Regulatory burdens contribute to physician occupational burnout

The vast majority of ophthalmologists opt in as a provider for Medicare because so many of our patients are older than 65 years. Less so for Medicaid, depending on the state. In Medicare, doctors have several choices. They can be a participating provider in Medicare, a nonparticipating provider in Medicare, opt out of Medicare or, according to Jeffrey Liegner, MD, but controversial and rare, if in a small practice with fewer than 10 employees, consider becoming a non-covered entity. In my experience, most ophthalmologists are quite altruistic and dedicated to the best interest of the patients in their practice and community. Patients older than the age of 65 have 10 times the eye pathology of those younger than 65, and almost all of them are enrolled in Medicare, including the wealthy. Thus, if an ophthalmologist wants to be available to a broad array of patients in the community, participation in Medicare is mandatory.Most of us want to provide quality care to friends and neighbors regardless of income. Many, if not most, patients could not afford us if we opted out of Medicare and switched to a cash-pay-only model. Select physicians, especially those who focus on cash-pay elective procedures such as refractive corneal surgery, refractive cataract surgery, cosmetic plastic surgery and the like, can definitely make a good living and simplify their lives by opting out of Medicare and for sure Medicaid. However, while we all must consider the economics of practice, most of us also want to be available to even the poorest members of our community, often providing care for many without insurance at no cost. This is the culture in our practice, Minnesota Eye Consultants, and while some of us could opt out and do fine financially, all of our doctors participate in Medicare and our state’s version of Medicaid/MinnesotaCare.

OCT useful in management of DME

Nearly 30.26 million Americans have type 1 or type 2 diabetes, and of those, 4.2 million adults aged 40 and older, or 29%, have diabetic retinopathy. An estimated 11% of all diabetic patients have diabetic macular edema, and 1% to 3% of those have visi…