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Young Ophthalmologists
Braving the Vortex: Inside the Big Leaders’ Meeting in D.C.
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It was the second week of January, and the polar vortex kept an icy chill over Washington, D.C. Nevertheless, 13 Academy leaders assembled at the annual Federal Affairs Secretariat meeting with one goal on their plate: to determine the year’s federal agenda for the world’s largest ophthalmology association.

This annual meeting of the Secretariat for Federal Affairs includes the Academy president and president-elect, the CEO and other notables, including medical directors, secretariat members and a representative from the Young Ophthalmologist (YO) Committee.

Why is a young ophthalmologist’s presence important? Because we bring a fresh perspective at a time when every decision made will directly impact our future.

As I walked away from this meeting, one thing was clear: we should have the utmost confidence that our leaders are doing everything they can to protect our patients and practices. While YOs pound out another night on-call, put final touches on a Grand Rounds presentation or see patient after patient in clinic, our Academy leadership is hard at work safeguarding our profession — and our future.

The meeting’s highlights included a look at where we went in 2013 and goals for 2014 and beyond.

What Did We Accomplish in 2013?
Several key Academy accomplishments last year have significant implications for young ophthalmologists.

Optometry scope-of-practice expansion: We prevented passage of the Optometric Equity in Medicaid Act and any expansion of the National Health Service Corps’s loan-payment program for optometrists only. We protected patients by stopping state bills that would have allowed optometrists to perform surgical procedures or anesthetic injections in Tennessee and Louisiana. We also promoted truth-in-advertising legislation, which included transparency and disclosure for patients.

Diana Shiba, MD, with Rep. Judy Chu during the 2013 Congressional Advocacy Day
Dr. Shiba with Rep. Judy Chu, D-Calif., during the 2013 Congressional Advocacy Day.
What’s in it for YOs: Fair treatment in any loan-repayment program, and appropriate reimbursement for ophthalmologists. These achievements also help patients understand the difference between us and optometry and protect them from surgical procedures by inappropriate providers. THANK YOU to YOs in Tennessee and Louisiana who helped with Facebook likes for Surgery by Surgeons and even went to the state legislatures and spoke on behalf of Eye M.D.s in the state!

Fair physician reimbursement: We derailed a looming 24 percent cut in Medicare reimbursement and gained a 5 percent positive update — the first positive update in three years. The Academy also defended certain procedure values, such as ectropion repairs, vitrectomies, Descemet’s stripping automated endothelial keratoplasty and the Ex-Press glaucoma shunt. In addition, we helped ensure passage of new exemptions from e-prescribing penalties.

What’s in it for YOs:
Stable payments for the near future. However, the Academy needs your help pressing Congress for a long-term repeat of the sustainable growth rate that’s triggered so many cuts and such payment uncertainty in the last decade.

New clinical data registry: In one of its biggest endeavors, the Academy launched the new IRIS™ Registry (Intelligent Research in Sight) — the nation's first comprehensive eye disease clinical registry.

What’s in it for YOs:
This system will one day help us meet the Physician Quality Reporting System (PQRS) and “meaningful use” requirements … and much more. Read YO Info’s story on the registry.

Patient access: The Academy successfully protected $10 million in funding for our veterans’ vision trauma research and worked to ensure that compounded generic medications, such as bevacizumab, are available to patients. The Academy also collaborated with the American Academy of Pediatrics and the National Association of School Nurses on a widely distributed brochure to educate parents about the benefits of pediatric vision screening that falls under the new health care act.

What’s in it for YOs:
Continued access to generic medications like bevacizumab and help continuing to serve the VA patient population with research.

What Are Some Hot Items for 2014?
Keep your eyes peeled for what’s in store.

Medicare/health care reform: In 2014, the Academy has several goals related to protecting ophthalmologists’ reimbursement. These include working to ensure that any increase in primary-care payments doesn’t come at the expense of specialists, and working with subspecialty societies to defend reimbursement rates for specific codes, such as glaucoma shunt and scleral graft codes. The Academy will also work to refine new codes, update their existing counterparts and eliminate old ones (such as those involving film and fluorescein angiograms).

What’s in it for YOs:
Stable Medicare reimbursement and the chance to get paid for new, more efficient procedures you learned in residency or fellowship. Although you may be learning cutting-edge techniques, government recognition of and payment can lag behind the technology.

Public health: On this front, Academy goals include preserving patient access to compounded pharmaceuticals like bevacizumab and working with the Food and Drug Administration to update color-coding schemes for ophthalmic products.

What’s in it for YOs:
Access to generic medications like bevacizumab for our patients and continued improvements to patient care.

Optometry federal agenda: The Academy’s goals aren’t significantly different from 2013, but leaders want to ensure that ophthalmology has equal treatment to optometry in any new loan-repayment program. They will also continue to promote truth-in-advertising and transparency for patients.

What’s in it for YOs:
Fair treatment in any loan-repayment program and help ensuring our patients know who is giving them eye care – an optometrist or an ophthalmologist.

Research/Veterans Affairs (VA): Clinician-scientists, fear not: the Academy will continue to do all it can to defend NIH/NEI funding and other ophthalmic research. We also want to maintain funding for the VA Vision Center of Excellence.

What’s in it for YOs:
Continued support for our VA patients and the services they receive.

2014 — and Our Future!
We are in a historic period for U.S. health care. Medicine is in flux and new and complex issues bubble to the surface almost weekly. But after attending the Academy’s Federal Secretariat meeting, I am confident that our leaders in ophthalmology will stand their ground and are well prepared to weather any storms ahead.

These leaders are also physicians, with practices and families just like you and I. They need our help and support. Sending a simple email to a member of Congress or making a small donation to OPHTHPAC can have a powerful effect when it comes en masse from our Academy membership.

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About the author: Diana Shiba, MD, is a comprehensive ophthalmologist with Kaiser Permanente in southern California. She chairs the Academy’s YO advocacy subcommittee, serves on the board of councilors for the California Academy of Eye Physicians and Surgeons, and is a member of the OPHTHPAC Committee and the Kaiser Legislative Forum. She is also a recipient of the AMA’s Excellence in Medicine Leadership Award.

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