SEP 2013

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

Issue link: https://digital.eyeworld.org/i/176967

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Page 27 of 98

September 2013 and he died completely unknown. These stories are inspirational, and they stand on their own. Dr. Chang: I assume that this wasn't part of your retina training. From where does your interest in history originate, and what is your background as a writer? Dr. Lam: I've had a passion for history since childhood, but in college, I realized that being a historian can be a solitary profession, and I preferred interacting with people, so I went to medical school. I still wanted to write books, but instead of writing historical studies of esoteric subjects, my goal has been to make history more accessible, and more interesting, to the general public. My first book was a historical novel set in China during World War II, titled Two Sons of China. This novel will be published by Bondfire Books in 2014. I developed the plot during my middle-of-the-night shifts in the Wills Emergency Department. With a new baby at home, this was the only time I could find to think in peace. Now I have four kids, but my wife would say that I remain remarkably good at tuning them out when I'm brainstorming on some book idea. Dr. Chang: Although these pioneers and their accomplishments are well known to ophthalmologists, what are some of the most interesting things that you learned through your research that most of us wouldn't know? Dr. Lam: Many ophthalmologists know the rough outlines of what these men achieved, but aren't familiar with their full stories. They may know about Ridley's inspiration for the IOL after seeing inert plexiglass in a fighter pilot's eyes, but not that the rejection of his peers pushed him into depres- EW NEWS & OPINION 25 sion and postponed the acceptance of IOLs until long after he had ended his somber career. They may know that Kelman's invention of phaco was inspired by his dentist's tool, but not about his preceding years of repeated failures and ever-present desperation to earn the approval of his peers. They may want to learn more about the stuttering, multi-national effort to develop refractive surgery— from Lans' experiments on rabbits, to Sato's initial success and ultimate failure with posterior corneal incisions, to Barraquer's crazy idea to shape frozen corneal buttons with a watchmaker's lathe, to Fyodorov's "conveyor belt" RK clinic, to Srinivasan's first use of the excimer laser on a turkey leg. The heroes in this book never gave up, despite repeated defeats. They endured. It is clear to me that the development of today's treatments was not inevitable. We are practicing in a golden age of oph- thalmology, and we owe much of our capability to these dedicated individuals. majority vote. One can only imagine how such decisions will be mired in process and politics, with the effect that such Congressional rejection seems unlikely. Even more astounding, hospitals and long-term care facilities are exempt from any such mandated cuts until 2020. Therefore, although physician costs account for only 10% of Medicare expenditures, the target will obviously be "providers" and the care we deliver. It is also obvious that this will greatly impact our patients and their choices. One assumption is that those physician services that are most common, and therefore most costly for Medicare, will be the primary target of such recommendations. ASCRS and the Alliance of Specialty Medicine have consistently opposed the establishment of IPAB, and now our efforts are directed toward calling for repeal of this board. Currently, there is a bill for repeal pending in both the House and the Senate. One of the primary messages that we took with us was the call to support repeal legislation (H.R. 351/S. 351). Our message was facili- tated by education on the topic, staff support, and clearly written position documents, which were left at each of our Congressional office visits. The strongest message, however, was being there in person to voice our concern for this unprecedented establishment of such a small, broadly empowered group. I hope ASCRS members will act now. More specific details about IPAB and the legislative effort can be found at the ASCRS website in the Advocacy section. I would call on all physicians in the U.S. to take this opportunity and help make our message clear by contacting their members of Congress with the strong call for repeal of the Independent Payment Advisory Board, by supporting either the House or the Senate bill. Everyone's help is needed in this effort. EW Dr. Chang: What is your next book going to be about? Dr. Lam: I'm currently working on a historical novel called Repentance, based on the 442nd Regimental Combat Team, the segregated Japanese-American unit that fought valiantly in Europe during WWII while many of their families were incarcerated in internment camps at home. It may surprise many that this Nisei regiment became the most decorated unit in U.S. military history. My goal with a book like this is to entertain, but also to educate and shine a light on stories that deserve to be more well known than they currently are. EW Contact information Lam: email@AndrewLamMD.com The Alliance continued from page 23 Calling for repeal of IPAB Priscilla Arnold, MD Bettendorf, Iowa Attending the Fly-In, which ASCRS co-sponsors along with other society members of the Alliance of Specialty Medicine, provided a unique opportunity to learn and to act on the most critical issues in legislation facing physician practice. I have been participating in these events for a number of years, but this program in July was the most impressive in my memory. Perhaps that is because the legislation of primary focus this year deals with special risks for the practice of medicine. The initial presentations gave all attendees a "boot camp" training of the priorities that have been set for discussion. Then several members of Congress spoke to our group, with particular focus on these issues. A recurring message is "Your presence here is important!" Most especially, Dr. Price emphasized that physicians have to be advocates for our profession and for our patients, who are facing problems they may not even recognize. Appropriately, the legislative focus of ASCRS and the Alliance is concerned with maintaining access to specialty medical care. Certainly one of the most important of the threats to specialty care access is the establishment of the Independent Payment Advisory Board (IPAB). This board is a key component of cost regulation included in the Accountable Care Act (ACA). It is comprised of an appointed—not elected—panel of 15 members, none of which can be practicing physicians. The specific mandate of the IPAB is to recommend Medicare spending cuts whenever a specified target number is exceeded. Their power to determine how spending will be reduced is broad. In many ways, this mirrors the sweeping authority given to the Secretary of Health & Human Services by much of the legislative language of the ACA. Those cuts recommended by the Board, having no public hearing or other physician consultation, will then go into effect unless Congress rejects the action by Contact information Paul Arnold: paulnarnold@gmail.com Priscilla Arnold: prisarnold@gmail.com Bakewell: eyemanaz@aol.com Lehmann: doctorlehmann@me.com

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