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.

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

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.

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.

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.