optoblog.com

Ever wonder what patients tell other people about you and their eye appointment? Here’s an example of what one patient says. I just did a technorati.com search for “optometry” and it searches the blogosphere for all entries that mention us. You could also easily get feedback if your website included a blog and bulletin board.

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AOA News website was recently launched. I finally took the time to login to see what it’s like. It has a blog format, but the disappointing thing is that they haven’t syndicated it with RSS or Atom. They also don’t allow you to see the full article unless you log in with your member number and password.
I really think they’re missing the boat on this. AOA News has the captive audience and the industry relationships to make a “bleeding edge” blog. If they could implement an RSS feed, I could have up to the minute optometric info, without having to surf a website. Robert Scoble, a prolific blogger, delivered a keynote address on the concept of web logs. Before, RSS he would have to visit each individual site to read the updates. With multiple sources of news, one cannot use a web browser to click through every site offering newsworthy content. It just takes too long.
RSS feed aggregators (like newsgator.com or bloglines.com) do the work for you by downloading the syndicated content at leisure and highlight the new posts. Scoble and other bloggers have over 1000 feeds that they keep track of.
Of course, in the optometric world, there are fewer sources of industry news than in the tech world. Still, optometry needs to think to the future which technology. We as a profession have historically been slow to adopt new technology. For the good of the profession, we must become more trend forward.
A visit to any optometric conference exhibit hall shows us that the future of our profession is integrated with technology. The time has come for our profession to start on the band wagon of information sharing through blogging and syndication (RSS/Atom). We need more optometrist blogs and more industry blogs. All optometric product companies should keep us current with feeds and blogs. If a blog doesn’t have an RSS feed, it’s just another website-not a true blog. AOA News should be the example to optometry by offering syndication for at least the non-login content. (Even the Official AAOphthal blog has an RSS feed.)

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Our service unit decided at the beginning of this year to break a long-held tradition. Non American Indian spouses and children of commissioned officers have usually been granted direct care at IHS clinics from service unit CEOs. In the past, what this meant was an office visit was performed and not billed to any insurance companies. Now, while non-Indian CC dependants are still granted care within IHS facilities, the new policy is to bill insurance, and the amount not paid by insurance is passed onto the patient. That is fine for the officer because his/her insurance covers 100%. The family will usually be on Tricare prime remote, which has a low deductible but only covers 80% for out of network providers, and IHS is out-of-network. According to an e-mail I was forwarded, IHS doesn’t ” . . . plan to become a provider within their networ[k] (it will have a negative impact on BMP billing, which is higher volume).”
So, someone crunched some numbers and determined that if IHS became a preferred provider for Tricare (accepting a lower fee as payment in full for both officers and dependants), they wouldn’t make as much money compared to staying out-of-network and getting the 100% fee charged for just billing the officers.
So, because Tricare reimburses so well for out-of-network visits for officers, their dependants get the shaft. Making the decision to bill all visits for non-ben CC dependants was done in the name of revenue enhancement; however, I don’t believe they will see a difference in revenue. The number one reason is that all things being equal (paying 20% co-pay to either IHS or a private doctor), I will go to the place with the best customer service and most convenient location. Often a commissioned officer will live in a town which is 20-30 miles away from the service unit, so the best location is in town. If the town happens to have doctors who accept Tricare allowables as payment in full, it’s a no-brainer.
Another reason why IHS won’t make any more money with this new policy is that because it ticks me off, I will avoid utilizing the IHS clinic, so their precious CC officer 100% out-of-network fee will not be earned.
Another negative impact will be loss of officer productivity. Anytime I or my kids are sick, I will spend more time out of clinic to go off-site for doctor visits.
Another issue, being a professional, I have the opportunity to give exams to my family. There is no way I’m going to pay IHS 20% per dependant for an exam that I perform. Now, if I were to choose to examine my dependants “under the table” that would make me subject to disciplinary action.
IHS can still get revenue enhancement and satisfy me if they would become in-network providers for Tricare, accepting Tricare allowables as payment in full. That way, everybody wins. They get money from exams on my family. I can still examine my family, and I don’t miss as much work because I can stay onsite to take my kids to the doctor.
An aside, my service unit claims that they aren’t able to bill Tricare for dependants because it is another government agency, so they are going to pass on 100% to the patient. This is absolutely false because I contacted a Tricare customer service representative and a claims processor and both stated that Tricare disburses payments to IHS facilities. (Of course if one is Native American, the Tricare claim would be denied, and if a claim is approved they would only pay 80% since IHS facilities are out-of-network). Our area office is currently investigating the Tricare billing issue.
I should point out that not all IHS service units are billing cc dependants, but it seems to be a growing trend. It is a very disappointing trend, and a slap in the face to me. I am the son of a PHS cc officer, and I grew up getting all my care at IHS clinics. I had joined PHS/IHS expecting the same arrangement for my family, but now that perk has disappeared from my service unit. I hope it doesn’t disappear from yours.

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The NIH has made plans to require all NIH-funded research to be published on their website according to Reuters. This is great news! The controversy comes from the journals who require large subscription prices in order to peer review the articles before publishing. The original plan gave a grace period of 6 months after publication before beginning free access, but the NIH finally compromised at one year.
I think this is a victory for tax payers and researchers. The journals I subscribe to are mandatory for my membership in an association (AAOpt and AOptA), so they won’t be hurt. Optometry students writing a thesis should be wary of only searching the NIH site, though, because not nearly all research is funded through NIH.
The database of papers will be available at www.pubmedcentral.gov.
Please tell me there will be an RSS feed of abstracts for topics I’m interested in!

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This week a received an unsolicited March 2005 issue of Sky & Telescope magazine. I never asked for it, and it has “David Langford, Optometrist- O D” on the label. I can only assume they got my name from the AAOpt mailing list. Ever since registering for San Diego 2002, I have received approximately 2 metric tons of junk mail from ophthalmic-related vendors and manufacturers. (Does anyone know how to opt-out of AAO partner mailings?)
Anyway, the astronomy magazine got me thinking about hobbies that optometrists may be more likely to take up. For example, my father, an optometrist, has an interest in astronomy and was an astronomy merit badge counselor for Boy Scouts. He also enjoys photography. These are two very optics-centered hobbies. On the other hand, I don’t take a keen interest in astronomy and am lukewarm with photography. Computers are my hobby. So, there may be no correlation between occupation and hobbies, but at the very least, I can look at my issue of Sky & Telescope and appreciate the content because I have some understanding of what they’re doing.
The greatest thing about receiving a free issue of Sky & Telescope is that I can put it in an exam room since I am in desperate need of newer magazines! (But seriously, I’m glad none of the AAOpt partners know my fax number.)

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The American Academy of Ophthalmology has one-upped optometry with their blog site (www.eyeorbit.org). It appears to have started around Sept. 2004. It’s a pretty nice looking site, although I think the site would be better served with a bulletin board for what they’re trying to do. I don’t get the point of having anyone being able to blog on a single web site. If anyone can post messages, isn’t that a board?
One interesting read on their “What’s a blog?” page (That’s right, they used “What’s a. . .”)

Q. What Do I Blog About?
A. There are two main types of blogs. Personal and business blogs.
Personal blogs can be about anything. For instance, one can blog about political advocacy and the battles with optometry’s scope expansion in their home state. Members-in-training can write about their training as eye surgeons and medical doctors. . .

Does anyone have a blog ranting about ophthalmologists in their home state who don’t spend enough time in the operating room, so they sell glasses for a living? If so, please leave a link in the comment section.
But I digress.
I think they’d be best served by having a very small number of some really interesting, known, and respected “Eye MDs” to post blogs, and then have all the boring nobodies post to a web board. (I can say that because I’ve never pretended to be an authoritative blogger, just an enthusiast blogger.)
Which leads us to discuss, how come optometry doesn’t have a blog sponsored by the AOptA or AAOpt? How come the major ophthalmic manufacturers don’t have blogs about upcoming products and technologies?
And how come we don’t call ourselves “Eye ODs”? (Or maybe that’s just what you call an eye doctor in Montana crazy enough to Rx cannabinoids for glaucoma.)

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According to the NEI/NIH and the November 2004 Ophthalmology, surgery for CNV in wet AMD is not effective.

Vision does not improve substantially for patients with age-related macular degeneration (AMD) who undergo surgery to remove lesions of new blood vessels, scar tissue, or possible bleeding beneath the retina, according to results of nationwide clinical trials sponsored by the National Eye Institute (NEI), part of the National Institutes of Health.

In other AMD news, due to media attention on high dosages of Vitamin E posing health/mortality risk, the NEI reviewed the AREDS formulation and found that the recommended daily vitamin E intake of 400 IU poses no increased risk of death.

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GIMC gained a new wing while Albuquerque clinic struggles to stay open.

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The 10/4/2004 US News and World report did an article on the state of healthcare with American Indians. The full article requires a subscription, but an excerpt can be found with the National Indian Health Board.
There were some interesting figures on dollars spent per patient.

But the Indian Health Service can’t spend money it doesn’t have, and it doesn’t have much. America spends an average of about $5,000 per person per year on healthcare. For government programs that deliver healthcare directly, the per-person expenditure varies enormously: $5,200 by the Veterans Administration, more than $3,300 by the armed forces, $3,800 per federal prisoner, and $1,900 by the Indian Health Service. Money isn’t everything, but without it you can’t buy healthcare. And without it a dent will never be made in the health disparities of these people to whom our government has given its word.

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The Armed Forces Optometric Society named CAPT Richard Hatch, OD their 2005 optometrist of the year. Included among the AFOS judges was CAPT Terry Schleisman.

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