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The Facts About Some Doctors and Laser Vision Correction

If you are considering Laser Vision Correction (LASIK or PRK),
Please Read an Consider the Following Information Carefully

Please Read the Disclaimer


1. YOUR DOCTOR MAY BE SELLING YOU TO THE HIGHEST BIDDER.

2. YOUR SURGEON MAY NOT LIVE CLOSE ENOUGH TO YOUR H
OME TO PROVIDE YOU WITH EMERGENCY POST-OPERATIVE CARE.

3. YOU MAY NOT BE RECEIVING YOUR PREOPERATIVE AND POSTOPERATIVE CARE FROM A DOCTOR TRAINED TO PERFORM YOUR SURGERY.

THE PROBLEM: CO-MANAGEMENT

Co-management, in the context of laser vision correction, is a term used to describe a relationship between a surgeon and a non-surgeon. Typically, the non-surgeon sends the patient to a surgeon who performs the laser procedure. The patient then returns to the care of the non-surgeon for continued care. Sometimes the referral back to the non-surgeon is after the postoperative care has been completed. Other times the postoperative care is performed totally by the non-surgeon.

Most commonly, the non-surgeon is an OPTOMETRIST, an eye doctor not licensed to perform surgery in most states. OPHTHALMOLOGISTS not trained in laser vision correction can also function as the non-surgeon in a laser vision correction co-management arrangement.

Surgeons performing Laser Vision Correction via LASIK are OPHTHALMOLOGISTS, MDs or DOs who have completed specialized training.

Co-management almost always involves a
FEE- SPLITTING arrangement. The surgeon either gives part of his fee to the non-surgeon, or in the case of some corporate laser centers, both the surgeon and non-surgeon are paid by the laser center. The fee split is supposed to be based upon the amount of work done by each individual. The problem is that the non-surgeon often has to do little or nothing to get his split.

Thus the term
ECONOMIC CO-MANAGEMENT has been coined. This refers to the payment for the referral of the patient with little or no further obligation by the referring doctor.

FEE
-SPLITTING HAS LONG BEEN CONSIDERED AN UNETHICAL PRACTICE IN MEDICINE.

While co-management is not an illegal practice, fee
-splitting is illegal in certain circumstances. For example, it is a violation of MEDICARE'S fraud and abuse policies for a provider to pay another provider, either directly or indirectly, for the referral of a Medicare patient.

See Related Articles on the Legality of Co-Management and Fee-Splitting


Since most laser vision correction patients are not Medicare age, and since there is presently not many third parties paying for these procedures, fee-
splitting is not illegal. That is not to say that it is ethical. The splitting of fees introduces a conflict of interest between the referring doctor and his/her patient.

The American Medical Association and the American Academy of Ophthalmology are in the process of introducing guidelines against co-management of patients, unless it is in the patients best interest. You see, there is no good reason why a patient who has had LASIK or PRK should receive his or her preop examination and postop care from anyone other than his or her surgeon. This is particularly true when the surgeon is readily accessible to the potential patient. It does not make sense, unless you see the real reason behind co-management arrangements.....
FEE- SPLITTING.

 

FEE-SPLITTING IS NO MORE THAN AN INDIRECT (OR SOMETIMES DIRECT) PAYMENT FOR A PATIENT REFERRAL.
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See Related Article:

View the AMA resolution against co-management of surgical patients.

See legal opinion as to Standards of Post-operative care as it Related to Co-management

EVER WONDER WHY OPTOMETRISTS ADVERTISE LASIK?

OPTOMETRISTS ARE NOT LICENSED TO PERFORM LASIK SURGERY. SO WHY DO THEY SEEK OUT PATIENTS WANTING LASIK SURGERY?

THE ANSWER:

Optometrists advertise because LASIK patients are a valuable commodity (
$$$). Co-management arrangements with LASIK surgeons have become a significant source of revenue to optometrists. Frequently there maybe little in the way of preoperative or postoperative work for the optometrist to perform.

In order to be fair, we must point out that some ophthalmologists who do not perform laser vision correction also refer patients for $$$, the same as optometrists!

Unfortunately, patients are often referred to the surgeon who will pay the highest co-management fees.

PATIENTS ARE BEING SOLD TO THE HIGHEST BIDDER!

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WOULD YOU HAVE SURGERY BY SOMEONE WHOM YOU HAVE NEVER SEEN AND WILL LIKELY NEVER SEE AGAIN?

It is becoming all to common that optometrists are taking their patients to laser centers run by large public corporations.

The surgery is being performed by surgeons who have never seen the patient before and will likely never see the patient again. The surgeon (AND PATIENT!) relies on the optometrist to do the correct preoperative evaluation and postoperative care.

THE PROBLEM: OFTEN THE SURGEON DOESN'T EVEN LIVE IN THE CITY WHERE HE PERFORMS THE SURGERY!

Who is going to take care of you in the event of a problem when your surgeon lives hundreds of miles away? The local surgeon, whom you bypassed to have your surgery, is certainly NOT going to care for you in this scenario.

WOULD YOU EVER CONSIDER HAVING YOUR GALL BLADDER REMOVED OR YOUR HERNIA REPAIRED BY SOMEONE WHO FLIES INTO YOUR HOSPITAL ONCE A WEEK?

Obviously, for someone living in a remote setting, this might be necessary. In the case of laser vision correction, we are usually talking about areas served by local doctors trained to perform the surgery.

REMEMBER: PUBLIC CORPORATIONS ARE FIRST RESPONSIBLE TO PROVIDE PROFITS TO THEIR   SHAREHOLDERS.

See Related Article on the Coprorate practice of Refractive Surgery


  hot_news_anim.gif (5741 bytes)  NEWS FLASH!  hot_news_anim.gif (5741 bytes)

   YOU MUST READ THIS

The American Academy of Ophthalmology
and
The American Society of Cataract and Refractive Surgery
Issue a Joint Position Paper on
the Co-Management of Postoperative Care

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BEFORE YOU HAVE LASER VISION CORRECTION
BE SURE TO FIND OUT THE FOLLOWING INFORMATION:

Make sure the doctor performing the surgery does his or her own preoperative evaluation of your eyes. After all, you would not have brain surgery without being first evaluated by a neurosurgeon.

Find out how much of the postoperative care will be performed by the surgeon and for how long? Find out if the surgeon is going to be available to you in case of an emergency.

Find out if the surgeon lives in your city or town.
Make sure you have a thorough discussion regarding the risks, benefits and alternatives pertaining to your surgical procedure with the doctor who will be performing the surgery. This is his/her legal and ethical responsibility. Accept no substitutes! THERE ARE SIGNIFICANT RISKS INVOLVED WITH THIS SURGERY.

Above all, make sure you have a comfortable relationship with your surgeon. Know the surgeon's reputation and qualifications.TAKE YOUR TIME AND MAKE THE CORRECT DECISIONS. DO NOT BE PRESSURED INTO A HASTY DECISION. DO YOUR OWN RESEARCH. YOU CAN NOT TAKE BACK WHAT WILL BE DONE.

DO NOT BE BLINDED BY SLICK MARKETING, UNREALISTIC PROMISES AND DEEP DISCOUNTS.


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Disclaimer

This page has been provided as a public service and for informational purposes only. Some of the content of this page represents the opinion of the webmaster and may not agree with the opinion of others. The editorial comments provided here are intended as a view on the refractive surgery industry as a whole. Nothing herein is intended to single out any individual, group or corporation as having done anything illegal or unethical. This site does not promote, or recommend, any individual or group performing refractive surgical procedures. This site is not designed to provide information on the specific risks, benefits or alternatives to refractive surgery. Please consult your individual eye doctor for further information on laser vision correction.

The author of this site does not give individual recommendations or information regarding refractive surgery.

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