At Press Time

Executive Transition at AAO

Planned Retirements for Dr. Hoskins, David Noonan.

By Jerry Helzner, Senior Editor

■ The American Academy of Ophthalmology (AAO) said that the Academy's Board of Trustees has accepted planned retirements of the organization's two senior staff leaders, H. Dunbar Hoskins, Jr., M.D., executive vice president and CEO, and David J. Noonan, deputy executive vice president and COO.

In announcing the transition, AAO President David Parke II, M.D., noted that the change arises out of a carefully orchestrated succession plan initiated by Dr. Hoskins and Noonan with the Academy leadership early this year.

"Our profession and the Academy have been fortunate to have benefited from the service of Dr. Hoskins as CEO for 16 years and Mr. Noonan as COO for 37 years. Consistent with their leadership style, they have carefully prepared the organization for change. Soon we will begin the search for a new executive vice president," commented Dr. Parke.

Noonan will leave his position in January. Dr. Hoskins will depart in the spring of 2009, pending selection of his successor. Both men will continue to serve the organization as consultants. "These two fine men have skills and a rich knowledge of the organization and profession that will benefit the Academy for years to come," noted Dr. Parke.

When asked to recount the highlights of the Academy achievements during his tenure as CEO, Dr. Hoskins noted that such a list was not his success but rather those of the Board, the volunteer physicians and a committed professional staff. "I am pleased that we can all take pride in having united and reduced divisiveness within the profession, cultivated ophthalmology as a force in medical advocacy, achieved financial success for the Academy, developed an electronic communication and educational site for the members (O.N.E.) and enhanced the Academy Foundation's ability to support future needs of the Academy and the profession."

Dr. Hoskins added, "The greatest accomplishment is in leaving behind an extraordinarily capable management team and professional staff."

H. Dunbar Hoskins, Jr., M.D.

Recalling his long career, Noonan, who participated in the growth of the Academy from its days in a small office in Rochester, Minn., said, "I take great satisfaction in having been a part of an organization whose members commit their lives to caring for people. In leaving my role as COO, I am delighted to have participated in building an Academy culture that permits the staff to bring the same commitment to the Academy membership."

GIVING BACK:

Dr. Alley: A Man of Many Missions

World Blindness Outreach Restores Vision to Thousands

By Leslie Goldberg, Associate Editor

■ Albert A. Alley, M.D., an ophthalmologist in Lebanon, Pa., has participated in more than 60 missions in more than 25 underdeveloped countries over the past 18 years. He co-founded World Blindness Outreach, Inc. (WBO) in 1990 after seeing a great need for medical care in Nigeria and the Philippines as a participant in a Rotary International mission. WBO recruits volunteers, raises money and treats correctable blindness through worldwide surgical eyecare missions.

"Volunteers participate on missions lasting between a week and 10 days," says Dr. Alley. "We usually operate for 5 days and the remainder is travel time. Our teams run from eight to 12 people." Teams include two or three ophthalmologists, two or three surgical nurses, an instrument technician and an A-scan technician, as well as several non-medical personnel. He explains that this gives laymen the ability to participate in the missions and become long-term supporters and spokespeople for the organization.

"We have several mission goals," says Dr. Alley. "One being that we like to perform as many surgical operations as we possibly can. We emphasize cataract surgeries because this is the leading cause of blindness around the world. We will do anywhere from 100 to 200 cataract operations on a single mission. Sometimes we take a pediatric ophthalmologist with us who performs 25 to 50 operations on children with strabismus and we perform other type procedures at the request of the local medical community."

Dr. Alley also emphasizes the importance of working closely with local medical personnel. "One requirement for hosting WBO is that local doctors must be willing to work with us to screen patients prior to surgery, stand with us during surgeries and be responsible for the follow-up care once we've left the country."

Dr. Alley and his sister Elaine Alley Wrone with Ethiopian patients following cataract surgery.

Another mission goal is to train the host doctors in surgical techniques. "We really work side-by-side with surgeons, assisting and observing one another and then talking about technique in between surgeries," says Dr. Alley. He says that e-mail is a wonderful means of communicating with the countries that WBO visits. "When we first started doing this, e-mail was not available. Now, with most of the areas we visit, communication can be instantaneous," says Dr. Alley.

WBO will usually leave behind surgical supplies for the local doctors for use after the volunteers have left the host country. Additionally, WBO has given many microscopes, autoclaves and surgical instruments to host doctors. "We have established several clinics," says Dr. Alley. "One in Nicaragua, one in Ecuador and one in the Dominican Republic. We've helped equip and continue to work with them once we leave. For example, in Ecuador, where we will be going on our ninth mission in September, we've contributed a great deal to supply the clinic. Many of these surgical supplies are donated by pharmaceutical companies and equipment manufacturers.

"WBO does not go into really primitive areas, because we are doing sophisticated surgeries," continues Dr. Alley. "We need electricity and running water. Other wise, complication rates can get very high."

Additionally, every year in the United States, the WBO sponsors a free surgery day in Lebanon, Pa., called Mission Cataract Lebanon Valley. "The program, which was started in 1995, has helped over 100 patients," says Dr. Alley. "People who are uninsured and underinsured can come and have the surgery done at no cost. It is a cooperative effort between WBO, the local surgical center and local doctors."

If you are interested in learning more about World Blindness Outreach, Inc., visit its Web site at www.worldblindnessoutreach.org or phone Dr. Alley at (717) 273-0662.

Medicare Fee "Fix" Is No Cure

Congress Buys Time to Create New Payment Formula.

■ Although ailing Sen. Edward Kennedy made an emotional return to the Senate following brain surgery to cast a key vote that helped reverse an imminent 10.6% cut in Medicare physician fees, the action by Congress only bought additional time to work out a permanent resolution to the fee issue.

The reversal came after strong pressure from organizations representing physicians, including the American Medical Association. The campaign resulted in overwhelming Congressional approval of the fee "fix" and an override of President Bush's veto of the Medicare bill.

The fix replaced the cuts scheduled to go into effect in July with an 0.5% fee increase for the last 6 months of this year and a 1.1% fee increase for all of 2009. However, under the current formula for determining Medicare physician fees, recent temporary fixes by Congress have only borrowed funds from future years and will translate to a 21% reduction in physician fees on Jan. 1, 2010.

Physician organizations have warned that a reduction of that magnitude would almost certainly cause some doctors to stop treating Medicare patients, or at the very least, to stop taking on new Medicare patients.

Both Republicans and Democrats in Congress have stated that they want to change the current Medicare physician fee formula, which dictates what many experts call an unrealistic "sustainable growth rate" for spending on doctors. However, the two parties have not yet come close to reaching an agreement on a new formula that would set fees at a level of reimbursement in line with the real costs of practicing medicine.