NATIONAL
Proposed legislation on cosmetic contact lenses
We are pleased to announce that legislation (Bill C-313) has been introduced in the House of Commons by MP Patricia Davidson (Sarnia-Lambton) to amend the Food and Drugs Act to classify cosmetic contact lenses as Class II medical devices, the same as corrective lenses are now classified. COS has been pursuing this legislation for a number of years.
Canadian Blood Services partnership
Over the past two years, Canadian Blood Services Canadian Blood Services (CBS) has led a consultative process on the design of an integrated interprovincial system for organ and tissue donation and transplantation in Canada. COS was pleased to participate in this initiative and is very grateful to Dr. Guillermo Rocha for leading this work on behalf of COS.
In April 2011, Canadian Blood Services, on behalf of the Organ and Tissue Donation and Transplant Expert Committees and Community, delivered Call to Action-a strategic plan to improve organ and tissue donation and transplantation performance for Canadians, to the Federal/Provincial and Territorial (F/P/T) Ministries of Health. This plan includes recommendations to improve ocular tissue donation and transplantation.
Canadian Blood Services met with the F/P/T Deputy Ministers of Health to discuss Call to Action in June, and it was agreed that governments will now take time to review the recommendations and understand their implications. Canadian Blood Services continues to work with governments in their further analysis of the report, and, in conjunction with Ministries of Health, looks forward to sharing Call to Action and defined next steps for implementation, later this fall.
Canadian Glaucoma Society's Proposed Model on Interprofessional Collaboration in Glaucoma Care
The Canadian Glaucoma Society's (CGS) Proposed Model on Interprofessional Collaboration in Glaucoma Care was endorsed by the COS Board at its meeting on June 9, 2011.
The role of the COS was to lead a consultation process and to ensure that the COS Board performed its due diligence before endorsing the document. We enlisted feedback and comments from many stakeholders, including comprehensive/general ophthalmologists from across the country and the entire Council on Provincial Affairs (CPA) where there is representation from each province. We wanted to ensure a transparent and collaborative process. We received excellent feedback which we then forwarded on to the CGS. After several iterations and upon the recommendation of the CPA at its meeting on June 9th, the COS Board endorsed the CGS' Proposed Model on Interprofessional Collaboration in Glaucoma Care. The document, including an Editorial, is now available online through the CJO website. An Editorial will appear in the December 2011 issue of CJO and copies will be distributed to the COS membership at that time.
Update on Clinical Practice Guideline on Diabetic Retinopathy
Work on the Diabetic Retinopathy (DR) Clinical Practice Guideline (CPG) is progressing well. The document has been reviewed by a number of External Reviewers and the feedback is excellent. We are looking at a publication date of early 2012. Special thanks to Dr. Phil Hooper for his tremendous efforts in leading this very important work on behalf of the Society.
On a related note, we are pleased to announce that we have received approval from CIHR for our Meetings, Planning and Dissemination grant entitled: Guideline Implementation through an Alliance of KT Researchers and Education Providers. Through this grant, we will develop and test a sustainable model for guideline dissemination, implementation and uptake using our own DR Clinical Practice Guideline. Working with the University of Ottawa, Office of CME and Academy for Innovation in Medical Education and divisions of Continuing Professional Development (CPD), we will look at how we can effectively achieve change in provider practices and practice patterns in the area of diabetic screening in the Champlain Local Health Integration Network (LHIN).
Wait Time Alliance
Past-President, Dr. Lorne Bellan, stepped down as Chair of the Wait Time Alliance (WTA) at the end of June 2011; he served as its longest running Chair. Dr. Bellan has been replaced by Dr. Chris Simpson of the Canadian Cardiovascular Society. Board member Dr. Yvonne Buys will be serving as the COS representative on the WTA.
The 2011 WTA Report Card was released on June 21. This year's report card circulation more than doubled over last year's, reaching an audience of over 12 million people. Unlike previous years, all components of the report card were picked up by Media and discussed the next day in the House of Commons. This is a testament to the credibility of the WTA.
2011 WTA Report Card
Reports and member benchmarks
Residents' Program
The COS's vision is to be a recognized leader in supporting the residents' program. Under the leadership of co-chairs Dr. Dan Rootman and Dr. Kelly Schweitzer, the Canadian Ophthalmological Residents Society (CORS) was formed over the past year or so. A residents' stream was organized as part of our Annual Meeting and the feedback has been excellent (please see section on Annual Meeting in this issue of Perspectives). We were very pleased to see such a large turn-out of residents at our June reception for residents and would like to acknowledge the tremendous work that has been done by the CORS' executive. Continuing to engage residents in the work of COS is one of our top priorities.
Residents' Survey
Key points
[Response rate: 52% ( n = 72)]
- Clinical education
Residents spend on average 3-4 months in each of cornea, glaucoma, retina, paediatrics, oculoplastics and neuro-ophthalmology rotations. Dedicated time on clinical rotations for uveitis, pathology, refractive surgery, low vision and oncology were more variable and generally less than 1 month in total days.
- Surgical education
Residents in Canada by the end of PGY5 perform on average 325 complete cataract surgeries, approximately 50 horizontal muscle surgeries and 6 trabeculectomies.
- Teaching and research
Over 50% of residents spend between 6 and 10 hours in didactic lectures weekly. Dedicated research time was variable across programs with 1/3 of programs offering none and 1/3 offering between 1 and 4 weeks per year. Most programs (>80%) will sponsor residents to present at least 1 scientific conference per year.
- Fellowships
2/3 of residents are planning to do a fellowship after graduation, with the most popular being surgical retina, paediatric ophthalmology, cornea and oculoplastics.
COS continues to support a number of initiatives undertaken by CORS, including a recent survey. Currently there are no national residency standards for Ophthalmology education in Canada. This creates a situation in which educational goals and directives are widely disparate across the nation. From a resident's perspective, there is little knowledge as to what are considered national educational standards, and whether their experience fits within these boundaries. The purpose of this investigation was to collect data on the clinical, didactic and surgical training environment in Canada in order that national 'averages' may be compiled. This information can be used by individual programs to understand the areas in which they are particularly strong and those in which they could improve. This will serve to enhance education for all Ophthalmology residents. Thank you to Dr. Dan Rootman for his leadership on this file.
PROVINCIAL
Council on Provincial Affairs
Dr. Andrew Budning, Chair of the Council on Provincial Affairs (CPA), reports the following:
The representatives for our specialty in each province have been hard at work representing our group over the past year. This year has brought difficult challenges that have been met with hard work from each group. Without strong provincial associations, our specialty would have been placed under a great deal of stress. Over the past year we have seen:
In British Columbia, the BC Society of Eye Physicians and Surgeons (BCSEPS) meet the challenge brought forward by the College of Optometry asking for Optometrists to have the authority to treat glaucoma entirely autonomously and independently. The group has had the opportunity to meet with Ministry representatives, and point out significant difficulties and concerns present with this view of glaucoma. In addition, the group has discussed the difficulties relating to the Ministry's understanding of modern cataract surgery, and the stress, time and expertise involved in the care of patients with cataracts, and appropriate compensation for the procedure.
In Alberta, Optometry has sought to expand its scope of practice to include surgery; the COS and the American Academy of Ophthalmology (AAO) joined forces in an attempt to defeat this proposed legislation; the government has sided with Ophthalmology.
In Saskatchewan, Optometry is looking to expand its role in therapeutics with increased management of glaucoma.
Manitoba: has seen strong advocacy lead to a new resident position. Continued strong leadership has helped foster continued good relations between eye care providers.
In Ontario, Optometrists have been given the right to prescribe therapeutics, including glaucoma medications.
In an effort to work with optometrists in order to provide better, more cost-effective and safe eye care, a new Eye Health Council of Ontario has been developed. The goal of the Council is to develop treatment algorithms indicating requirements to initiate treatment, and level of acuity when referral to an Ophthalmologist is in the patient's best interest. In addition, having the College of Optometrists of Ontario and the College of Physicians and Surgeons of Ontario participating at the table has encouraged dialogue between all interested parties. The group is currently working on diabetic eye care.
Québec: the last 12 months have been full of excitement. The issue of Lucentis has been prominently featured in the media, unfortunately resulting in bad press for ophthalmology and a class action suit against the Ministry of Health and retinal specialists. The Minister has made injections for AMD available free of charge in private offices.
The Order of Professions is meeting with ophthalmology, optometry and the optician's groups in order to try to clarify the role of each player in the ocular health system. Québec continues to lead in development of telemedicine, particularly in the area of diabetic retinopathy.
The Maritimes as well have great leadership and this will continue to position them well in the future.
A new resident position has been introduced to CPA in order to ensure a resident's voice on the Council.
COS has developed closer ties to AAO, working together to share ideas aimed at promoting eye care and our specialty in the future, sharing political and financial changes across Canada aimed at promoting what we do, and reducing the lightening rod effect for certain fees considered over-valued.
We have also improved our leadership expertise when dealing with government by working to unify our approach and message to Government.
SOCIETY
Annual Business Meeting, June 11, 2011
At the Annual Business Meeting on June 11, 2011, the COS 2010 Annual Report was released. COS has realized some significant achievements over the past year including:
COS Annual Meeting - Vancouver 2011
Congratulations to Dr. Allan Slomovic (Chair), the members of the COS Continuing Professional Development (CPD) Committee and Inika Anderson (Manager CPD) for organizing another successful Annual Meeting. In spite of coinciding with the Stanley Cup Playoffs in Vancouver, the meeting was enjoyed by over 1300 delegates and the positive feedback from presenters, exhibitors and meeting attendees has been overwhelming. We are looking forward to the next meeting in Toronto in 2012!
- Increased financial stability by completely eliminating the deficit from 2009. However, the Society is projecting a deficit of $70,000 largely due to decreasing advertising revenues for the CJO; this challenge is widespread across the sector with national Specialty Societies experiencing significant drops in advertising revenue;
- Achieved the highest marks from the Royal College of Physicians and Surgeons of Canada (RCPSC) during accreditation and review of our Continuing Professional Development (CPD) educational programs;
- Strengthened our CPD program by organizing a stellar Annual Meeting and a number of co-developed programs;
- Strengthened our Residents program by providing support for a number of new initiatives. Resident engagement is critical to the future of the Society;
- Increased Government Advocacy efforts at the federal level and providing support to the provinces through the Council on Provincial Affairs (CPA);
- Raised our international profile by appointing COS members on the International Federation of Ophthalmological Societies, the Pan-American Association of Ophthalmology (PAAO) and the American Academy of Ophthalmology (AAO);
- Raised our profile nationally through a number of key partnerships (Canadian Blood Services; the RCPSC; the CMA; the National Coalition for Vision Health, etc);
- Received an unrestricted grant from Pfizer in the amount of $150,000 to focus on a needs assessment, e-learning/web-based learning for CPD credit; co-developed programs, and targeted activities;
- Reviewed the Canadian Glaucoma Society's (CGS) Proposed Model on Interprofessional Collaboration in Glaucoma Care;
- Worked on the Clinical Practice Guideline on Diabetic Retinopathy for publication in early 2012;
- Conducted a membership survey to better understand the needs of our members and recommendations for moving forward;
- Developed a Balanced Scorecard to measure results/outcomes for the organization.
$50 Fee Increase for Members
At the Annual Business Meeting on June 11, the membership voted to increase COS membership fees for active members by $50 annually. This increase is the first for COS members in almost 9 years. Organizations typically increase membership fees by 3-5% annually in order to keep pace with inflation. In addition, the CJO is projecting a deficit of $56,000 this year, due to declining advertising revenues. While this situation is not unique to COS, it must be addressed. Further, Annual Meeting expenses and revenues are variable (depending on location) and COS has undertaken a number of new programs and initiatives supported by a small skeleton staff. It was agreed that it is far better to have a small increase now than to allow unbalanced budgets which will lead to needing a larger increase at some time in the future.
$50 Fee for Life Members (Retired)
At the present time, those who have been a member of COS for 25 consecutive years receive a complimentary membership. The financial situation of the Society is such that it was felt prudent to ask Life Members (retired) to pay a nominal fee to offset the expense of mailing the CJO, the newsletter Perspectives, and the Membership Directory.
COS Tagline approved!
Canadian Ophthalmological Society
Eye Physicians and Surgeons of Canada was endorsed by the general membership. More information to come.
Special Presentation
A special presentation was made to Dr. Lorne Bellan who was stepping down from the COS Board. Among his many achievements, Dr. Bellan:
2011-2012 COS Board of Directors
At the June 11, 2011 Annual Business Meeting, the following Slate of Directors for the 2011 - 2012 COS Board of Directors was approved by the COS membership:
Dr. François Codère, President (2010-2012)
Dr. Paul Rafuse, President-Elect (2011-2012)
Dr. David Maberley, Secretary (2010-2013, 2nd*)
Dr. Yvonne Buys, Treasurer (2010-2013, NR*)
Dr. Stephanie Baxter, Chair, Council on Eye Chair; Board Liaison, Residents' Affairs (2009-2012, R*)
Dr. Andrew Budning, Chair, Council on Provincial Affairs (2011-2014, 2nd*)
Dr. Allan Slomovic, Chair, Council on Continuing Professional Development (2011-2014, 2nd*)
Jennifer Brunet-Colvey, Executive Director and CEO
*Notes: R = renewable once, 2nd = 2nd term, not renewable, NR = not renewable
- Served as Chair of the COS Cataract Clinical Practice Guideline;
- Led the development of the document on Uninsured Services;
- Served as the longest running Chair of the Wait Time Alliance (WTA);
- Served on the National Coalition for Vision Health (NCVH);
- Development excellent relationships at the federal public level and provided advocacy support to the various provinces;
- Served as the primary Liaison with the AAO and on the Board of the PAAO and forged new partnerships and strengthened existing ones.
Dr. François Codère, on behalf of the Board and membership, thanked Dr. Bellan for his tremendous leadership and presented him with a certificate of appreciation.
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Abstracts for the 2012 meeting in Toronto are being accepted now until December 4.