the american academy of ophthalmology and otolaryngology

618 Pages·2006·19.56 MB·English

The Foundation of the American Regional Oral History Office
Academy of Ophthalmology The Bancroft Library
655 Beach Street University of California
San Francisco, CA 941 09-1 336 Berkeley, CA 94720
THE AMERICAN ACADEMY OF OPHTHALMOLOGY
AND OTOLARYNGOLOGY:
ORAL HISTORY RECOLLECTIONS OF PAST
AND PRESENT LEADERS
Volumes 1 - 3
Interviews with
Wendell L. Hughes, M.D. David J. Noonan
W. Howard Morrison, M.D. Stanley M. Truhlsen, M.D.
Daniel Snydacker, M.D. Lawrence A. Zupan
John W. Henderson, M.D. Bradley R. Straatsma, M.D.
Clair M. Kos, M.D. Bruce E. Spivey, M.D.
Frederick C. Blodi, M.D. H. Dunbar Hoskins Jr., M.D.
With a Series Introduction by
William H. Spencer, M.D.
Interviews Conducted by
Sally Smith Hughes, Ph.D.
1990-1 997
Copyright O 1998 by The Foundation of the American Academy of Ophthalmology and
The Regents of the University of California

Cataloging information
THE AMERICAN ACADEMY OF OPHTHALMOLOGY AND OTOLARYNGOLOGY:
ORAL HISTORY RECOLLECTIONS OF PAST AND PRESENT LEADERS, 1998,
564 PP*
Retrospective interviews about the American Academy of Ophthalmology and Otolaryngology
(AAOO), and the American Academy of Ophthalmology (AAO) with 11 past and present
leaders, and with a former executive of the American Association of Ophthalmology.
Characteristic administrative styles of successive Executive Secretary-Treasurers and Executive
Vice Presidents; Annual Meetings at the Palmer House hotel; pioneering Continuing Education
Programs and Instruction Courses at the Annual Meetings; the Home Study Course; Academy
organization and the Committee of Secretaries during the Benedict administration; the
Transactions of the American Academy of Ophthalmology and Otolaryngology; AAOO
organizational changes during the Kos administration; appointment of David Noonan; movement
toward separation into two Academies; voting on separation; division of funds; the AAO move
to San Francisco; AAO reorganization during the Spivey administration; switch from a
bimonthly transactions to the monthly peer reviewed journal Ophthalmology; creating the Basic
and Clinical Science Course in Ophthalmology; the Ophthalmic Knowledge Assdssment Course;
ethics and the AAO; Federal Trade Commission approval of the Academy's code of ethics; the
AAO assumes a political role; the Washington office; merger of the AAO with the American
Association of Ophthalmology; women and the Academy; the Foundation of the AAO; the
National Eye Care Project; the endowment fund; growth of women members; organizational
redesign at the outset of the Hoskins administration; changes in the decision-making process and
planning mechanisms; public members on the Board of Trustees; the Academy's advocacy role
and its response to the growth of managed care; the Surgical Care Specialty Coalition; outcome
studies, cost-effectiveness and quality of care; the Website and communications with the public;
the growth of international membership; relationship between Ophthalmology and Optometry;
the Work Force Study.
Interviews with Wendell L. Hughes, M.D.; W. Howard Morrison, M.D.; Daniel Snydacker,
M.D.; John Warren Henderson, M.D.; Clair M. Kos, M.D.; David J. Noonan; Frederick C. Blodi,
M.D.; Stanley M. Truhlsen, M.D.; Lawrence A. Zupan; Bradley R. Straatsma, M.D.;-Bruce E.
Spivey, M.D.; and H. Dunbar Hoskins, M.D.
Preface by William H. Spencer, M.D.
Interviewed 1990-1997 by Sally Smith Hughes, Ph.D., Regional Oral History Office, the
Bancrofl Library, University of California, Berkeley.

TABLE OF CONTENTS--The American Academy of Ophthalmology and Otolaryngology:
Oral History Recollections of Past and Present Leaders
SERIES INTRODUCTION by William H . Spencer. M.D. ................................................i
INTERVIEW HISTORY by Sally S . Hughes. Ph.D. .........................................................v
THE BENEDICT ADMIlYISTRATION (19 42-1968)
WENDELL L . HUGHES. M.D. (Vol. 1). ...........................................................................1.. .
W . HOWARD MORRISON. M.D. (Vol . 1). ....................................................................2..1.
DANIEL SNYDACKER. M.D. (Vol . 1) ............................................................................8..3.
JOHN WARREN HENDERSON. M.D. (Vol . 1). ...............................................................1..2 7
THE KOS ADMINISTRATION (1968-1978)
CLAIR M . KOS. M.D. (Vol . 2) .............................................................................................1 71
DAVID J . NOONAN (Vol . 2) ...............................................................................................2 23
THE SPIVEY ADMINISTRATION (1978-1992)
FREDERICK C . BLODI. M.D. (Vol . 2) ............................................................................2..5. 3
STANLEY M . TRUHLSEN. M.D. (Vol . 2) ..........................................................................2 77
LAWRENCE A . (LARRY) ZUPAN (Vol . 2) ......................................................................3. 05
BRADLEY R . STRAATSMA. M.D. (Vol. 2) .....................................................................3..3 9
BRUCE E . SPIVEY. M.D. (Vol . 3). ......................................................................................3 81
THE HOSKINS ADMINISTRATION (1992- )
H . DUNBAR HOSKINS JR.. M.D. (Vol . 3) .......................................................................4..1 9
APPENDICES (Vol. 3) ...................................................................................................4..4..7.
Academy Chronology ............................................................................................-.4..4 9
Notes on the Board of Secretaries 1956 to 1962 -Daniel Snydacker, M.D ............4 55
.
Additional Recollections by Mr Zupan Regarding
American Association of Ophthalmology Activities ..........................................4. 57
American Academy of Ophthalmology Strategic Plan 1997. ....................................4 63
Report of the Ad Hoc Committee on Organizational Design ....................................4 71
INDEX (Vol . 3) .....................................................................................................................5 51

SERIES INTRODUCTION
Since its inception, the American Academy of Ophthalmology and Otolaryngology (AAOO)
has been in the forefront of the movement toward specialization in American medicine and in
the development of innovative continuing education programs. During its fledgling years, when
quality educational opportunities for budding ophthalmologists and otolaryngologists were few
and far between, the Academy's Annual Meeting provided its members with a much-needed
national forum where information could be exchanged about the diagnosis and treatment of
diseases they encountered on a daily basis.
The AAOO also participated in the establishment of the first and second medical specialty
examining boards (the American Board of Ophthalmology in 19 16, and the American Board of
Otolaryngology in 1924), and pioneered several educational and quality assurance programs
subsequently adopted by other branches of medicine. Its groundbreaking meeting format, which
mixed auditorium presentations with small group instruction courses, inaugurated the concept of
a Continuing Education Program under the aegis of a national specialty society. This innovative
program introduced Academy-sponsored medical correspondence courses (the Home Study
Course); pioneered the use of scientific exhibits at an annual medical society meeting; collabo-
rated with the Army Medical Museum to build a permanent collection of ophthalmic and
otolaryngologic pathology (the forerunner of the Registries of Ophthalmic and Otolaryngologic
pathology and the inspiration for the current American Registries of Pathology at the Armed
Forces Institute of Pathology); originated the production of medical specialty society
publications in the form of course synopses, manuals, atlases and textbooks, and launched
an in-service examination designed to provide educational feedback to ophthalmologists in
training and their faculty (the Ophthalmic Knowledge Assessment Program).
Sharon Bryan's lively chronicle of the AAOO's formation and growth provides the most
comprehensive published account of the early Academy's internal organization, as well as its
relationship with medicine as a whole and with federal and state agencies.1 Bryan skillfully
utilized original source materials, such as the minutes of Academy Council meetings, programs
of Annual Meetings, the Perceiver (the society's early news bulletin), the Transactions of the
American Academy of Ophthalmology and Otolaryngology, the Wherry scrapbooks, and
William Benedict's correspondence. In 1989 the Foundation of the American Academy of
Ophthalmology published Dr. William Felch's detailed synopsis of important events leading
to the decision to divide the MOO into separate academies.2 Felch acquired much of his
data from a combination of archived documents and personal interviews with Academy of
Ophthalmology (AAO) leaders and staff. Additional valuable resources include back issues of
Argus (now Eyenet, the society's current news magazine), essays read by members of the Cogan
Bryan, Sharon A. Pioneering Specialists: A History of the American Academy of Ophthalmology and
Otolaryngology. American Academy of Ophthalmology, San Francisco, CA; American Academy of
Otolaryngology-Head and Neck Surgery, Rochester, MN, 1982.
Felch, William C., M.D.D ecade of Decision: American Academy of Ophthalmology 1979-1989.
San Francisco: Foundation of the American Academy of Ophthalmology, 1989.
Ophthalmic History Society for the History of Ophthalmology during the Centennial Meeting of
the Academy in Chicago,3 and vignettes presented at annual meetings of the Cogan Ophthalmic
History Society. All documents are archived, either at the Museum of Ophthalmology of the
American Academy of Ophthalmology in San Francisco or the museum of the American
Academy of Otolaryngology in Alexandria, Virginia. The reader is also referred to Dr. Stanley
Truhlsen's chapter, "The American Academy of Ophthalmology," in Albert and Edward's book
The History of Ophthalmology.4
In 1986, the AAO's Foundation, in collaboration with the Regional Oral History Office of the
University of California at Berkeley, initiated a series of ophthalmology oral histories consisting
of in-depth interviews with senior ophthalmologists and others who had made significant
contributions to the specialty. The eight indexed and bound transcripts of the interviews,
published between 1988 and 1994, were intended to preserve the memories, experiences, and
insights of extraordinary ophthalmologists and visual scientists who had lived through, and
participated in, the impressive changes that occurred in ophthalmology during the years before
and after World War 11.5 Together, and separately, these volumes add a personal dimension to
our understanding of America's ophthalmic heritage and preserve a fbnd of historic information
that might otherwise have been lost (at this writing, five of the eight participants in the project
have died).
The present work differs from the oral histories noted above. Focused on the Academy, it is
composed of a compilation of interviews with past officers of the MOO, and with past and
present officers of the AAO and related organizations. The interviewees were nominated by
the AAO Board of Directors and the Board of Trustees of the Foundation of the Academy.
The collected histories are intended to supplement previously published information about
the Academy and to help characterize the "flavor" of Academy activities. The discussions
encompass the personal recollections of the participants concerning a gamut of pivotal events,
ranging from the era when Academy leadership was paternalistically controlled by one
individual, and AAOO efforts were almost exclusively directed toward the education of
American ophthalmologists and otolaryngologists, to the present era where decision making
and planning is a broader process and the AAO is committed to an agenda that still emphasizes
educational issues, but includes societal and political issues as well.
"A Century of American Ophthalmology." A combined symposium on the history of ophthalmology given by the
American Academy of Ophthalmology and the Cogan Ophthalmic History Society. Presented jointly at the
American Academy of Ophthalmology Centennial Annual Meeting, October 30, 1996.
4~lbertD, aniel M., Edwards, Diane D. Editors. The History of Ophthalmology. Cambridge, MA: Blackwell
Science, Inc., 1996.
Ophthalmologv Oral History Series, A Link With Our Past. Conducted by Sally Smith Hughes, Regional Oral
History Office, University of California at Berkeley, in cooperation with The Foundation of the American Academy
of Ophthalmology.
During the years embraced by the reminiscences of the participants, the AAO moved its
headquarters from Rochester, Minnesota to San Francisco, California and underwent significant
leadership, staffing, and organizational changes. Wider participation by members in AAO
governance was encouraged, and limits were placed upon terms of office (thus minimizing
hierarchical entrenchment). Concurrently, a dramatic expansion took place in national and
international membership, and substantial revisions were made in the scope of the educational
program (e.g., publication of OphthaImoIog~a s a monthly peer-reviewed scientific journal to
supersede the Transactions; modification of the Annual Meeting format to replace the single
daily plenary session with multiple programs and symposia primarily composed of subspecialty
topics; presentation of an annual display of posters providing clinical and research data; broad
growth of continuing education offerings to include "hands-on courses" and a plethora of written
materials directed toward lifelong education in ophthalmology). In addition, the AAO sponsored
the establishment of a professional liability program (the Ophthalmic Mutual Insurance
Company) and created the Foundation of the American Academy of Ophthalmology to support
and develop Academy public service programs (e.g., the National Eye Care Project, Diabetes
2000, Glaucoma 2001), and to preserve ophthalmic heritage through support of the Museum of
Ophthalmology and its public outreach programs.
Eleven interviews were conducted between 1990 and 1993 with the intention of completing the
editorial and production process in time for the Academy's 1996 centennial celebration. For
logistical reasons, and because there was uncertainty about how the materials would be used, this
did not occur during the Centennial Meeting.
During the short five to seven years since these interviews took place, the American healthcare
system has rapidly undergone fundamental changes that have imposed significant regulatory
controls on physicians and others who deliver our nation's medical care and educate our future
physicians. Medical specialties, including ophthalmology, have been particularly affected by
these changes, and individual ophthalmologists have increasingly relied upon the AAO to
express their concerns to Congress and healthcare agencies. For this reason, and to place these
memoirs into perspective, the FAAO's Archives and Oral Histories Committee and the Editors
have added a twelfth interview with Dr. H. Dunbar Hoskins Jr., the AAO's current Executive
Vice President, in which he expresses his views about the Academy's role in assisting
ophthalmologists to meet these challenges.
The individual oral histories are divided into four groups, each designated by the name of its
chief administrative officer (Executive Secretary-Treasurer, Executive Vice President). Overlap
between groups, as well as continuity, is provided by interviewees, who have witnessed
successive administrations.
The "Benedict Administration" interviews with Drs. Hughes, Morrison, Snydacker, and
Henderson focus on their recollections of the ambiance and governance of the AAOO during
the relatively quiescent years when the AAOO was headquartered in Rochester, Minnesota,
when the impelling force was solely educational, and when virtually all ophthalmologists
and otolaryngologists were generalists who looked upon the annual AAOO meeting as an
opportunity to learn about each and every aspect of their respective fields. Subspecialization
was in its infancy, and discussions about related topics took place in small groups at individual
instruction courses, rather than the single daily plenary session.
The "Kos Administration" interviews with Dr. Kos and Mr. Noonan acquaint the reader with
the perspectives of otolaryngologist members of the AAOO, touch upon reorganization of
AAOO administrative procedures initiated by Dr. Kos in Rochester, and present the views of
otolaryngologists about separation into two academies. As the only former employee of the
AAOO who moved to San Francisco with the newly formed AAO, Mr. Noonan provides the
reader with his unique observations of the Academy's organizational growth during the past
quarter century.
In the "Spivey Administration" interviews, Drs. Blodi, Truhlsen, Straatsma, and Spivey, as well
as Mr. Zupan, recall their participation in the events leading to separation of the AAOO and
establishment of the AAO in a new headquarters city with a completely new organizational
structure. They also discuss merger of the AAO with the American Association of
Ophthalmology, growth of the continuing education program, establishment of a refereed
monthly Journal (Ophthalmology), formation of the AAO's Foundation, relations with other
organizations, development of a Washington Office of Governmental Relations, creation of an
Academy Code of Ethics, and changes in Academy demographics-with increasing numbers of
women and international members.
As noted earlier, the interview with Dr. Hoskins highlights theAAO's activities at a time when
managed medical care groups have limited patients' access to specialists, and the Academy has
become ophthalmology's central advocate to private and governmental healthcare agencies
regarding patient access, reimbursement, and practice expense issues.
William H. Spencer, M.D.
August, 1997