ASOPRS JOURNEY IN THE WORLD OF ADVOCACY: MY QUEST
Category: SASOPRS Article Blogs
Sep
05
ASOPRS JOURNEY IN THE WORLD OF ADVOCACY:
MY QUEST
Commentary by Stuart R.Seiff
As I began my career in medicine, I never thought that I would be sucked into the world of medical advocacy. But I guess stranger things have happened. Don Quixote sought to save the world by slaying windmills. Such has become my fate as well.
My first role was as an associate preceptor (program director) and then as a preceptor. Somehow, I was asked to chair the Preceptors Committee, which got me a non-voting role on the Executive Committee, followed by a job as Secretary of Meetings. From there came the three-year Presidential track, followed by the Chair position on the Committee for Government and Intersociety Affairs (a 10-year term). All of this provided me with a window seat on the EC for over 2 decades.
When I first entered ASOPRS in the late 1980’s, oculoplastic surgery was finding its way among the plastic surgery specialties, and it seemed that our relationship with ophthalmology and AAO was a bit of a ball and chain. Facial Plastic Surgery was successfully battling general Plastic Surgery for its share of the pie. Although the AAO had recently brought all of ophthalmology under one umbrella, there was a sense ASOPRS needed to break free. With the success of Facial Plastics in establishing a Board, such talk started among ASOPRS members as well in an effort to get the recognition we wanted among other specialties and the public.
Under the leadership of such luminaries as Mike Hawes, Bill Nunery, Russ Gonnering, Brad Lemke, Ralph Wesley, Chris Fleming and others, Board Certification became the holy grail. We learned that this would need to be blessed by the ABO. After many requests, Dennis Oday, then chair of the ABO, finally agreed to look at options for Board Certification of “Oculoplastic Surgery” if we could get buy in from the “Greater House of Ophthalmology”. This meant approval by the AAO Counsel. Our leadership group learned to advocate and “work the room.” We next needed an ACGME curriculum, which was spearheaded by Bryan Sires. We were successful and the curriculum, with positive modifications, still exists and is the model for our ASOPRS fellowships. We were slowly learning how to advocate for ourselves in a very big house of medicine.
Roger Dailey took on ASOPRS Advocacy as his AAO LDP project and brought home the concept that “if we are not at the table, we are on the menu.” Our destiny was cast. We continue to struggle with the Board Certification issue, but that quest illustrates our need to establish relationships within and outside of ophthalmology. Roger, Chris Fleming, Bob Kennedy, Jeff Nerad, and I really pushed that envelope. This led to the creation of the Committee for Intersociety and Government Affairs that I had the pleasure to chair for 10 years. I passed the chair to Mark Mazow, who has incredible insight into how to navigate the waters of organized medicine and government. With this Committee, ASOPRS had the advantage of “institutional memory,” and we were able to engage medicine and government on many levels on behalf of our members.
A glimpse at what ASOPRS has accomplished is impressive.
Roger Dailey encouraged us to become a part of the Physicians Aesthetic Coalition (PAC). This enabled us to meet and find common ground with our aesthetic surgery Core 4 partners. These contacts have been invaluable as we navigated the troubled waters of regulatory medicine.
ASOPRS became involved in the Surgical Scope fight because optometry perceived eyelid surgery to be an area where Ophthalmology might let them get a surgical foothold. Their first win was New Mexico, and since then, ASOPRS has been at the table with AAO fighting, state by state, with impressive success to date. However, I think we need to be flexible in this fight moving forward.
The bundling of ptosis and blepharoplasty was clearly a blow to our members. Although we have not been able to overturn this, our Society has provided members with work arounds. That said, when CMS decreed that a Medicare beneficiary could not undergo a cosmetic procedure as part of a functional procedure, ASOPRS and AAO leadership, along with a coalition of our plastic surgery colleagues, promptly got this overturned. These relationships are invaluable.
ASOPRS has worked with our AAO colleagues to limit Medicare RAC and SMRC audits. We continue to try to reduce the burden of prior authorization, as well as these audits, in many areas of our field.
When COVID struck, ASOPRS and AAO worked with Congressional contacts and, ironically the restaurant industry, for modifications to PPP Loan rules that allowed a larger percentage of the loan to be used for operating expenses. We also worked with our colleagues in the House of Medicine to modify FDA limitations on office compounding of drugs.
The role of an organization such as ASOPRS is to provide education and advocacy for our members and patients. However, advocacy is a bit like Don Quixote’s quest to make the world a better place. Slaying windmills is a good place to start, but beware that even when many of the windmills are eliminated, more will grow. Thus, as our Senior members fade into the sunset, ASOPRS needs the next generation to pick up the torch and protect the interests of our members and patients. BACK to Newsletter
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