EyeNet Magazine

Academy Notebook

What's Happening 

Ophthalmologists Interested in Seeing More Patients

According to the biennial Academy membership survey,1 56 percent of U.S. ophthalmologists would like to increase their patient load. On average, those ophthalmologists would like to see an increase of 18 percent.

“While perhaps bad news for some individual ophthalmologists, the extra capacity comes as good news for the system as a whole,” said Samuel Masket, MD, who is chairman of an Academy task force that is examining ophthalmologist supply-and-demand patterns. “We will need that capacity to deal with the leading edge of the Baby Boom generation.”

There is, however, significant variation within the population of U.S. ophthalmologists as to how much more work they would like to take on.

Predictably, those U.S. ophthalmologists with five years or fewer in practice were the most likely to want more patients, with 82.7 percent wanting to see more patients. On average, new practitioners wanted to see 33 percent more patients, and 11 percent of this population said they want to effectively double the number of patients that they see.

Perhaps surprisingly, 47 percent of ophthalmologists with 16 or more years of practice experience were also interested in seeing more patients. On average, this group wanted to see 13 percent more patients. “I was a bit surprised that so many seasoned ophthalmologists want to see more patients,” said Academy Secretary for Member Services Ruth D. Williams, MD. “One wonders if retirement concerns, the need to pay for children’s college tuition or general economic uncertainty is driving this.”

In addition, 58.9 percent of women wanted more patients vs. 54.8 percent of men. “Women tend to be newer to practice than men and thus are more likely to want more patients,” said Dr. Williams.

By subspecialty, refractive surgeons were the most likely to want to see more patients, with 75 percent seeking more work. On average, refractive surgeons wanted to see 27 percent more patients. Pediatric ophthalmologists were the least interested in adding new patients, with only 46 percent expressing such a desire.

“With the retirement of the Baby Boomers looming, it will be interesting to see what this survey looks like in a few years,” said Dr. Masket. “This might be a classic case of ‘Be careful what you wish for because you might get it.’”

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.


Academy Publications Earn High Scores in Industry Rankings

Ophthalmology and EyeNet Magazine have both maintained high readership ratings again over the past year. In the 2007 Perq/HCI Media- Chek Eyecare study, Ophthalmology’s high-readership score ranked first among all ophthalmic publications, while EyeNet ranked first among non-peer-reviewed publications.1

These scores reflect how thoroughly and frequently ophthalmologists read these publications.

The Academy is also pleased that its Web site was named first among the most useful research sites by 24 percent of all ophthalmologists surveyed, more than double the responses for PubMed, its nearest competitor.

The data also show the Web site was selected as most useful by those ophthalmologists with a high-volume practice or a surgical practice, as well as those aged 45 and younger.2

1 Perq/HCI Media-Chek Eyecare 2007, Table 101 (www.perq-hci.com).
2 Perq/HCI Media-Chek Eyecare 2007, Table 1403.



Benchmarking Survey Web Conference

On March 12 at 2 p.m. EDT, the American Academy of Ophthalmic Executives will host a free one-hour Web conference to orient members to the benchmarking survey. Topics will include the information needed in order to enter a practice into the survey database, an overview of the submission process and more.

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

Conversations With the Experts Videocasts

These videocasts feature leading Academy members discussing current issues in ophthalmology. Free to Academy members, each update combines an educational discussion featuring today’s top thought leaders.

The conversations posted include:

  • Antiangiogenic Agents for Retinal Vascular Disease
  • Management of the Patient With Non-Neovascular AMD
  • Management and Treatment of AMD and Diabetic Macular Edema
  • Current Concepts in the Treatment of Diabetic Macular Edema
  • Improving Compliance With Glaucoma Therapy
  • Evolving Paradigms in the Management of Neovascular AMD
  • Update in Glaucoma Diagnostics

To view the videocasts, visit www.aao.org/one and click “Educational Content” and “Podcasts/Conversations.” Users can earn 0.25 CME credits per videocast.


Ask the Ethicist: Communications to the Public

This month EyeNet inaugurates a bimonthly “question and answer” column on ethics in the ophthalmic practice. The column will be written by the Academy’s Ethics Committee, which welcomes your participation.

Q: My marketing director published a Yellow Pages ad without my knowledge. The ad attributes to me a level of skill and expertise greater than that of nearby ophthalmologists, and I am unable to substantiate the claims. I have distributed a notice to my patients explaining the ad’s origin and correcting the inaccuracies. What else should I do to mitigate the damage?

A: You appear to understand that you are personally responsible for your marketing materials, even if you did not write them. You have taken a positive first step by notifying your patients of the unsubstantiated claims. Additional steps include placing a clarifying notice in the public areas of your office and printing the notice in the local paper. A final step—and the most important—is to contact your colleagues personally to explain the problem and your subsequent actions. Your prompt public retraction, and your notice to us about potential concerns are commendable, and the former may also mitigate the impact that the advertisement may have on your relationship with your colleagues.

Advertising claims must:

  • be accurate and truthful,
  • be able to be substantiated,
  • not be false, deceptive or misleading,
  • not be deceptive by omission,
  • not appeal to a patient’s anxiety or create unjustified expectations of results,
  • not misrepresent credentials, training, experience or results,
  • identify actors in testimonials, and
  • provide in testimonials only that information about which the average patient is knowledgeable (if testimonials are allowed by state law).

If advertisements fail to meet these standards, they may be brought to the attention of the Ethics Committee as a potential violation of Rule 13 of the Code of Ethics.

For information about communications to the public, visit www.aao.org/about and click “Ethics” and “Advertising.” To submit a question for this column, contact the Ethics Committee staff at ethics@aao.org.


Academy Store 

Animations for Patient Education

Digital-Eyes Ophthalmic Animations for Patients (#050116) offers a collection of more than 40 high-quality animated segments showing and discussing a wide variety of eye anatomy and treatment topics. These videos can be used on your Web site and in your office, and are offered in a variety of formats.

Digital-Eyes Ophthalmic Animations for Patients costs $280 for members and $355 for nonmembers.

Stay on Top of Coding Challenging Cases

Code This Case (#012180) features examples of usual and unusual surgical cases for all subspecialties in ophthalmology and provides appropriate CPT, ICD-9 and HCPCS codes for surgeons, as well as coding for ambulatory surgical centers.

This book also provides excellent examples of operative reports for young ophthalmologists. Code This Case costs $145 for members and $175 for nonmembers.

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 (#012266) and Ophthalmic Coding Coach CD-ROM (#012267) 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 2008 Ophthalmic Coding Coach and Ophthalmic Coding Coach CD-ROM together and save 30 percent. This Ophthalmic Coding Coach Kit (#012268) is priced at $275 for members and $368 for nonmembers.


Meeting Matters 

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 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/moc, click “Scientific Program” and “Presenter Central.” For further information, e-mail meetings@aao.org or phone 415-447-0343.

ISRS/AAO Cancún Registration Deadline Approaching

The advance registration deadline for the ISRS/AAO Cancún meeting is April 16.

This year’s meeting, Refractive and Cataract Surgery: Today and Tomorrow, will take place May 29 to 31 at Fiesta Americana Grand Coral Beach in Cancún.

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.

For more meeting information, visit www.isrs.org/cancun.


Members At Large 

Academy’s Leadership Development Program Ushers in 10th Class

Academy President David W. Parke II, MD, welcomed the 10th class of Leadership De-velopment Program (LDP) participants during a series of interactive sessions from January 18 to 20 in San Francisco.

The LDP was launched in 1998 by the Academy’s Secretariat for State Affairs based on the recommendation of the Council, the Academy’s policy input body. The Council’s State Section leaders were concerned about identifying and grooming potential leaders for state ophthalmology societies and recommended that the Academy implement a leadership development program.

“We had several secretariat meetings where we discussed how best to devise a program to help state societies with the issue of leadership succession planning, and the result has been an award-winning program emulated by other state and national medical societies, as well as by international ophthalmic societies,” said Paul Sternberg Jr., MD, former LDP director and one of the LDP founders.

The LDP X class includes Eye M.D.s nominated by state, subspecialty and specialized interest societies that have representation on the Council, along with one physician from Kuwait, Manal Bouhaimed, MBChB, PhD, who was nominated by the Middle East African Council of Ophthalmology (MEACO). “In addition to the expansion of the program to include representation by subspecialty societies, for the past five years the LDP has had one slot for an international participant. International participants have included Eye M.D.s representing the Pan-American Association of Ophthalmology (PAAO), the European Society of Ophthalmology, the All India Ophthalmological Society, the Asia Pacific Academy of Ophthalmology and now MEACO. This has been a great way to share knowledge globally,” said current LDP director Dan J. Briceland, MD. “Also, the joint sessions our LDP holds with PAAO’s equivalent program—its Curso de Liderazgo—are invaluable for information exchange.” PAAO’s Curso was the outcome of the efforts of LDP graduate and present Curso director Zelia M. Correa, MD, PhD, who was participating in the LDP by jointly representing PAAO and the Council of Brazilian Ophthalmology.



Robert F. Melendez, MD, has been selected for the 2008 AMA Foundation Leadership Award, presented in association with the Pfizer Medical Humanities Initiative.

The award will finance attendance to the AMA National Advocacy Conference in Washington, D.C., from March 30 to April 2. Dr. Melendez is also currently a member of the Academy’s Young Ophthalmologist Committee and a participant in the Academy’s Leadership Development Program X.

The Association for Research in Vision and Ophthalmology has selected George O. Waring III, MD, to receive the 2008 Weisenfeld Award. The award will be presented during the association’s annual meeting in April. Dr. Waring was chosen for his leadership in the field of refractive surgery and for applying stringent scientific principles in his pioneering work.



Judah Folkman, MD, a path-breaking cancer researcher who faced years of skepticism before his ideas led to successful treatments, passed away on January 14. He was 74.

The Academy was honored to have him present the keynote address during the 2007 Annual Meeting in New Orleans.

Dr. Folkman, a professor at Harvard and director of the vascular biology program at Boston’s Children’s Hospital, is considered the father of the notion of angiogenesis. He hypothesized that the tumors could not grow beyond a certain size without a blood supply and that tumors must have some mechanism to induce the formation of blood vessels. The approach is now embodied in several cancer drugs.

His research on angiogenesis inhibitors sparked major advances in the treatment of eye diseases and other illnesses that involve excessive or abnormal angiogenesis. Because of his work, ophthalmology has witnessed advances in saving and even regaining the eyesight of patients with age-related macular degeneration.

Dr. Folkman attended Ohio State University and then Harvard Medical School. Trained as a surgeon, he was chosen to be surgeon-in-chief at Children’s Hospital Boston in 1967 at the age of 34.

Reginald J. Stambaugh, MD, the first president and chairman of the board of the Ophthalmic Mutual Insurance Company, died December 15. He was 77.

A fifth-generation Floridian, Dr. Stambaugh worked as an ophthalmologist up until the day he suffered a stroke in the middle of last year. He graduated from the University of Florida and the University of Miami Medical School, where he was class president. He later studied at Emory University for his internship and residency. Dr. Stambaugh contributed to medicine throughout his life, including his invention of the triple needle for surgical use. He also served on the Academy’s board, was president of the Florida Society of Ophthalmology and served as an editor for Ophthalmology Times.


Washington Report

HIT: The Next Government Mandate?

Federal agencies and Congress are increasing efforts to bring about physician adoption of health information technology (HIT). A provision is likely to be included in a Medicare bill with the belief that HIT will improve the quality of care patients receive by allowing for patients’ medical records to be centralized. The only question is whether to offer physicians incentives or mandates.

Efforts by several senators to foster the development and utilization of HIT have resulted in the introduction of S.1693, the “Wired for Health Care Quality Act.” The Academy, along with the American Medical Association and much of the rest of organized medicine, believes the legislation fails to address the essential elements needed to ensure a national HIT network that is functional, interoperable and adequately addresses barriers to adoption.

Legislation introduced early last December in the House and Senate would mandate e-prescribing for Medicare beginning in 2011. The bill, E-MEDS Act of 2007, would give physicians one-time Medicare grants to help offset the startup costs of e-prescribing, award bonuses to physicians for e-prescribing in Medicare, and grant one- or two-year waivers to practices that face difficulties in acquiring and implementing e-prescribing technology.

CMS’ 2008 Physician Quality Reporting Initiative (PQRI)—a voluntary program with a Medicare bonus—includes measures on e-prescribing and HIT adoption. If a practice has the required software in its office and is participating in PQRI, then reporting on every claim for which they used e-prescribing or HIT is a way for them to qualify for the bonus. Looking at the hospital quality reporting program as a model, however, demonstrates how this incentive program can look like a mandate when failure to get the bonus seems like a penalty.

In 2007, Health and Human Services announced a five-year demonstration project that will be conducted by CMS to encourage small- to medium-sized physician practices to adopt HIT. The demonstration is open to participation by up to 1,200 physician practices and will begin in the spring. It will provide financial incentives to physician groups using certified HIT software to meet certain clinical quality measures. A bonus will be provided to the practice each year based on a physician group’s score on a standardized survey.

The federal government appears to be unified in seeing HIT adoption become universal. The Academy maintains the position that any mandate must be funded to offset the financial burden a practice may incur by implementing HIT.

The Academy maintains that any mandate must be funded to offset the financial burden accrued by implementing HIT.


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