This was the first year residents were invited to attend the Mid-Year Forum. The goal was to raise awareness of political issues and to increase resident involvement. I'm back from the AAO Mid-Year Forum. I learned tons, and I have increased respect for the AAO and state medical societies. These organizations are fighting for our future as ophthalmologists and demanding high quality of care for our patients. The AAO does wonderful things for ophthalmology and patients. In addition to the political side of ophthalmology, there were sessions on documentation of resident competency, bridging the gap between academic medical centers and private practitioners, and Medicare fee solutions. I'll discuss some of these issues in detail below. My goal is to pass on what I learned so that medical students and residents interested in ophthalmology can become more involved. As residents, we need to prepare ourselves intellectually, surgically, and politically. The political process is very important. We all must start by giving money to our Political Action Committees (PAC). There are 40,000 optometrists and 14,000 ophthalmologists in the US. Optometrists, historically, have given several fold more than ophthalmologists; thus, organized optometry is a powerful and formidable political group. The average ophthalmologist gives $50/year to his/her PAC. As residents, we can easily match this. As attendings and staff, we should be giving several fold more. Perhaps we should learn from our colleagues in law who give an average of $1000/year! I. Optometric Laser Surgery in the VA The #1 agenda was advocating for surgeons doing surgery in the VA system. Oklahoma is the only state that allows their optometrists to perform some laser procedures. However, with the events last week, a bill, if signed by the Governor, will make Oklahoma optometrists into ophthalmologists. Because Oklahoma ODs can perform laser procedures, they started performing laser procedures in the VA located in other states. It's ironic that these same procedures, if performed across the street in a private office, would be illegal. http://www.aao.org/aao/news/release/20040407.cfm "Fueling the debate, the Academy recently was made aware of credentialing sheets [for optometrists] from VA facilities in Los Angeles outlining that include surgical privileges for multiple eye procedures, including ?focal photocoagulation of microvascular fundus lesions,? ?pan-retinal photocoagulation for proliferative retinopathy and iris neovascularization,? and ?parenteral injection of pharmaceutical agents for treatment of complex diseases or conditions of the eye.? In Tuscon, YAG capsulotomy is not even listed on ophthalmology?s privileging sheet, but does appear on optometry?s, along with ?local subcutaneous injection of pharmaceutical agents,? and ?excision of minor lid lesions??evidence of optometry?s effort to establish these surgical procedures as part of its standard of care." Dmitry Pyatetsky, MD and me on advocacy day. see below Representative Leach and me after our meeting. see below After meeting with Senators and Representatives, I realized several things. It's important for physicians to be involved politically. It's our duty to maintain a high standard of care for our patients and for future generations. If I had not attended advocacy day, then nobody from Iowa would have met with Representative Leach, one of the co-sponsors of the VETS bill. He needed more information about the key issues. Many members of congress do not have a good understanding of our training and what it takes to be an eye surgeon. It was helpful for Representative Leach and his staff to hear from a physician's perspective. Otherwise, they only hear from organized optometry who claim that their graduates complete "residencies", when in fact, these "residencies" are only 1 year long and less than 10% of ODs complete a "residency".