Ophthalmologists Hiring More Support Staff
Trend data from the biennial Academy membership survey1 show that more practices are employing coding specialists, office managers, noncertified medical ophthalmic personnel and Joint Commission on Allied Health Personnel in Ophthalmology–certified ophthalmic medical personnel. “Practicing ophthalmology and managing the business of medicine is increasingly complex,” said Academy Secretary for Member Services Ruth D. Williams, MD. “Ophthalmologists are responding by employing more specialized support staff.”
The percent of ophthalmologists who practice in a group that employs coding or billing clerks has increased from 70 percent of respondents in 2001 to more than 80 percent in 2007. Similar trends are noted for other support services such as practice administrators, secretaries, receptionists and ophthalmic technicians. “Some of this is explained by the growing trend toward larger practices,” said Dr. Williams, “but this overall growth of support staff is noted in practices of all sizes.”
The use of both nurses and opticians in ophthalmic practices has been steady since 2001. About 30 percent of ophthalmologists work in a setting that employs nurses. Half of ophthalmologists surveyed work with an optician in their practice.
Physician assistants are much more likely to work in a practice with six or more ophthalmologists than in a smaller practice.
On average, ophthalmology practices in 2007 employed 4.8 full-time- equivalent staff members. Practices with six or more ophthalmologists have the fewest support staff (average 4.4) per doctor. Practices with two ophthalmologists have the most support staff (average 6.7) per doctor.
1 This survey was sent to 2,200 U.S. practicing members, 854 of whom responded. The sampling error is +/– 3.4 percent. Separate surveys were sent to U.S. members-in-training and international members.
For the Record
On Nov. 12, voting opened for seven positions on the 2008 board of trustees. One month later, voting closed and the results are as follows:
- President-Elect: Michael W. Brennan, MD
- Senior Secretary for Ophthalmic Practice: David A. Durfee, MD
- Secretary for Annual Meeting: Edward J. Holland, MD
- Trustee-at-Large: Christie L. Morse, MD
- Trustee-at-Large: Peter J. Whitted, MD, JD
- Chair, The Council: Martin Wand, MD
- Vice Chair, The Council: Jean E. Ramsey, MD
Visit www.aao.org/elections to see the ratified amendments to the Academy’s bylaws.
Nominations for the Academy Board
By C. P. Wilkinson, MD
As past-president of the Academy, it is my privilege to serve as chairman of the Academy’s nominating committee in 2008. This committee represents a variety of interests within the Academy and is charged with identifying appropriate candidates for the open positions on the 2009 board of trustees.
We are especially interested in cultivating leaders who have a clear vision of the future of organized medicine and who reflect the strength and diversity of our members. The Academy’s leaders should be knowledgeable, experienced and prepared to devote the time and energy required by a large organization in these challenging times. This work is both demanding and rewarding for those interested in helping to assure the Academy’s success and responsiveness to members. With these characteristics in mind, I ask you to assist the committee by suggesting appropriate candidates for the following positions in 2009:
- President-elect (to serve as president in 2010). Because the president-elect automatically becomes president the following year, it is crucial that nominees are individuals who have had leadership experience within the Academy. They also should have demonstrated leadership qualities in clinical practice, in their own ophthalmic communities and in other medical or ophthalmological organizations.
- Senior secretary for advocacy (a three-year term). This senior secretary coordinates the Academy’s programs and activities that are developed through the secretariat for Federal Affairs and the secretariat for State Affairs.
- Trustee-at-large (four-year term). This individual should be an Academy fellow or life fellow who is especially attuned to the needs and expectations of our members. In addition to demonstrating strong leadership potential, as part of the Academy leadership they should be able to represent and articulate to the Academy board the needs and concerns of members.
- Two public trustees (a renewable three-year appointment; an advisor to and member of the board of trustees). The bylaws allow the board to appoint up to three public trustees. We currently are well served by Mr. Humphrey Taylor and Dr. Paul Ginsburg. Mr. Taylor is chairman of Harris Interactive and will complete his fifth term in 2008 and is eligible to be nominated for a sixth term. Dr. Ginsburg, nationally known economist and health policy expert, is president of Center for Studying Health System Change and is serving the second year of his second term. Public trustees do not vote on Academy governance, the budget or other programmatic issues. They do, however, provide insight on how ophthalmology can better work with the rest of medicine, the public, government and industry. A public trustee should not be an ophthalmologist, but should be someone who is familiar with and has a personal interest in current medical issues. The nominating committee will be pleased to receive suggestions for appropriate individuals, which may include physicians from other medical specialties or leaders in industry, government, public policy or advocacy.
Thank you for your interest and participation in this process. Membership participation is vital, not only for the Academy but also for our collective goals to be able to provide appropriate, accessible, affordable eye care to the public. I look forward to receiving your suggestions as we seek to identify the leaders among our members.
Send your confidential suggestions by Feb. 4 to the following address: C. P. Wilkinson, MD, Nominating Committee Chair, American Academy of Ophthalmology, P.O. Box 7424, San Francisco, CA 94120-7424. Suggestions can also be e-mailed to email@example.com or faxed to 415-561-8526.
AAOE Announces Its New Board of Directors
Sandra Farr, CPC, CCS-P, OCS, at the Texas Tech University Health Sciences Center, assumed her one-year term as chairwoman of AAOE this month. Gaye Baker, OCS, has assumed the position of past chairwoman. AAOE also welcomed two new board members—Gregory S. Brinton, MD, MBA, and Dianna L. Seldomridge MD, MBA.
For more information on members of the AAOE board, visit www.aao.org/aaoesite/board_of_directors.cfm.
The Academy Honors Latest Life Members
The physicians below have been members of the Academy for 35 consecutive years. The Academy honors them for their support by granting them “life” status:
Louis J. Antonucci, MD
John G. Apostol, MD
Carl F. Asseff, MD
Arnold Barron, MD
Martin J. Belkowitz, MD
Donald R. Bergsma, MD
Thomas C. Black Jr., MD
David M. Brothers, MD
Harry S. Brown, MD, FACS
Seymour Brownstein, MD
Howard L. Bruckner, MD
William H. Campbell, MD
Stanley Carson, MD
Leverett L. Chapin, MD
Roy Y. S. Chen, MD
Franklin E. Cignetti, MD
Mark M. Cohen, MD
Milam S. Cotten, MD
John R. Crawford III, MD
Andrew A. Dahl, MD
Floyd L. O. Davis, MD
Thomas M. Dixon, MD
Paul A. Dorn Jr., MD
Robert J. Dreher, MD, FACS
Arthur J. Edelstein, MD
David A. Edwards, MD
John R. Elder, MD
James M. Errico, MD
Crayton A. Fargason, MD
Jay L. Federman, MD
Gerald J. Fivian, MD, FACS
Daniel H. Framm, MD
Bartley R. Frueh, MD
Alexander R. Gaudio, MD
Gerald F. Geiger, MD
Stephen P. Ginsberg, MD
Michael H. Goldbaum, MD
Ronald J. Goldman, MD
Fletcher H. Goode, MD
Robert J. Gormley, MD
Maxwell Greenman, MD
Irwin Greenspan, MD
William R. Griffith, MD
John D. Griffiths, MD
Peter P. Gudas, MD
Nickie J. Haddad, MD
Herbert F. Hein, MD
James E. Hulbert, MD
Alfred Hutt, MD
Barry N. Hyman, MD
Ivan R. Jacobs, MD
Dan B. Jones, MD
Yasier Kanawati, MD
Martin B. Kaplan, MD
Ali A. Kashani, MD
Thomas L. Kelly, MD
Yong J. Kim, MD
Don B. Knapp II, MD
Jay H. Krachmer, MD
Allan R. Kunimoto, MD
Joseph Kurstin, MD
Kenneth C. Lafleur, MD
Leon V. Lewis, MD
Suresh R. Limaye, MD
Linferd G. Linabery Jr., MD
Jay I. Lippman, MD
Martin L. Lipson, MD, FACS
Dertad Manguikian, MD
Gene R. Matusow, MD
William E. McCaleb III, MD
John J. McGroarty, MD, FACS
Thomas D. McKinnon, MD
Paul R. McNeer, MD
Glenn A. Meltzer, MD
Armin A. A. Mohr, MD, FACS
Everett A. Moody, MD
Michael A. Naidoff, MD
Aaron L. Nathenson, MD
Clyde A. Newton, MD
Thomas O. Nicklas, MD
Thomas J. Panichella, MD
Stephen J. Poor III, MD
John T. Ramsell, MD
Silas C. Read Jr., MD
Frank H. Reuling Jr., MD
Stuart A. Rosenthal, MD
Paris E. Royo, MD, FACS
Lawrence E. Sadowski, MD
Arnauld F. Scafidi, MD
Ronald L. Seeley, MD
Joseph Shalev, MD
Jerry A. Shields, MD
John P. Shock Jr., MD
Richard G. Shugarman, MD, FACS
Sheldon Singal, MD
Matthew Sloan, MD
Joseph Snyder, MD
John B. Sohocki II, MD
Louis M. Spencer, MD
Mervyn R. Stein, MD
Richard M. Susel, MD
Stanley D. Swinton, MD
T. Ramsey Thorp, MD
Andrea Cibis Tongue, MD
Michael P. Tragakis, MD
Henry L. Trattler, MD
Henry Y. Upton, MD
Elizabeth R. Vaughan, MD
Spero Vozeolas, MD
Neil D. Wainwright, MD
Harold L. Waldman, MD
A. Alan Weber, MD
Ruth H. Weichsel, MD
Paul E. Wittke, MD
Larry W. Wood, MD
Wilfred W. Yeargan, MD
Bijan Youssefi, MD
James P. Znajda, MD
International Ophthalmologist Education Award
The Academy is pleased to announce the recipients of the International Ophthalmologist Education Award for 2007. This award acknowledges Academy members who have demonstrated their commitment to staying current with advances in medicine through participation in CME and professional development activities.
Martin H. Devoto, MD (Argentina)
Jeffrey D. Chambers, MD, FRCSC (Canada)
Patrick Saurel, MD (Canada)
Joao F. Lopes, MD (Chile)
Vatche D. Der Garabedian, MD (Greece)
Sanjoy Chowdhury, MBBS (India)
Ajit G. Kulkarni, MBBS (India)
Raja Narayanan, MD (India)
Naji E. Waked, MD (Lebanon)
Branislav M. Djurovic, MD, PhD (Serbia)
Romero P. Aroca, MD (Spain)
Birkan Can, MD (Switzer- land)
Chieh-Chih Tsai, MD (Taiwan)
J. Fernando Arevalo, MD, FACS (Venezuela)
The award is open to all international members not currently enrolled in a training program. To receive this award, members must obtain 90 CME credits within three years after applying for the award.
To apply, visit www.aao.org/international.
|ETHICS IN ACTION: Procedures for Academy Investigations |
Although the Ethics Committee has been active since 1984, many Academy members are unfamiliar with an important function of the Committee—the investigation of allegations of noncompliance with the Academy’s Code of Ethics. The following summary describes how challenges under the Code are managed from their receipt to final adjudication, with an emphasis on the detailed process that has been designed to eliminate nonmeritorious challenges, to assure due process for potentially meritorious cases, and to assure that a just outcome is based on the facts and circumstances of a particular case. It will also become apparent that the Ethics Committee has clearly limited powers, and is answerable to the Board of Trustees in all matters potentially resulting in disciplinary action.
INQUIRY BASICS The Ethics Committee receives approximately 100 submissions per year. About a third of these are “inquiries,” requiring an informal or formal advisory opinion on a particular topic, and do not involve allegations of a violation of the Code of Ethics. The remainder are formal challenges, in which a challenger alleges that an Academy member has violated one or more Rules of the Code of Ethics. (The Code can be viewed at www.aao.org/about/ethics/code_ethics.cfm)
The challenger may be another Academy member or any member of the public, such as a patient. The identity of the challenger must be made known to the person who is the subject of the challenge, except for challenges about public domain materials such as advertising, in which case the challenger may remain anonymous. A series of rigorous deliberations then assess the allegation:
- A challenge is initially reviewed to determine whether it is actionable under a specific Rule of the Code, and for apparent merit. At the discretion of the committee chair, cases that are frivolous or inconsequential or that contain insufficient information are rejected, and only the remainder that appear to be potentially valid under the Code are investigated. In cases of potentially serious violations of the Code that might result in adverse action being recommended to the Board of Trustees after an adjudicative hearing, the decision to proceed with a formal investigation is based on a majority decision of the Ethics Committee with the assistance of legal counsel.
- Any member of the Ethics Committee who practices in the same general location as the subject of the challenge, or who has a conflict of interest, is excused from any participation in the investigation or resolution of the challenge.
- To initiate an investigation, the member is informed of the exact nature of the challenge and is invited to reply.
- In many cases, the initial response satisfies the Committee that a violation of the Code did not occur, and the case is closed. If the initial response does not resolve the matter, the investigation typically continues by additional correspondence, telephone interviews and examination of medical records, and occasionally through reviews by volunteer members who have special expertise and who agree to a pledge of confidentiality.
Notice of a challenge is in no manner a finding of wrongdoing, but only communication of a potentially actionable challenge to the member. Once a letter of investigation is received, however, cooperation becomes mandatory. All ophthalmologists who are fellows or members of the Academy in any class of membership are required to comply with these administrative procedures; failure to cooperate with the Ethics Committee or the Board of Trustees in a proceeding on a challenge may be considered by the Committee and by the Board of Trustees according to the same procedures and with the same sanctions as failure to observe the Rules of Ethics.
- The Ethics Committee’s jurisdiction includes only fellows and members of the Academy. Resignation of membership during an ethics investigation results in the challenge being dismissed and the record being sealed. A fellow or member who resigns during the pendency of an ethics proceeding may not reapply for membership in any class. A member resignation does not result in a report to the National Practitioner Data Bank and may or may not be reported to the membership at the Board of Trustees’ discretion.
- If an ethics challenge cannot be resolved through correspondence and the other forms of communication, the member is entitled to an adjudicative hearing, or an alternative disposition in lieu of a hearing. The latter consists of a voluntary settlement specifying that a Rule of the Code was violated, a pledge that the violation will not continue or recur and an appropriate sanction. Although available sanctions include private and public reprimand, suspension or permanent termination of Academy membership, usually alternative dispositions are accepted when lesser sanctions are appropriate. Hearings have been few in number and are generally reserved for more egregious or significant allegations of violation of the Code.
- Hearings are conducted by a panel of Committee members with at least 30 days written notice to the challenged member of the date, time and place of the hearing. Hearings are held in locations of maximal convenience for all of those involved and, if patients will be present at the hearing as witnesses, then the hearing is always held in their hometown.
- The individual who is being challenged usually elects to be represented by legal counsel. Both sides may call witnesses, and a transcript is made, which then becomes part of the record of the investigation of the challenge, and it may be used in Board of Trustees’ review and appeals. Continuances may be granted for cause (e.g., if additional evidence is determined to be potentially helpful but is not immediately available).
- The Committee’s experience to date has been that the challenged member often convinces the panel that there has been no violation. In the event that there is a finding of a violation of the Code of Ethics, the individual who is the subject of the challenge is notified of the finding, and the Ethics Committee recommends whether the Board of Trustees should make a determination that the fellow or member who is the subject of the challenge has failed to observe the Rules of the Code of Ethics. The Committee also recommends imposition by the Board of Trustees of an appropriate sanction. The Board of Trustees may accept, reject or modify the Committee’s recommendations. If the Board of Trustees agrees with the Ethics Committee’s finding and approves a sanction, the fellow or member is notified of the determination and the sanctions.
- Perhaps surprisingly, the process is not yet final—the fellow or member is then entitled to appeal the outcome. If the fellow or member elects to appeal, an appellate body composed of fellows or members of the Academy who did not participate in the Ethics Committee’s investigation or in the Board of Trustees’ determination is convened by the Board of Trustees. The appellate body is charged with providing an objective review of the original challenge, investigation and recommendation of the Ethics Committee and the determination of the Board of Trustees, but not, however, the sanction imposed, within a 90-day time frame. At this point, the outcome is final, and the challenger is again notified of the outcome, and the sanctions are imposed and may, at the Board of Trustees’ discretion, be made public.
THE VALUE OF RESPECT FOR THE PROCESS Once a finding is officially made public or becomes known by other means, it is common for colleagues to formulate their own opinions of whether or not justice was served. Because the process is confidential, such judgments are invariably made by those unfamiliar with all of the specific facts and circumstances: Despite good intentions, they may be grossly inaccurate and unfair to the challenger and possibly others who participated in the process as witnesses.
The investigation of potential violations of the Code is confidential and is therefore largely unseen by the Academy membership. It is also exhaustive and potentially lengthy, and can be frustrating to participants on both sides of the allegation. In return, however, the Academy maximally protects the rights of its fellows and members who are accused of unethical behavior and gives all parties maximum confidence in the justice of the outcome. The process helps maintain standards of professionalism among the fellows and members of the Academy and ophthalmology’s credibility in the eyes of the public.
—Charles M. Zacks, MD
Seeking Outstanding Humanitarians
Would you like to nominate a colleague for this year’s Outstanding Humanitarian Service Award? The Academy must receive your nomination by March 14.
The award recognizes Academy fellows and members for outstanding contributions to humanitarian efforts, such as participation in charitable activities, care of the indigent and involvement in community service. It acknowledges those who have performed above and beyond the normal duties of an ophthalmologist.
To obtain a nomination form, please contact Member Services by phone, 866-561-8558 (toll-free in the United States) or 415-561-8581, by fax, 415-561-8575, or by e-mail, member_services@ aao.org. You can also complete a nomination form online: Go to www.aao.org, select “Member Services” and then “Awards.”
Renew Your Academy Membership for 2008
By now you should have received your membership renewal packet in the mail. Renew immediately so you can continue to take full advantage of all the benefits of Academy membership. To ensure uninterrupted benefits, your Academy membership dues must be paid by June 1.
To renew your membership online, please visit www.aao.org/member/paydues. You can also renew by mail, fax or phone, as specified in your renewal packet.
If you have any questions, please contact Member Services by phone, 866-561-8558 (toll-free in the United States) or 415-561-8581, by fax, 415-561-8575, or by e-mail, firstname.lastname@example.org .
Need Coding Advice? Codequest Experts Are on the Road
Get up to speed on the trickiest of coding conundrums by attending a Codequest seminar.
Designed specifically for the ophthalmology practice and sponsored by AAOE and your state or subspecialty society, these Codequest seminars are scheduled to take place throughout the United States. They offer a comprehensive review of the most clinically relevant information in all practice emphasis areas.
For a list of seminars, visit www.aao.org/aaoesite/promo/coding/codequest.cfm.
Get Savvy to the Latest Coding Changes
Use the American Academy of Ophthalmic Executives’ newest coding resources to get up to speed in 2008. The 2008 Ophthalmic Coding Coach and Ophthalmic Coding Coach CD-ROM are comprehensive coding references with detailed content on each CPT code affecting ophthalmology. Each is priced separately at $195 for members and $263 for nonmembers.
Buy the book and CD-ROM together and save 30 percent. This Ophthalmic Coding Coach Kit is priced at $275 for members and $368 for nonmembers.
To 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.
Focal Points 2008: Online and in Print
The 2008 print version of the Academy’s Focal Points CME program features 12 modules on hot clinical topics. Combining the latest research findings with concise clinical discussions on diagnosis and treatment of a specific disease or condition, every module also includes the popular “Clinicians’ Corner”—an experts’ forum on controversial clinical issues discussed in the module.
Purchase of the print version includes access to Focal Points Online, which features video clips and direct links to online references. Subscribers also have the option of receiving only the online version at a reduced price. While the print modules will be mailed in four quarterly packets, online modules for the first time will be published monthly, beginning this month. Both versions have been completely redesigned for ease of use.
This year’s module titles include:
- Wavefront-Guided LASIK
- Management of Astigmatism in Lens-Based Surgery
- Evidence-Based Medicine in Glaucoma: Clinical Trials Update
- Advances in Lamellar Corneal Surgery
- Neuro-Ophthalmologic Emergencies
- Current Options for Retinal Detachment Repair
- Current Trends and Challenges in Glaucoma Care
- Managing Accommodative Esotropia Patients and Their Parents
- Necrotizing Herpetic Retinopathies
- Retinal Pharmacotherapy: Targeting Ocular Neovascularization
- Herpetic Corneal Infections
- Preseptal and Orbital Cellulitis
Sample module. For a free sample of a past module, visit www.aao.org/focalpoints.
CME, Earn up to two AMA PRA Category 1 credits per module for a maximum of 24 credits per subscription.
Cost. A one-year subscription for the combined print/online package is $175 for members and $235 for nonmembers. The online version alone is $145 for members and $195 for nonmembers.
To order a 2008 subscription, visit www.aao.org/focalpoints points or phone the Academy Service Center at 866-561-8558 (toll-free in the United States) or 415-561-8540.
Atlanta Welcomes Back the Academy in November
The Academy’s 2008 Joint Meeting with the European Society of Ophthalmology (SOE) will take place Nov. 8–11 at the Georgia World Congress Center in Atlanta. It will be preceded by the Academy’s Subspecialty Day, Nov. 7–8, which will feature meetings in refractive surgery, retina, glaucoma, uveitis and pediatric ophthalmology.
For updates on the Joint Meeting, visit www.aao.org/2008.
Submit Abstracts for Papers, Posters and Videos
If you are interested in being a presenter at this year’s Joint Meeting, abstracts must be submitted online:
- For Instruction Courses and Skills Transfer Courses, the online submitter closes on Jan. 8.
- For papers, posters and videos, the online submitter opens on March 12 and closes on April 8.
- If you plan to submit a video abstract, the deadline to submit the actual video is April 25.
- Be sure to download the guidelines before making your submission.
For information on submitting an abstract, visit www.aao.org/2008, select “Scientific Program” and “Presenter Central.” For further information, e-mail email@example.com or phone 415-447-0343.
|Registration Opens Soon for the ISRS/AAO Cancún 2008 Meeting |
Join ISRS/AAO for the 2008 meeting, Refractive and Cataract Surgery: Today and Tomorrow, at Fiesta Americana Grand Coral Beach in Cancún, May 29–31.
This fourth annual regional meeting is in partnership with the Asociación Latina de Cirugía de Catarata Refractiva y Segmento Anterior and the Centro Mexicano de Cornea y Cirugía Refractiva. Program directors Ramon Naranjo-Tackman, MD, José Manuel Vargas, MD, and Steven E. Wilson, MD, are planning a program on the latest innovations in refractive and cataract surgery.
The deadline to submit abstracts for e-papers is Jan. 31. Preregistration will be open from Jan. 23 to April 16.
For more information, visit www.isrs.org/cancun.
Claim Your 2007 New Orleans CME Credits by Jan. 23
The CME credits that you earned at the 2007 Annual Meeting and/or Subspecialty Day must be reported by Jan. 23.
As a service to members only, the Academy maintains a transcript of Academy-sponsored CME credits earned, provided the member reports those credits to the Academy. Members may also report credits earned through other CME providers so that a record of all CME credits earned is available on a single transcript.
To report your CME, go to www.aao.org/cme.
Enjoy Highlights of the 2007 Annual Meeting in New Orleans
If you missed a particular session from the 2007 Subspecialty Day or Annual Meeting, you can still catch up on the following highlights.
- Go online for Scientific Posters. View hundreds of scientific posters from 2007 and other past Annual Meetings for free.
- Download individual audio sessions in MP3 format. Review a New Orleans presentation by purchasing an MP3 from the archives; or order a CD-ROM.
- Buy a New Orleans DVD-ROM. Five DVD-ROMs cover the Subspecialty Day programs—Cornea 2007: Contemporary and Future Issues; Glaucoma 2007: Achieving Balance; Neuro-Ophthalmology 2007: Practical Approaches to Common Clinical Scenarios; Refractive Surgery 2007: What a Wonderful World; and Retina 2007: A View to the Future. DVDs are also available for Spotlight on Cataracts 2007 and select LEO sessions.
- Download course handouts. Handouts from 2007 Instruction Courses are available to download in PDF format.
To take advantage of these highlights and more past Annual Meetings and Subspecialty Days, select “Scientific Program” and “Meeting Archive” at www.aao.org/2008.
Best Papers was a new designation at last November’s Annual Meeting in New Orleans. At the conclusion of each Free Papers session, the panel members conferred and selected the paper they considered the best of the group.
Sunday’s Best Papers were:
- Cataract. Postoperative Optic Opacification of Silicone IOLs: Analyses of 20 Explants, presented by Liliana Werner, MD, PhD (Event Code PA006)
- Glaucoma. Randomized Trial on Early Phaco vs. Laser Peripheral Iridotomy to Prevent IOP Rise After Acute Primary Angle Closure: 18-Month Results, presented by Dexter Yu-lung Leung, MBChB (PA013)
Monday’s Best Papers were:
- Cornea Session 1. Prospective Study of Pterygium Extended Removal Followed by Extended Conjunctival Transplant to Evaluate Efficacy and Safety, presented by Lawrence W. Hirst, MD, MBBS (PA031)
- Cornea Session 2. A New Glide Insertion Technique for Descemet-Stripping Automated Endothelial Keratoplasty, presented by Donald Tan, MD, FRCS, FRCOphth (PA021)
- Glaucoma. Assessing the Safety of Trabeculectomy Among Elderly Americans, presented by Joshua D. Stein, MD, MS (PA075)
- Orbit, Lacrimal, Plastic Surgery. Orbital Lymphoproliferative Tumors: Analysis of Clinical Features and Systemic Involvement in 160 Cases, presented by Hakan Demirci, MD (PA072)
- Ocular Tumors and Pathology. Prospective Phase IV/II Clinical Trial to Evaluate the Efficacy of Photodynamic Therapy for Symptomatic Circumscribed Choroidal Hemangioma, presented by Anna Boixadera, MD (PA067)
- Pediatric Ophthalmology. Telemedical Retinopathy of Prematurity Diagnosis: Intraphysician Agreement Between Ophthalmoscopic and Image-Based Examinations, presented by Michael F. Chiang, MD (PA050)
- Neuro-Ophthalmology. Visual Function After Optic Neuritis: Final Follow-Up of the Optic Neuritis Treatment Trial, presented by David I. Kaufman, DO (PA038)
- Refractive Surgery. Risk Assessment for Ectasia After LASIK, presented by J. Bradley Randleman, MD (PA044)
- Retina. Tachyphylaxis of Intravitreal Anti-Vascular Endothelial Growth Factor Pharmacotherapy, presented by Shlomit Schaal, MD (PA061)
Tuesday’s Best Papers were:
- Refractive Surgery Session 1. Prospective Comparison of Night Driving Performance After Wavefront-Guided and Conventional LASIK for Moderate Myopia, presented by Steven C. Schallhorn, MD (PA093)
- Refractive Surgery Session 2. Ten-Year Follow-Up of PRK for High Myopia, presented by Orkun Muftuoglu, MD (PA098)
- Retina Session 1. Treatment of Macular Edema Following Central Retinal Vein Occlusion With Pegaptanib Sodium (Macugen): A One-Year Study, presented by Thomas A. Ciulla, MD (PA085)
- Retina Session 2. Autologous Transplantation of Bruch Membrane-Attached Retinal Pigment Epithelium for Exudative AMD, presented by Zhizhong Ma, MD (PA088)
To view the Best Papers abstracts, go to www.aao.org/meetings, click “Annual Meeting,” “Scientific Program” and “2007 Online Program,” and type in the paper’s Event Code.
Members At Large
Academy and PAAO Leadership Participants Meet
“It was a fantastic interchange of ideas and projects between the Latin American and U.S. Eye M.D.s,” noted Daniel J. Briceland, MD, director of the Academy’s Leadership Development Program (LDP), when speaking of the joint orientation session of the Academy’s and the Pan American Association of Ophthalmology’s (PAAO) incoming LDP and Curso de Liderazgo classes.
The orientation session, held Nov. 10 in conjunction with the Annual Meeting in New Orleans, served to welcome the incoming classes and introduce them to Academy and PAAO leaders, while also providing an opportunity for the new students to hear from participants of the graduating LDP and Curso classes regarding the projects they worked on over the course of their yearlong programs.
Among the Curso project presenters was Alexandre C. Taleb, MD, who was nominated to participate in PAAO’s 2006–2007 Curso de Liderazgo by the Brazilian Council of Ophthalmology.
Dr. Taleb presented the threefold purpose of his project: to organize and host the II Ocular Health National Forum in the Brazilian Chamber of Deputies during the XXXIV Brazilian Congress of Ophthalmology in Brasilia in September 2007; to create a human graphic—called the “Eye Hug”—with Brazilian ophthalmologists in front of the Three Power’s Square in Brasilia, where Brazilian legislative, executive and judiciary bodies are located (see photo page 67); and to write a Report on Ocular Health Status in Brazil to improve data to support ophthalmology advocacy actions.
The report was developed, with more than 5,000 copies freely distributed during the Brazilian Congress of Ophthalmology and to all congress members, as well as to government and ministry of health technicians.
State Affairs Awards
In recognition of the ongoing challenges Eye M.D.s are having with finding and training technician staff, the Ohio Ophthalmological Society (OOS) established its Ophthalmic Technician Training School to provide classroom instruction for technicians taking a home study course. The pilot program in Columbus received great feedback, and OOS hopes to expand it across the state in other cities. “The Academy’s secretariat for State Affairs commends the OOS and its leadership for this innovative approach to this practice management issue,” said Academy Secretary for State Affairs Cynthia A. Bradford, MD.
The secretariat for State Affairs selected the OOS as a 2007 State Affairs Star Award recipient for its work on the Ophthalmic Technician Training School.
Three other societies also received the State Affairs Star Award for their outstanding programs and were recognized during the Annual Meeting:
- Connecticut Society of Eye Physicians for its effort that led to passage of a bill concerning medical liability reporting for optometrists.
- Minnesota Academy of Ophthalmology for its Stop Optometric Surgery Fund, an emergency monetary reserve specifically designed to oppose any scope of practice legislation that would allow optometric surgery within the state of Minnesota.
- Washington D.C. Metropolitan Ophthalmological Society for its successful membership drive, wherein the society nearly doubled its membership by creating new member benefits, and for improving its scientific programs.
Ellen R. Strahlman, MD, MHSc, has been named vice president of worldwide business development at Pfizer. Dr. Strahlman is a graduate of Harvard University, The Johns Hopkins School of Medicine, where she received her MD, and The Bloomberg School of Public Health at Johns Hopkins, where she received her MHSc. An active Academy member, she is also a member of the Academy Foundation’s advisory board.
The Association of American Medical Colleges has honored M. Roy Wilson, MD, with the Herbert W. Nickens Award. Dr. Wilson is chancellor of the University of Colorado, Denver and chairman of the board for the University of Colorado Hospital, and he has conducted a breadth of research on glaucoma and minorities.
Pressure for Physician Accountability
Two years ago the Centers for Medicare and Medicaid Services (CMS) initiated the Physician Voluntary Reporting Program in an effort to improve the quality of care beneficiaries receive. CMS has a long history of implementing quality initiatives, and it recently documented positive results from hospital quality reporting.
PQRI update. Congress established a 1.5 percent Medicare bonus for physicians who voluntarily chose to participate in CMS’ 2007 Physician Quality Reporting Initiative from July 1 through Dec. 31, 2007. Nearly 60 percent of Academy members participated in this pilot program. The goal of the Academy’s efforts remains providing ophthalmologists with a way to participate in the bonus program should they choose to. In anticipation of continuation of the program, the Academy worked with ophthalmic subspecialties through the AMA Physician Consortium for Performance Improvement to create six qualified eye care measures. The Academy has also joined with the AMA, American College of Surgeons and others to ensure that these quality-reporting efforts remain voluntary and use measures that are evidence-based and are developed by physician organizations.
Pressure for performance measures. Owing to rising health care costs, employers and consumers have been putting pressure on physicians, payers and the health care system to provide information that differentiates physicians on their quality of care. In addition, policy makers support moving to a pay-for-performance (P4P) system that rewards physicians on quality, not solely on quantity. CMS is currently working to create a data “value exchange” to collect and share information about physicians, which it expects would lead to an improvement in the quality and cost of available health care. Grants and other support will be provided to community health groups that form to review physician-level performance measurement results from Medicare and private insurers.
Looking toward the future. Physicians are rightly skeptical of such P4P programs after experiencing ranking by private plans that couldn’t differentiate between specialist and subspecialist, or between patient severity-of-illness issues. The jury is still out on whether physician quality reporting programs will have a positive impact on medicine and patient outcomes. The Academy’s task force on P4P implementation is at the table to make certain that ophthalmologists are heard and that any future programs don’t repeat the mistakes of past programs.
Challenges related to data accuracy and severity-of-illness issues must be overcome to produce fair results in ranking physicians.