The integration of Europe influences the practice of medicine, including ophthalmology. The free transfer of health care professionals, students and even patients between countries, along with increased co-ordination in research and education, will influence our professional activities more and more. At the moment we are looking at the integration of Europe, which has already been decided upon, but in the future we may be looking at an even wider level of international co-ordination of ophthalmology and health care in general. The question does not so much concern whether we are in favour of this integration, because it is happening anyway, but, rather, how we can best deal with it and how we can influence these developments in a positive way.
The practice of ophthalmology in the Nordic countries has placed a greater emphasis on public health, public good and equal access than in many other parts of the world. This has been supported by a strong scientific foundation and an emphasis on education, which have contributed to the creation of a system of health care which is admired by many. Many of us, including myself, continuously complain about various aspects of the administration of health care in our countries but I doubt that we or our patients would like to exchange the Scandinavian system of health care for that of any other country. We might want to borrow individual components, such as the British approach to education or the American support of scientific research, but it would be difficult to find an entire health care system that better serves its patients and population.
As ophthalmology develops in Europe and the rest of the world, we need to make sure that the Nordic point of view is heard. Future standards of care and practice in ophthalmology should take into account the experience and expertise of Nordic ophthalmologists, because we have much to contribute to our colleagues and their patients. We should see this as an opportunity to promote the Scandinavian approach to medicine and ophthalmology and make sure that our way of thinking and of doing things is taken into account and contributes to the development of the practice of ophthalmology in years to come, both in Europe and elsewhere.
Within Europe there are strong national societies of ophthalmology, such as the German, French and Italian societies of ophthalmology and the British Royal College of Ophthalmology. These societies co-ordinate education and training, help set standards and represent ophthalmology internally and externally. If Nordic ophthalmology wants to operate on an equal footing with these large societies it must stand united. In many ways we are already united. We are brought together by the biannual Nordic Congress of Ophthalmology; we have a journal of the Nordic ophthalmological societies, namely Acta, and we have a co-ordinating committee, the Nordic Ophthalmology Committee (NOK). These are the same components that make up most national ophthalmological societies or academies: the American Academy of Ophthalmology, for example, holds an annual academy meeting, publishes a journal of ophthalmology and runs an office which administrates educational and policy matters, among others.
It is time to bring our own respective components together to form a single organization that could be called the Nordic Academy of Ophthalmology. It would be quite easy to make this happen. We already have two committees or boards, which represent all the national societies of ophthalmology in the Nordic countries. The Acta Board has two members from each national society and the NOK also has two members from each country. The Acta Board is responsible for overseeing Acta Ophthalmologica and the NOK is responsible for the Nordic Congress of Ophthalmology, among other things. I propose that these two committees be combined into one board which would be responsible for controlling Acta Ophthalmologica, overseeing the Nordic Congress of Ophthalmology and developing other functions important to Nordic ophthalmology, such as co-ordination of education, setting standards and policy and representing ophthalmology where appropriate.
It is not necessary to do everything at once. If the national societies were to agree to this innovation, they would each need to elect two or three members for this new board. The bylaws of Acta and the NOK would need to be adjusted to allow for the resultant changes. The new board would continue to oversee Acta as the Acta Board does today. It would also oversee the Nordic Congress of Ophthalmology in the same way that the NOK has done until now. In addition, the board would be responsible for developing other functions of the Nordic Academy of Ophthalmology. These might include the co-ordination of educational opportunities between the various Nordic countries and the provision of information and help for students and residents who might want to attend ophthalmology courses in the various Nordic countries. It would also provide a forum for discussion of the development of ophthalmology within the Nordic countries and help set standards and policy for the practice of ophthalmology. It would be valuable for most of us to be able to point to a common Nordic standard and to draw on external expertise and opinion when we are trying to convince our health authorities or hospital administrations about what are appropriate standards for the practice of ophthalmology. These and other functions are something that the board would develop step by step, learning from the large national societies that have taken similar steps before, such as the American Academy or the Royal College.
Acta Ophthalmologica already has an editorial office and it would be practical, at least in the beginning, to use this office to serve the academy and its executive committee. This would both limit costs and facilitate the use of Acta for disseminating policy discussion and educational announcements, for example, on behalf of the Nordic Academy.
The idea of a Nordic Academy of Ophthalmology is not new. Extended discussion on the subject took place 15 years ago, but was unfortunately not carried through. Now is the time to come together in a Nordic Academy of Ophthalmology that would both strengthen and simplify our collaboration. It would give us one focus of Nordic collaboration in ophthalmology rather than two; it would give Nordic ophthalmology an opportunity to speak with one voice, both internally to our individual health authorities and governments as well as externally, and it would provide us with a forum to develop Nordic ophthalmology in the way we see fit in the years to come. If the Nordic national societies were to decide to move in this direction, it would be possible to reach a decision about the establishment of a Nordic Academy of Ophthalmology at the NOK Congress in Copenhagen in 2006.