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Subspecialty certification needed in oculoplastics
Mark R. Levine, MD, FACS, reported on the state of oculoplastics at the OSN Section Editor Summit.
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Oculoplastic surgeons, in order to increase our scope of practice, need to have subspecialty certification. Oculoplastics is very different from the other subspecialties. We are in competition with plastic surgery and facial plastic surgery rather than with the general ophthalmologist.
I see our inability to achieve this objective as an in-house problem. The American Board of Ophthalmology designated the American Academy of Ophthalmology to measure the support for having a board certification in oculoplastic surgery within ophthalmology. That mandate was turned over to the Council of the American Academy of Ophthalmology, which conducted a statewide referendum in every state to determine whether ophthalmologists would be in favor of having oculoplastics obtain board certification. Two-thirds of the ophthalmologists turned us down. On the positive side, one-third were in our corner.
So why did two-thirds turn us down? I believe the general ophthalmologist has a concern that we might be restrictive of the ophthalmologist performing oculoplastic procedures, which really is not the case.
Roadblock
For a number of oculoplastic surgeons in the United States, our problem has been getting certified or credentialed to perform surgery in hospitals and ambulatory surgery centers. We sometimes have trouble getting credentialed because we can not show that we are credentialed within our own Academy. We need that piece of paper. So, therefore, plastic surgeons and facial plastic surgeons are able to keep us from doing the procedures we do best.
The American Society of Ophthalmic Plastic and Reconstructive Surgeons (ASOPRS) has done a great job in promoting our skills. We have oculoplastic surgeons now continuing on to take facial plastic fellowships and then training others. The bar has been elevated.
ASOPRS is revisiting how we can achieve our goal of board certification. It may take a number of years to do it. But we know for sure that our organization promotes nothing but the highest in integrity, research and surgical skills to result in the best outcomes.
Once again going back to the concerns of the general ophthalmologists, I truly believe our society wants to educate residents in residency training programs to performs as many procedures as the resident is capable of doing. If residency programs are deficient in oculoplastics, there are fellowships available. There are plenty of oculoplastic procedures to go around.
Other advances
Finally, there have been great additions to our subspecialty, including Botox (botulinum toxin type A, Allergan), and the dermal filler Restylane (hyaluronic acid, Medicis), which have become very popular.
For Your Information:
- Mark R. Levine, MD, FACS, is a clinical professor of ophthalmology in the department of ophthalmology at Case Western Reserve University. He can be reached at University Suburban Health Center, 1611 South Green Road, Suite 306A, South Euclid, OH 44121; 216-291-9770; fax: 216-291-0550.