ASO EyeWatch April 2020 edition

Message from the President Peter Sumich

Welcome to uncertainty.  It’s not much fun; but it’s the new normal.  Here’s the update.

Elective surgery is now closed.  Rooms are running in low maintenance mode or for higher priority patients.  If you are operating differently then you are not playing by the rules.  RANZCO released guidelines yesterday which I recommend to you and the Moorfield’s triage guidelines.

Intravitreal injections are a continuing controversy.   Federal funding is contingent on states taking over the day surgeries for their own use.  The day surgery injectors will lose their day surgery if they hand over to state health, or take up the funding which means they need to move injections to their rooms.  It will have to be a state by state, day surgery by day surgery negotiation as to which pathway you choose to go down.  These are commercial matters over which ASO has no jurisdiction.  Most injections are not urgent if it is only maintenance.  However, clearly some patients are sensitive to delays and need their IVI.  It will have to be a case by case decision. 

The ‘JobKeeper’ package is an ongoing work in progress by the Federal Government.  We advise you to speak to your accountant because each practice is structured differently.  Cutcher and Neal are our enterprise partners and they have a thorough understanding of all the complexities.

This week I have been on conference calls with COPS, the AMA and Day Surgeries Association about the public-private hospital partnerships.  At some stage the larger privates may take some state health elective surgery and then contract it out to affiliated surgeons.  The AMA welcomes the opportunity to help during COVID-19, but are cautious that longer-term precedents for managed care do not evolve out of this partnership.  The AMA will likely release guidance soon; to which I will most certainly contribute on your behalf.  The smaller day surgeries may also be tasked to assist, but it would be a local negotiation.

Telehealth is a new option for some.  I personally can’t see much use for it in my practice but some practices will find it helpful in certain circumstances.  Please stay within the rules and note that any consultation must be between a doctor and a patient about a genuine clinical matter, not merely a booking discussion.

We continue to update our resources on the ASO COVID-19 toolkit page.  This is an extremely valuable members-only resource and we have received much positive feedback about it thus far.  Do make sure you have a look at it soon if you are in need of guidance.

Stay well.   News blasts to follow if (or perhaps I should say when) something develops.

Mental Health During COVID-19

Dr Joann Lukins, Associate Professor (Adjunct) at James Cook University and Sports Psychology Consultant to the NRL North Queensland Cowboys, has been kind enough to provide us with some expert advice regarding resilience and mental health during the COVID-19 crisis via these two videos:

Building Resilience

Resilience is our ability, in the face of a challenge to bend and not break. In this video, Dr Lukins outlines the four key elements of resilience, why it is helpful to understand them and how you can build your personal resilience to manage challenges better


How to Stand Up when you’ve been Stood Down

An unprecedented shift in restrictions in employment has meant that too many Australians have been stood down by their employers. This has been a heart-breaking and necessary decision in response to the health crisis, Covid-19. Few of us are immune to this experience, either because it has happened to us, or someone that we love. This video helps to understand the grief experience for people who have lost their employment, and what can be done to pick ourselves up and move forward.


Dr Lukins has also provided us with some expert advice regarding our own mental health during the COVID-19 crisis.  You can read more about this in the April edition of the ASO Members’ Bulletin. 

ASO in the Media

Last month we told you about Dr Ashish Agar’s appearance on Channel Nine News following MSAC’s approval of an MBS item for standalone micro-bypass glaucoma surgery.  Shortly after this Dr Bill Glasson appeared on Channel 10 News, which also covered the successful MIGS decision.  Dr Ashish Agar then completed the hat-trick of television appearances with a length interview on ABC News Breakfast.  We thank them all for their efforts in helping to promote the ASO’s role as a major medico-political body. 


How to Connect With Us

Now more than ever it’s important to keep connected.  We have recently seen some robust action on both our Facebook and Twitter accounts, with significant increases in impressions & reach, profile & page views, and followers.  Please ensure you follow us on Facebook or Twitter if you haven’t already.


Working From Home

For many of us remote working for ourselves and our staff is something which has been thrust upon us recently.  However, studies show that remote workers are not only happier at work, but they’re 13% more likely to stay at their current job for the next 5 years than their onsite counterparts.  Here’s some tips for helping you navigate the remote life.

Eye Learning: Open For Business

The spread of COVID-19 has affected businesses across Australia and the world.  Ophthalmic clinics aren’t immune from this and now face a period of reduced demand and patient numbers.  However, we would like to remind you that Eye Learning courses can be completed online 24/7.  This means that staff can complete them in quiet periods at the office or from home.  Courses can be used to improve your staff knowledge of infectious diseases, control and effective PPE.

The ASO will continue to work with Eye Learning to provide affordable staff training to ophthalmic clinics.  ASO members also have an exclusive discount on all courses.  Please contact Eye Learning directly if you are interested in registering your staff. 

Women in Ophthalmology

On March 8 we celebrated International Women’s Day.  We asked member Amy Cohn to reflect on the role of women in ophthalmology.

The first thing to say is that medicine is an amazing career choice for both male and females. To be able to combine intellectual rigour with helping people is a very unique position. Much has been written about the gender balance within medicine. Whilst women make up half of all medical school graduates, they remain under-represented in most specialty areas. This is most notable in surgical specialties. Published data from 2016 suggests that only 12% of female doctors are surgeons. This is not due to lack of interest. Rather, there are many reasons that have been suggested – the perception surgery is not well suited to family life, the lack of flexibility during training and lack of role models are just a few.

Amy Cohn

In my year of my ophthalmology training I was the only female trainee in Victoria. However, I never felt discriminated against. My fellow trainees were only ever supportive of me – particularly leading into our final exams. I had my first child 17 days before our written RACE examination and without their unreserved encouragement, I wouldn’t have passed. I will never forget their support.

I do think the future is bright within ophthalmology for women. Firstly, I think that removing unconscious bias during selection of trainees is vital. Many professions including medical colleges use deidentification of CV’s during the employment selection process and this is a fantastic start. Ensuring role models are accessible and visible is paramount. For example, the move to having 30% female representation on all scientific boards and conference panels by RANZCO is a brilliant move. “Tapping” people on the shoulder to encourage them to step up also removes the hesitancy women may feel in putting themselves forward for roles. I also think we need to view ambition in a woman as a positive character trait and not a detrimental flaw. Ambitious women have made enormous social and political contributions throughout history.

Who has been your role model?

I have been incredibly fortunate to have two wonderful female role models throughout my training and now career. It has been said “You cannot be what you cannot see” and I have had two very visible colleagues to guide me. During my time as a registrar, my mentor was Associate Professor Penny Allen. She provided me measured, considered advice about all aspects of my training. Like me, she had to balance the demands of her training with young children. It is invaluable to be able to discuss shared experiences if only to strategize and empathise. She continued to help me through my fellowship in Moorfields and we now work together in private practice. Penny’s amazing career speaks for itself and I am always in awe of how she manages to combine research, clinical work and family life with what looks like such ease.

I am also fortunate enough to be mentored by Professor Robyn Guymer. I work with her in her capacity as head of the Macula Research Unit of the Centre for Eye Research Australia. She manages to carry out incredible world class research with humility and with such a generosity of spirit it is impossible not to be inspired.

What is the most rewarding aspect of your job?

Ophthalmology has very measurable and immediate rewards for both the doctor and the patient. I never tire of patient’s delight when there is an improvement in their vision following something like cataract surgery or an intra-vitreal injection.  You are giving people the most amazing gift and that to me is such a privilege. I am also involved in research through my position as a Senior Research Fellow at the Centre for Eye Research Australia. I find being at the forefront of the possible “next big thing” immensely satisfying even if I am only a small cog in the greater wheel. To know that one day we may have treatments for things like geographic atrophy or macula telangiectasia is incredibly exciting.

Is there still a glass ceiling in ophthalmology?

I hope not! It is important to duly recognise the women that have come before us to afford the opportunities that are present for us today. Forty years ago, I may not have had the same path through medicine or even university. So much change has happened to allow women to forge a surgical path if they desire.   

What particular skills or sensitivities do you think you bring to the field because of your gender?

There is no doubt that people have different consulting styles – some of these differences can be attributed to gender. I tend to spend longer with my patients than some of my male colleagues. Perhaps my manner might differ too. This may resonate with some patients while others may prefer the style of a male doctor. I think there is a place for both, and we need to actively ensure we have a balance of genders in ophthalmology. There is plenty of evidence to suggest that workplaces with gender-diverse leadership outperform those that are male top-heavy. Much has been written about systemic issues that prevent women advancing in the corporate sector. The same reflections are well and truly starting to happen in medicine.

Do you think the perception of females as homemakers and mothers is still a factor and create serious conflicts when jobs are demanding and time intensive?

I think there is no doubt that this is an issue. I think that as a society we need to make this a family issue and not a female issue. The French cartoon of last year – The Mental Load – resonated with me, as I know it did many of my female, medical colleagues. It talked of the mental space that parenting and running a household occupies – often at the expense of having the space to read that extra journal article or to invent a new surgical technique. Unfortunately, flexible training opportunities are still being explored for many surgical training posts. I know that both male and female colleagues would like a more flexible approach to training to better share the load of parenting and home life.

COVID-19: Home office tax deductions

In the wake of the COVID-19 pandemic, more businesses and their employees are working from home. This means an increase in home office expenses being incurred by an individual to facilitate their working from home arrangements. ASO’s preferred partner Cutcher and Neale* have prepared the following advice for members on home office deductions: 

Read C&Ns blog post here

*ASO members are entitled to a complimentary first consultation with Cutcher & Neale contact them here or phone 1800 988 522

Have you seen this?

The COVID-19 Practice Toolkit is now available in the member area of the ASO website.


New Members

Welcome aboard to the new members who have recently joined the ASO: 

Dr Antony Clark

Dr Timothy Greenwell

Lauren McGann

Dr Georgia Cleary

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