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A bi-monthly blog detailing the latest news and perspectives from the president of the Colorado Society of Eye Physicians and Surgeons.

 

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President's Update: July/August 2019

Posted By Chet Seward, Tuesday, August 13, 2019

As we enter past the halfway mark for 2019 there are two relevant issues for ophthalmologists in Colorado to consider. One of the biggest events in the medical community is that an exploratory committee has been created to evaluate the state has been directed by the legislature to develop a plan to implement a "public healthcare option" by Governor Polis. Continued high health care costs, among other political motivations, clearly are a driver of this work. While details have yet to be fleshed out, this could have significant impacts on the practice of medicine. During meetings with the Colorado Medical Society in July, issues such as attempts to cap physician reimbursement were met with strong disapproval. We believe that these restrictions only will limit access to care for our patients in the State.  As the governor continues to push for to develop a public option for Colorado continues, CSEPS stands to protect ophthalmologists from reimbursement limits, scope of practice expansion and required participation in plans with historically terrible reimbursements. Please watch for more details and be ready to act. 

Secondly, there has been a recent study showing that there are some limitations of access to medical care issues for ophthalmology in Colorado. When it comes to getting an office visit in a timely fashion, ophthalmology currently ranks as the most limited specialty in the state. For most of my friends who have a burgeoning practice in Boulder, Denver and Colorado Springs this may seem absurd, but for uninsured and Medicaid patients the modeling in this study shows a different story and it’s likely that parts of the state experience this differently. Though we are investigating the exact rubrics of the study further, it is clear that limits placed on ophthalmologists in any way serve only to reduce patient access especially in rural areas. Ophthalmology is an expensive specialty with expensive equipment, large staffing, and specialized surgical needs. The state needs to be supportive of ophthalmology if they we want to prevent even further reduction in ophthalmology access. Read more about the study in the story below. I also want to hear what you think so we have created a secure, members-only forum for you to share your thoughts on the study, potential solutions and next steps. Please click here and join in the dialogue and then stay tuned for more information. It is the goal of CSEPS to educate and engage with our legislators about the needs of our patients and our specialty so that we can to what our needs are as a specialty to offer the most robust and best care for our patients possible. 

Enjoy the summer and if you have questions feel free to email me at or our administrative head Chet Seward

Sincerely,
Chris

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President's update: May/June 2019

Posted By Chet Seward, Friday, June 7, 2019
As we reach the halfway point for 2019 it is time to take stock. There have been challenging changes in the legislature that affect physicians in Colorado. An out of network limit has been created for physicians which may interfere with the negotiating powers of physicians and groups. On a good note, we joined the successful fight against trial lawyers that wanted to pierce the confidentiality of the peer review process and prevailed to preserve these critical protections. We also got a little legislative relief for prior authorization administrative burdens and our neighboring state of Wyoming resisted a vigorous optometric scope of practice expansion to protect ophthalmologists there. Though we have had challenges the practice atmosphere in Colorado has still been good for ophthalmologists. 

It is important to have continued membership and involvement to protect our specialty. CSEPS will be holding a social mixer this summer on July 24 to engage in fellowship with our colleagues. I hope to see as many surgeons as possible in attendance. It will be a fun time for all and will help to keep our connection as colleagues. Additionally, we are looking for surgeons who would welcome legislatures to observe them in the operating room setting. Creating a bond through direct observation will help legislatures understand the critical and precise work that ophthalmologists do when they perform surgery. If you are interested in volunteering please email me or Chet Seward and we will work out the details to make this visit both easy and meaningful for you. Thank you so much and looking forward to a great rest of 2019.

Sincerely, 
Chris

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President's update: March/April 2019

Posted By Chet Seward, Wednesday, May 15, 2019
As 2019 starts off there have been some interesting legislative issues that could have a direct impact on ophthalmology. A bill that was introduced to cap out of network costs for patients has passed preliminary stages in the Colorado legislature. CSEPS stands against the bill with other medical specialties. It would indirectly give insurance companies the upper hand in negotiations with doctors and medical groups since the alternative for contracted care would have financial limits. 

On a good note, our colleagues in Wyoming narrowly won a scope of practice battle which would give optometrists wide authority to perform certain laser and surgical procedures. It is safe to assume that this type of legislative effort will come to Colorado shortly. Ongoing discussions with our colleagues about this is the only thing that will promote involvement and participation in membership. 

Finally, the outlook for ophthalmologists in the state is good for this year. Colorado has sustained good economic prosperity, low unemployment and an influx of people moving into the state. Our Colorado ophthalmologists stand as one of the most cutting edge, technologically advance eye surgeons in the country. We look forward to a great rest of year and look forward to what the future will hold.

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President's Update: January/February 2019

Posted By Chet Seward, Thursday, February 7, 2019

ChristopherThiagarajah, MD
As we look towards 2019, I would like to first take the time to thank you for the honor of serving you this year as the president of the Colorado Society of Eye Physicians and Surgeons. Moving here from Washington D.C in 2015, it has been an honor and privilege to get to know my colleagues professionally and socially in Colorado. The Colorado ophthalmology community is indeed unique and offers the highest standards of patient care found anywhere in the nation. 

This year my goal is to maximize ophthalmologist involvement and membership in our society. We truly need "all hands on deck." Ophthalmology offers us the opportunity to provide medical and most importantly surgical care of our patients’ vision. We know that one of the major reasons why ophthalmologists say they belong to CSEPS is advocacy. This year, there are several challenges facing the eye physician community and we need you with us in these advocacy fights. Lawyers that sue physicians are making moves to destabilize the medical liability climate and loosen confidentiality protections associated with peer review. We fully expect a concerted push during this legislative session. You know the anticipated effects of these efforts – more lawsuits, increased costs for patients due to defensive medicine, increased malpractice premiums and access to care problems caused by physicians be driven from the state. We certainly need all the ophthalmologists in our state to protect our specialty and most importantly our patients from this. 

I ask all members in our society to reach out to colleagues to simply talk about what is going on and ask, "Are you a member in CSEPS?." Colleague involvement is the first step to protecting what I consider one of the most amazing medical specialties in an amazing state. I wish you the best in 2019 and look forward to working with you. Feel free to reach out to me at or 202-550-1190 if you have any questions or would like to get more involved.

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President's Update: November/December 2018

Posted By Chet Seward, Friday, November 30, 2018

Leonard Seibold, MD
As physicians today, we have to practice medicine in an increasingly stressful environment. In the 1980s, Maslach and colleagues described the term physician burnout as a combination of emotional exhaustion, depersonalization, and low personal accomplishment caused by the chronic stress of medical practice. Estimates of this self-reported syndrome range as high as 80% of all physicians in a recent JAMA review article. Ophthalmology has been described as among the happiest of all medical specialties both in and outside of work, but with some of the grim realities of practice today, even a substantial amount of us are affected by burnout. Increasing bureaucratic tasks, extensive charting requirements, and electronic medical records have been pegged as three of the most common reasons for burnout in a recent survey of ophthalmologists. Increasing government regulations and decreasing reimbursement were also frequently cited for deteriorating job satisfaction. Add to this the ever-escalating demands and expectations of patient’s vision and it is no surprise why we are more stressed than ever today. 

So, what to do about the increasing prevalence of physician burnout? The solution is likely even more complicated and amorphous as defining the condition itself. Joining a yoga studio or enrolling in mindfulness classes may help reduce stress, but they fail at addressing some of the root causes of the problem. However, with better understanding of what leads to burnout, I think we can begin to search for solutions. As your state ophthalmology society, the mission of CSEPS is often aimed to help address some of these issues. 

Our legislative committee serves to constantly surveil legislation than can affect your practice patterns and oppose those measures that increase your administrative burden or compromise scope of practice, while supporting measures that decrease bureaucratic headaches, and protect fair reimbursement. Outside of advocacy, we strive to support our members in other ways. Social events such as a recent social mixer with COA help to reconnect you with fellow ophthalmologists and build good will with our optometric colleagues. Clinical and practice management education are among other ways we help to promote your well-being as an ophthalmologist in Colorado. Your membership serves to vitally strengthen our society and our ability to minimize these practice burdens as well as protect patient safety. Burnout is a complex problem but CSEPS and AAO can play a small but critical role at minimizing future burdens and rolling back present ones.

As I near the end of my term as CSEPS president, I am deeply grateful to our membership and board of directors for helping maintain the strength of our noble profession in Colorado. The vision and drive of our past leadership has fulfilled our mission to promote excellence in patient care through advocacy, education and fostering professional fellowship. It has been an honor to serve in furthering this mission over the past year, and I look forward to the future direction of our 2019 president, Chris Thiagarajah.

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President's Update: September/October 2018

Posted By Chet Seward, Tuesday, October 9, 2018

One thing that continues to amaze me is how little effort it takes to make a big impact for our profession. Defending our profession and protecting our ability to provide superb eye care to the patients of Colorado does not require a weekly visit to the state capitol or a second home in Washington D.C. It can be as simple as joining or continuing your membership in CSEPS. As your state ophthalmology society, we are largely funded by dues which are essential to lobby on your behalf. Another surprisingly simple way to have a big influence is by reaching out to your legislator for a visit. I would like to congratulate a couple CSEPS members who recently did just that. 

Last month, Ron Pelton, MD and Dean Carlson, MD, of Colorado Springs met with state representative Larry Liston (district 16) to provide a real-life exposure to the complexities of eye surgery. This meeting was in part the fruit of an earlier connection made at our inaugural legislative reception this past April that representative Liston attended. These types of relationships can develop in many different ways but are critical to building an alliance for ophthalmology. By simply contacting your legislator’s office you can help to do the same in your district and CSEPS is here to assist in getting the ball rolling. 

Also last month, I had the pleasure of meeting with US Representative Mike Coffman (CO-6) at the 

It was great to spend time with Congressman Coffman and have Erin Sieck, MD, there to help hit the policy highlights.
UCHealth Eye Center on behalf of the AAO and CSEPS. After touring the facility and demonstrating the technology, staff and resources required to provide cutting-edge eyecare, we sat down to discuss a few key issues facing ophthalmology across the nation. Specifically, this included truth in health care advertising, relief from burdensome prior authorization requirements, and the rising cost and decreasing availability of drugs recently. Underlying all these issues was the essential goal of creating an ally for our profession. While it is hard to know the long-term benefits, we are already seeing immediate results. After the meeting Rep. Coffman pledged his support to help address the prior authorization abuse. 

We will continue these grassroots efforts at CSEPS to ensure your ability to practice ophthalmology across the state. I again invite you all to consider joining in these efforts locally. You will be amazed how a small amount of time and effort can prove extremely rewarding.

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President's Update: July/August 2018

Posted By Administration, Tuesday, August 14, 2018

The ongoing mission of CSEPS is to promote excellence in patient care through advocacyeducationand fostering professional fellowship.  We strive to achieve this noble mission through a variety of methods that are relevant and practical to you as a practicing eye physician in Colorado. So what have we been doing to attain these goals recently? 

 

Advocacy

We are constantly monitoring potential legislation that may impact you and your ability to provide the best care for your patients. With the adjournment of the 2018 legislative session on May 1st, our focus is shifting toward the election cycle and maintaining a base of support for ophthalmology at the capitol.  Building relationships with freshman legislators and reinforcing friendships with veteran lawmakers is crucial to ensuring strong support for ophthalmology in our state.  

 

As president of CSEPS, one my priorities is to double down on these efforts to maximize our voice at the capitol. Our society leadership has excelled in this endeavor in years past, but I need your help to ensure success in the future. During the current election cycle we need CSEPS members who can help develop and bolster these friendships for our profession. Our society can provide you with the campaign check, you just need to give 30 minutes of your time to meet and sit down with your local legislator and provide some real-life experiences of what a Colorado ophthalmologist does to improve and save vision in our state.  Although this may sound daunting to some, I am still amazed at how laid back and rewarding these interactions can be and what a lasting positive impact we can leave. If you have an interest in getting involved as an advocate, please email our executive director, Chet Seward at to get more information. 

 

Education

In September, CSEPS will again partner with the University of Colorado Department of Ophthalmology to deliver their 22ndannual Ophthalmology Symposium.  The ACCME accredited course will include a mixed format of didactic lectures, open forums on high yield topics, and challenging case discussions.  Course lecturers include department faculty as well as five invited nationally renowned experts from different ophthalmology subspecialties. Members of CSEPS receive a discount on registration for this course. Complete meeting information and registration is available, so register now


Fostering professional fellowship

Last month, CSEPS held a lively social mixer at Top Golf in Centennial. Despite the heat, members in attendance enjoyed some excellent food and drink while socializing with colleagues. While the top golfers will not be revealed on this newsletter, I am confident everyone released a healthy amount of stress on the golf balls that day.  Stay tuned for future social events coming up in the fall/winter.

 

Finally, I want to thank you for your membership in CSEPS – it is an essential step toward achieving our collective vision for our profession and the patients we care for.

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President's update: May/June 2018

Posted By Chet Seward, Friday, June 8, 2018

Colorado ophthalmologists went to Capitol Hill in Washington D.C at the AAO Congressional Advocacy Day last month. Joined by over 400 colleagues from every state, we met with our nations legislators and staff to advocate for our profession and our patients. 

The five principal agenda items this year were:

  • Maintain access to compounded and repackaged drugs – particularly for intravitreal injections
  • Simplify Merit-based Incentive Payment System (MIPS)
  • Support the VA’s Technology-based Eye Care Services (TECS Program)
  • Secure regulatory relief from over-burdensome prior authorization requirements
  • Support funding increases for the NIH/NEI and the DOD’s Vision Research
Colorado Advocacy Ambassadors Drs. Erin Sleck, Michael Wildes and Cullen Ryburn.

It is always a point of pride to witness our consistently strong delegation from Colorado at this crucial event.  In addition to practicing CSEPS members, this year we were accompanied by three residents from the University of Colorado to serve in the Academy’s Advocacy Ambassador program. This innovative program is designed to educate and motivate our young ophthalmologists on the vital importance of advocacy for our profession.  These young doctors are often the most convincing voice in legislative meetings. As a product of CSEPS mentorship and this program myself, I firmly believe we must continue to cultivate this upcoming generation as our future leaders.

For those unable to make it to D.C this year, we were extremely fortunate to have AAO president Keith Carter, MD, visit our great state just a couple weeks ago.  He provided CSEPS members in attendance with an extremely informative briefing on the Academy’s agenda items in 2018.  Some key tasks included building “big data” through the IRIS registry and utilizing its power to improve clinical outcomes and fulfill billing requirements, online education revamps/updates, preparing for a shift in reimbursement methods, and grappling with scope of practice issues not only for optometry, but physician extenders such as nurse practitioners and physician assistants as well.  

Dr. Carter also provided an in-depth review of surgical scope victories and defeats throughout the nation in years past as well as ongoing and proposed future battles. Fortunately, in Colorado, we have enjoyed good relations with our optometry colleagues with no major scope battles in recent years.  These battles can be extremely challenging and costly to defend patient safety and maintain surgery by surgeons.  I encourage you all to contribute to the Surgical Scope Fund, which provides targeted support to these battleground states every year.  Furthermore, consider contributing to OPHTHPAC and our state EYEPAC, which provides support to physicians and political candidates who support ophthalmology’s interests on the national and state level, respectively.

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President's update: March/April 2018

Posted By Chet Seward, Friday, April 13, 2018

Spring is a beautiful time in Colorado as the temperatures climb, trees begin to awaken, and native wildflowers bloom as the snow fades into swelling rivers. It’s a great time to venture outdoors more and experience the expansive beauty of our wonderful state. It is also a crucial time for advocacy for our noble profession and the patients we take care of on a daily basis. The recent news of Anthem’s denial for coverage of monitored anesthesia care (MAC) during cataract surgery is just one glaring example of why we must be vigilant to combat assaults on our ability to safely and effectively care the for the eye health of our patients. 

On a national level, the AAO Mid-Year Forum meeting will take place April 18-21, 2018 in Washington, DC. The pinnacle of this event is the Congressional Advocacy Day where I will join a delegation from CSEPS to meet with our national legislators from Colorado to build support for key ophthalmology issues affecting our field across the country. 

Here in our great state of Colorado, we continue to closely monitoring several relevant legislative measures including the recent signing of HB 1012 by Governor Hickenlooper on March 29. CSEPS helped support this bill which prohibits vision care plans from setting onerous and overreaching requirements on eye care providers. As part of our continuing mission, CSEPS will continue to work through advocacy and lobbying efforts on your behalf to support measures that support your practice and oppose those that work against it. 

Finally, I want to thank everyone that attended our first ever legislative reception on April 12. It was a strong showing on behalf of ophthalmology.

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President's update: Jan/Feb 2018 – One step

Posted By Leo Seibold, MD, Wednesday, February 7, 2018

Greetings fellow Colorado ophthalmologists, 


Leonard Seibold, MD

It's hard to believe we are already into February of the new year! Time certainly waits for no man, and only seems to pick up steam with each passing day. With this in mind, we have to remind ourselves to seize the opportunities of each day before we find ourselves at the end of year wondering where it all went.  
As I take the helm for CSEPS in 2018, I would like to congratulate and thank our outgoing president, Alan Kimura, for his skillful leadership in the year past. He epitomizes what an advocate should be and has remained committed to service for our profession and our patients.

One of the most inspiring speakers during the AAO leadership development meeting was a man who is helping to lead the fight against human trafficking in the United States. As a successful businessman he had no experience whatsoever in fighting these atrocities, but he knew it was wrong, and he simply took "one step" to do something about it. That "one step" led to the next one, and so on until his rudimentary but inspired efforts led to the creation of an international foundation dedicated to this humanitarian mission. It was an inspiring story that resounded with me and exemplifies the profound impact of simply taking that initial step. 

The mission of CSEPS is to promote excellence in patient care through advocacy, education, and fostering professional fellowship. We can only accomplish this through your membership and engagement. So as your new CSEPS president for 2018, I invite all of you to join me in taking just "one step" forward for our noble profession. No matter what your past involvement has been, there are a number of ways you can do that this year.

  • If you have been sitting on the sidelines, take that first step toward joining ranks with your fellow ophthalmologists as a member of CSEPS. 
  • If you have been a member but never participated in any program, make your one step be attending one of the many educational, practice management and social events held throughout the year. 
  • If you are already a participating member, consider making that next step in serving on our board of directors or becoming an advocate at the state or national level.
  • Connect with your local representative and invite them to your clinic and operating room to bolster support for ophthalmology and our patients in the legislature. 

Sometimes that first step is the most difficult one to take, but it may start you on the path to achieve feats you never thought possible. So, take that first step with me, and let's see what we can accomplish together in 2018.

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