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*Edit* Whoops. Someone brought to my attention that to get this deferment, you had to have had a loan before 1993. So disregard most of my lamenting below. Still, why would an established optometrist need a deferment? I would think they’d give it to us younger, income-deficient USPHS officers.

Holy Cow! All this time I’ve been paying back my student loans when I could have deferred them if they had come out with this sooner!
They have had Armed Forces and Peace Corps deferment for a long time, but the USPHS and NOAA deferment must be recent because the last time I checked the website 3 months ago, they didn’t have this.
I think I’m going to cry. I’ve been paying back my loans for the last 2 years because the IHS Loan Repayment program lately hasn’t had enough money to give more than one new award each year. The awards are based mostly on how remote you are, and while I’m in Montana, 2 hours from the closest Big Box Store, there are others more remote in places up in Alaska.
Getting paid half as much as an established practitioner, and 3/4 as much as classmates who went commercial hasn’t been easy. I like to think that the benefits make up for it, and they do; however, I would have liked to save the money towards starting my own practice. Oh well.
Now that I’m leaving, the Dept. of Education finally recognizes the USPHS.

*edit* The deferment may be used a maximum of 36 months.

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Here is what your patients are reading. I can imagine what some future patient is going to ask me.

“Sheesh, doc. Even the local humor columnist got the laser eye surgery. How come you don’t get it?”

“Well,” I say. “I’m not a good candidate because my expectations are too high.” [I expect a good excellent result 100% of the time. There shouldn’t be corneal ectasia in a low risk patient for some undetermined reason. I expect to have great vision for the rest of my life without jeopardizing it with risky cosmetic surgery.]

Too bad this columnist never had the chance to wear the new silicone hyrogels when he was young. So, how come you, doctor, haven’t already got “some new eyeballs?”

*edit* You can follow up with humor columnist Robert Kirby. Apparently it has gone okay so far. It’s lucky to be in part of the 99% group.

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I just took a MaximEyes online demo today. They sent me a demo CD last week, and I was interested, and so I agreed to have the online presentation. They have some nice functionality.

VSP calculator. I once worked as an optician for exactly one month in Hillsboro, OR. Everyone in Hillsboro has VSP because everyone works for Intel. When ever someone asked me how much their glasses are going to cost them, I had no idea. VSP has an infinite amount of plans and coverages. Once they decided what frames and lens options, then we’d get out the tables and eventually be able to tell them. Well, what happens if they decide that, I’d rather change this option, how much is that? Well, here we go again. With MaximEyes, it’s easy. Just click on the options, press a button and there you have it. What to price a different lens option? No problem! I’d be happy to. Click. Click. There you are.

Electronic interface with EyeFinity for VSP authorizations. Very nice. No waiting on the phone going through some phone tree.

EMR has a very slick feature. Let’s say you see some lattice in the peripheral retina. You diagram it with their drawing tool. It has a little picture that represents lattice that you can drag onto the fundus drawing. Once you drag that on there, it automatically adds the ICD-9 code to your superbill. Sweet! And guess what, completely customizable. I can create my own little picture and assign it an ICD-9 code! Wow.

They also allow you to completely customize the layout of your exam view. Don’t like where the keratometry box is? Move it anywhere you want. Want to keep track of some data point that isn’t already on Maximeyes, there is a way to go create it. Think of the possibilities for research! Pretend you went back in time and no software out there kept track of central corneal thickness, but you wanted it. MaximEyes allows you to create new fields to keep track of in your database.

Your printed reports are completely customizable. Very nice.

They also have a service that if you pay ~$500/year, your patients can go to your website and enter in all their history/welcome form. The data automatically gets populated in your database. What a huge time saver!

Basically MaximEyes addresses most all of my requirements, except price. Call them for a quote, but it’s in the 10-18K range depending on how many work stations you require. Also it costs 2600 per year for support and updates. Ouch.

The consultants will tell you that software is like buying another piece of equipment; however, there is a large discrepancy in price between the low, mid, and high end software solutions. I hate to buy the most expensive, if something half as much will only inconvenience me a little. I will say that if I was planning on having most my business with VSP patients, I would go MaximEyes for sure.

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Three U.S. Public Health Service optometrists are being deployed to aid in the Hurricane Katrina aftermath. Two from IHS, and one from the FDA. I’m not sure what role the FDA optometrist will be performing, but I have heard that the IHS optometrist from Montana will actually perform eye doctor duties, while the other from Oklahoma has been deployed as an “administrative officer.”

Good luck, Captains and Lt Commander! We’ve been told they will be reporting to secure areas, but we’ll still pray for their safety, and we’ll look forward to possibly having a report published at www.optometry.ihs.gov when they return?

Speaking of return, in the past deployments, a USPHS officer would only be sent for 2 weeks. Seeing how the recovery may be protracted, I wonder if they won’t have to stay a week or two longer than usual. Anyone heard?

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I’ve been demo’ing about every ECP PMS and EMR solution out there. Can anyone say “lousy user interface?” First of all, I think more of these software companies should be hiring graphic designers. Think Apple. Think pretty. Think cool.

I’ll name names. RLiSYS and eyecareconnect.com have the most boring looking GUI out there. It is so windows95. In this post iPod era we need styling. Sure it might take more beefy computers, but nowadays we have those available.

Second, a big pet peeve is having to demo a product with an online presentation. I can’t remember the next day half the stuff from the presentation (a.k.a. high pressure sales technique). I’d rather have a demo CD to play around with. Then if I like it and if the price is reasonable, let’s do an online presentation to answer more prepared questions. I’ve wasted too much time demo’ing online for some $16-18 THOUSAND dollar software apps that are only slightly better than the $5-10K apps.

Also, what’s the deal with the secret price? I had a vendor (myODPro if you must know) e-mail me a “Confidential Pricing Overview.” How lame is that?!!? Do they send me one quote and give the ECP down the street a better offer? If not, then why the secrecy?

Also, I swear it takes a full half hour just to document the exam. How can that increase my productivity? I need something faster. Maybe an EMR built specifically for tablet PC. Maybe an exam form that fits on one page. How come my paper exam fits on a single page, yet the EMR exam is separated by 4-5 tabs that I’ve got to click through? How come if I print out an EMR exam, it takes 3 pages? All forms that the software prints should be completely customizable by the user (sort of like how you can do with an MS Access database form). That way I can arrange in my preferred format the exam contents and save paper by putting it all on 1-2 pages max.

Also, how come it has to be MS Word? Why not be compatible with openoffice.org or even WordPerfect. Dell has been selling the less expensive WP a lot, and OOo is free. (Something I like after having to spend $10K+ on PMS/EMR.)

Any help?

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I’m a Lieutenant in the Commissioned Corps of the US Public Health Service. There is something called the CCRF which used to be a volunteer thing for officers to go assist with disaster relief. Recently it was mandated that all officers are required to meet deployment readiness standards. I just completed mine today (the physical fitness part has been holding me up for months.)
USPHS officers have been helping out in the recent hurricanes, but all of them had signed up to go. Well, for what looks like it could be the biggest natural disaster in recent history, the USPHS has put all officers on alert that they could be deployed for Katrina. The personnel list doesn’t include optometry (yes, we do have our own deployment category), so I’m not sure how likely it is I’ll have to go. However, optometry is my primary deployment role. I could potentially be called up for some other secondary role.
I’ll let you all know. If called up, I promise to blog about it provided an internet connection and a moment of free time are available.

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Okay, I thought Similasan was a little borderline marketing their drop for pink-eye, but now I think they’ve totally gone overboard. Introducing the first drop for cataracts: Similasan Cataract Care. Just to clarify, they market it as relieving the symptoms of cataracts. (However, the active ingredient Cineraria is “indicated for cataract and cloudy vision.” What? Explain that to me!)

I first saw this advertised to ECPs in the August 2005 issue of Optometric Management (pt 34). Similasan, instead of an ad similar to what you would use to market your product to patients, I’d like something tailored to us scientifically-oriented eye doctors. When they link to information for healtcare professionals, they only give me the party line, provide a link to information on homeopathy, and don’t site any studies. One could slap a label on a bottle, but it doesn’t mean that is what it actually does. I would like to have available some of the studies you conducted and reviewed to determine that the active ingredients in your product actually help with cataracts, or the symptoms thereof.

There’s a whole field of homeopathic medicines of which my education did not train me to understand. Apparently Cineraria has been around for a while from other eye drop makers (some even marketed to pet owners). I don’t know what to tell people. I could say,” sure try it out,” but if they spend the money and it doesn’t work, they could have just as well burned their hard-earned dollars or have given their cash to me!

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This is a good example of why I visit web forums. It helps to talk with other professionals about stuff. You learn something new (or relearn something old). By the way, this optical-centric forum has an RSS feed.

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Have you heard the Book Never Written jokes? Like, Under the Grandstands, by I.C. Butts.
Well, I was thinking of eye doctor practice trade names never written:

• The Evil Eye Center
  Dr. Lucy Fuhr
• Ojo Loco
  Dr. Nicolas Riviera
• Center for Blindness
  Dr. Woopy A. Daisy
• Spit in your Eye
  Dr. Toba Koe
• Lazy Eye Clinic
  Dr. Couch
• Potato Eye Clinic
  Drs. Ida Ho and “Spud” French
• Crossed Eye Center
  Dr. Strawberry Mousse
• Pink Eye World
  Dr. Moe Pink

Any others?

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The IHS optometry bulletin board is new and improved.

Some of the information presented in the former string entitled “Information for New Users” is obsolete since the IHS IT people upgraded the software that runs the forum in early August 2005. There are many new and improved features. Gone is the old user interface (although you can still see it by selecting “tree view”). You can now add a small picture to your profile that displays beside each of your posts. The best new feature is the addition of the site feed (the little orange XML icon). Feeds are available for the whole board, each conference (aka forum), and each topic (aka thread).

Below is a copy of an e-mail I sent the IHS optometrists.

The IHS IT people have upgraded the antiquated user interface of our IHS optometry webboard. To access the new and improved IHS Optometry forum, you will need to use the following url:
http://www.forum.ihs.gov/WB/default.asp?boardid=optometry&action=0

Please update your bookmarks.

The WebBoard 8 application that our new forum uses has brought several improvements, among them is a site feed (aka site syndication, XML, RSS, Atom). A site feed allows you to reed the content from a website without actually having to visit the site. For example, let’s say you like to keep updated on information from several (or hundreds of) different websites. In the old days you would have to click through each site (either entering the web address or clicking on your bookmarks and then browse the whole site to see what’s new). With XML or RSS feeds, you only have to use a feed aggregator, subscribe to a site feed (our optometry forum site feed url is http://www.forum.ihs.gov/WB/rss/?a=61&b=0 ) then anytime there are updates, you are notified and can read them right from the aggregator instead of clicking through. Aggregators (or feed readers) come in all types. One can use a stand alone program on your own computer like the one at feedreader.com. Most e-mail clients like Thunderbird and web browsers like Firefox and IE7 also employ this functionality. I find it convenient to use a web-based aggregator like www.bloglines.com or , http://www.newsgator.com/ , or even my.yahoo.com so that I can view my content from any computer (except IHS computers which usually block websites related to blogs and site syndication).

For more information on how site feeds work, I suggest the following (note many of these resources are blocked by IHS content filtering, so you may need to forward this e-mail to your home computer):

• http://en.wikipedia.org/wiki/News_aggregator
• http://en.wikipedia.org/wiki/List_of_news_aggregators
• www.bloglines.com
• http://en.wikipedia.org/wiki/Web_Syndication
• http://www.faganfinder.com/search/rss.shtml

Or just do a web search on key terms like RSS, Atom, XML, RDF, site feed, and aggregator.

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