insight - sacramento valley optometric society · 2016-10-13 · page 2 svos insight the svos...

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SACRAMENTO VALLEY OPTOMETRIC SOCIETY What is it about contact lenses that drives patients to abuse and overwear? Is it a lack of understanding of physiology? Poor emphasis on hygiene? Too much emphasis on cost? Or is it our fault for not educating the patient properly? How do we express to our patients that these are medical devices placed on highly sensitive and irreplaceable tissue? How do we clarify that one infection in the wrong spot can cause permanent vision loss? How do we remind them that contact lens trials are not meant to be worn for a whole year? As we approach Halloween, I’m obliged to share my favorite contact lens abuse horror story… Years ago, I examined a twentysomething male who told me he was a “chain puller.” Apparently, this occupation involves feeding raw materials into automated machinery and/or pulling them out as roughly manufactured products. He was also an extended wear contact lens wearer. And by “extended wear,” I mean that his c urrent contact lenses were over six months old… and had not been removed once over that period. As would be expected, the lenses were in pretty bad shape. However, it was the embedded chunks of metal that really caught me by surprise. Apparently, my young patient’s contact lenses had absorbed multiple pieces of metal shrapnel, presumably from his dangerous occupation (no safety glasses, by the way). My shock at the state of my patient’s lenses was only outweighed by his nonchalance in the face of my recriminations. “You have metal embedded in your contact lenses! Doesn’t it hurt?!?” “Doc, I just need my prescription,” he replied. I still don’t understand the mindset of that young gentlemen, just as I do not understand the lack of cognizance of most of my contact lens abusers. Their excuses for their transgressions are abundant, but I do my best to have an answer for each one: “I can’t replace my lenses that often; they are too expensive!” Contact lenses are a luxury. If you cannot afford to replace your contact lenses appropriately, then you cannot afford to wear contact lenses. In addition, the money saved by stretching your lenses out will immediately be wiped away by the $150 bottle of antibiotic drops I will prescribe to treat your first corneal ulcer. “I don’t own glasses, I wear contact lenses instead.” You can be a 99% contact lens wearer, but you cannot be a 100% contact lens wearer. If you require correction to function at work or be safe to drive, you must have an adequate pair of glasses before I will fit or refit you with contact lenses. If you lose a lens, get an infection or use up your last pair, you must have glasses to fall back on to continue to function. Shupe’s Scoop – The Contact Lens Conundrum I NSIDE T HIS I SSUE 1 Shupe’s Scoop 2 Upcoming Events 2 October General Meeting 3 Presenter Bio: Aaron Lech, OD 3 October Birthdays 4 MIPS - Questions Answered 5 US House Bill Introduced to Curb Illegal Online Contact Sales 5 Classifieds 5 September Board Meeting Recap October 2016 By Adam Shupe, OD INSIGHT Sacramento Valley Optometric Society 800 Commons Dr Sacramento, CA 95825 Phone: (916) 447-0270 Fax: (916) 471-0560 Contact: Tamalon Littlefield [email protected] Website: www.svos.info Please see Shupe’s Scoop continued on Page 3

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Page 1: INSIGHT - Sacramento Valley Optometric Society · 2016-10-13 · Page 2 SVOS Insight The SVOS invites you to join us at our October General Meeting to meet and greet your colleagues,

SACRAMENTO VALLEY OPTOMETRIC SOCIETY

What is it about contact lenses that drives patients to abuse and overwear? Is it a lack of understanding of

physiology? Poor emphasis on hygiene? Too much emphasis on cost? Or is it our fault for not educating the patient properly?

How do we express to our patients that these are medical devices placed on highly sensitive and

irreplaceable tissue? How do we clarify that one infection in the wrong spot can cause permanent vision loss? How do we remind them that contact lens trials

are not meant to be worn for a whole year? As we approach Halloween, I’m obliged to share my favorite contact lens abuse horror

story… Years ago, I examined a twentysomething male who told me he was a “chain puller.” Apparently, this occupation involves feeding raw materials into automated machinery and/or pulling them out as roughly manufactured products. He was also an

extended wear contact lens wearer. And by “extended wear,” I mean that his current contact lenses were over six months old… and had not been removed once over that period.

As would be expected, the lenses were in pretty bad shape. However, it was the embedded chunks of metal that really caught me by surprise. Apparently, my y oung

patient’s contact lenses had absorbed multiple pieces of metal shrapnel, presumably from his dangerous occupation (no safety glasses, by the way). My shock at the state of my patient’s lenses was only outweighed by his nonchalance in the face of my

recriminations. “You have metal embedded in your contact lenses! Doesn’t it hurt?!?” “Doc, I just need my prescription,” he replied.

I still don’t understand the mindset of that young gentlemen, just as I do not understand the lack of cognizance of most of my contact lens abusers. Their excuses for their transgressions are abundant, but I do my best to have an answer for each

one: “I can’t replace my lenses that often; they are too expensive!”

Contact lenses are a luxury. If you cannot afford to replace your contact lenses appropriately, then you cannot afford to wear contact lenses. In addition, the money saved by stretching your lenses out will immediately be wiped away by the $150 bottle

of antibiotic drops I will prescribe to treat your first corneal ulcer. “I don’t own glasses, I wear contact lenses instead.”

You can be a 99% contact lens wearer, but you cannot be a 100% contact lens wearer. If you require correction to function at work or be safe to drive, you must have an adequate pair of glasses before I will fit or refit you with contact lenses. If you lose

a lens, get an infection or use up your last pair, you must have glasses to fall back on to continue to function.

Shupe’s Scoop – The Contact Lens Conundrum

I N S I D E T H I S IS S U E

1 Shupe’s Scoop

2 Upcoming Events

2 October General Meeting

3 Presenter Bio: Aaron Lech,

OD

3 October Birthdays

4 MIPS - Questions Answered

5 US House Bill Introduced to

Curb Illegal Online Contact Sales

5 Classifieds

5 September Board Meeting

Recap

Octob er 2016

By Adam Shupe, OD

INSIGHT

Sacramento Valley Optometric Society

800 Commons Dr

Sacramento, CA 95825

Phone: (916) 447-0270

Fax: (916) 471-0560

Contact: Tamalon Littlefield

[email protected]

Website: www.svos.info

Please see Shupe’s Scoop continued on Page 3

Page 2: INSIGHT - Sacramento Valley Optometric Society · 2016-10-13 · Page 2 SVOS Insight The SVOS invites you to join us at our October General Meeting to meet and greet your colleagues,

Page 2 SVOS Insight

The SVOS invites you to join us at our October General Meeting to meet and greet your colleagues, enjoy a delight ful dinner and take in a CE lecture by Aaron Lech,

OD, FAAO. Multiple exhibitors will also be present to discuss their wares and services.

PROGRAM AGENDA 6:00 pm Reception and Exhibits

6:45 pm Dinner Served 7:00-8:40 pm 2 Hour CE Program

Speaker: Aaron Lech, O.D., FAAO Title: “Glaucoma Update 2016 – A Practical Approach”

Summary: This lecture will go from suspect to diagnosis and treatment and then we will explore current thought on the latest diagnostic and treatment strategies. There

will be practical answers to questions like: - When do you decide to treat? - What is the drug of choice?

- How often is an adjunctive therapy needed and what is this trigger? - What do I do with side effects? - Is surgery a reasonable option?

Meal Choices: Watermelon Salad with Cucumbers, Almonds, Feta Cheese and Tessemae Honey

Balsamic Dressing Assorted Rolls and Cheesecake dessert Entrée choice (choose one):

(__) - Coconut Spiced Chicken with Butternut Squash Rice and Seasonal Vegetables (__) - Vegetarian Cavatappi Pasta with Grilled Vegetables, Fava Beans, Parmesan

and Olive Oil

Please RSVP [email protected] (with meal choice) by October 11th

!

Non-members are welcome to attend; the fee is $45 and will be collected at the door. ____________________________________________________________________

Tuesday, October 18th, 2016

General Meeting at 6:00 PM

UPCOMING EVENTS

October General Meeting

October 18, 2016 6PM Courtyard Marriott Cal Expo

Speaker Aaron Lech

2 CE Hours

Monterey Symposium

November 18-20, 2016 Monterey Marriott Hotel &

Conference Center

Monterey, CA

November General Meeting

November 15, 2016 6PM Courtyard Marriott Cal Expo

Speaker TBD

2 CE Hours

SVOS Holiday Party

December 4, 2016

2017 Ocular Symposium

March 5, 2017 Marriott, Rancho Cordova

Rancho Cordova, CA

2017 SVOS Tahoe Summit July 21-23, 2017

Hyatt Regency Incline Village

Incline Village, NV

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SVOS Insight Page 3

Dr. Lech graduated from the Illinois College of Optometry and holds

a degree in biology from UC, San Diego. Upon graduation, he served in the Navy and practiced at Balboa Naval Hospital in San Diego, CA, where he served as Director for both the Optometry

Clinic and Specialty Contact Lens Services. In 2004, he relocated to northern California with his family and opened ClearVue Eye Care. Dr. Lech pursued optometry because, "I wanted a profession

that allowed me to care for people, impact healthcare in the third world and devote myself to my family."

“My last eye doctor said these contact lenses lasted three months!” I do not know how the miscommunication occurred, but it is your responsibility to take care of your own eyes. Manufacturer-recommended replacement schedules exist for

a reason. Replace your lenses appropriately or risk vision -threatening damage to your corneas.

“What solution do I use? The one that is on sale!” You understand that Wal-Mart and Target do not make contact lens solution, right? Those companies purchase cheap, generic solutions and package them up as Equate

and Up & Away. However, they do not have to tell you what is actually in those bottles. What happens if Wal -Mart gets a better deal from another supplier? Do they change the Equate box to reflect its new contents? Of course not. You could buy two

boxes of store-branded solution and receive two completely different products; and one or the other may not be compatible with your contact lenses.

“My prescription hasn’t changed in years. Why do I need to be seen to renew my prescription?” When I fit you with contact lenses, you and I are entering into an agreement. I am

stating that, to the best of my ability, I have selected a lens that fits your eye properly, will correct your vision adequately and keep your eye healthy if worn appropriately. You are agreeing to follow my directions as to wear and care of the contact lenses. If

you do not return for regular follow-up, I cannot verify that the lens I prescribed for you is still holding up my end of the bargain, nor check to make sure that you are continuing to follow a proper lens care regimen.

For sure, there are many more problems with the contact lenses marketplace, such as online sales, low reimbursement for services and disruptive technology. But those

are global problems that cannot be solved individually. Re-education about proper lens wear and care can occur in-office, when your patient is in the chair in front of you. Do not miss out on an opportunity to improve the long-term ocular health of your

contact lens patients. .

October Birthdays

October 1 Don Fong

Laraine Low Cory Vu

October 3 Margaret Raulino

October 4

A William Meyer

October 9 James Mitchell

October 10

Donna Scolaro

October 15 Larrance Larson

October 18

Ellen Park

October 23 Henny Toy

October 25

Tomas Borsky

October 29 Katrina Gallardo-Chang

Stephanie Yoshimura October 31

Lynn Buttino Darlene Okura

Presenter Bio: Aaron Lech, OD, FAAO

Shupe’s Scoop continued from Page 1

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Page 4 SVOS Insight

Recently, AOA and COA have received many questions related to the new Medicare Merit -Based Incentive Payment

System (MIPS) and CMS-related requirements and deadlines. These are important questions as doctors do not want to suffer negative Medicare reimbursement adjustments that would begin in 2019 by not participating in MIPs. The fol lowing is a lengthy, but hopefully informative discussion of the MIPs and related programs rollout.

Generally It is important for doctors of optometry to understand that the program requirements for MIPS are not yet finalized, though the final program requirements are expected to be released very soon. Based on the questions received, we wanted to

ensure that doctors are aware that participating in a Practice Transformation Network (PTN) is no t a Medicare requirement. Rather, CMS has proposed that participating in a CMS Transforming Clinical Practice Initiative and the related Practice Transformation Networks (PTN) and Support and Alignment Networks (SAN) may be considered a

Clinical Practice Improvement Activity that can help doctors to meet one set of program requirements under the proposed program structure. Participation in a PTN or SAN is just one of many options available for meeting certain program requirements. While there may be specific deadlines related to participation in a PTN and SAN, there is no overall CMS

related MIPS deadline at this point. CMS Announces Needed Flexibility for Merit Based Incentive Payment System

On September 8, in response to concerns raised by the American Optometric Association and other physician organizations, the Centers for Medicare & Medicaid Services (CMS) announced that CMS will offer needed flexibility for the first year of the Merit Based Incentive Payment System (MIPS). CMS has indicated that doctors will have options with

regard to how to participate in this new program in 2017.

Test the Quality Payment Program by submitting at least some data for the program.

Participate for part of the calendar year.

Participate for the full calendar year

Please note that CMS had proposed that participating in a CMS Transforming Clinical Practice Initiative (TCPI) and the related Practice Transformation Networks (PTN) and Support and Alignment Networks (SAN) may be considered a

Clinical Practice Improvement Activity that can help doctors to meet program requirements under the proposed program structure. Participation in a TCPI-related program, such as a PTN, is not required, but can help to earn points under the proposed system. Similarly, there are several proposed activities related to Qualified Clinical Data Registry use, such

as AOA MORE, that can also help doctor to earn points under the proposed program requirements. CMS intends to release final rules related to these program options prior to November 1. Look for additional

updates in the coming weeks. Read more from CMS here. If you have questions regarding MIPS, please contact Kara Webb at the American Optometric Association at: [email protected]

CMS Proposed Changes for 2016 Meaningful Use Program Impact AOA MORE Responding to significant concerns from physicians organizations, such as AOA, the CMS has proposed to change the electronic health record (EHR) reporting period for Meaningful Use to 90 days in 2016. This proposed change to shorten

the previous 12 month reporting period could have a positive impact for many doctors of optometry. Under the Meaningful Use program, one of the objectives requires doctors to engage with a specialized registry , such

as AOA MORE (the Measures and Outcomes Registry for EyeCare) To receive credit for this objective, at a minimum, doctors of optometry must register their intent to submit data to a registry with the first 60 days of their EHR reporting period. If CMS finalizes the 90 day reporting period for this year, doctors who choose the last 90 days of 2016 as their

reporting period will have more time to register with AOA MORE to meet this program requirement. Visit www.aoa.org/MORE to register with AOA MORE and look for updates on CMS final actions on this proposal in the coming weeks.

MIPS - Questions Answered from COAvision.org

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SVOS Insight Page 5

H.R. 6157 was introduced late last month to modernize the prescription verification

process, effectively curbing deceptive and illegal contact lens sales tactics by companies. Authored by Reps. Pete Olson, R-TX, and Kathy Castor, D-FL, the bill complements COA and AOA-supported S. 2777, the Contact Lens Consumer Health

Protection Act of 2016, which would:

Prohibit overfilling of orders

Strengthen enforcement of prohibitions against filling expired prescriptions

Hold sellers accountable for illegal sales tactics and false claims

Ban use by internet sellers of disruptive automated “robocalls” into doctors’ offices as the mechanism for verifying patient prescription information

Ensure contact lenses must be dispensed exactly as the prescription is written by the doctor

Increase fines to sellers to $40,000 per infraction.

Help COA and AOA help you. If you have a patient who was able to refill their expired contact lenses prescriptions online, please report the incident to the FTC (select "Other" in the menu to file a complaint ). Complaints make our case that

this is a significant problem and that the easy availability of online contact lenses can lead to bad patient outcomes.

(See “Online Colored Contact Lens Business Pleads Guilty in Largest-Ever Counterfeit and Misbranded Contact Lenses Investigation” in this edition for more on this topic.)

The Septmeber SVOS Board Meeting was held on Tuesday, September 13th, 2016 at Seasons 52 Restaurant. In attendance were: Adam Shupe, Brian Park, Ellen Liebowitz, Lynn Buttino, Tom Fleischmann, Krister Holmberg, Jane Libershteyn, Jonathon Ross ,

Linda Rappa and Tamalon Littlefield. TREASURER'S REPORT

This year's Tahoe Summit financial breakdown was covered. Dr. Liebowitz will continue training Dr. Buttino to take over treasurer responsibilities.

MEMBERSHIP REPORT There were 4 new members, 3 new graduates an 1 transfer from a different society .

TAHOE SUMMIT REVIEW The summary of the Tahoe Summit evaluation forms were covered. SVOS is contracted to stay at the Hyatt through 2018. Due to the BBQ's success, the board opted to have

the event return for next year. The board decided to continue to use the new event planning services used at this year's Summit for future events. Options for catamaran rides and registration costs will be re-discussed at a future board meeting. Speakers for

next year's event were read.

Classifieds

PTE OD Needed in Auburn Looking for a part-time optometrist to work

1-3 days, with f lexible days and hours and

very competitive pay.

Office is located in Auburn and the position

is immediately available.

Please send CV/resume

to [email protected]

Health Fair in Need of Volunteers

on November 30 The Consortium for Community Services is in need of optometrist volunteers for their

assistance in screening a high-risk population in Sacramento.

The fair will be held at the Consortium

off ice (205 Dos Rios St, Suite A1) in Sacramento on November 30th, 2016 from 11:00 am to 3:00 pm. For more information

on volunteering (or to recommend someone w ho can help), pleasue contact Community Resource Liaison Brittany at [email protected].

Sacramento Associate OD Needed

Seeking a part-time associate OD init ially one day a week (Fridays) available

immediately, expanding to 3 days a week (Wed, Thurs, Friday) beginning January 2017.

If interested send CV to: [email protected]

Volunteers Needed for Veterans Needing Eye Exams in Citrus

Heights

Citrus Heights HART (Homeless Assistance Resource Team) Group sponsors an event each year for homeless

veterans called Veterans Stand Dow n, where many services and resources (food, clothing, sleeping bags etc) are provided. This coming year we are expecting

approximately 100-150 veterans in attendance seeking services and resources.

We have need for optometrists to provide cursory eye exams for these veterans. The event is scheduled for Tuesday, April 18th from 9 am to 4 pm. If you would like to

participate, contact Dick Bartlett at [email protected] or by phone (916)342-3965.

SVOS September Board Meeting Recap

US House Bill Introduced to Curb Illegal

Online Contact Sales

Please see Board Recap continued on Page 6

from COAvision.org

Page 6: INSIGHT - Sacramento Valley Optometric Society · 2016-10-13 · Page 2 SVOS Insight The SVOS invites you to join us at our October General Meeting to meet and greet your colleagues,

Page 6 SVOS Insight

OCULAR SYMPOSIUM 2017 A draft of the brochure was created and approved. The first week of November was targeted for the first mailing of

brochures. All exhibitor space is sold out for March and two spots remain for next year's Tahoe Summit. SEPTEMBER 2016 VSP MEETING

63 people were registered for the meeting. Dr. Meister will speak for one CE unit after lab tours. SVOS NOMINATING COMMITTEE

Rob Omoto will chair the nomination committee. An announcement will be made at the next meeting to ask for members who are interested in serving on the board.

COA PRESIDENT'S COUNCIL The current president and president-elect will attend the President's Council in February. Various topics the board would like for our representatives to present at the council was covered.

SVOS 2016 HOLIDAY PARTY The holiday party is scheduled for Sunday, December 4th. The board decided to keep the party at Season's 52. Tamalon

will contact Seasons 52 to reserve the space. MARCH 2017 INSTALLATION DINNER

Dr. Park will let Tamalon know a date and place for his March installation dinner. Dr. Earhart will be asked to lead the installation for Dr. Park.

Board Recap continued from Page 5

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SVOS Insight Page 7

INSIGHT SACRAMENTO VALLEY OPTOMETRIC SOCIETY

JANUARY, FEBRUARY, APRIL, MAY, OCTOBER 2016, NOVEMBER

SACRAMENTO VALLEY OPTOMETRIC SOCIETY

President Adam Shupe, O.D.

President Elect Brian Park, O.D. Secretary Linda Rappa, O.D.

Co-Treasurer Ellen Liebowitz, O.D. Co-Treasurer Steven Omoto, O.D.

Past President Robert Omoto, O.D.

SVOS 2016 BOARD OF DIRECTORS

Board Members Lynn Buttino, O.D.

Tom Fleischmann, O.D. Krister Holmberg, O.D.

Jane Libershteyn, O.D. Jonathon Ross, O.D.