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2013 ASCRS•ASOA San Francisco Daily News Sunday

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10 EW SHOW DAILY Sunday, April 21, 2013 Friday March 25, 2011 ASCRS News Today ASCRS Resident and Fellow Program highlights realities of practice by Chiles Aedam R. Samaniego EyeWorld AP Senior Staff Writer Sonia H. Yoo, MD, and Bonnie An Henderson, MD, at the "Challenging Video Cases for the Young Surgeon" symposium. T he ASCRS Residents Task Force, ASCRS Young Physicians and Residents Clinical Committee, ASOA Physician Relations Committee, and the Cornea Society devoted SAturday morning to providing young physicians with "really important seminars" that will "impact [the young ophthalmologist's] life from day to day in practice, not just in training," said Bonnie An Henderson, MD, Boston. Dr. Henderson co-chaired the ASCRS Resident and Fellow Program with Edward J. Holland, MD, Cincinnati. Nancy McCann, ASCRS•ASOA director of government relations, began the program by encouraging attendees to be more politically active. Quoting Former North Carolina Sen. Sam Ervin she said: "If men and women of capacity refuse to take part in politics and government, they condemn themselves, as well as the people, to the punishment of living under bad government." The government, she said, sets and influences reimbursement rates; dictates medical practice; enacts and enforces laws that can fine ophthalmologists and/or even put them in jail; controls the process for approving and paying for new technology; funds research and sponsors public health initiatives; and funds medical education. Young ophthalmologists, she added, can begin by learning about the issues through www.ascrsgrassroots.com. Through the website, interested parties can become ASCRS "eyeContacts." They will then receive alerts informing them of issues and asking them to contact their representatives in Congress. "If you don't act now, someone else will," said Ms. McCann. "Don't let someone without your technical and professional knowledge make the rules you follow." Should any ophthalmologists be interested, she said, the ASCRS staff will be available to help. Providing a view of the flipside of the ophthalmologist's relationship with and responsibility to society, Mark E. Kropiewnicki, JD, LLM, Health Care Law Associates, talked about "How to avoid being sued: What you can do to reduce the risk of regulatory or malpractice liability." It is important to be aware of the relevant laws, but to begin with, said Mr. Kropiewnicki, it helps to learn a kind of pattern recognition— knowing when you may be getting yourself into trouble. Some major rules that young ophthalmologists should be aware of include the Anti-Kickback Statute, which attempts "to curtail the corrupting influence of money on healthcare decisions"; Stark, the Physician Self-Referral Law; the False Claims Act (FCA); the Civil Monetary Penalties Law (CMP); the Health Insurance Portability and Accountability Act (HIPAA); Coding Issues; and documentation. On the latter, if you didn't document, Mr. Kropiewnicki said, it didn't happen. To reduce the risk of malpractice liability, first is maintaining good rapport with patients. Good patient relationship and communication, he said, is essential. It also helps to be competent— flow sheets and protocols reduce the chances that important factors are overlooked. Mr. Kropiewnicki also recommended never guaranteeing results to patients; understanding the implications of informed consent; never criticizing another healthcare professional's work; respecting patient confidentiality and privacy; thorough and honest documenta- tion; being prepared to deal with misinformation; taking responsibility; and knowing how to "fire" patients—sometimes the relationship between the doctor and patient can itself create a situation that increases the risk of litigation. At the conclusion of their training, residents and fellows face a third reality in medical practice: coding and billing. Because the topic is so extensive, Kevin J. Corcoran, COE, president, Corcoran Consulting Group, could only offer a short list of what young ophthalmologists need to know: that remuneration for professional services is part of the fundamental structure of practice; practitioners need to communicate with their support staff; they need to comply with statutes, regulations, and policies. Mr. Corcoran also directed attendees to published documents they could consult to learn more: Current Procedural Terminology (CPT), International Classification of Disease (ICD-9; ICD-10 in 2014), Health Care Procedure Coding System (HCPCS), and medical policies available as public documents online. In a nutshell, he said, billing entails asking two questions: what service? and why? Other concerns include whether the payer covers the cost, the contract payment rate, and what the beneficiary owes. The Corcoran Group, he said, helps by, among other things, providing training materials and programs available on their website. The morning session of the program ended with talks on engaging in public discourse, with Nick Mamalis, MD, Salt Lake City, speaking on "Effective communication skills: Tips for public speaking, writing and publishing," and Jan continued on page 12

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