Eyeworld

EW NEWS & OPINION 12 Dr. Chang: How did you become involved as a leader within ASCRS? Dr. Lewis: I joined ASCRS 15 or so years ago to get educated in high quality anterior segment surgery. There was nowhere else to get it! Only at ASCRS could you get the ed- ucation to keep current. Glaucoma, perhaps the most deficient in surgical innovation, was also in the midst of big change. Newer and safer surgical glaucoma options were being discussed. Many of my glaucoma colleagues (Reay Brown, MD, Alan Crandall, MD, Brad Shingleton, MD, Tom Samuelson, MD, Ike Ahmed, MD, and others) were already involved. It was a very exciting time to be on the newly formed ASCRS Glaucoma Clinical Committee. Canaloplasty was being launched and the new MIGS cate- gory of devices was being studied. Many of us were involved in con- sulting for the glaucoma device companies and in clinical trials. We started Glaucoma Day prior to the ASCRS•ASOA Symposium & Congress with a focus on glaucoma surgery. Becoming involved with ASCRS has been a tremendous source for me for new information and skills transfer; it has been transformative in my approach to anterior segment surgery. Dr. Chang: You are in private practice and have managed an ophthalmology-only ASC. What are the most pressing issues facing ambulatory surgery centers? Dr. Lewis: For many years, my surgery was performed in a hospital- based ASC. Ophthalmic surgery was a small part of the overall volume and received little attention. Equip- ment was seldom updated, scrub techs would float through, and turnover time was quite slow. We started our own ophthalmic spe- cialty ASC 10 years ago focusing only on anterior segment surgery. There was no looking back. Today, our specialty ASC, Capital City Surgery Center, performs more than 3,000 (mostly cataract) procedures a year. With a great staff and the latest surgical equipment, our ASC provides outstanding outcomes and remains a most efficient venue for eye surgery. The challenges for all ASCs today have to do with the myriad regulatory demands. We recently underwent a Medicare audit. As good as our facility is, the ever- increasing demands on our staff to document compliance are daunting and costly. Another problem that specialty ASCs face is the introduc- tion of new technology. New phaco machines, femto lasers, intraopera- tive aberrometry, and others have cut into the profitability and efficiency of our ASC. Balancing these demands requires strong management and cooperation among the partners. Dr. Chang: What are the biggest challenges facing our members in private practice? Dr. Lewis: ACA, ICD-10, ODs, EMR, SGR—this is just some of the "alphabet soup" of current and pending challenges for ophthalmol- ogy. These regulatory initiatives raise clinical and practice-related ques- tions: Can we survive in this new world? How do we maintain efficiency? How do we keep up especially with the onslaught of new and expensive technology? How do we stay profitable? The sense of frustration among our members that we are "under siege" is all too common today. Yet, when we reflect on what we have accomplished to help our patients, it is truly remarkable. Our biggest challenge is to sustain the remarkable innovation and improvements with patient care while maintaining value (reimburse- ment) for what we do. Given the massive increase in patients with the Affordable Care Act, the need for what we do will only expand. The real question is under what circumstances will we be working? Dr. Chang: You have also served as president of the American Glaucoma Society. Does this experience shape your goals for leading ASCRS? Dr. Lewis: After my glaucoma fellowship at U Iowa, I was hired to head the glaucoma section for UC Davis. Although I loved academics, I was a clinician at heart and my academic publications focused on glaucoma surgery and clinical stud- ies. From the start, I enjoyed teach- ing and was interested in getting involved. I formed the West Coast April 2014 by David F. Chang, MD Conversation with the new ASCRS president I am very excited to introduce Richard Lewis, MD, as the next president of ASCRS. Rick is uniquely qualified to lead our organization by combining a strong academic reputation in glaucoma with a notable and exceptional leadership background. Following his fellowship in glaucoma, Rick started in academics and subsequently transitioned into an ophthalmology group private practice in Sacramento, Calif. He later cofounded an ophthalmology single specialty ASC. Rick is very active in clinical research and has been involved in many important glaucoma clinical trials. Through multiple ORBIS trips, he has been an active teacher in the devel- oping world. Rick therefore understands and reflects the concerns of our broad membership, which covers the spectrum of private and group practice, ASC ownership, residency training, and academia, both in the U.S. and abroad. Rick has merited and been recruited for leadership in three major societies. In addition to chairing the ASCRS Glaucoma Clinical Committee, he is a past president of the American Glaucoma Society and was selected to be the inaugural chief medical editor of Glaucoma Today. Rick was a founder and subsequent chair of the AAO Subspecialty Day Program and served on the AAO Annual Meeting Secretariat Committee, which oversees the meeting's scientific programs. I've had the privilege of working closely with Rick both on this latter AAO committee as well as on the ASCRS Governing Board, and have found him to be one of our most insightful, pragmatic, and effective leaders. You will not meet a more likeable, caring, and modest person in ophthalmology. ASCRS is indeed fortunate to have Rick leading our organization as we tackle the many challenges facing us in the year ahead. David F. Chang, MD, chief medical editor Richard Lewis, MD Dr. Lewis with outgoing president Eric Donnenfeld, MD Source (all): Richard Lewis, MD Chief medical editor's corner of the world

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