Viewpoint

Seen and Heard at the AAO

Larry E. Patterson, MD

I just returned from the AAO meeting in Chicago, which was home to the ASCRS meeting this year as well. This was very much like in 2009, when both groups met in San Francisco. (Note to meeting planners: Please, please coordinate this better. For those of us who routinely attend both meetings, a change in venue would be nice.) As usual, I came away with a few random thoughts and observations.

Doctors are afraid. Not trembling (just yet), at least not in ophthalmology, but very concerned about the future. Coming off the recent presidential election, I’ve never seen doctors more dejected. The results have solidified the Affordable Care Act into some sort of convoluted and disastrous reality, and our future is more uncertain than ever.

To add insult to injury, doctors were just learning the news of the largest one-year percentage cut in Medicare cataract surgery service fees in years, around 13.5%. This is in addition to the looming “fiscal cliff” with another 2% reduction, and of course the ever-present SGR crisis. Add to this mix growing regulations in our offices and surgery centers, EHR mandates and ICD-10, and the mood grows ever gloomier. It’s becoming apparent that with the coming flood of patients, both from the baby boomers and the soon-to-be-insured, we’ll be working harder yet making less money.

One speaker made an observation that really jolted me. The AMA, due to a series of missteps and just downright poor policy decisions through the years, now only represents around 17% of physicians in this country. On the other hand, hospitals are buying doctors’ practices right and left, to the point that now about 20% of doctors are owned by hospitals. The frightening conclusion was of course that the hospital lobby now represents more doctors than the AMA.

Next, I’d like to offer a partly tongue-in-cheek note to certain company reps in the exhibit hall. Yes, I know that at every meeting you feel the crowds are at their lowest levels ever. And yes, US doctors often come only for the weekend because they’ve got to get back to work, and you are left with less foot traffic on Monday and Tuesday. And yes, it may seem like no one is buying anything (see the previous two paragraphs).

I’m sorry. I really am. I feel your pain. But please, this is a medical conference. When I’m trying to get from point A to point Z, I necessarily pass by many other booths. If I smile or make eye contact, that doesn’t mean I’m interested. I’m just being polite. If I’m interested in your product it will be obvious. I’ll stop. I’ll ask questions. And despite economic uncertainties, I’ll probably eventually buy lots more stuff, just like I did (once again) this year.

In closing I’d like to share a line that was going around just before the election. “Poor President Obama. If he gets re-elected, look at the mess he’ll inherit!” Good luck Mr. President. Happy holidays, and here’s wishing all of us, somehow, a more prosperous new year!