• Growth of the Independent Organization, Part 2

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    In our last issue, we published “The Great Split: Our Oral History, Part 1” from David Noonan’s Academy history, he recalled his first days with the combined American Academy of Ophthalmology and Otolaryngology, the singlehanded focus on education, the governance and meetings, and the “divorce” organizationally between ophthalmology and otolaryngology. We now pick up on his description of the American Academy of Ophthalmology’s infancy under the leadership of Bruce E. Spivey, MD.

    Bruce E. Spivey, MD, Academy EVP, 1979-1993

    Moving the American Academy of Ophthalmology to San Francisco was approved by the new board of directors, ostensibly based on a 30-page document demonstrating a comparison of sites among Washington, D.C., Chicago, and San Francisco, Dr. Spivey’s home. They wanted Spivey! The Spivey years have been described as the era of growth. Growth springing out of a much broader role the organization could fulfill by maximizing members’ interests beyond clinical education.  

    No sooner had the ink dried on the divorce papers than the membership recognized decisions were being made in Washington affecting research and residency training. It was deemed advisable to have an Academy “listing post office in Washington D.C.” to be sure you had a voice. As this voice grew in volume and success, members who belonged to both organizations (AAO and American Association of Ophthalmology) recognized the employment of similar tactics and began to wonder if one voice would better serve the profession. 

    If divorce was hard, marriage can be difficult too, particularly when it calls for joint family reunions. Issues and egos were assuaged. New membership categories allowed for a much broader membership involvement, the new Academy Board represented a broader pallet of interests beyond education. 

    The merged ophthalmic Academy included a council that you might recognize today. The board saw the council as an adviser to issues needing organizational involvement by the Academy. 

    Here are some examples of growth and expansion of scope for the Academy:

    When 600 members of the Academy were told that their malpractice insurance was no longer going to be underwritten, the Ophthalmic Mutual Insurance Co. (OMIC) was formed. OMIC not only underwrote those immediately affected, but within five years could demonstrate that the level of malpractice incidents could be reduced from that comparable to neurosurgery, to that akin to family practice. This fact alone caused other insurers to reduce their premiums as well.

    The “new” merged Academy required an amended tax status. This, in turn, permitted the creation of the foundation, which could advance the philanthropic and public service aspects of the organization. As a result, EyeCare America remains the only national medical society service outreach program, recognized by presidential citations from multiple administrations. The foundation also gave rise to our Ophthalmic Heritage Program, which we hope will finally evolve to a freestanding Museum of Vision.

    When I was a high school student, my father’s opinion was that in any organization, you will find about 2 percent who do not behave well either out of avarice or ignorance. In recognition of this, the Academy established its Code of Ethics. With its clear, concise, aspirational principles, coupled with examples of appropriate behavior, the Academy’s code rarely has had to employ its enforcement provisions to the final disposition. In my opinion, this program ranks as high as any achievement, developed by the Academy in protecting the public opinion of your profession.  

    In 1990-91, a challenge to the organizational structure occurred. 

    Some members of the Academy grew dissatisfied with its decision process, organizational representation and strategic direction. It grew out of the belief that a House of Delegates structure would lead to a more representational governance. This structure had been adopted by the American Medical Association and many state medical societies. This dissension led to the largest and most comprehensive examination of the Academy in its history.

    The final report preparation included 220 individuals involved in its creation, review and critique with the report 79 pages in length. The study concluded that a House of Delegates structure would not serve the Academy well. It recommended that a Board of Trustees involving highly representational positions with staggered terms and responsibilities was a better pathway. The Council would continue as an advisory to the board and represent both state and subspecialty interests. This report was submitted to the entire membership at the Annual Meeting and was adopted by a vote of 2,011 to six.