Eyeworld Daily News

EW SHOW DAILY 8 Saturday, April 26, 2014 ASCRS News Today Conversation with the new ASCRS president by David F. Chang, MD I am very excited to introduce Richard Lewis, MD, as the next president of ASCRS. Following his fellowship in glaucoma, Rick started in academics and subsequently transi- tioned into an ophthalmology group private practice in Sacramento, Calif. He later cofounded an ophthalmol- ogy 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 developing 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. 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. 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 surgi- cal innovation, was also in the midst of big change. Newer and safer surgical glaucoma options were being discussed. It was a very excit- ing time to be on the newly formed ASCRS Glaucoma Clinical Commit- tee. 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 with a focus on glaucoma surgery. Becoming in- volved with ASCRS has been a tremendous source for me for new information and skills transfer; it has been transformative in my ap- proach to anterior segment surgery. Dr. Chang: You are in private practice and have managed an biggest challenge is to sustain the remarkable innovation and improve- ments with patient care while main- taining value (reimbursement) 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 studies. From the start, I enjoyed teaching and was interested in getting involved. I formed the West Coast Glaucoma Society and partici- pated in the inaugural meeting of the American Glaucoma Society (AGS) in 1984. I started the first Subspecialty Day for the American Academy of Ophthalmology (AAO) in 1995. This was a tremendous educational and financial success for AAO, and other Subspecialty Day meetings soon followed. I became president of the AGS in 2000. The value of bringing colleagues together for education to advance our field has always been very important to me. The AGS at the time was an organization with 350 members. With ASCRS our educational initiatives can have greater impact especially with the incredible technology now at our disposal. My predecessors Ed Holland, MD, David Chang, MD, Eric Donnenfeld, MD, and the earlier pioneers of ASCRS have put in place remarkable opportunities to keep our membership well educated and up to date. This is a vibrant and healthy organization. Dr. Chang: What areas will you focus on during your term as president? Dr. Lewis: The mission of ASCRS for education is as important as ever. In past years, the focus was limited to clinical/surgical education. This is still very important and perhaps what defines and separates us from other specialty organizations. Transfer of information through ASCRS•ASOA education initiatives must remain current and innovative. Yet the current medical milieu also necessitates additional skills. Efficiency in patient care will be crucial. How do we manage new technology and how do we become more efficient? ASCRS must respond to these needs using all the tools and resources available. The demo- graphic of the new ophthalmologist is changing. The ASCRS membership needs to explore ways to make our practices more productive. This in- formation needs to be shared among ASCRS members as we travel down the road of the ACA. Despite the many challenges ahead, the goals of ASCRS to promote the delivery and advancement of high quality eyecare will continue and flourish. EW 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. Today, our specialty ASC, Capital City Surgery Center, performs more than 3,000 (mostly cataract) proce- dures 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 "alpha- bet soup" of current and pending challenges for ophthalmology. These regulatory initiatives raise clinical and practice related questions: 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 David F. Chang, MD Richard Lewis, MD Dr. Lewis is unable to join us in Boston due to an injury. At today's Opening General Session, attendees will see a previously recorded address from Dr. Lewis and hear comments from outgoing president Eric Donnenfeld, MD.

• Cover