Hi Denice
Nicely put. This is THE topic that at least requires thorough discussion. I
look forward to hearing more from the experiences of Optimal members who by
definition care and are concerned at this insidious dumbing down of our
profession.
Chris Barry
________________________________
From: optimal-bounce@xxxxxxxxxxxxx <optimal-bounce@xxxxxxxxxxxxx> on behalf of
CPMC Ophthalmic Diagnostic Center <cpmceyelab@xxxxxxxxxxxxxxxx>
Sent: Wednesday, 27 September 2017 11:05 PM
To: optimal@xxxxxxxxxxxxx
Subject: [optimal] Re: [**External**] Re: Replace me thread
I concur. As I teach across the country I continue to find “imagers: not
versed in basic anatomy, photographic or imaging terminology, basic concepts
across the board in ophthalmology.
Having said that, the role of the “pure” imager is shrinking. The huge crowds
at JCAHPO attending imaging classes support my anecdotal opinion.
We need to do as Congress must- reach across the aisle to our brethren and
break down the walls of stratification. A position I have been pilloried for
in the past. We are them, they are us and only respecting each other’s
strengths and weaknesses will the OPS remain viable.
Respectfully,
Denice
Denice Barsness, CRA, COMT, CDOS, FOPS
CPMC Dept of Ophthalmology/ The Eye Institute
Ophthalmic Diagnostic Services
711 Van Ness Avenue Suite 250
San Francisco CA 94109
415-600-5781
FAX 415-558-7011
From: optimal-bounce@xxxxxxxxxxxxx [mailto:optimal-bounce@xxxxxxxxxxxxx] On ;
Behalf Of Paula Morris
Sent: Wednesday, September 27, 2017 1:41 AM
To: optimal@xxxxxxxxxxxxx
Subject: [**External**] [optimal] Re: Replace me thread
WARNING: This email originated outside of the Sutter Health email system!
DO NOT CLICK links if the sender is unknown and never provide your User ID or
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I'm sure it is inevitable, Kirby, but designing that certification will be a
big task.
Even though angiography is being performed less, OCT has not completely taken
its place. And OCT-A is still developing. The knowledge appropriate for
performing good ocular angiograms (actually understanding what you are seeing
and knowing how to provide the best study for the physician to accurately
review) is applicable to all the new technologies. The preparation for the CRA
is invaluable in increasing expertise.
This is our profession. Granted it is changing and evolving, but if we as
photographers fail to support our professional credentials, we can't expect the
rest of the ophthalmic community to do so. Accounting software has not yet
replaced CPA's, surgical robotics have not yet replaced surgeons.... if we
continue to do the best imaging, best quality, most consistent and repeatable,
ophthalmic imaging will continue to hold ground in the practice of
ophthalmology. We need to STAY the experts in ophthalmic imaging - adaptable,
flexible, knowledgeable professionals, who have the expertise to perform all
modalities of imaging and put them to their best use.
Paula Morris, CRA
I ain't dead yet either
P
________________________________
From: optimal-bounce@xxxxxxxxxxxxx<mailto:optimal-bounce@xxxxxxxxxxxxx>
[optimal-bounce@xxxxxxxxxxxxx] on behalf of rayriverdove
[dmarc-noreply@xxxxxxxxxxxxx]
Sent: Tuesday, September 26, 2017 11:27 AM
To: optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx>
Subject: [optimal] Replace me thread
It's really hard for me to ask my assistant to test for CRA. Well, in all
honesty, I won't
ask. Some hybrid certification to include angiography, Super wide angle, OCT,
OCTA seems inevitable.
Kirby Miller, CRA
Not dead yet
-----Original Message-----
From: Richard Hackel <richardhackel@xxxxxxxxx<mailto:richardhackel@xxxxxxxxx>>
To: optimal <optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx>>
Sent: Tue, Sep 26, 2017 10:04 am
Subject: [optimal] Re: [External] OCTA
A few decades ago I thought some process would eventually replace silver for
photography, but I assumed it would be another chemical process.
Richard
On Sep 26, 2017, at 8:43 AM, Ethan Priel
<prieleye@xxxxxxxxxxxxxxxx<mailto:prieleye@xxxxxxxxxxxxxxxx>> wrote:
Good morning,
I think that the OCT A enthusiasts might be overlooking part of the time
considerations:
- Even if it does take only a few short minutes to generate a (small….)
macular scan with OCTA, it is neigh impossible to scan the near, not to mention
the far, periphery
- Following the scan art, it takes at least as long to review and
interpret – often by a physician – which raises the cost-per-minute
considerably. Arriving at a comprehensive diagnosis based on an FA often takes
no longer than a glance…
- In addition, OCTA does not offer ( as of yet) information regarding
flow, leakage and stereo imaging, all which are readily available while
employing the art of the FA
And yes, long live. And prosper.
Ethan
From: optimal-bounce@xxxxxxxxxxxxx<mailto:optimal-bounce@xxxxxxxxxxxxx>
[mailto:optimal-bounce@xxxxxxxxxxxxx] On Behalf Of Critser, Douglas B
Sent: Tuesday, September 26, 2017 5:39 AM
To: optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx>
Subject: [optimal] Re: [External] OCTA
Not to mention, in the time it takes to do a proper FA, you could do 5-6
OCT-A's. We still don't know true flow information, but for areas of
non-perfusion, it's great! The art is dying folks, long live the art.
Brice Critser, CRA
Director of Diagnostic Imaging
University of Iowa Hospitals & Clinics, Department of Ophthalmology
On Sep 25, 2017, at 9:02 PM, Darrin Landry
<darrin@xxxxxxxxxxxxxxxx<mailto:darrin@xxxxxxxxxxxxxxxx>> wrote:
The argument I get from everyone regarding OCTA is that you can’t get
reimbursed (other than as an OCT). So with the reimbursement cuts for
fluorescein angiography, and the increase in the cost of NaFl, I did a cost
analysis in a practice. With photographer time, supplies, maintenance, etc, it
costs the practice $5 for each angiogram. So yes, you don’t get reimbursed for
OCTA, but now, you don’t get reimbursed for FA, either.
Food for thought…
Darrin A. Landry, CRA, OCT-C
Ophthalmic Consutant
Bryson Taylor, Inc.
www.brysontaylor.com<https://na01.safelinks.protection.outlook.com/?url=http%3A%2F%2Fwww.brysontaylor.com&data=02%7C01%7Ccpmceyelab%40SUTTERHEALTH.ORG%7C9a3593cd840441f5eaff08d50583928a%7Caef453eadaa243e0be62818066e9ff63%7C0%7C0%7C636420985025086120&sdata=saQY33L39S3Bt4ei5Jjoy%2FSc%2B29WSWG0S21AXZ8PNFU%3D&reserved=0>
207-838-0961
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