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CAR: Your Inside Connection to the Board of Trustees

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One of the most interesting and intriguing aspects of the Academy is its governance. For example, did you know that the Academy has a Council made up of representatives from 52 state societies, as well as 29 subspecialty and specialized interest societies?

The Council has 102 Eye M.D. members, and their role is to advise the Academy’s Board of Trustees on a wide variety of issues. Issues are brought to the Board via the Council Advisory Recommendation (CAR) process (login required).

The Value of the CAR Process
According to Jean Ramsey, MD, Vice Chair of the Council, “The value of the CAR process cannot be overestimated. It begins when an Academy member or members identify issues that affect our patients and our profession. This issue is then presented and deliberated at the CAR hearing. The CAR hearing is a wonderful opportunity for open discussion of issues to determine their level of priority for members across the country and across all subspecialties.

“It is a powerful experience to watch consensus develop during the CAR hearing as councilors and other Academy leaders and members share opinions and explore alternatives to the issues our profession faces. All Board of Trustees and Committee of Secretaries members attend the CAR hearing, so they have a chance to hear members' concerns first hand. The free-flow of information and ideas is great! I highly encourage all members who attend the spring Council meeting to attend the CAR hearing. It is really a chance to see the Academy's policy advisory body in action.”

The Lifecycle of a CAR

  • CARs are submitted by councilors on behalf of the society the councilor represents. Academy members can take issues to the society(s) they belong to and request that the society writes a CAR.
  • CARs are submitted about two months ahead of the spring Council meeting to allow time for a Board member to write a background statement for the CAR. (The spring Council meeting is held in conjunction with Academy’s Mid-Year Forum each April.)
  • CARs are first presented during the opening session of the Council meeting. They may then be discussed during the regional meetings and Council section meetings. The position of a Council region or section may be presented during the CAR hearing, when the whole Council is present.
  • The issues raised in the CARs are discussed and debated during the CAR hearing with the purpose being to reach consensus regarding the Council’s recommendations. That is, the majority councilors will need to agree with the overall recommendation before it is referred to the Academy’s Board of Trustees. When the Council is not able to reach consensus, it will be so indicated to the Board of Trustees.
  • Once the discussion of each CAR is complete, the Council votes first on the priority of the issue and second on whether or not the issue should be referred to the Board. There are instances when the issue being addressed in the CAR is very important, but the recommendations in the CAR are not considered the appropriate way to deal with the issue.
  • CARs that are referred to the Board are then assigned to the appropriate Academy division, secretariat or committee to research and implement if the Board agrees to take action on the CAR.
  • The Board discusses the CARs at its June meeting each year. Following the meeting status reports for the CARs are sent to the Council. Further updates are given as necessary at the fall Council meeting and subsequent Council meetings.

To better understand this, let’s take a look at a sample CAR. In February 2006, the Louisiana Ophthalmology Association submitted CAR 06-06: Participation Incentives and Rewards. This CAR recommended that the Academy recognize advocacy contributions by awarding points towards the Academy Achievement Award. This CAR was supported by councilors during the CAR hearing and was referred to the Board. The Board approved the addition of advocacy contributions as a category for which members can earn points towards the Achievement Award at its June 2006 meeting. This change went into effect on Jan. 1, 2007.

CARs Often Result in Board Action
As Dr. Ramsey explains, “During the past eight years, the Council has submitted 92 CARs, and two-thirds of them were referred to the Board of Trustees. Of the CARs referred, about half resulted in new action and implementation of programs, products and/or services, and the other half were already in effect. Some CARs I have witnessed come to fruition over the past few years are the creation of an advocacy course for the Annual Meeting, a BCSC companion volume on ethics and advocacy and a conference for state legislative chairs, which was offered for the first time this year.”

Get Involved!
As you can see, the Academy strongly encourages and supports feedback from its members. And the CARs are a great way to communicate directly with the top tier of Academy leadership.

To make sure that your voice is being heard, you should get involved with your state society, subspecialty society, specialized interest group or all three! This is one point Dr. Ramsey cannot stress enough. “The bottom line is that being involved with your state or a subspecialty/specialized interest society gives young ophthalmologists (and all Academy members) real access, via the Council, to the leadership of the Academy,” Ramsey says. “It allows for an exchange of information and ideas. Academy leadership wants the input and involvement of all members.”

For more information about the Council and CARs, visit the Council section of the Academy Web site. If you do not know which councilor(s) represent you, view the Council roster (login required). If you are not already a member of your state society, what are you waiting for? Sign up and let your voice be heard!

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About the author: Megan Jolly is a manager with the Academy’s Ophthalmic Society Relations Department.