• Academy Notebook

    News, Tips, Resources

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    WHAT’S HAPPENING

    Member Survey Results

    The Academy conducts a biennial prac­tice environment survey to learn about members’ general attitudes toward ophthalmology and to gather infor­mation on practice demographics and patient services. The primary objective of the research is to capture practice environment statistics and gain a better understanding of member needs. The findings enable the Academy to develop programs and services that are truly responsive and relevant to the ophthal­mology community.

    The data below are from the 2017 survey conducted by Loyalty Research Center. The results are based on 980 responses (684 domestic practicing ophthalmologists, 296 domestic members in training) collected from a representative sample of the Academy’s membership.

    U.S. practicing ophthalmologist members. Overall, there has been no change during the past 10 years in the percentage of members who report practicing comprehensive ophthalmol­ogy, subspecialty ophthalmology, or a mix of both. However, there was a significant decline in the last 2 years of physicians in solo practice (32% to 26%). More than half of the solo physicians surveyed indicated ex­periencing a decrease in net income (some because they have transitioned into part-time practices); one-third plan to retire or sell their practice to become employees within the next 5 years. Additionally, only 2% of mem­bers-in-training conveyed interest in pursuing solo practice after residency training. Compared with 2015, more ophthalmologists in 2017 are offering ancillary services such as dispensing or fitting contact lenses (65% to 72%) and are providing refractive surgery (44% to 52%).

    Regarding EHR adoption, 78% of members have EHR systems in their practice. Unfortunately, EHRs have not resulted in more productive workplac­es: 56% of members say that their EHR has decreased practice productivity. Overall, only 38% rate the quality of their system as “excellent” or “very good,” 53% rate it as “good” or “fair,” and 10% rate it as “poor.”

    Despite evolving changes with the regulatory environment and physician payment, satisfaction with ophthalmol­ogy as a career is at an all-time high. Nearly 9 of 10 members are “extremely satisfied” or “very satisfied” with their career choice.

    U.S. members-in-training. Members-in-training are individuals currently enrolled in a residency or fellowship program. Among residents, 61% plan to complete a fellowship before en­tering practice. Retina, cornea, and glaucoma continue to be the most popular subspecialties among domestic members-in-training.

    Members-in-training also report an all-time high in satisfaction with their residency programs. Among these ophthalmologists, 80% rate their res­idency training as “excellent” or “very good,” compared with 71% in 2015. The top challenges and concerns that residents have related to when starting to practice are surgical complications, understanding business activities (bill­ing, staffing, and administrative needs), being prepared enough to practice independently, and simply finding the right job.

    TAKE NOTICE

    Seeking Outstanding Ophthalmologists

    Would you like to nominate a colleague for next year’s Outstanding Humanitar­ian Service Award? The Academy must receive your nomination by March 12, 2018. This award recognizes Academy fellows and members for outstanding contributions to humanitarian efforts, such as participation in charitable activities, care of the indigent, and community service. It acknowledges those who have performed above and beyond the normal duties of an oph­thalmologist.

    To obtain a nomination form, con­tact Member Services by phone, 866-561-8558 (toll-free) or 415-561-8581; by fax, 415-561-8575; or by e-mail, member_services@aao.org. You may also complete a nomination form at “Outstanding Humanitarian Service Award.”

    Remember the Foundation on Giving Tuesday

    After the holiday shopping rush on Black Friday and Cyber Monday, remember to kick off your year-end charitable giving on Giving Tuesday, Nov. 28. Entering its 6th year, this global day of philanthropy involves thousands of charitable organizations and encourages donating to initiatives that are important to you.

    Please consider supporting Academy programs including the Ophthalmic News and Education (ONE) Network, EyeCare America, global outreach, and the Robert A. Copeland Jr., MD, Advocacy Education Fund. Your tax-deductible gift can be made in honor or memory of someone special.

    To donate, visit “Giving Options.”

    Donate Textbooks to Global Medical Libraries

    Global Medical Libraries (GML) is an initiative to improve health care in de­veloping countries by providing med­ical textbooks and other references to health care professionals. To date, GML has donated $2.5 million in health science textbooks to 25 countries, at no expense to the recipients. This summer, SEE International partnered with GML to reimburse shipping costs to Amer­ican ophthalmologists who donate textbooks to GML recipients with ophthalmology or optometry training facilities, such as the Magrabi IOC Cameroon Eye Institute.

    For more information and to donate, visit www.globalmedicallibraries.org and www.seeintl.org/gml.

    The 2016-2017 Foundation Annual Report

    With donor support, the Academy Foundation funds education, quality of care, and service programs that are among the most innovative in all of medicine. Read Together, We’re Mak­ing a Difference at aao.org/foundation to see how your colleagues are taking advantage of these initiatives to make a positive impact on patients’ lives.

    MIPS and EHRs: Are You Planning to Apply for the Hardship Exception?

    Advancing care information (ACI) is the EHR–based performance category of the Merit-Based Incentive Payment System (MIPS). It replaces the mean­ingful use program.

    The significant hardship exception. Clinicians can apply to be excepted from the ACI performance category if they are facing a significant hardship, such as insufficient internet connec­tivity.

    Application deadline may be changed to Dec. 31, 2017. The pro­posed MIPS rules for 2018 included several provisions that—if included in the final regulations—would apply retroactively to the 2017 performance year. This includes a proposal that the deadline to apply for an ACI hardship exception be changed from March 2018 to Dec. 31, 2017. The final regulations were expected to be announced in October or early November but hadn’t been published at time of press.

    To learn more about ACI excep­tions, visit “MIPS Manual 2017—ACI: Some Clinicians May Be Exempt From ACI.”

    Academy Teams With the Nevada Academy of Ophthalmology
    ACADEMY TEAMS WITH THE NEVADA ACADEMY OF OPHTHALMOLOGY. During the national convention of the American Legion at the Reno-Sparks Convention Center on Aug. 18-24, Hardeep S. Dhindsa, MD, Academy councilor representing Nevada, joined Reno area ophthalmologists to perform free glaucoma screenings and rein­force the importance of high-qual­ity eye care. They assisted more than 100 veterans and their family members during the course of the convention. Veterans’ eye care is a top priority for the Academy, which continues to partner with state ophthalmology societies to provide screenings during Ameri­can Legion meetings.

    MEMBERS AT LARGE

    Dr. Maa Presents on TECS

    April Maa, MD, was a presenter at the Veterans Affairs annual health care and technology Innovation Demo Day on Aug. 8 at Georgetown University in Washington, D.C. The Innovation Demo Day showcased 100 innovators discussing proj­ects that they have created to improve the lives of vet­erans. Dr. Maa presented on Technol­ogy-Based Eye Care Services (TECS), a program for rural military veterans with vision ailments. Her presentation was titled “TECS: Beyond Screening.” TECS is hosted by the U.S. Department of Veterans Affairs. It improves rural veterans’ access to eye screening services for the most common causes of visual impairment.

    Passages

    William H. Spencer, MD, ophthalmic pathologist, clinical teacher, and author, passed away on Sept. 24. He was 92.

    Dr. Spencer served on the Academy’s Board as Secretary for Continuing Ed­ucation, as well as on multiple commit­tees including the Centennial Com­mittee, the Ophthalmology Editorial Advisory Committee, and the Museum of Vision Academy Archives Committee (where he developed the oral history program). He also served as executive director and chairman of the American Board of Ophthalmology and president of the American Ophthalmological Society, among other ophthalmic leadership roles. He trained hundreds of residents and fellows, delivered mul­tiple named lectures, received numerous honors and awards, and wrote hundreds of articles.

    Bruce E. Spivey, MD, former exec­utive vice president and CEO of the Academy (1978-1992), said, “Bill Spen­cer was a leading figure in ophthalmic pathology and the successor editor to Hogan and Zimmerman of the classic Ophthalmic Pathology: An Atlas and Textbook. Bill had a unique and encyclopedic memory for ophthalmic details, and his absence will be deeply felt by all who knew him.”

    ACADEMY STORE

    Simulate MOC Exams

    Quickly identify and fill your knowl­edge gaps with the Practicing Ophthal­mologists Learning System, 2017-2019. This tool has 4,000+ self-assessment questions. A 1-minute-per-question timer is now available, allowing you to simulate the MOC test-taking experience. If you have purchased this product previously, it has already been upgraded to include the new feature.

    Get a 10% discount at the Resource Center (Hall G, Booth 3140).

    Read Ophthalmology Retina abstracts in Ophthalmology

    The Academy created the Ophthal­mology Retina journal in response to the growing volume of high-quality research within the retina subspecialty of ophthalmology. Abstracts from our new journal are published bimonthly in our flagship journal. Visit Ophthalmol­ogy’s website, aaojournal.org, to access the latest abstracts from Ophthalmology Retina. To subscribe to Ophthalmology Retina, visit the Academy Store.

    Launch celebration at AAO 2017. Early subscribers and published authors of the new Ophthalmology Retina jour­nal are invited to meet editor-in-chief Andrew P. Schachat, MD, and the editorial board. When: Monday, Nov. 13, 10:00-11:00 a.m. Where: Museum of Vision, Booth 3047.

    D.C. REPORT

    Collaboration Fuels Cosmetic Blepharoplasty Win

    In August, CMS abandoned its decision to prohibit patient billing for cosmetic blepharoplasty. The Academy’s success in helping to roll back this decision, thus preserving the procedure’s billing, is the result of a year-long campaign, which stems from a partnership with the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS). The joint effort showcases the effectiveness of sharing resources and expertise in advocacy.  

    Background. In May 2016, CMS announced its decision to prohibit patient billing for cosmetic blepharoplasty. The Academy’s community of ophthalmologists immediately objected. “The Academy brought in a skilled legal team and personal connections. ASOPRS brought the clinical realities to the table and a few of our connections, too. Addi­tionally, we rallied specialties across medicine to support our cause, including the American Medical Association,” said Stuart R. Seiff, MD, ASOPRS past president.

    How we won. The Academy devoted significant resources to halt­ing this ill-conceived payment policy, including:

    • Enlisting legal and medical experts
    • Soliciting the critical perspectives of oculoplastic surgeons
    • Arranging 3 meetings between CMS and leaders from the Academy and ASOPRS
    • Arguing that CMS has no legal basis to regulate cosmetic surgery
    • Having oculoplastic surgeons explain to CMS the distinct differences between blepharoplasty and ptosis surgeries.  

    The Academy maintains that CMS acted through a fundamental misunderstanding of these eyelid surgeries. “The effort to overturn the May 2016 decision was a group effort and none of our organiza­tions could have done this alone,” said Dr. Seiff. “Our success can be a model for the cooperative efforts needed to allow us all to care for patients in this increasingly over-regulated environment.”