© 2019 American Board of Ophthalmology

Message From the CEO: An Experiment in Cooperative Individualism

In June we looked at the ABO’s commitment to financial transparency and integrity, and last month we examined our goal of making the certification process an aspirational goal. In this column I will comment on our principle: “The ABO is an independent certifying board of practicing ophthalmologists who collaborate whenever possible with professional societies, organizations, and other stakeholders who strive to advance excellence.”

 

A quick word about the first ten words. It should be self-evident and universally accepted that a certifying board needs to be independent, beholden to no one other than the public whom it is committed to serve. In contrast, it is not universally required amongst certifying boards that their Directors be practicing clinicians. The ABO believes, however, that if we are setting standards, we should abide by them and understand how they affect our colleagues in the “real world.”

 

With that preamble, the focus of this essay is on the second part of our principle: collaboration. Although the ABO is an independent entity, to achieve our mission we must work productively with others. I am pleased to report a number of encouraging activities on that front.

 

First, we appreciate the opportunity to learn from other certifying boards. A great example is our recently launched Quarterly Questions initiative. This was developed “in house” but we benefitted from advice and support from staff at the American Board of Pediatrics, to whom we are most grateful.

 

Second, the ABO has asked the major ophthalmic subspecialty societies to nominate liaisons with the aim of enhancing two-way communication. We will introduce these individuals in a future Diplomate Digest article once all have been identified but thus far we are delighted that colleagues in cornea, glaucoma, neuro-ophthalmology, pediatrics and strabismus, medical retina, surgical retina, oculoplastic surgery, and uveitis have stepped forward to serve. We will learn from their (your) wisdom and experience.

 

Third, the ABO is working actively with the American Academy of Ophthalmology (AAO) on a number of joint projects. A major goal, of course, is to optimally integrate the IRIS registry with requirements for Maintenance of Certification (MOC) as currently defined by the American Board of Medical Specialties (ABMS). The purpose of such exercises is not simply to “check a box” but rather to develop means by which AAO members/ABO diplomates can meaningfully (and with minimal effort) improve patient care. Reaching this goal will not happen overnight, as developing valid outcome measures for multiple subspecialties and mapping them to IRIS from multiple electronic health records is much more complicated -- and expensive -- than most people realize. At the same time, the ABO and other certifying boards are working with the ABMS to improve the MOC process. More about that in a future essay.

 

Another collaborative initiative with the Academy is to include “learning from our mistakes” cases in the Morning Rounds section of EyeNet. Please watch for these educational vignettes later this year.

 

During a recent meeting of senior leaders from the AAO and ABO, Academy President David Parke pointed out that mutually supportive relationships between a specialty’s membership organization and its certifying board are not as common as one might imagine across medicine. The reasons vary. For instance, in some specialties there are several (competing) membership organizations. We are fortunate in ophthalmology that more than 90% of practicing ophthalmologists belong to the AAO, and a similar portion is certified by the ABO. With both organizations serving a common constituency, collaboration yields great benefits, especially when the ultimate goal of each group is to serve patients and their families. Having served as an AAO Trustee for seven years, I can attest that decisions are always made with the patient’s best interest in mind -- a laudable achievement for any membership organization.

 

I’ll conclude with an explanation for the title of this essay. In her 1941 book The Doctors Mayo, the historian Helen Clapesattle described the Mayo Clinic as “an experiment in cooperative individualism.” Although she was referring to the teamwork of multiple physicians pursuing a common goal in a small town in rural Minnesota, the phrase is generalizable to many successful organizations and also seems applicable to healthy relationships between organizations themselves. Ophthalmology comprises numerous outstanding societies and the ABO is eager to work with all that share our mission of serving the public.

 

 

 

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