| joyceb 2004-10-06, 4:07 am |
| Thanks for your thoughtful response, Glenn.
If I understand you correctly, most optometrists will have at least
some financial incentive to refer patients to surgeons for LASIK (or
one of the other varieties of laser eye surgery), as opposed to
keeping them in glasses or contacts. This is as I expected; providing
financial incentives to sales representatives is sound strategy in any
business. And I would not presume to dictate what is a "fair" amount
of compensation, nor trust anyone else to dictate it; I'm a market
economist at heart -- "whatever the traffic will bear", etc.
Perhaps a re-statement of my concern is in order.
From my perspective, people buying a car are generally aware of the
salesman's motive, and adjust their approach to car-buying as
appropriate. Also from my perspective, people generally don't view
doctors (or other providers of medical services) as salesmen.
If a friend of mine were to purchase a car based purely on what the
salesman told her, I would have very little sympathy for her when it
became clear she had been taken to the cleaners. My question would
have been something like, "Have you ever wondered why there are so
many jokes about car salesmen?"
Doctors enjoy a somewhat different reputation; in my experience,
people generally believe that doctors' motives are comparatively
pristine. For various reasons (some reasonable, some not, IMHO),
people generally accept a doctor's recommendation without consulting
any other readily-available resources. Is this not somewhat unique?
Now consider a poll in which you presented the general public with the
following statement:
"My car salesman would not let his professional judgment be impaired
by a financial consideration."
If you asked the respondents to assign a number value to how strongly
they agreed with this statement, with 1 being "strongly disagree" and
10 being "strongly agree," I think it is safe to say that most would
be laughing uncontrollably as they circled "1".
Now modify the poll:
"My doctor would not let his professional judgment be impaired by a
financial consideration."
I will assume that we can at least agree that the results would be
quite different.
So, given that unnecessarily long and convoluted lead-in, here are my
questions:
(A) Do you believe most patients who have been referred by an
optometrist to a surgeon for laser eye surgery are made aware of the
details of the financial arrangements between those two (or more)
parties?
(B) Do you believe that most patients considering laser eye surgery
have a realistic perspective on the degree to which optometrists' and
eye surgeons' professional judgment can be impaired by financial
considerations?
(Please note that I don't pretend to know the degree; in fact, it is
irrelevant. My question pertains to the unique status of doctors in
western society, and the ramifications thereof.)
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