| Glenn - USAEyes.org 2004-10-06, 11:09 am |
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>(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?
I believe that most referrals from optometrist to refractive surgeons
are of the casual variety, with the OD mentioning the MD whom the
patient should consider, but there is no comanagement or financial
incentive involved.
I do not believe that many comanaging physicians provide detailed
information regarding who gets paid what. There is a general
assumption that the patient understands a portion of the global fee
goes to the doctors providing the care, but I am doubtful the exact
amounts are discussed with the patient.
Additionally, while a mention of a "association" with an MD may be
stated, the exact nature of a partnership or ownership environment may
not be referenced.
Comanagement ownership can actually be a positive. If the referring
optometrist(s) has the ability to "fire" a surgeon who provides less
than optimal outcomes, then the patient's trust in that OD may be more
valuable than just a referral or simple comanagement.
>(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?
No. There is generally a trust in physicians that they will do what
is best for the patient, not necessarily what is best for their
pocketbook. For the most part, IMO that trust is earned and
appropriate. There are, however, a few doctors who push the limits of
propriety.
These are the issues that a patient needs to raise. That is, of
course, if the patient is interested. For all the concern we state
about these financial arrangements, I find that the attitude of the
public is that they don't care who gets what or who does what as long
as they get what they want. It is only if there is a poor outcome or
poor service that the issue of monetary distribution becomes important
to the patient. That may be naive, but it does seem to be the way the
public perceives the situation.
Glenn Hagele
Executive Director
Council for Refractive Surgery Quality Assurance
Email to glenn dot hagele at usaeyes dot org
http://www.USAEyes.org
http://www.ComplicatedEyes.org
I am not a doctor.
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