Ophthalmology on the Hill

Stories from the AAO Mid-Year Forum

By Mohsin H. Ali, MD, and Siya Huo, MD

At the 2016 Advanced Vitreoretinal Techniques and Technologies (AVTT) meeting, Jennifer I. Lim, MD, discussed the role organized advocacy plays in ensuring that policymakers understand the needs and concerns of retina specialists. In the interest of bringing a little bit of the AVTT meeting to the pages of NRMD, two of Dr. Lim’s residents share their experiences advocating for ophthalmology.

—Scott Krzywonos, Editor-in-Chief

“Medicine is a social science, and politics is nothing else but medicine on a large scale.”

— Dr. Rudolph Virchow

As aspiring ophthalmologists, we envision careers in which we will make meaningful differences by restoring health and enhancing the lives of patients. We carefully study the pathophysiology, signs, symptoms, and treatment of diseases. When in residency, we attempt to apply this knowledge to heal our patients.

However, as we gain more practical experience, we realize that treating patients is much more complex and nuanced than our textbooks suggest. The health of our patients is often just as much affected by our medical advice as it is by factors outside the exam room—factors including socioeconomic status, health literacy, social support systems, and public health policy. The weight of these factors can feel insurmountable for patients and physicians.

It is easy to resign ourselves to a learned helplessness, ignoring the impact of factors we feel powerless to change and convincing ourselves that maximizing our medical acumen and surgical prowess is sufficient fulfillment of our roles as physicians. Such thoughts create a problem: By remaining insular academics and practitioners, we limit our potential to influence the overall health of our patients.


There is another perspective worth considering. It demands more of our time and energy and requires us to broaden our understanding of what it means to be a physician. Success may lead to widespread change with the potential to extend beyond our individual practices. This perspective was well articulated by Dr. Rudolf Virchow, the preeminent German physician and social medicine activist (whose doctoral dissertation, interestingly for ophthalmologists, was De rheumate praesertim corneae, or On Rheumatism, Chiefly of the Cornea).


• Consequences of electronic health record mandates
• Funding to support vision research
• Improving contact lens safety for patients
• Ensuring truth in medical advertising
• Ensuring that ophthalmic surgery is performed by qualified physician-surgeons
• Preventing reimbursement cuts to physicians
• New reimbursement formulas issued by the Centers for Medicare and Medicaid Services

In the words of Dr. Virchow, “Medicine is a social science, and politics is nothing else but medicine on a large scale. Medicine, as a social science, as the science of human beings, has the obligation to point out problems and to attempt their theoretical solution: the politician, the practical anthropologist, must find the means for their actual solution.”

Dr. Virchow’s perspective suggests that the ideal physician should not limit his or her medical practice to the confines of the exam room and OR, but instead strive to also address the socioeconomic factors that help to determine the health of individual patients and the broader public. Working in the trenches of patient care every day, physicians are the most qualified—and thus the most heavily obligated—to advocate for laws and policies in the best interests of our patients.

Additionally, physicians must advocate on behalf of our own profession and for policies that foster the most fertile environment to practice medicine and perform innovative and useful research.


It is within this context that the American Academy of Ophthalmology (AAO) Mid-Year Forum is of utmost importance. Every spring during the Mid-Year Forum, hundreds of ophthalmologists, ranging from junior residents to department chairs, gather on Capitol Hill in Washington to serve as advocates on behalf of our patients and profession. Our goals are unified: (1) to serve as voices for our patients, (2) to protect our profession, (3) to safeguard public health, (4) to ensure access to care, and (5) to speed access to innovative treatments.

As ophthalmologists in training, we took part in the Advocacy Ambassadors program—a collaborative effort among the AAO, state ophthalmology societies, ophthalmic subspecialty and special interest societies, and training programs that encourage young physicians to get involved.

Last year’s Mid-Year Forum began with formal presentations on the most relevant politics, policies, and practice management issues that affect ophthalmologists. With this knowledge in hand, we then participated in Congressional Advocacy Day, when more than 400 ophthalmologists from across the country congregated on Capitol Hill to meet with their respective members of Congress to raise awareness about dozens of important issues, some of which are enumerated in the sidebar on this page.

We were lucky enough to attend the most recent AAO Advocacy Day. During meetings with our federal representatives, we shared personal experiences regarding our medical training, poignant patient anecdotes, and other details that highlighted the breadth and depth of ophthalmology as a profession. We discussed the intangibles of the health care system that affect our lives, their lives, and the lives of our patients. We offered unique perspectives on the positive and negative consequences federal health care policies have on our practices. Most important, we lobbied for the issues vital to us and in the best interests of our patients. In our time on the Hill, we ran into members from dozens of other professional groups—ranging from agriculture to the pharmaceutical industry—who were also there to advocate for policies affecting them. This served as a powerful reminder that it is the right and responsibility of every profession to advocate on behalf of its own interests.


Physicians can often become engrossed in their long hours of clinical practice and lose perspective on the bigger picture. However, if we join together, we have the capacity to make wholesale changes to the health care system that can enhance our ability to care for our patients.

For those who need a reminder of our responsibilities beyond the exam lane and the OR, or for those looking for ways to engage with advocacy endeavors, the AAO’s Mid-Year Forum provides the perfect springboard. It highlights the tremendous behind-the-scenes work performed by the AAO and state societies to protect patients and physicians, and it provides a forum through which one can be heard.

However, advocacy does not begin or end at the Mid-Year Forum. Those who are unable to make it to Washington this April can still make an impact by calling or writing their local politicians and lawmakers and encouraging their patients to do the same. All of this, of course, is of heightened importance in the current political climate in which profound changes are occurring in the American health care system.


Special thanks to the AAO, the Illinois Society of Eye Physicians and Surgeons, and the Illinois Eye and Ear Infirmary for sponsoring our trip to the 2016 AAO Mid-Year Forum.

Mohsin H. Ali, MD
• resident, department of ophthalmology and visual sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago

Siya Huo, MD
• resident, department of ophthalmology and visual sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago


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About New Retina MD

New Retina MD delivers cutting-edge content to retina specialists in their first 15 years of practice. Each issue provides fresh insight from younger physicians plus established mentors on clinical and nonclinical issues affecting ophthalmologists in the earlier stages of their careers. NRMD features surgical pearls, clinical research endeavors, practice management, medical reimbursement and policy, continuing educational requirements, financial planning, innovations, and more.