On what issues do you intend to focus your efforts during your term? My primary objectives fall into several categories. First, there is the perception that the pharmaceutical industry has too much control over the prescribing patterns of physicians and that the manufacturing sector has too much influence over physicians' presentations, meetings, publications, etc. The ASCRS remains very concerned about these issues and continues to dedicate time to determine the best balance of information. This is an important matter, as credibility is crucial to me, individually, and to the ASCRS. However, one cannot overlook the fact that the industry's contributions to our patients' benefit as well as our member physicians' incomes have been enormous over the past 2 decades. The partnership that we share is spectacular. I consider all of us a part of a surgical industrial complex, a term I use with both positive and negative connotations. The collaborative efforts that bring products and techniques to patients are fantastic. Yet, we must ensure that the information we present within our profession and to the public is based on fact, with as little bias as possible. Next, the ASCRS will continue to expand and strengthen its relationships with sister organizations on a worldwide basis. We can share information with colleagues abroad, and, in turn, we have the opportunity to work with our international colleagues in the off-shore development and evaluation of products that have not yet progressed through the FDA's approval process. Third, the ASCRS is concerned about Medicare and the Centers for Medicare & Medicaid Services (CMS). Fortunately, within the last year, the CMS has allowed patients to pay a premium for products that they deem worthwhile, namely presbyopia-correcting IOLs. I hope that additional products and services will be similarly recognized. For example, the CMS has a code for complex cataract surgery, and I would like to expand upon it to include other conditions associated with cataract so that more individuals, such as the one-eyed patient, may qualify for the complex cataract code.
What will be your biggest obstacle over the next year? It is undoubtedly the question of regulation and reimbursement. At this moment, the government is developing a Pay-for-Performance program that will ultimately mandate that the quality of our work is a factor in reimbursement. Additionally, the Federal Administration plans to reduce the Medicare budget. Given expanding technology and an aging population, this seems counterintuitive. Therefore, swimming upstream against the “reimbursement tide” will be among the biggest challenges for the ASCRS and for me this year. Moreover, I would like to encourage the membership to be more involved in advocacy issues, both at the national and state levels. I am disappointed that slightly more than 100 of our 6,500 domestic members contribute to the political action committee fund. The members must recognize that their time and support are central to our advocacy efforts.
Do you plan to make changes to any current systems or policies? The ASCRS has developed numerous clinical committees that have become an important part of the society. I intend to expand the base and responsibility of these committees and to broaden their spectrum of activities so that they may play an even more prominent role. Through our clinical committees, I hope to develop the future leadership of the ASCRS. It is vitally important that we relate and appeal to our younger members and instill in them the zeal for leadership opportunities.
How will your new position affect you as an ophthalmologist/your other responsibilities? I firmly believe that whatever is in the best interest of the patient is in the best interest of the doctor, and that is the philosophy by which I practice. In planning for this transition, I am concerned about my availability to my patients and my practice. Fortunately, I have a wonderful young associate, Gavin Bahadur, MD, who, I anticipate, will find himself busier in the coming year. I also expect that my new role will impact my career positively by allowing me to garner more leadership and organizational skills.
Did you have any mentors early on in your career? I held a part-time strabismus fellowship with Phillip Knapp, MD, who was at the Harkness Eye Institute at Columbia Presbyterian Hospital in New York City. Dr. Knapp was impeccably honest with his patients and coworkers. His manner of dealing with patients has stayed with me forever. Besides being a giant amongst the strabismologists, he was an incredibly humble and generally interested physician. He influenced me more in my style of practice than any other physician I have ever known, and I hold him in incredible esteem. n