Ophthalmologists face several public policy issues, AAO official says

When the Centers for Medicare and Medicaid Services (CMS) publishes reports onthe physicians who participate in the Physician Quality Reporting Initiative, patients may besuspicious of physicians who don't participate, said William Rich III, MD, medical director ofhealth policy, American Academy of Ophthalmology (AAO). He provided the perspective of thepractitioner during a mini-symposium on glaucoma public policy.

He also said that the transactional approach to health care, wherein a physician provides aservice and then is paid, is changing to a system that recognizes efficiency in care.

The drive for enhanced quality measures with an emphasis on outcomes is here to stay, Dr. Richsaid. Any system measuring quality and outcomes, however, be it in the public or privatesector, should recognize (in the case of eye care) that some ophthalmologists aresubspecialists for whom the majority of patients have more serious conditions than those seenby general ophthalmologists or optometrists. Not all systems have this ability right now, headded.

"We have to get consumer groups involved," Dr. Rich said.

The public policy issues related to glaucoma that Dr. Rich addressed included the use ofeconomic profiling, the overvaluation of services, the search for a new fix for the sustainablegrowth rate, the increased scrutiny of new devices, and relations with industry. On the latterpoint, Dr. Rich said, ophthalmologists should examine their individual relationships withindustry. Pressure to report the receipt of meals, drug samples, pens, and the like, isincreasing, he said.