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Message from the Chair
GEORGE A. WILLIAMS, MD, OMIC Board of Directors
Stuff happens.
At the most basic level, insurance is a rather simple business involving the assumption of risk. The risk may be a hurricane, car accident, fire, illness, or medical liability. Virtually anything can be insured. In order to assume risk, we must understand the probability that an adverse event will (not may) occur. That probability is then applied across a covered population. The cost of risk is determined by frequency (how often) and severity (how much in cost) of an adverse event. The cost is distributed across the population as individual premiums and deductibles.
Every service we provide our patients has risk and, regardless of how hard we try, there is no way to completely eliminate it. Simply put, stuff happens. Among the most feared risks for an ophthalmologist is endophthalmitis. Fortunately, the frequency of endophthalmitis is low. Unfortunately, the visual consequences of endophthalmitis are often dire and therefore the severity may be high. This issue of the Digest discusses the OMIC experience with endophthalmitis.
The low frequency of endophthalmitis sometimes leads to surgeons’ complacency or even denial. We all know the signs and symptoms of endophthalmitis, but we may think or hope that the post-procedure inflammation we see is sterile. Since endophthalmitis is a recognized complication, when it is recognized and treated in a timely manner, OMIC rarely loses a lawsuit regardless of outcome. Such cases are vigorously defended. Conversely, we almost always lose when the diagnosis or treatment is delayed.
Although we can’t eliminate the risk of endophthalmitis, we must do all we can to minimize the risk. Attention to sterile technique has always been critical, but as Anne Menke notes, so is patient engagement. An engaged, educated patient is our first line of defense.
The face of endophthalmitis is changing. Historically, the most common cause of endophthalmitis has been cataract surgery. With the explosion of intravitreal injections, that is certain to change. We know from the IRIS Registry that the incidence of endophthalmitis following both cataract surgery and intravitreal injection is approximately 1 in 2,000 procedures.
However, injections far exceed cataract surgery and continue to grow. Already the IRIS Registry has recorded over 10,000,000 injections. The power of such large numbers provides OMIC with a potent risk management tool. That is why OMIC has been a strong supporter of the IRIS Registry.
This support is another example of the unique synergy between OMIC and the American Academy of Ophthalmology. Of course, this is one of the many advantages OMIC has over other malpractice carriers; just what you would expect from a company of ophthalmologists for ophthalmologists. When stuff happens, OMIC will be there for you.
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