American Academy of Ophthalmology Web Site: www.aao.org
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March 2012

 
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WHAT’S HAPPENING 

ECA Chinese

EXPANDED SERVICE FOR CHINESE-AMERICANS. EyeCare America has added a Chinese-language option to its online referral service. Chinese speakers may now visit www.eyecareamerica.org and find out if they qualify for a free eye exam given by one of nearly 7,000 volunteer ophthalmologists across the United States and Puerto Rico.

"As a longtime EyeCare America volunteer, I am excited that a Chinese language option has been added to the organization's online referral center," said David S.C. Pao, MD, president of the Chinese American Ophthalmological Society. "Now even more patients will be able to connect with this program."



Employment Trends in Ophthalmology at Home and Abroad

Trend data from the biennial Academy membership survey1 show that the average U.S. practice has six ophthalmologists, while six support staff are hired by the practice to assist each ophthalmologist.

Specifically, the survey data confirm that these support staff, including coding/billing clerks and certified and noncertified ophthalmic medical personnel, play a vital role in the integrated eye care team. For example, certified and noncertified techs are employed by 78 percent and 83 percent, respectively, of practices with three doctors and 93 and 78 percent of practices with more than six doctors. Coding/billing clerks are employed by approximately 76 percent of all U.S. ophthalmologists.

Since 2009, there’s been a slight drop in the proportion of practices employing clerks and certified ophthalmic personnel, but the use of receptionists, practice administrators, opticians, optometrists and nurses has held relatively steady. “It will be interesting to see what effect, if any, the adoption of EHR will have on how many and what type of employees will be utilized in ophthalmology practices of the future,” said Academy Secretary for Member Services Tamara R. Fountain, MD. “It is a trend the Academy will be watching closely.”

Staffing around the world. According to survey responses from both domestic and international Academy members, their practices employ roughly the same number of full-time positions each, including ophthalmologists.

However, several interesting differences stand out. The average U.S. ophthalmology practice includes just over six doctors, while the average international practice includes 12 doctors. Optometrists are employed by 50 percent of all practices in the United States and 40 percent of international practices—reflecting a leveling off of a 10-year upward trend evident both here and abroad.

And although staff size may be comparable for both U.S. and international practices, the type of support staff varies. A greater percentage of U.S. practices employ opticians, optometrists and certified and noncertified medical personnel, while international practices tend to have more physician assistants and nurses. Dr. Fountain noted, “Whether ophthalmic technicians for U.S. physicians or physician assistants and nurses for our international colleagues, it is clear that ophthalmologists across the globe are increasingly reliant on allied health professionals to meet the eye care needs of their patients.”
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1 This survey was sent to 7,000 U.S. practicing members, 960 of whom responded. The sampling error is ± 3.2 percent. Separate surveys were sent to U.S. members in training, international members and international members in training.
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ONE SPOTLIGHT: Get News in a Single Location. The Ophthalmic News and Education (ONE) Network provides Academy members with the latest news in ophthalmology, from meeting reports and industry news to summaries of top clinical studies and expert opinion. Members can browse by subspecialty or search for specific information or publication dates. Social media features also allow readers to provide commentary on articles and share links via Facebook and Twitter accounts. New articles are added almost daily.

Browse the “News” section by three article subtypes:

  • “Headlines”—latest industry news
     
  • “Current Insight”—expert commentary on recent practice developments
     
  • “ONE Editors’ Choice”—summaries of the month’s top studies from leading peer-reviewed journals

To get started, visit www.aao.org/one and click the “News” tab.

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TAKE NOTICE 

March Is AMD/Low Vision Awareness Month

GetEyeSmart.org, the Academy’s public education website, now features an interactive simulator for your patients that demonstrates how age-related macular degeneration affects vision.

To find the simulator and other patient education resources, visit www.geteyesmart.org and click “Age-Related Macular Degeneration (AMD)” and “Macular Degeneration Vision Simulator.”

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ACADEMY STORE 

Keep Your Patients Informed

The Academy has produced a host of booklets and brochures that can help your patients better understand their eye health and treatment options—as well as help your practice reduce malpractice risk. Materials are written in a clear, nonclinical style, include full-color images, and are reviewed regularly by ophthalmologists for currency.

The Academy has three booklets and 55 brochures in English, and nine brochures in Spanish—covering a variety of topics. Booklets come in packs of 20; each pack is $44 for members and $55 for nonmembers. Brochures come in packs of 100; each pack is $32 for members and $40 for nonmembers.

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

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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.

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MEMBERS AT LARGE 

Documenting the History of the Eye

Ivan R. Schwab, MD, has written a new book, Evolution’s Witness: How Eyes Evolved, now available from Oxford University Press. Combining physiology, anatomy and phylogeny with an examination of the fossil record, he traces the development and progression of visual systems in the animal kingdom.

“If you have ever wondered how our marvelous sense of sight got started or how eyes have become so diverse across the animal kingdom,” Dr. Schwab said, “this book will answer these questions and more. It will also leave you with a sense of continued wonderment with vision—and our profession.”

He is professor of ophthalmology and director of the cornea and external disease service at the University of California, Davis. Besides comparative ophthalmology, his other research interests focus on stem cell grafting and wound healing.

For more information, visit www.evolutionswitness.com.

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Collaboration Continues Between Minnesota and Norwegian Societies

Following their participation in a joint meeting of the Academy’s Leadership Development Program (LDP) and the European Society of Ophthalmology’s EuLDP, Abdhish R. Bhavsar, MD, of Medina, Minn., and Bente Haughom, MD, of Oslo, Norway, discussed opportunities to collaborate in the future. The outcome of these discussions was last year’s development of an ophthalmology exchange program linking the Minnesota Academy of Ophthalmology (MAO) and the Norsk Oftalmologisk Forening (Norwegian Ophthalmology Society [NOS]). “There is a tremendous need for ophthalmologists to learn from one another on a global level,” Dr. Bhavsar said.

Former NOS board member Birger A. Olsen, MD, made the first visit to Minnesota last year. He spent several days sharing research ideas and practice management tips with MAO members. Dr. Bhavsar’s most recent trip to Norway this past November included a visit to Ullevaal University Hospital in Oslo, where he toured the retina clinics and operating room with chief of the retina division Ragnheiður Bragadóttir, MD, and spent the afternoon observing and assisting in different surgical cases. Dr. Bhavsar also delivered a talk to the Oftalmologisk Selskap i Oslo (Oslo Ophthalmology Society) about a day in the life of a Minnesota ophthalmologist and met with several physicians around the city to discuss retina care.

Drs. Bhavsar and Haughom look forward to continuing this exciting program. The next exchange has already been planned for this year when NOS members Ola M. Rygh, MD, and Øystein Mjanger, MD, will visit Minnesota. “We hope that other U.S. state societies and countries forge friendships of this nature, as we have been so fortunate to do as part of our Minnesota-Norway connection,” Drs. Bhavsar and Haughom said.

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MEETING MATTERS 

Check Out 2012 Subspecialty Day in Chicago

Visit www.aao.org/2012 to find information about the seven Subspecialty Day meetings that will be held at McCormick Place in Chicago on Nov. 9 and 10. Registrants are free to float among the meetings taking place on the same day:

  • Friday, Nov. 9, and Saturday, Nov. 10: refractive surgery and retina.
     
  • Saturday, Nov. 10: cornea, glaucoma, oculofacial plastic surgery, pediatric ophthalmology and uveitis.

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Submit Abstracts for Papers, Posters and Videos

If you are interested in presenting a paper, poster or video at the 2012 Joint Meeting, you must submit an abstract online. The submission portal opens on March 14 and closes on April 10. Be sure to review the abstract guidelines before making your submission.

For more information, visit www.aao.org/presentercentral or e-mail meetings@aao.org .

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Save These Dates for Chicago

Don’t forget to mark your calendar for the Academy’s Joint Meeting with the Asia-Pacific Academy of Ophthalmology. Circle the following dates:

  • June 1 Virtual Advance Program available online.
     
  • June 27 Registration and housing open to Academy and AAOE members.
     
  • July 11 Registration and housing open to nonmembers.
     
  • Aug 8 Early Registration fee deadline.
     
  • Oct. 17 Last day to register online for the Annual Meeting.

For the most up-to-date information and archival materials from previous meetings, visit www.aao.org/2012.

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D.C. REPORT 

D.C. REPORT: Outlook for 2012 Medicare Payments

Unlike other specialties, ophthalmology started 2012 with a small increase in Medicare payments, despite a CMS “accurate payment” initiative that is aggressively challenging specialty codes and shifting resources to primary care. While there was a 2 percent bump from continued implementation of new practice expense data—which was advanced by the Academy—the overall increase in payments to ophthalmology is 1 percent. The difference is the result of continued reduction in payment for ophthalmic services such as OCT, retinal laser procedures and intravitreal injections— despite Academy objections and recommendations from the agency’s own refinement panel that was established to resolve payment evaluation disputes. Along with subspecialty societies, the Academy will continue to fight for fair payment values at the AMA/Specialty Society Relative Value Scale Update Committee meeting, where cataract surgery is slated for review.

SGR. Although a 27 percent Medicare physician pay cut caused by the sustainable growth rate (SGR) formula was derailed in December, Congress must immediately revisit the issue; the cut was postponed only until Feb. 29. The Academy, the AMA and others pressed for a permanent solution to the SGR formula used to calculate Medicare physician pay. Although a two-year, House-passed SGR fix would have provided some stability, the House and the Senate had not reached agreement on a fix at the time of EyeNet’s publication.Academy is lobbying against a Medicare Payment Advisory Commission–recommended SGR solution paid for in part through a 17 percent pay cut for specialists. The estimated cost to repeal the SGR is $300 billion.

Congressional leaders are unlikely to pass a permanent SGR fix without some agreement on physician payment reform. Many legislators point to new payment mechanisms being tested by CMS, such as accountable care organizations and bundling.  Mandating that all physicians participate in one of these new payment mechanisms or face cuts in Medicare pay—a recently touted solution—appears premature, since evaluation of their effectiveness is years away. Instead, the Academy will point CMS to new measurements for quality improvements to reform Medicare.

Sequestration. Physicians also face an additional Medicare pay cut caused by the sequestration process triggered when a joint House and Senate committee failed to identify $1.2 trillion in federal deficit savings. Next January, sequestration will apply across-the-board cuts equally to defense and nondefense spending, including Medicare. The Academy will advocate to stop the cut while pushing Congress for a permanent SGR fix.

The Academy will continue to fight for fair payment values at the AMA/Specialty Society Relative Value Scale Update Committee meeting, where cataract surgery is slated for review.

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