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Young Ophthalmologists
An Inside Look at the Mid-Year Forum

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For this issue of YO Info, Stephen Khachikian, MD, shares his experiences at the 2008 Mid-Year Forum. Dr. Khachikian is a third-year resident in Albany, N.Y., and will be entering a cornea fellowship in Albany in July. He was sponsored by the Cornea Society through the Academy’s Advocacy Ambassador Program.

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When I found out the Cornea Society was going to sponsor my attendance at the 2008 Mid-Year Forum in Washington, D.C., I was very excited. I had heard that it was one of the best ways to get involved and understand the legislative side of ophthalmology. For many people in medicine, lobbying and law-making all seem to be foreign concepts, in terms of what can and cannot be achieved through legislation. During the time I spent in the capitol, I soon learned exactly what we can accomplish if we all work together.

I arrived Wednesday night and attended the Academy’s Congressional Advocacy dinner briefing. We were given a solid background on the lobbying and law-making process and learned how to be more influential with Congress.

Later in the evening, I attended a special session specifically for all Advocacy Ambassadors (resident/fellow attendees sponsored to attend the Mid-Year Forum by state and subspecialty societies). This was great. I was able to get to know lots of other physicians just like me, most of whom were also first-time attendees. I then received my congressional appointments for the next day.

On Thursday, I joined three or four other Academy members who knew the drill and visited the offices of three legislators. I met with representatives for Rep. Carolyn Maloney, D-N.Y., and Sens. Hillary Clinton, D-N.Y., and Charles Schumer, D-N.Y. During these meetings, I was amazed to hear from the more experienced ophthalmologists just how much patient care has changed in the last 10 years.

In fact, I learned that many Academy members are concerned that patient care has been negatively affected by certain legislation. It was nice to see how open and understanding the representatives were and how interested everyone is in finding a workable solution to the problems facing our profession. I was also amazed to discover that in order to be truly influential with Congress, you need to help with the fundraising effort. Clearly, our work to ensure the best quality care for our patients doesn’t end in the office or operating room, but must continue in the legislative realm as well.

After our meetings on Thursday, we spent the majority of the day on Friday attending a variety of Mid-Year Forum symposia. I was particularly interested in one that discussed the Veterans Administration (“Ophthalmology on the Front Lines”), as many residents like myself do part of their training at the VA. This session explored the challenges facing veterans, including eyewear used on the front lines, as well as care received once they return home.

I was also intrigued by the discussion about conflicts of interest in medicine. Specifically, this session addressed the issues of research grants, consultant fees and the potential difficulties in making an unbiased clinical decision when you are involved in either of these work situations. The speakers explained how other specialties (such as cardiology) handle conflicts of interest, what works and what doesn’t. They emphasized that we must take it upon ourselves to disclose all relationships with any and all companies, financial or otherwise. It seems that all fields of medicine are moving toward more regulation in this area.

Next, I listened as three prominent ophthalmologists gave different perspectives on the practice of ophthalmology by discussing three different practice models. Richard Lindstrom, MD, talked about a high-volume practice. David Durfee, MD, talked about a small, two- to three-physician practice. Finally, Richard Lee, MD, discussed the pluses and minuses of a small private practice that typically sees fewer patients a day and has lower overhead, which allows the physician to spend more time with patients.

But the most interesting event I attended at the Mid-Year Forum was the Council Meeting, which the Academy’s Board of Trustees also attended. It was great to be able to sit in and listen to the issues that affect the Academy and how they are handled at the upper level. It’s a great opportunity to see how policies and guidelines are developed and what the reasoning is behind them.

As part of the Council Meeting, the nine individual Council regions met to discuss the issues that directly affect each specific region and the states within that region. I am in the Metro East, and listened while the leaders from different areas discussed their specific takes on issues that directly affect them, the doctors in those states and the patients they serve.

As I was leaving Saturday morning, I couldn’t help but reflect on what a great learning opportunity the entire experience had been. I learned about the issues facing my state, the nation and the greater ophthalmic community. I also discovered how to get involved and be a part of the solution. Best of all, I was able to learn these lessons from people who have been involved in the legislative side of our profession for years.

Had it not been for my experience at the 2008 Mid-Year Forum, I may never have thought about the legislative issues facing our profession. But now I see that there are two faces to the practice of ophthalmology — the clinical and the legislative. And while it is certainly easier to just stay in a practice and not get involved, I discovered that you must play a role if you want to have a voice in the future of ophthalmology.

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