Wednesday, September 6, 2017

October 16: Optometry at the Capitol Day

In my last editorial, I promised more information about your opportunity to advocate for your profession. Thanks to the hard work of the POA Legislative Affairs Committee, staff, lobbyists, and Board of Directors, we bring to you Optometry at the Capitol Day on October 16, 2017! We are hoping to see hundreds of POA optometrists and Salus students rush the Harrisburg Capitol Complex to promote optometry and the ocular health of Pennsylvania’s residents. Believe me when I say that your volunteer leadership, staff, and lobbyists have been banging optometry’s drum since the beginning of this legislative session. Regardless, it is vital for the legislators to hear from the rank and file optometrists about how the pending legislation helps not only their constituent optometrists, but also their constituents that are patients in our practices.

We have created a program chocked full of information to educate you on the legislative initiatives that relate to optometry. You will hear from legislators about the value of advocacy and what they want to hear from you. You will hear from the legislators who introduced the bills and why they feel they are important for Pennsylvania’s residents. We have members from the AOA and the POA Advocacy teams to help train you on how to intelligently communicate with your legislators. All of this leads up to the opportunity to meet with your legislators and discuss these important bills.

Now when you get out your calendar to mark down the date, you’re going to realize that October 16 is a Monday, and for most of us Monday is a busy patient day. So now the question comes, how can I afford to take a day off for this? Well, the answer is you really can’t afford not to. Our profession is a legislated profession. No matter what your training is in optometry school, if your state law doesn’t say you can do it, you can’t do it. It is essential that we promote these bills that allow us to practice to the level of our training and be able to provide the best level of care to our patients. Please, please help contribute to this process. Take the day off, allow your associate doctors to take the day off, and travel to Harrisburg to advocate for your profession. Come spend the day with your colleagues and reconnect with your friends. Make some new friends! Think of this as an investment in your professional future. Don’t worry, your patients will be there on Tuesday. I’m sure each and every one of you can think of a day you took off to play a terrible round of golf, or sit through a terribly boring CE class, or to catch up on yard work. Well, let me tell you that this will be a much more rewarding experience, and you will find yourself looking forward to the next opportunity to advocate again. So, I expect to see each and every one of you on October 16th in Harrisburg.

Steven Eiss, O.D.

Friday, June 30, 2017

A is for Advocacy

By the time you are reading this, thousands of optometrists and optometry students will have converged on Washington, D.C. for the 2017 Optometry’s Meeting (OM). If you are a regular or even occasional attendee of OM, you would have noticed that this year was a little different. In the past, the AOA has held their Advocacy Conference every April in Washington, D.C. That meeting centered around visiting legislators to advocate for optometry-related bills. A big part of that meeting was student participation. A high percentage of the students who had participated in the Advocacy Conference converted into AOA members. Since OM was in D.C. this year, the AOA combined it with the Advocacy Conference, which meant a big increase in student attendance. The really cool thing about this was that a lot of optometrists will have had the opportunity to interact with their legislators and the students. If you have never had the opportunity to do this, I would strongly suggest you do in the future. Every year at the Advocacy Conference, we have had a number of doctors and students with no experience in speaking with their legislators. The hesitation—and sometimes even fear—in their eyes as we prepared for the visits was easy to see. The statement “you don’t really expect me to talk, do you?” was frequently heard, but it was really rewarding to see these same individuals taking the lead in the discussion by the second or third visit. Almost everyone would then look forward to coming back the next year.

So, this year’s meeting has given me the opportunity to strike this same fear into the eyes of some of our members that would never normally think of attending the Advocacy Conference. As I write this, I have already begun the process of recruiting a number of attending POA members into the ranks storming Capitol Hill in 2017. I can already hear the hesitation through the emailed replies: “you expect me to set up an appointment with my Congressperson, and then to actually go!?” Yes, I do! And I really look forward to the follow-up question, “when can we do this again?” The answer is coming to Harrisburg in the near future—stay tuned.

Steve Eiss, O.D.
POA President

Monday, May 1, 2017

Spring is here; time to get moving

As the weather starts warming up, everything begins to get moving. And, believe it or not, so does the Pennsylvania legislature. All joking aside, we do have bills being introduced that have an impact on our profession.

Senator Ward has again introduced her “Quality Eye Care for Insured Pennsylvanians” bill, SB 257. This bill provides Pennsylvanians protection from the actions of Vision Care Plans. The designs of these plans often attempt to restrict the patient’s freedom of choice by dictating the suppliers and brands of products that are covered by their plans. As these companies continue to vertically integrate, they increasingly force our patients into products that financially benefit the Vision Care Plan, at the expense of patient choice. The bill also helps to limit the discounts our members are forced to give, limiting it to services and products that are actually covered by the plan. 

In addition, Representative Marshall is reintroducing his handicapped placard bill. Currently, optometrists are not authorized to certify a patient as disabled, even though blindness is an eligibility criteria for a parking placard. Obviously, this will be a huge convenience for our disabled patients, preventing them from having to schedule an unnecessary office visit with another health care provider just to be certified.

And finally, Senator Gordner plans to introduce a scope of practice bill. Optometrists are currently subjected to some outdated regulations in the Optometric Practice Act. Any new medications need to be approved by the Secretary of Health, resulting in a delay in our patients having accessibility to new and beneficial treatments. For example, when Xiidra was introduced last summer, it took about four months for it to be approved. Another regulation requires optometrists to consult with a medical doctor when a patient’s treatment exceeds six weeks. This requirement was not included when the scope legislation was modified to include glaucoma. If there is no issue with optometrists treating glaucoma beyond six weeks, there should not be an issue with dry eye or allergy drops either. It is definitely time for these outdated regulations to be removed. The bill will also allow optometrists to prescribe hydrocodone again, which was lost when it was reclassified as a level 2 narcotic, and allow injections for anaphylaxis and into the upper and lower eyelids. 

Spring also means it is time for you, our member, to get moving, too. For these legislative initiatives to have success, there are a couple things we need from you. First, we need you to begin forging a relationship with your local Representative and Senator. Watch for any events they are sponsoring in your district, make an attempt to attend, and introduce yourself as an optometrist in their district. If you already have a good relationship with your legislator, and are not a Keyperson for that legislator, please contact the POA office and let Executive Director Joseph Ricci know. Keep your eyes open for communications from the POA as we will advise you of the appropriate times to contact your legislators about these bills. Also watch for legislative training sessions coming to your part of the state soon! Lastly, we need continued support of POPAC. If you are not currently on a monthly contribution schedule, please call the POA office and set that up.

Remember that all of the work that has been done on these initiatives will be for naught if there is not significant support from the general membership. It will take the support and contribution of every member if you want some of these changes to happen. I continue to look forward to a productive year and hope to see everyone in Pittsburgh for Congress from May 18-21!

Steven Eiss, O.D.

Wednesday, March 1, 2017

This isn’t what I signed up for!

Don’t worry, I am not about to go on a rant about my first month as POA president. The title of my editorial came to me as I was having an email discussion with a member about MIPS and PQRS. After some back and forth about the various measures we will have to be reporting, the response I received was, “Remind me why I went into medicine?” For me, that pretty much sums up what I think many of us in the healthcare community are feeling.

As the payment reform train continues hurdling down the tracks, many of us probably feel we are being left behind. We spent many years of training learning to care for our patients, diagnose and treat their problems, make sure they get to the correct provider to address their ailments. Now we feel we have to take away from our time caring for our patients, instead staring at a computer screen making sure we are clicking all the right boxes. It is a bit ironic that if you spend more of your time examining and listening to your patient, and less time clicking the boxes on your computer screen, you will be deemed as providing inferior care and thus penalized in your reimbursement. Huh? 

But this is the brave new world we are entering. Data collection is king, just look at ICD-10. We now have dozens of codes to specify how severe your glaucoma or macular degeneration is. I’m sure the day will come when we will be graded on the percentage of moderate glaucoma patients that convert to severe glaucoma. 

For those of us who have been doing this for many years, it is hard for us to comprehend anything but fee for service reimbursement. But I see the MIPS program as the first real step away from our traditional payment methodologies and towards a quality- and outcomes-based reimbursement system. If the thought of this scares you to the brink of early retirement, fear not, you are not alone. 

I truly believe optometrists in general provide some of the highest quality of care in the healthcare field. We spend a lot of time evaluating and listening to our patients. The challenge is to make sure we are communicating this into the electronic box that now takes up most of our desktop. But don’t worry, your professional associations are here to help. 
The AOA has developed an optometric-based registry, AOA MORE, that will allow you to link your electronic health records and be able to seamlessly report your quality data directly through the registry. The days of having to make sure you remember to add all the correct PQRS codes will be gone. The best part is that AOA MORE is a free member benefit, so if you have electronic records, make sure you register for AOA MORE. If you don’t have an EHR, the AOA just recently held a webinar on how you can participate in MIPS too. So, don’t think that if you are not electronic, you have to be left behind.

It is not just providers coming under more scrutiny for quality care, either. The insurance companies are subject to these measures, too, and are graded by HEDIS and STAR scores. 

Here at the POA, we have been able to utilize our Diabetic Eye Health Alliance to advance optometry’s role here, too. Our pilot program with Geisinger Health Plan (GHP) has seen our members partner with GHP to get 71% of their delinquent diabetics dilated retinal exams in 2015, and we’re seeing similar results for 2016. As we expand this program to Highmark and hopefully more health plans this coming year, this will help cement optometry’s role as the primary eye care provider in this new world, and allow us to work with the insurance companies to provide higher quality care to all of our patients. And isn’t that what we have all been trying to do, even before electronic health records, PQRS and HEDIS scores—provide better care to our patients?

Stay tuned; the ride is just beginning!

Steve Eiss, O.D.

Tuesday, January 3, 2017

End of an era

By the time you are reading this, the Pennsylvania Optometric Association will be transitioning to a new executive director for the first time in almost 20 years. The retirement of Dr. Charles Stuckey will definitely mark the end of an era in our association. For those of you unfamiliar with Dr. Stuckey, which I am sure is not many of you, let me give you a little history lesson. Dr. Stuckey graduated from Southern College of Optometry in 1974. After graduation, he settled in Pennsylvania to begin practicing optometry. He saw patients for a number of years, eventually merging his practice with an ophthalmology practice. He was probably among the first optometrists to partner in a multi-specialty practice and became the managing partner. Throughout this time, he always remained active in organized optometry, from the AOSA as a student to eventually serving as POA President in 1990. 

Then in 1997, the position of executive director of the POA became available. As a result of his astute ability as a leader and advocate, the POA leadership at the time asked him to consider the position. And here we are almost two decades later. 

The reason I describe this as the end of an era is that I don’t believe we will see many optometrists as association executive directors going forward. When Dr. Stuckey took the position, Pennsylvania optometrists only had just progressed past diagnostic privileges. For those younger docs out there, yes, that means we were only able to dilate patients, but not treat any of their ailments with therapeutic medications. Dr. Stuckey ushered us through the legislative and regulatory processes to allow us to use ocular medications for infections and eventually the use of systemic and glaucoma medications. Having an executive director who was in the profession was invaluable when we had to present to legislators why we should be allowed to expand our scope of practice to these new levels. 

As our privileges expanded, we had to work with the medical carriers to have them allow optometrists to join the panels and get reimbursed for the services they were providing. Again, having one of our own guiding the association was a great asset, and with the current legislative climate it will be interesting to see if other associations find former optometrists willing to take on this challenge in the future.

In 2009, Dr. Stuckey received the Virgil Deering Optometric Executive Director of the Year Award for his service to the association, and in 2013, the H. Ward Ewalt Meritorious Service Award for outstanding service to the POA and optometry. Dr. Stuckey also has a strong interest in the third-party arena.  

I want to make sure we take a moment to thank Dr. Stuckey for his many years of service to the POA. Although it is a paid position, he has always gone well beyond the job description for his profession, and I’m not sure we can ever properly compensate him for the “heartburn” he has had to endure over the years. And being the glutton for punishment that he is, I am sure he will continue to serve the association going forward any way he can. Although I am confident that our next executive director, Joseph Ricci, will be a great asset to the POA and bring his own set of unique skills to our association, I’m not sure we will ever again see the pure passion for our profession that Dr. Charles J. Stuckey, Jr. brought to the table. So for that, I thank you, my colleague and my friend....ya know.

Steve Eiss, O.D.

Tuesday, November 1, 2016

Presidential year in review

By the time you read this, we will either have a newly elected president of the United States or be a few days away from the outcome. As I reflect back on my time as POA President, I can say that this past year was as unpredictable as the national election has proved to be. 

Here are some of the highlights from my presidential year:

  • ICD-10 became a reality and doctors were still paid in a timely fashion. The POA Electronic Claims Service helped the transition go smoothly.

  • The Pennsylvania Diabetic Eye Health Alliance continued to expand its influence with third party payers, resulting in more diabetic patients seen by our members.

  • ACT 31 became a requirement for license renewal and the POA provided courses to fulfill this new requirement. ACT 31 requires all licensed health professionals to complete at least two hours of Board-approved continuing education in child abuse recognition and reporting requirements as a condition of license renewal.

  • The Think About Your Eyes program for POA members was voted on and passed by the House of Delegates. POA members will benefit from the increased advertising and online presence that TAYE provides starting in 2017.

  • Despite our best efforts to pass our scope modification bill, Senate Bill 1012 remains within the Senate Consumer Protection and Licensure Committee. Likewise, Senate Bill 795, which would further define ophthalmic surgery, did not see the light of day and remains within the same committee. SB 795 was introduced by Ophthalmology, who would like to see a very broad definition of ophthalmic surgery.

  • Senate Bill 978, the “vision plan bill” that was introduced by Senator Ward, successfully made it out of the Senate Banking and Insurance Committee, and was passed 12-1. Our plan is to reintroduce both our scope bill and SB 978 in 2017 and keep the process moving forward.

  • A data breach affecting optometrists across the nation was reported by the AOA. Many POA members reported being affected and were advised to take steps to protect their credit ratings and identity. No optometric organization has come forward to accept full responsibility.

  • Optometry’s Meeting caught us by surprise when Dr. Greg Caldwell announced that he would not run for re-election to the AOA board for 2017. Greg continues to remain active on several committees at the AOA and POA levels, and remains dedicated to organized optometry. 

  • The Contact Lens Consumer Health Protection Act (S. 2777) to crack down on unscrupulous internet based contact lens sellers was introduced by Senator Bill Cassidy, an internist from Louisiana, with support of the AOA and other major contact lens companies.

  • 1-800-CONTACTS entered into an agreement with Opternative and began to offer online “refraction” as a way to bypass a visit to an eye care practitioner. An app called “Simple Contacts” marketed itself to consumers as a way to renew your contact lens prescription in less than five minutes.

  • VSP wanted to implement a reduction in reimbursement to doctors who did not purchase $6,000 worth of Altair/Marchon frames. As a result of action taken by the AOA this program was stopped.

  • Dr. Charles Stuckey announced his intention to retire as the POA Executive Director after serving for 19 years!

I want to take this opportunity to thank my current POA Board, the entire POA staff, and the POA membership for the opportunity to serve as your president this past year. It was truly an honor and a privilege to serve the profession and I hope to remain active within organized optometry for many years to come. The POA is in excellent hands as I pass the President’s gavel over to Dr. Steven Eiss. I am confident that under his leadership the POA will continue to be your voice for a strong optometry.

One thing I can say for sure is that under my watch there were no 3 a.m. tweets about any former Miss Universe contestants and no private email servers containing classified information at the POA!

Wishing you all a happy Thanksgiving and a wonderful holiday season,

Mark M. Margolies, O.D.

Thursday, September 1, 2016

Your voice for a strong optometry

This editorial features the 2016 POA Board of Directors, eight of the many dedicated volunteers that drive the association forward. The POA tagline, which is included on the front page of every Keystoner, is “Your Voice for a Strong Optometry.” The POA Board works as your voice. They are here for you and willing to serve the profession. In order for members to know these volunteers better, I recently asked the following questions:

  • What type of practice setting are you in and for how many years?
  • Do you have any specialties?
  • Please tell me an interesting fact about your practice.
  • What one thing do you love about optometry?
  • What do you like to do in your spare time for fun or relaxation?
  • What does POA membership mean to you?

Mark M. Margolies, O.D. 
Out of my 31 years of practice, 22 have been spent as a solo practitioner in private practice in Levittown. Prior to that, I had practiced at a LensCrafters location, an ophthalmology-owned practice, and a multi-disciplinary practice that was owned by an insurance company.
I love primary care, and my specialties include treating glaucoma, removing corneal foreign bodies, co-managing macular degeneration with retinal specialists, and traditionally prescribing and dispensing eyeglasses and contacts. What I love about optometry is the ability to deliver primary care to a wide variety of patients in one day ranging from infants to seniors. An interesting fact about my practice is that my spouse, Sandra, began to work there in 1996 as a three-month experiment and it has turned into a twenty-year partnership that is still going strong! It’s not for everyone, but it has worked for us. 
In my spare time, I love playing Blues guitar and exercising. I also love to spend time with my grandchildren. 
POA membership is about being stronger together for our profession and for our patients. I would not be able to practice the way I do today if it wasn’t for the efforts of the POA. Together we can make a difference for the future of the profession.

Steven P. Eiss, O.D. 
For the past 21 years, I have been in a multi-doctor, multi-specialty private practice with offices in Emmaus, Pennsburg and Quakertown. I had worked part-time at a corporate location for many years while growing this practice. I currently provide full-scope optometric care. Being located in a semi-rural area, I have gained a large number of glaucoma patients and see a number of ocular emergencies on a daily basis. Optometry provides me the opportunity to be both a medical provider and a business owner all in one profession. I enjoy the challenges of caring for a patient’s health and running a successful business at the same time. 
When I joined my practice, it was a part-time, single-doctor practice. Over the years, it has grown into three locations with six doctors. About five years ago, our third location came about when we merged an ophthalmology practice into our corporation.
Most of my spare time is spent chasing after my seven-year-old twins. I am a big baseball fan, and have just completed my 32nd season of playing fast-pitch softball.  
Initially, my association membership allowed me to garner information from other doctors on how to treat disease and to learn how to handle business and insurance issues. I was able to grow into a position where I am able to contribute to the advancement of the profession through committee and Board service. Of course, much of this revolves around the camaraderie and friendships I’ve made, and now being able to mentor others.

Rebecca L. Wincek-Bateson, O.D.
For the last thirteen years, I have been in private practice in Indiana, PA, where I have developed a specialty in pediatrics and traumatic brain injury.
What I love about optometry is getting to know the families in my practice, watching the kids grow up to graduate from high school and college, grandparents sharing pictures of grand kids, and couples marrying and having children. It’s a blessing to be able to share in it. Most of my fun and relaxation time is spent on the baseball or softball fields lately, but I love being with friends and my husband and twins, Wil and Lira. I enjoy traveling, snowboarding, kayaking, triathlons, running or most anything outdoors.
The POA is the only member-driven organization to advocate for our profession in Pennsylvania. I personally feel that being a member is like having “job insurance.” When Opternative, 1-800-CONTACTS, insurance companies and other providers are working against optometry and the care I provide my patients, the POA and AOA are advocating and fighting back for optometry. I am proud to belong to a group of doctors across the states that have a vested interest in protecting our profession. POA members are fortunate that we have a great group of doctors, lobbyists, attorney and staff that are constantly watching out for our futures. 

Lori Gray, O.D. 
I’m in private practice in Gilbertsville and have been for eight years. I also guest lecture at Salus University. I specialize in disease management. I love that optometry allows me the flexibility to have both a fantastic career and to be there for my family. 
In my free time, I love spending time with my husband, Austin, our two children, Maggie and Zach, and our new puppy, Minnie. We enjoy hiking, golfing, skiing and spending as much time as possible outdoors. 
POA membership is the insurance policy I carry on my profession. I want to be sure optometry is going to be a viable profession for the entire duration of my career and beyond. The POA works hard to ensure this.

David A. Evans, O.D. 
For 32 years, I have worked in a solo private practice in Nanticoke. I also work in two rehab hospitals and see individuals who have sustained strokes and injuries of the head and brain. One thing I love about optometry is the relationships I am able to build with my patients. This profession often allows me to get to know the whole family. Having been in practice for this long, I now am seeing the children of the children I examined when I opened my office. I have many families that I see four generations of patients.
My spare time is spent with my family. I am also an avid hunter and love the outdoors.
My POA membership is very important to me. Besides myself, my wife and brother are both optometrists. Since 1983, when optometrists couldn’t even bill Medicare for exams, I have seen the profession grow into what it is now, which is significantly more medically-oriented than when I began practicing. The POA has been instrumental in expanding the scope of optometry in Pennsylvania.

Edward B. Savarano, O.D., MS 
At the beginning of my 31 years of practice, I bounced from commercial setting to commercial setting, finally settling on a solo private setting in Belle Vernon and a position at the Veteran’s Administration in Pittsburgh. I have spent 23 years at the private practice and 15 at the VA. Medical optometry has always been a passion, but lately post-trauma rehabilitation has proved to be most stimulating. Traumatic brain injuries take away simple things that we take for granted: single vision, not falling when walking, reading without maximum effort, and driving without a headache to name a few. It is exciting to watch patients who suffer from post-trauma vision syndrome/visual midline shift take their first few balanced steps without a walker.
All of this has been provided by organized optometry and I am very grateful. The future holds more than we can imagine, but we need an advocate to make those dreams a reality. The POA has helped to fulfill many and continues to speak for our future. 
So, what do I do in my spare time? I’m a cheer dad! My daughter, Gabby, is the captain of her high school cheer squad and competes on an All-Star team as well. It is a travelling squad, extending to Kentucky, Ohio, Connecticut and Florida. Thankfully, we love to travel, too. The Grand Canyon, Wyoming’s Teton Wilderness, The Snake River, Yellowstone, King Salmon Alaska and next year, Africa. When the “Cheer Dad” hat is off, I hunt for coyotes, trap beaver, and fish for whatever bites...usually mosquitoes. 

Mark J. Dalton, O.D.
I practice in Allentown as a solo owner with one full-time associate. I have owned my practice since 1998, after spending about nine months in a corporate setting. We are a primary care optometry practice, treating everything possible within our scope of practice. I see a lot of diabetic patients and treat a lot of glaucoma. I love the variety of both optical and medical ocular conditions that I diagnose and treat, which ensures that each day is unique and never boring. I love the relationship I have with many of my patients whom I have been seeing for up to 18 years. 
Spare time relaxation includes reading, listening to and playing music, drawing, and spending time my family. Because my practice is in a busy, urban location, with a large population on medical assistance, we’ve been forced to become very efficient. At our peak, we were seeing about 12,000 patients per year. 
POA membership to me is essential to protecting my investment in optometry. Since we are a legislated profession, we need a strong association to represent us, protect us, and help move us forward. The hard work of the POA volunteers and staff have made possible our increased scope of practice that has helped all Pennsylvania optometrists. Also, for me personally, the POA Board has become a second family to me, always there for help and support. Some of my best memories in the past few years revolve around the POA meetings and Congress. 

Richard P. Christoph, O.D. 
I’ve been leasing space from Wal-Mart in Temple since I graduated in 1992. I see everyone, from six-month-olds to those over 100. I complete a lot of traditional refractive care and contact lens fittings, but also treat all types of topical conditions and a surprising amount of trauma. I also co-manage surgical cases, and what I’m not comfortable treating or don’t have the equipment to manage properly, I try to refer to my local optometric colleagues whenever possible. The thing I love the most is being able to make a difference in people lives. The child whose grades improve because they can see what is happening in the classroom or the adult with a challenging Rx and complicated visual demands that needs a creative approach to their prescription and eyewear are the most rewarding. 
In my spare time, after seeing patients six days a week, I manage to fit in volunteering with our local minor league hockey team, attending 40 to 50 hockey games a season, and taking care of my four senior rescue dogs, ages ranging from seven to over fifteen years old. My wife and I also foster dogs from Henry’s Hope Dog Rescue and often dog-sit for our friends and neighbors. I have a large Hispanic patient population, including at least one patient per day who doesn’t speak English. Because of that, the majority of my staff members are bilingual. It has been a big practice builder, and a real learning experience. 
The POA and AOA are the way we come together as a profession to address all the issues that “somebody should do something about.” I’ve found over the last 20+ years that the more you put into it, the more you get out of it. I’ve learned so much about patient care, practice management, third party billing, staffing, and every aspect of optometry from my colleagues. Many of those topics I never even sought out help with, they just came up in the process of volunteering or while having lunch or dinner at a POA event.

Please thank your 2016 POA Board for what they do on behalf of the profession when you see them at your local society meetings. In return, you will find a colleague who is more than happy to help you or, at the very least, point you in the right direction. If you would like to contact a Board member by email or phone, all contact information can be found on the POA website here:
On behalf of the current POA Board of Directors, I want to wish everyone a productive fall season. 


Mark M. Margolies, O.D.
POA President