Presidents challenge ophthalmologists to build alliances

New Orleans-Building on the adage that there's strength in numbers, Allan D. Jensen, MD, president of the American Academy of Ophthalmology (AAO), welcomed members of the AAO to the opening session of its first joint meeting with the European Society of Ophthalmology (SOE).

Dr. Jensen commented that it seems "appropriate that we are having a joint meeting, because the spirited success in facing challenges requires coalitions and alliances with various groups: ophthalmological, medical, and others."

He said that since ophthalmology comprises only a small percentage of the U.S. medical community, ophthalmologists need the support of others at the international, national, and local levels to achieve many of their goals.

"This presidential year has been busier than expected. Each president begins his term with enthusiasm and a theme," he said. "My hope is to address the challenges facing ophthalmological education. There is concern that ophthalmology departments are being financially stressed, being affected by the same segment reimbursement as private physicians, while administrative requirements are increasing, and liability rates are soaring."

In addition, Dr. Jensen said that 25% of programs are having difficulty recruiting permanent chairmen. Fewer ophthalmologists are volunteering, and resident work hour rules are costing tens of thousands of dollars.

But frequently, we cannot choose our battles, he said. As this year began, two new but related challenges presented themselves. First, the legislature of Oklahoma passed a law that would allow optometrists to perform essentially all types of ocular surgery, and the optometry board to determine their own scope of practice. Second, the Veterans Administration (VA) rescinded a policy prohibiting eye surgery by optometrists, and proposed to permit optometrists in the VA to practice up to the scope permitted by their state of licensure.

"The academy opposes optometric surgery because it threatens quality eye care, trivializes medical education, dilutes surgical opportunities by potentially tripling the number of eye surgeons, and thus, threatens ophthalmology training programs," he said. "The AAO addressed most of these issues promptly with the assistance of various coalitions and alliances."

As she begins her term, president-elect Susan H. Day, MD, challenged ophthalmologists to recall the academy's recent launch of the EyeMD campaign and to ask: "Why MD?"

"Can anyone imagine a more wonderful vocation than helping people see?" she asked. "Why, then, is there unease among us? What's eroding the feel-good in our ranks?"

Dr. Day said the answers might be found by looking at lessons from centuries ago. "Without a doubt, knowledge is on our side. The depth of our training ensures we have the tools to care for our patients," she said.

She proposed four essential behaviors ophthalmologists can adapt to stop the "irresistible tide" by: maintaining our ties to medicine; maintaining our own competence; involving ourselves in the medical community; and training tomorrow's ophthalmologists.

Why MD? "It's the process of our education which makes us what we are," she said. "Now, it's the behavior of each of us that will help determine our future."