In the dark of the night, your pager goes off. It’s 3:15 a.m. Your hair is a mess, but you think, It’s good enough for 3:15 a.m
., as you throw on some scrubs and look around for your car keys. You find them, flop into the car and then drive numbly on dark, eerily quiet roads to the ER — where a consult is waiting at the county hospital.
Or maybe you’re in the middle of clinic, and you’re an hour and 45 minutes behind, and you know patients are getting antsy out in the waiting room. Your technician is getting antsy. You’re getting antsy. But the sweet 87-year-old patient in your exam chair is not
antsy… and is telling you in great detail about how her granddaughter is faring in medical school.
Taking call, sitting through long resident lectures, staying late at work to learn the ins and outs of really running a practice — all while getting married, having a young family and trying to find time for dinner with your partner. How do you do it all?
Now throw in making time for the Academy? Why should you? Maybe you’re thinking, why would the Academy want to hear from me? I don’t know what SGR and PQRI stand for… and what’s PECOS? Or is it picos? Or pesos?
Why? Because you’re a young ophthalmologist! Because you’re working in the trenches, actively engaged in patient care on the in-patient units, in the trauma bay and in the community — and all in the midst of health care reform. Now is the Time to be Heard
Dr. Shiba at the secretariat meeting.
At the Academy’s recent Federal Secretariat meeting, an annual meeting of senior leaders who review the past year’s achievements and set the upcoming year’s agenda, I felt like the peon of the group. Sitting at a table with the likes of Academy President Randy Johnston, MD, and CEO/EVP David W. Parke II, MD, prior to the meeting, I sat in my designated spot (a corner spot) and smiled a lot. But, as the secretariat arrived, everyone was very warm and welcoming, with Dr. Johnston specifically introducing himself and mentioning how much he valued YO input. They wanted to hear the YO voice
. And I was ready! I had input from YOs in the military, in academics and in private practice, in residency and fellowship, in the United States and abroad and from the YO Committee and its subcommittees.
Based on an informal survey, I knew what YOs felt were the top three most important issues facing the Academy. Every single comment I received — which ranged from concerns over scope of practice to electronic medical record integration to fair physician reimbursement, tort reform and health care reform — was passed on to every single member at the Federal Secretariat meeting. What surprised the participants the most was how so many items coincided with the Academy’s 2010 agenda. Meeting Take-Aways for YOs
There were three insights from the meeting that I found particularly pertinent for young ophthalmologists. They include:
The Importance of Advocacy
- Eye M.D.s will see a $550 million Medicare payment boost over the next four years, based on an update for practice expense. For 2010, continued advocacy for patient health care access and coverage and fair physician reimbursement will remain priorities. This includes supporting legislation to eliminate the sustainable growth rate (SGR) — a Medicare formula affecting health care reimbursement — as well as the development of new CPT billing codes, and ensuring that Physician Quality Reporting Initiative (PQRI), along with health information technology incentives, remain fair and equitable for ophthalmologists.
- Did you know that the Academy defeated legislation that would have made optometrists “physicians” under Medicaid? And succeeded in limiting optometry scope of practice in nine states last year? This included Idaho, which would have allowed scalpel and laser surgery by optometrists, and Nebraska, which would have allowed all surgery except “17 surgical procedures that would be outside the optometric scope of practice.” For 2010, efforts will concentrate in Massachusetts, Pennsylvania and South Carolina, all of which involve bills that allow ODs to either perform injections, eyelid and laser surgery and/or empowers their board to determine the definition of “non-invasive” surgery.
- In 2009, the NEI received roughly $174 million in additional funding via the American Recovery and Reinvestment Act of 2009. For 2010, Congress increased funding for the NEI by 2.7 percent (or $18.5 million).
Why is advocacy so important? Why is it important to have a voice? Because it’s important for our patients
. Advocating for our profession allows us to continue with achievements like the above in the future, so we can continue to deliver the kind of eye care we know our patients deserve. It’s important for the consult you saw in the ER at 3:15 a.m.; for the 7-year-old boy with Medicaid, who had to travel by ambulance from another ER 120 miles away so he could be seen at a county hospital. And for the 87-year-old Medicare patient with macular degeneration who thinks the world of you and hopes a cure can be found for her disease.
For the sake of your colleagues, your patients and your family, get involved. If not, who will be their advocate? Who will be their voice? Only YOU
, as one doctor, one human being, can make a difference in the lives of many.
Attend the legislative workshops at the annual and YO meetings, where you can be kept apprised and give input on critical issues. Help with the Surgical Scope Fund
, and attend the Mid-Year Forum
, where you can meet with members of Congress and potentially have a role in shaping U.S. health policy.
No matter which you choose, start today. There’s no better time.
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About the author: Diana Shiba, MD, is in her first year of practice at the Kaiser West Los Angeles Medical Center, and is on the YO Committee's subcommittee on advocacy. And, by the way, it’s PECOS — the online Medicare physician enrollment system “Provider Enrollment, Chain and Ownership System.”