fund comprehensive eye exams for children who have been identified as having an eye disorder. The bill also funds both treatment to correct the vision problem and development and distribution of educational materials.
How Long Do Your Patients Wait for Exams and Surgery?
The number of days that a patient must wait for a routine eye exam is one indicator of workforce supply and demand. A survey of Academy members found that the average wait-time for patients to get a routine appointment—measured as time elapsed from their phone call to their office visit—is about two weeks (mean is 13.8 days; median seven days).¹ The time that elapses from when the patient calls with a non-emergent eye problem to when they are seen is about a week (mean is seven days; median three days). “Younger ophthalmologists provide the shortest wait-times,” reported Academy Secretary for Member Services Ruth D. Williams, MD, “and this makes sense for our members who are still building a practice.”
For routine appointments, general ophthalmologists tend to have a larger backlog: mean wait-time is 15.4 days for a new patient; 13.7 for an established patient. Ophthalmologists who practice general ophthalmology with a subspecialty interest have a mean wait-time of 12.7 days for a new patient; 12.3 for an established patient. Subspecialists, who practice their subspecialty at least 91 percent of their time, have a mean wait-time of 11.8 days for a new patient; 14.9 days for an established patient.
Patients also experience variable wait-times from when the surgery is recommended to when it is performed. On average, non-emergent eye surgery occurs a mean of 18.56 days (median 14 days) after it is deemed necessary. The largest ophthalmology practices, those with more than 650 patient visits per week, have the longest wait-times for surgery—a mean of 23 days (median 21 days).
1 This survey was sent out to a large sample of Academy members last year and EyeNet has been publishing its results since the November/December issue. See www.eyenetmagazine.org/archives for those highlights.
What’s New With BCSC 2006–2007
The new edition of the Basic and Clinical Science Course will be published this month.
Ten volumes have undergone minor updates and three have undergone major revisions:
- Section 1: Update on General Medicine (Product #0280016) informs ophthalmologists about the medical conditions most likely to affect their patients, such as infectious, metabolic and cardiovascular diseases; cancer; and rheumatologic disorders. It includes a discussion of geriatrics and an extensively revised chapter on statistics. It also contains numerous updated references as well as helpful tables listing the names, indications and side effects of antibiotic, antihypertensive and anticancer drugs.
- Section 6: Pediatric Ophthalmology and Strabismus (#0280066) introduces strabismus with discussions of extraocular muscle anatomy and motor and sensory physiology. It examines the clinical features, diagnosis and treatment of eso- and exodeviations, horizontal and vertical deviations, nystagmus and amblyopia. It covers the full range of pediatric ocular disorders, including those related to craniofacial malformations. It also features a chapter on establishing rapport with children during an ocular exam.
- Section 8: External Disease and Cornea (#0280086) explores the basic and clinical concepts of corneal and external eye disease. It covers ocular surface disorders and surgery of the ocular surface, infectious diseases, immune-mediated and neoplastic disorders, congenital anomalies of the cornea and sclera, and dystrophies and degenerations. It also discusses toxic and traumatic injuries as well as corneal transplantation.
Order the complete set. An order for the complete set of BCSC includes 13 print volumes plus the Master Index. You also have the option of including a companion book for an additional cost. There are two companion books to choose from: International Ophthalmology or The Profession of Ophthalmology: Practice Management, Ethics, and Advocacy.
CD-ROM. The 2006–2007 BCSC series is also available on CD-ROM, which offers the same content as the 13 print sections, including more than 5,000 pages and 3,000 images. The CD-ROM features a conveniently searchable format and the ability to highlight text, write notes and bookmark important sections.
CME. Each of the 13 BCSC volumes provides up to either 30 or 40 AMA PRA Category 1 CME credits. CME credit is also offered for the CD-ROM.
To place an order or find out about pricing information, visit www.aao.org/bcsc or phone the Academy Service Center at 866-561-8558 (toll-free in the United States) or 415-561-8540.
Basic Principles of Ophthalmic Surgery
In 2003, a group of ophthalmology residency program directors determined that there was a great need for a book covering essential principles in ophthalmic surgery.
As a result, Anthony C. Arnold, MD, headed a team of 25 leading ophthalmology educators to produce Basic Principles of Ophthalmic Surgery (Product #0283001).
- Part I covers patient selection and describes how patients and surgeons should prepare for surgery.
- Part II discusses surgical instrumentation and materials, including loupes, microscopes, instruments, blades, suture materials and needles.
- Part III thoroughly reviews seven specific aspects of surgery. These range from aseptic technique to ophthalmic anesthesia to wound construction.
- The final section is devoted to postoperative considerations: dressings, the healing process and postoperative management.
The book includes more than 200 photographs and illustrations.
The volume costs $69 for Academy members ($99 for nonmembers).
To place an order, visit www.aao.org/store or phone the Academy Service Center at 866-561-8558 (toll-free in the United States) or 415-561-8540.
Do You Have What It Takes?
With the midterm elections just five months away, the role of a congressional advocate is becoming increasingly important. The Academy’s Congressional Advocacy Program is looking for Eye M.D.s to serve as key contacts for every legislator on Capitol Hill. These ophthalmologists play a critical role in educating lawmakers about issues of importance to ophthalmology.
As a congressional advocate, you would be responsible for:
- establishing a direct, personal relationship with your elected federal officials,
- representing the views of ophthalmology and
- being aware of any pending federal legislation that might impact ophthalmology, and then being prepared to discuss its impact with legislators.
Are your legislators covered? There are currently 80 federal legislators from 32 states who still need a Congressional Advocate. To find out how to get involved, visit www.aao.org/advocacy/action/need_advocate.cfm.
Members at Large
Miss America Joins Alabama Eye M.D.s on Pediatric Task Force
Next month, Deirdre Downs, is due to start medical school at the University of Alabama, Birmingham. Although she has several years to go before she starts practice, she hopes to have a more immediate impact on eye health by leveraging her status as Miss America 2005.
In March, Ms. Downs met with leaders of the Alabama Academy of Ophthalmology (ALAO) to discuss kids’ eye health. She will serve with several ALAO members on a children’s eye task force that will report to the Alabama Legislature in 2007.
Wonsuck Kim, DO, ALAO president, said, “We are pleased that representatives from both the ALAO and the American Academy of Ophthalmology are working with Ms. Downs to formulate a plan whereby she will promote pediatric eye issues at both the state and national levels.”
Former U.S. Representative John C. Cooksey, MD, has been named to the Louisiana State Medical Society’s Hall of Fame. Early in his career, Dr. Cooksey spearheaded a movement that led to Louisiana placing a cap on limited liability in lawsuits against physicians and other health care providers.
In Arkansas, Gov. Mike Huckabee appointed Robert D. Lowery, MD, to the state’s Commission on Eye and Vision Care of School Age Children.
On April 28, the Academy of Medicine of Cleveland/ Northern Ohio Medical Association presented its Outstanding Service Award to Thomas L. Steinemann, MD, for his advocacy efforts against the nonprescription sale of decorative contact lenses—a practice that was resulting in serious eye injuries. (Legislation passed last October now regulates all contact lenses as medical devices regardless of their intended use.)
Oregon Health & Science University has named David J. Wilson, MD, chairman of the ophthalmology department at its medical school.
Who's in the News
If you saw The Wall Street Journal on April 6, you may have recognized David A. Fleishmann, MD, on the front page. The Journal recommended his Web site, www.antiquespectacles.com, which contains more than 2,100 spectacle-related images.
On April 16, The Arizona Daily Star reported that the Tucson branch of the American Diabetes Association had presented Charles S. Gannon, MD, with its Care Award for his service to local diabetes patients.
Should physicians participate in executions? Not according to Alan Nakanishi, MD, a Republican assemblyman in the California Legislature who coauthored a bill that, if passed, would prohibit the state from using licensed physicians in executions. An April 18 article in The San Diego Union-Tribune quoted him as saying, “The one purpose of our profession is to heal. Execution is not a medical task, no matter what method you use.”
An Indiana man enjoyed a remarkable visual recovery after praying to Blessed Mother Guerin, a 19th-century nun who is expected to be canonized as the 8th U.S. saint. The Catholic Church asked Nicholas R. Rader, MD, to review the case, reported The Indianapolis Star on April 29.
In a March 2 article, Chicago newspaper The Star, reported that local Rotarians —including Sriram Sonty, MD—were helping to support an eye hospital in India that performs 4,000 cataracts each year. “People living in rural India get cataracts in their 40s and 50s and it advances fast because farmers are in the sun all day with no sunglasses,” said Dr. Sonty.
Look out for reruns of Miracle Workers, an ABC reality series that has featured two ophthalmologists. In the opening episode, Edward J. Holland, MD, treated a man who had been blind since childhood after an allergic reaction to penicillin. In the fifth episode, Peter Zloty, MD, performed a corneal transplant on an 11-year-old boy who had been blind since birth.