2008 Mid-Year Forum
Last month, more than 480 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:
Political Climate Change. The Academy’s two public trustees led off a panel with their cogent analyses. Humphrey J. F. Taylor called America’s health care system “the most expensive, inefficient, inequi-table and unpopular in the world.” Paul B. Ginsburg, PhD, observed that Medicare is stuck in the Sustainable Growth Rate (SGR) rut and that a per-manent fix would likely be possible only in the context of Medicare system reform. Len Nichols, PhD, an economist with the New America Foundation, a public policy institute based in Washington, D.C., observed the time is ripe for health system reform because the middle class is fearful of the cost of care, and business is fearful of being globally noncompetitive because of it.
Ophthalmology on the Front Lines. A more seamless transition for injured military personnel between the Department of Defense (DoD) and the Department of Veterans Affairs (VA) is the goal of leaders of both organizations, and substantial progress has already been made. In an effort to overcome the ophthalmologist recruitment and retention woes that have plagued the VA, the Academy successfully advocated with the Association of Veterans Affairs Ophthalmologists (AVAO) for increases in VA ophthalmologist salaries with the latest increase effective in July 2007. During 2008, the Academy will collaborate with the AVAO to advocate for in-creased compensation for VA ophthalmic technicians and for expanded support for ophthalmology leadership in the VA.
Dancing With the Devil: Are Conflicts of Interest Real-ly Manageable in Today’s Environment? Physicians’ relationships with pharmaceutical and medical device companies are under much closer examination. It’s becoming clearer that medical societies will have to police these conflicts of interest in their educational programs or someone else will—possibly the federal government.
At the beginning of the session, the audience was polled on whether financial interests would bias behavior. Eighty-two percent said yes for their colleagues, while only 60 percent said yes for themselves. Then, ophthalmologists on both sides of the issue discussed conflict of interests and whether or not, in their opinion, they can be managed.
For more on the Mid-Year Forum, go to www.aao.org/myf.
Satisfaction With Career Choice and the Academy
According to the biennial Academy membership survey,1 the average ophthalmologist is happy with his or her career choice and satisfied with the Academy.
Eighty-four percent of U.S. fellows and members indicated that they were satisfied with their career choice, and 85 percent would recommend a career in ophthalmology to a young person. “We often focus on the challenges of running a practice and lament the complexities of the environment that we operate in,” said Academy Senior Secretary for Ophthalmic Practice David A. Durfee, MD. “Nonetheless, this survey demonstrates that ophthalmologists are a fairly happy group and part of a very rewarding profession.”
Sixty-nine percent of U.S. fellows and members and 78 percent of both members-in-training and international members indicated that they were “extremely” or “very” satisfied with the Academy. “The survey shows a very high level of member satisfaction,” said Academy Secretary for Member Services Ruth D. Williams, MD. “The recent launch of O.N.E. as well as the decision to make many Maintenance of Certification products free will probably add to this perception going forward.”
Satisfaction with the Academy was not equally distributed across subspecialties, however. Seventy-six percent of pediatric ophthalmologists and 74 percent of glaucoma specialists reported that they were extremely or very satisfied with the Academy, while only 50 percent of refractive surgeons said the same. And 71 percent of general ophthalmologists were extremely or very satisfied with the Academy. In addition, 72 percent of group practitioners were satisfied overall with the Academy, as compared with 62 percent of solo practitioners.
The survey showed that the Academy could improve its standing with young ophthalmologists. When young ophthalmologists were asked how well the Academy was meeting their unique needs, only 51 percent were extremely or very satisfied with the Academy. “Young ophthalmologists have different needs than more established members or members-in-training,” said Dr. Williams. “The Young Ophthalmologist Committee is dedicated to meeting these needs.”
General satisfaction with the Academy has increased consistently over the past decade. In 1999, 58 percent of U.S. fellows and members were extremely or very satisfied with the Academy. This figure has increased by two or three percentage points per biennial survey. “The Academy has historically done a good job of listening to its members and not getting complacent,” said Dr. Williams. “It must continue to focus on continuous improvement and adding value for the member.”
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.
Still Time Left to Attend ISRS/AAO Cancún Meeting
Preregistration has ended, but you can still attend this year’s ISRS/AAO meeting. Refractive and Cataract Surgery: Today and Tomorrow will take place May 29 to 30 in Cancún. Program directors Ramon Naranjo-Tackman, MD, José Manuel Vargas, MD, and Steven E. Wilson, MD, have planned a program on the latest innovations in refractive and cataract surgery.
The meeting will be presented in partnership with the Asociación Latina de Cirugía de Catarata Refractiva y Segmento Anterior and the Centro Mexicano de Cornea y Cirugía Refractiva.
For more information, visit www.isrs.org/cancun.
International Agency for the Prevention of Blindness Assembly
The International Agency for the Prevention of Blindness will hold its eighth general assembly from August 25 to 28 in Buenos Aires.
Excellence and Equity in Eye Care is cosponsored by the World Health Organization and seeks to involve the entire spectrum of eye care workers, including ophthalmologists, public health experts and rehabilitation professionals.
For more information and to register online, visit 8ga.iapb.org or e-mail firstname.lastname@example.org.
Membership Dues for 2008—A Reminder
Have you paid your 2008 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, Ophthalmology and EyeNet Magazine.
Renew your membership and pay your dues online at www.aao.org/member/paydues, by phone at 866-561-8558 (toll free in the United States) or 415-561-8581, or by fax at 415-561-8575.
Update Your Member Profile
To ensure that your information is current and accurate for Find an Eye M.D., the online directory of practicing ophthalmologists, please take the time to visit “Update Member Profile,” located in “Member Services” at www.aao.org.
For more information, contact Member Services by phone, 866-561-8558 (toll free in the United States) or 415-561-8581, or e-mail, email@example.com.
A+ Marketing: Proven Tactics for Success
Containing practical ideas, action plans and examples from successful practices, A+ Marketing: Proven Tactics for Success (#012182) will help you to identify cost-effective marketing opportunities for your practice.
It includes information on how to:
- maximize your practice’s profit potential,
- tell your story to the neighborhoods you serve,
- provide exceptional customer service, and
- capture and retain key customers.
The book costs $99 for members and $113 for nonmembers.
Test Your Coding Knowledge
The Ophthalmic Coding Specialist (OCS) exam is offered year-round to coders who want to demonstrate their proficiency. Those who pass the take-home exam will be awarded the OCS designation as recognition of their coding expertise. Visit www.aao.org/aaoesite/coding to learn more about the OCS exam and get tips about how to prepare for the test.
The AAOE’s Ophthalmic Coding Series (#012328) is the study guide for the open-book test. The guide costs $495 for members and $668 for nonmembers.
Educate Your Patients About Laser Trabeculoplasty
The new Laser Trabeculoplasty (#051323) patient education brochure is now available for purchase. The brochure covers open-angle glaucoma, how laser trabeculoplasty can help treat the disease, and the risks of the procedure.
It comes in packages of 100 and costs $31 for members and $39 for nonmembers.
Member At Large
Illinois and Polish Societies Continue Their Collaboration
Given the large Polish population in Chicago, it is only fitting that the relationship between the Illinois Association of Ophthalmology (IAO) and the Polish Ophthalmological Society (POS) continues to flourish.
That relationship developed out of a pilot “twinning program” in conjunction with the June 2007 Joint Congress of the European Society of Ophthalmology and the Academy. During that meeting, five state ophthalmological societies had twinned with national European ophthalmic societies to present joint symposia. Academy President-Elect Michael W. Brennan, MD, and Zbigniew F. Zagorski, MD, of Lublin, Poland, were instrumental in bringing the IAO and POS symposia participants together.
In preparation for the 2007 Congress, Susan M. Ksiazek, MD, an IAO member, partnered with POS President Jerzy Szaflik, MD, PhD, and his son Jacek P. Szaflik, MD, PhD, to deliver a symposium featuring members of both societies titled The Influence of Cooperation on the Integration of Clinical Expertise, New Technologies and Economical Benefits.
On summing up that experience, the junior Dr. Szaflik noted, “Many colleagues attended the session and a lively discussion ensued following the lectures. There were special concerns about the range of applications of the new, high-resolution optical coherence tomography and its impact on angiographic examinations.”
Commenting on their relationship in 2008, IAO executive director Richard H. Paul reported, “The twinning effort between the two organizations is alive and well. The IAO hosted Drs. Jerzy and Jacek Szaflik at the joint IAO/Chicago Ophthalmological Society meeting this February and the POS has invited two IAO members to speak at their September conference in Warsaw. Joint research projects are also under discussion.”
Robert G. Martin, MD, has received North Carolina’s highest civilian honor, the Order of the Long Leaf Pine, for his contributions to health care. The founder of Carolina Eye Associates, Dr. Martin is credited with helping bring modern ophthalmic surgical techniques to the state, most notably small-incision surgery, which he performed using phacoemulsification with implantation of an IOL.
Who’s in the News
Stephanie Jones Marioneaux, MD, was interviewed by U.S. News & World Report for its Feb. 10 story on providing baseline eye exams for people with no signs or risk factors for eye disease. “Many eye diseases progress without any warning signs,” said Dr. Marioneaux. “One of the hardest adjustments a person can make is adapting to life with permanent vision loss.”
David I. Silbert, MD, was interviewed by the Intelligencer Journal, a Lancaster, Penn., newspaper for his pilot program to catch cases of amblyopia early in city schoolchildren. “I was frustrated after 14 years of seeing 14-year-old kids coming in with amblyopia when it’s tougher to treat,” said Dr. Silbert.
To order products from the Academy Store, 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.
SGR Cuts Are Imminent
In less than 60 days, physicians will experience a substantial reduction in Medicare Part B payments unless Congress intervenes. On July 1, the first of two Medicare reimbursement cuts, 10.6 percent, is scheduled to be implemented. Another five percent cut is scheduled for Jan. 1, 2009.
A long-term solution to both Medicare funding and sustainable growth rate (SGR) reform has been hampered in Congress because of the more than $300 billion price tag and the lack of agreement between Democrats and Republicans on funding the fix. Last year, many obstacles stood in the way of reforms, including a slim majority in the Senate and objections from the White House to a fee-fix funded by cutting Medicare Advantage overpayments. These obstacles resulted only in a temporary six-month 0.5 percent update.
Despite these obstacles, Sen. Max Baucus (D–Mont.), Senate Finance Committee chairman, hopes to pass a bill that provides an 18-month fix. The challenge continues to be lack of agreement over funding for the fix as partisanship has only increased in an election year.
While a Medicare bill is needed for an SGR fix, it holds risks for doctors as key legislators seek to include problematic provisions, including a ban on physician ownership of specialty hospitals, a mandate for physician e-prescribing and a requirement for accrediting all imaging equipment. The Academy supports moving back to multiple conversion factors as an interim SGR solution because of its fair treatment of surgery.
The Medicare Payment Advisory Commission (MedPAC) recommends a 1.1 percent Medicare physician payment update for 2009 in its annual report to Congress released March 1. Physicians have raised concerns about a controversial productivity adjustment that MedPAC used in its recommendations.
MedPAC continues to discuss solutions to the growth in spending on Medicare physician services, including a bundled payment for all services tied to a hospital episode. A first step would be for CMS to confidentially report to individual physicians the resources they used for an episode of care for select conditions for a two-year period. Implementing the bundle payment for services and resources would be a second or third step. Medicare’s issuing of one check for an episode of care is problematic, leaving it to the physicians and hospitals to work out who receives what share of the payment.
A long-term solution to both Medicare funding and sustainable growth rate reform has been hampered in Congress.