Eyeworld Daily News

3 EW SHOW DAILY ASCRS•ASOA Symposium & Congress, New Orleans 2016 now produce more law than does Congress," he said. "You have a very different system, where the center of gravity of lawmaking has moved over to this fourth branch." Many even view this as a better option than Congress, Professor Turley said. "The problem is that it's not Con- gress." When agencies are making very important decisions, they're being made by insular individuals, and factional interests are not being transformed. "It's true you can do a lot more if you use an agency system," he said. "The framers were aware of that." But the problem is the possibility of tyranny. It would be nice for us at least to have a debate, for the American people to have a choice in which system they prefer, Professor Turley said. Professor Turley specifically dis- cussed the impact on physicians and their role in this system. The Centers for Medicare & Medicaid Services (CMS) has grown exponentially. There is also the issue of the rise of big health and big data, which isn't always a positive. He highlighted re- of power was actually viewed as a protection of liberty. "The framers believed that the concentration of power was the greatest threat to liberty in any hands," Professor Turley said. They created a system that, through checks and balances, guaranteed no one would have the power to govern alone. Part of being human is a ten- dency to group, and that creates factions. James Madison wanted a system that would encourage these factions to manifest. In Congress, there are all of these factional interests that come in, and through that process comes majoritarian compromise. Sometimes there is not a compromise because the nation is too divided, he said. "What we have had in the past few years is the greatest crisis in the separation of powers," Professor Turley said. There has been uni- lateral action that has pushed to further the rise of the fourth branch of government, or a collection of federal agencies that have tremen- dous power in the country. "You can honestly say that agencies cent struggles in creating databanks of health information, which has seen some physicians and states at odds because of the states' desire to compile a databank of medical infor- mation and hesitation of physicians because of health privacy laws. A databank idea like this, Profes- sor Turley said, means more trans- parency. The purpose of a databank is to monitor performance, as well as what doctors are prescribing and how they're performing. The size of these databanks is unbelievable, he said. The next step would be an algorithm to evaluate all the data and isolate conditions and treatments. There could be black box medicine where CMS starts to computerize the role of analysis to identify common traits in databanks. When does the machine take over? What becomes the role of the physician in evaluation if you're the gatekeeper? The role of physi- cians is changing, Professor Turley said, and so is the rest of the medical profession in terms of treatment and protecting the rights of patients. Medicine is one of the most important industries, he said. "But if you look down the road, few decisions governing public health will actually be made by Congress because we have this fourth branch making decisions for us." Should this matter? Professor Turley said that maybe it's archaic to think that we have a system where the public makes decisions through the representatives, but he thinks there should be debate before any decision is made. "The problem with our system is it's the greatest system on Earth, but every generation has the ability to lose it," he said. Profes- sor Turley is fearful that his children are going to inherit a system that's very different from the one he grew up with. "The medical profession has a unique role in our society in terms of educating the public and letting them know what's at stake," Profes- sor Turley said. This growth of the fourth branch needs to be discussed, he said, and if we want to yield to this type of industry system, then so be it, but at least we should have a choice. EW continued from page 1 continued from page 1 Dr. Cionni highlighted some of the many important things that have been accomplished in the past year. ASCRS has reached out to its membership through focus groups and comprehensive needs assess- ment surveys to better understand some of the educational needs of the members. "Based upon what we heard, ASCRS expanded the number of regional meetings and webinars being offered," he said. Industry partners make so much of what we do possible, Dr. Cionni added, highlighting the approved educational grants, comprising about $4.5 million in funding for education. Such funding allows for rich opportunity in learning from the annual meeting and numerous other venues, he said. Last year, more than 2,000 members partici- pated in the ASCRS Clinical Survey, he added. Another valuable on- demand service is the ASCRS online calculators, which get 145,000 uses annually. Dr. Solomon officially took over the ASCRS presidency from Dr. Cionni during the session and spoke about how the organization was founded. ASCRS provides a venue for members from all over the world to share clinical experiences, think outside the box, learn from each other, and advocate for their patients, he said. There are several new ASCRS initiatives that Dr. Solomon said will change the way physicians communicate with each other. Some of these initiatives include the newly launched ASCRS 365 App, the online Center for Learning, and free online CME activities. "We're working hard to find new ways for you to get involved with ASCRS and provide more value to your member- ship," Dr. Solomon said. Advocacy is another way physi- cians can get involved, Dr. Solomon continued. ASCRS has been at the forefront of some key legislative and regulatory accomplishments. "We have been effective, but we must remain vigilant," he said. "This is such a critical time in health care." For the first time, ASCRS is sponsor- ing and sending 5 ophthalmology residents to this year's Alliance of Specialty Medicine Legislative Fly-In. "There are a lot of opportunities to get engaged and involved, and more are coming," Dr. Solomon said. He pledged to work hard to get members more involved. Also in the Opening General Session, Spencer Thornton, MD, Nashville, Tennessee, was honored for his involvement in the ASCRS Film Festival. A moment of silence was held for those ophthalmologists who died in the last year. David Chang, MD, Los Altos, California, Stephen Lane, MD, Still- water, Minnesota, and James Mazzo, Irvine, California, gave an update from the ASCRS Foundation in the session. Mr. Mazzo said the founda- tion is working hard to expand part- nership opportunities between the foundation and industry supporters. Dr. Lane highlighted the founda- tion's domestic initiatives, particu- larly the Operation Sight program to help qualified uninsured Americans obtain cataract surgeries they need. The program has helped arrange more than 430 charitable surgeries, he said, and he encouraged every- one to join this nationwide effort to help needy patients who often fall through the cracks. Finally, Dr. Chang highlighted the ASCRS Foundation's international initia- tives. He highlighted the success of the Robert Sinskey Eye Institute in Addis Ababa, Ethiopia; in 2015, it helped 19,000 needy patients. He mentioned the foundation's partner- ship with DigiSight (San Francisco), a smartphone imaging technology, in Nepal, and he introduced the Swim for Sight campaign and recent partnership with Olympic swimmer Missy Franklin. EW Editors' note: The speakers have no financial interests related to their comments. The winner of Saturday's EyeWorld event drawing was: Todd Hovis, MD, Columbus, Texas

• Cover