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This year, the Academy's political action committee—OphthPAC—celebrates 25 years of advocacy on Capitol Hill. From reimbursement to scope of practice, it continues to play an essential role today.
For the past quarter of a century, OphthPAC's achievements have been underpinned by the enthusiasm of Academy members and a shrewd utilization of funds, which have been used to support the election campaigns of select Democrats and Republicans. By working with politicians on both sides of the aisle, OphthPAC can help ensure Eye M.D.s get a fair hearing when legislation and regulations are being made.
HOW DID EYE CARE GET POLITICAL
Tom Moore, MD, a pediatric ophthalmologist in Phoenix, Ariz., was the first chairman of OphthPAC, serving from 1986 to 1990. He explained that the impetus behind establishment of the PAC came from his and other state ophthalmology leaders' experience in the late 1970s and early 1980s as they worked to counter bills in their state legislatures that would have expanded optometric scope of practice. Though Dr. Moore and his colleagues defeated these bills in Arizona, ophthalmologists in other states were not as successful. In 1978, an optometric scope of practice bill was passed in West Virginia. Because state leaders were "aware of how bad things could get," they began to urge the Academy leadership to establish a national political presence to prevent further erosion of patient protections and to ensure fair compensation for ophthalmic services.
In 1981, the American Association of Ophthalmology, which had been active in legislative advocacy, was incorporated into the Academy, introducing a strand of political DNA into an organization that had been primarily known for its focus on physician education. This merger was accompanied by the creation of an advisory body, the Academy Council, which provided state society leaders with a venue to urge the profession to be more involved in the political process at both the state level (on scope of practice) and the national level (on physician fee reimbursement issues).
As a result, in 1985, the Academy board of trustees voted to establish a federal political action committee, OphthPAC. It had started soliciting donations by the end of the year and by 1986, its first year of operation, was the largest specialty PAC after receiving over $240,000 in contributions.
25 YEARS OF ACHIEVEMENT
OphthPAC has achieved an impressive number of accomplishments in helping to prevent Medicare payment cuts, increasing physician reimbursements, blocking federal efforts to expand optometric scope of practice, increasing funding for basic eye research, and expanding vision care services for uninsured children. In the last two years, OphthPAC led the national coalition to rebase physician practice expenses (resulting in a 10 percent increase in Medicare reimbursements for ophthalmologists), led the coalition to secure appropriate reimbursement for Avastin, and participated in a coalition to ensure that ophthalmology was represented in the legislation on health care reform.
“We are very excited to be celebrating 25 years of OphthPAC successes,” said current chairman S. William Clark III, MD, a comprehensive and cataract ophthalmologist from Waycross, Ga. “OphthPAC has evolved over these past 25 years and is now much more sophisticated in how it goes about advocating for protecting patients and for ensuring an adequate level of physician payments.” Dr. Clark added that many members might be surprised and impressed at how well the Academy works with the American Optometric Association on some issues. “Much of our work in D.C. directly increases payments to practicing ODs as well as Eye M.D.s.” He also said that in the last election cycle, OphthPAC received contributions from approximately 20 percent of Academy members. As a result, OphthPAC was able to disburse nearly $1.7 million to help elect many successful congressional candidates who are supportive of ophthalmology’s goals.
David W. Parke II, MD, Academy executive vice president and CEO, emphasized the spectrum of issues tackled by OphthPAC. “OphthPAC is integral to coordinating advocacy strategies with other organizations so we can effectively address issues such as physician payment, funding of the National Eye Institute, health care reform, passage of a glaucoma detection bill, and federal scope of practice challenges.” It is because of these ongoing issues, said Dr. Parke, that it is important for Academy members to support advocacy efforts. “The 80 percent of members who do not contribute are getting a free ride on the backs of those members who do contribute,” he said. “I realize it may be confusing to members to be solicited by so many PACs, but the reality is that we need all members to support OphthPAC as part of a total advocacy strategy that includes Congressional Advocacy Day, the Surgical Scope Fund and state ophthalmology PACs.”
One Academy member who has contributed to OphthPAC for each of its 25 years is Kevin W. Treacy, MD, a comprehensive ophthalmologist and cataract surgeon in Duluth, Minn. When he was asked to explain his motivation for supporting the PAC, he replied: “That’s easy. Since attending my first Academy Annual Meeting in 1986 in New Orleans, I’ve been impressed with the organization’s efforts to educate Eye M.D.s and to advocate on behalf of our patients and profession. Whenever asked to contribute to OphthPAC, I feel it is one way I can and should participate in that advocacy, for I just wouldn’t feel good about benefiting from the process without helping to defray the costs.”
BECOME A PHYSICIAN-ADVOCATE
“While writing a check to OphthPAC is critical, achieving our goals requires more,” said Dr. Parke. “Take the next step and become involved in building personal relationships with members of Congress. We need to speak with them in person to remind them that many ophthalmology issues are quality-of-care and patient-safety issues.”
Battling on several fronts. Laurie Gray Barber, MD, who chaired OphthPAC from 2002 to 2006, further underscored the importance of member involvement. “Ophthalmologists need to understand that each ophthalmology advocacy group is phenomenally important. OphthPAC, state PACs and the Surgical Scope Fund are critical,” she said. “Academy members need to be actively involved in all of them. Beyond financial support, face-to-face involvement with state and federal legislators is crucial to achieving legislative successes.” Dr. Barber is a comprehensive ophthalmologist in Little Rock, Ark., and professor of ophthalmology at the University of Arkansas’ Jones Eye Institute.
Strength in numbers. Dr. Barber, currently chairwoman of the Surgical Scope Fund, pointed out that some nonphysician advocacy groups have more than 20 percent support among their members, and she said she hoped the percentage of Academy members who support OphthPAC would continue to increase. “Look at OphthPAC’s key successes, such as preventing nonsurgically trained optometrists from doing laser eye surgery in Veterans Administration hospitals,” said Dr. Barber, who emphasized the PAC’s key role in getting the ear of legislators. “Maintaining access to lawmakers would be even more effective with greater member support,” she said. During her tenure as chairwoman of OphthPAC, Dr. Barber actively worked to get more young ophthalmologists and residents involved in the PAC and advocacy. As a result, more than 50 percent of residents attending the Academy Mid-Year Forum now contribute to OphthPAC and the Surgical Scope Fund.
DONATIONS OPEN DOORS
“The benefit of OphthPAC’s support of candidates is that it increases access to, and relations with, legislators and their staffs,” said Dr. Clark.
From testimony to regulatory language—helping with the details. “Our Washington, D.C., office is very effective in working with congressional staffers to arrange for testimony at public hearings and to provide language for regulations as they are being drawn up. Much of our impact is in such details.” This, Dr. Clark explained, ensures that congressional leadership has the information it needs to validate ophthalmology’s positions. “We need to remain focused only on issues that protect patients and our profession,” he said.
Difficult decisions on who to support. Though there have been some disagreements among Academy members regarding OphthPAC’s support for particular candidates, Dr. Parke regards such disagreements as healthy and as part of the necessary dialogue between the OphthPAC leadership, state ophthalmology societies and individual members in identifying candidates and incumbents who may be helpful in the achievement of ophthalmology’s goals. “Most Academy members understand that OphthPAC’s activities are driven by a set of principles and procedures directed toward achieving results on issues directly related to ophthalmology,” Dr. Parke said. “It is important for us to support candidates or members of Congress who are supportive of our major goals. This sometimes means supporting a candidate who may differ with our objectives on a specific issue, but who can play a leadership role in supporting our greater agenda. The difficult decisions regarding which candidates to support are made with the utmost thought by the OphthPAC Committee in consultation with state societies, and so far OphthPAC has been very successful.”
Helping physicians get elected. Dr. Parke’s assessment of OphthPAC’s success is borne out by a recent analysis that ranks OphthPAC as #3 among the top 20 health industry PACs that supported candidates in the 2010 election. More than 60 percent of OphthPAC’s contributions supported winning candidates.1 In last November’s elections, this support helped increase the number of physicians serving in Congress to 18—two in the Senate and 16 in the House—an increase of 64 percent. One of these physicians was ophthalmologist Nan Hayworth, MD, who won her race for the U.S. House of Representatives in New York’s 19th District. This was her first run for elective office, demonstrating how effective OphthPAC support can be.
Expressing his thanks to those who have supported OphthPAC, Dr. Parke said, “Their support for our advocacy efforts will be critical going forward as we deal with physician payment reform and health care reform.”
1 www.kaiserhealthnews.org/stories/2010/November/17/PAC-chart.aspx published online Nov. 17, 2010.
SIGN UP FOR ADVOCACY DAY
Sign up for the Academy’s 2011 Congressional Advocacy Day—April 6 and 7—for an opportunity to lobby members of Congress on the issues that affect you and your patients. There is no registration fee.
Learn how to lobby like a K Street pro. Prepare for your visit to Capitol Hill with a meeting on the evening of April 6, where you will be briefed on key legislative priorities and learn tips on advocating effectively to Congress.
Meet the legislators. On April 7, put your advocacy skills to work when you meet with members of Congress and their staff. The Academy’s Federal Affairs staff will schedule these appointments.
Stay in D.C. for the Mid-Year Forum. Advocacy Day is held in conjunction with the Academy’s Mid-Year Forum, which takes place from April 6 to 9. Topics under discussion will range from electronic health records to the outlook for Medicare payment as health care reform gets implemented.
For more information, visit www.aao.org/myf.
MEET YOUR OPHTHPAC TEAM
OphthPAC is run by a committee of doctors who represent a range of subspecialties, geographic areas and modes of practice. The chairman consults with state ophthalmology societies to select potential new members who are then appointed by the Academy board of trustees. Committee members serve one-year terms for up to five years, and committee chairs can serve for up to an additional five years.
Physicians provide direction. The OphthPAC chairman, Dr. Clark, is joined by 14 other committee members: Charles C. Barr, MD, (Louisville, Ky.), William Z. Bridges Jr., MD, (Asheville, N.C.), Dawn C. Buckingham, MD, (Austin, Texas), Donald J. Cinotti, MD, (Jersey City, N.J.), James E. Croley III, MD, (Cape Coral, Fla.), Anna Luisa Di Lorenzo, MD, (Troy, Mich.), Andrew P. Doan, MD, PhD, (Temecula, Calif.), Warren R. Fagadau, MD, (Dallas), Alan E. Kimura, MD, (Denver), Jeff S. Maltzman, MD, (Tucson, Ariz.), Andrew J. Packer, MD, (Hartford, Conn.), Andrew M. Prince, MD, (New York), Kristin E. Reidy, DO, (Santa Fe, N.M.) and Ann A. Warn, MD, MBA, (Lawton, Okla.). Gregory P. Kwasny, MD, OCS, (Milwaukee, Wis.) works closely with OphthPAC as Academy secretary for Federal Affairs.
Staff members work to provide support. The day-to-day work of the PAC is administered by the OphthPAC director and the OphthPAC manager, Heather Falen, in the Academy’s Washington, D.C., office, with support from Academy director of finance and OphthPAC treasurer Steven Rausch in the Academy’s San Francisco headquarters. The D.C. office is headed by Cathy G. Cohen, Academy vice president of Governmental Affairs.
For more information on OphthPAC and the Academy’s advocacy efforts, visit www.aao.org/advocacy.
25 YEARS OF ADVOCACY
Five Leaders of the PAC
TOM MOORE, MD
“A PAC ‘opens doors’ by enabling organized ophthalmology to talk with legislators before a bill even comes up. You can find out where candidates stand and educate them on the issues.”
RONALD C. MAY, MD
“We should be thankful to Tom Moore for causing the Academy to realize the absolute need for an effective PAC. In its early years OphthPAC went through growing pains and was a major learning curve. It survived and became a key adjunct in the Academy’s advocacy efforts.”
RANDOLPH L. JOHNSTON, MD
“Continuity is key in political contributions. OphthPAC helps us develop long-lasting relationships with key legislators. This makes us into familiar and friendly faces when discussing bills.”
LAURIE GRAY BARBER, MD
“The Academy is fortunate to have amazing personnel in D.C.—headed by Cathy Cohen—who know their way around politics, campaigns and legislators. They could be fiercely more effective if all members chipped in with funds, time and political friendships.”
S. WILLIAM CLARK III, MD
“Our mission has evolved to add federal advocacy to our original political functions. Last year, OphthPAC merged with the Congressional Advocacy Committee. We are now matching each member of Congress with a constituent ophthalmologist who will help us advance the Academy’s Washington agenda.”
CONTRIBUTE TO OphthPAC
To make a donation to the Academy's nonpartisan federal PAC, visit