AUG 2013

EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.

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14 EW NEWS & OPINION August 2013 Chief medical editor's corner of the world Trying legislative advocacy: There's always a first time T he annual Alliance of Specialty Medicine Legislative Fly-In was held in Washington, D.C. last month. Of the more than 100 attendees from the different specialty societies that comprise the Alliance, ASCRS once again brought the largest contingent. Through its member organizations, the Alliance now represents more than 100,000 specialist physicians, which exceeds the entire membership of the AMA. This year's meeting occurred at a very opportune time by coinciding with the markup of bipartisan draft legislation from the House Energy and Commerce Committee to repeal the SGR. We were told that this is the furthest along that an SGR repeal proposal has gotten during the past few years, and we were able to voice our concerns over payment reforms contained in this draft legislation to key Congressmen and their staffers. In addition, both the Alliance and ASCRS were invited by committee staff to provide our feedback regarding the draft legislation in private closed door sessions. For those of us attending, this was a clear example of a positive outcome resulting from our presence on the Hill. I want to commend the continuing unsung and dedicated efforts of our ASCRS Government Relations Committee under the skillful leadership of Brock Bakewell, MD, and our Government Relations Director Nancey McCann. For understandable reasons, many physicians are too busy, too apathetic, or too cynical to engage in the process of legislative advocacy. Others may feel too intimidated or ill prepared to discuss the issues, and prefer to rely on the advocacy efforts of better informed colleagues. This is why I was particularly glad to see a number of new attendees from ASCRS this year, including several younger ophthalmologists. I have asked four of them to share their personal experiences and impressions from their first Fly-In with EyeWorld readers this month. I believe that many of you can more closely identify with these first-time attendees, and I hope you will consider attending the Alliance Legislative Fly-In next July. David F. Chang, MD, chief medical editor Chief medical editor's note: As we go to press, the latest SGR repeal/reform bill being marked up by the Energy and Commerce Health Subcommittee reflects the majority of the changes that the Alliance and ASCRS requested and focused on. Yuri McKee, MD Price Vision Group Indianapolis As physicians, we face significant challenges in delivering quality care to our patients. Immense regulatory burdens, looming reimbursement cuts, and frivolous tort action threaten our profession on a daily basis. While it is easy to commiserate and accept our fate, the end result of such inaction will be untenable. Advocacy at the local, state, and national level becomes an indispensable tool to protect our patients and our livelihoods. One need not be politically involved or connected to be a successful advocate. You only need to care enough about the future of medicine to donate a few days of your time. There is a significant impact made when physicians call upon the elected officials of their district. Legislators know that you interact with a large and diverse segment of the population every day. They know that you stand as a pillar of honesty and integrity in your community. On any given day, your opinion is probably the most important thing heard by your patients. Your status in the community matters, your opinion matters, and your actions matter. There will always be those who advocate for their own self interests to the government. If you do not advocate for your patients, then they (and you) will lose by default. I implore each of you, especially the young physicians, to commit to supporting your profession with action. Participation in the annual Legislative Fly-In is both an educational and rewarding experience. The critical issues before our legislators will affect the daily operation of your practice. Many of these legislators are poorly educated on the issues and the stakes involved in our complex medical system. Could you sit down for 10 minutes and explain the importance of maintaining access to quality care for our Medicare patients? Could you explain why runaway malpractice claims lead to the expensive practice of defensive medicine? Do you have just a few examples of how the unnecessary regulatory burden interferes with your practice? The ASCRS Govern- ment Relations Committee has taken the time to compile talking points and help draft legislation that protects our patients and our practices. Now they need you, the respected physician, to personally educate our representatives on how they can vote to improve our medical system instead of further burden it. The Legislative Fly-In is fun, educational, and effective. You will meet ophthalmologists and other specialists from around the country who have all taken time from their busy schedules to benefit patients and doctors alike. You will meet senators and representatives and you will have their undivided attention. There are no speeches or presentations to prepare. There is no speaking in front of a large group. The goals and talking points will be thoroughly discussed in meetings prior to your congressional appointments. A staff member will escort you to each scheduled meeting on the Hill. So what's stopping you? Please join us and commit to securing the future of medicine for our patients. I challenge my colleagues to field at least one ophthalmologist from every state to lobby on behalf of our patients next year. Contact the ASCRS Government Relations Committee to pledge your time and influence today. I hope to see you there. Bryan Lee, MD University of Washington Seattle During our training, ophthalmologists learn an incredible amount of information in a relatively short time. The Basic and Clinical Science Course is 13 volumes (almost all of which I have actually read), and that doesn't even count the surgical skills that take years to hone. What they don't teach in residency, however, can powerfully affect your practice. I have been fortunate to attend other ophthalmology advocacy days before, but my first Alliance of Specialty Medicine Legislative Fly-In this summer was a unique and valuable experience. One thing that stood out was our incredible access not only to senators and representatives but also to the professional staff that does much of the actual lawmaking. Unlike other ophthalmologyonly events, this was a collaboration with other specialists. Far too often, doctors see issues as a zero-sum game, so specialists fight with each other or with primary care providers over specific proposed cuts. By doing this, we make things too easy on the policymakers and weaken the voice of medicine, which already has so much less political clout than hospitals, insurance companies, and industry. The demographic trends are clear—the statistic we heard quoted most often during our time in Washington was that 10,000 people a day will be added to Medicare for the next two decades. The pressure the Baby Boomers will put on the federal government's budget is a pressing concern no matter your party or political affiliation. Because ophthalmologists have a high percentage of patients with Medicare, we have to stay engaged in the political process, no matter its flaws and frustrations. This is especially true for those of us at the beginning of our careers. Younger ophthalmologists have the most at stake because the bulk of our career is going to occur during this unprecedented expansion in Medicare enrollment. At the same time, we are arguably the most effective representatives of our issues with Congressional staffers because we are their peers. I enjoyed making new friends at the Fly-In, getting updated on the issues, and feeling the satisfaction of representing our profession and our patients. In comparison, giving up an OR day and clinic time was not much of a sacrifice. I am looking forward to attending next year's event and strongly recommend that you do so as well. Jay Fiore, MD Heimer Eye Care Associates State College, Pa. When I was invited by Parag Parekh, MD, to attend the Fly-In 6 months ago, my initial reaction was that I was nowhere near informed enough on the current healthcare issues facing continued on page 16

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