Lasik Eyes Surgery - WALL STREET JOURNAL FEATURES ONE OF CRSQA'S FINEST....

Author

WALL STREET JOURNAL FEATURES ONE OF CRSQA'S FINEST....

Wizkid

2004-10-29, 7:16 pm

MARKETING VISION - EYE DOCTOR TO ELITE BLAZES NEW TRAIL IN SELLING
SURGERY

IN A PATIENT-PAYS-ALL WORLD, DR. MALONEY TREATS LASIK LIKE A LUXURY
PRODUCT.

He 'Didn't Like Sick People'

By RHONDA L. RUNDLE
Staff Reporter of THE WALL STREET JOURNAL
October 26, 2004; Page A1

LOS ANGELES -- Robert K. Maloney, seated on a low stool, peered
through a microscope as he operated on a man's left eye. "Chris, I'm
just working to get it into position," Dr. Maloney gently reassured
his patient.

This wasn't an effort to save Christopher Robin's sight, or even to
improve his vision. Dr. Maloney was implanting a tiny platinum jewel,
shaped like a star, into the corner of the white of his patient's eye.

For Mr. Robin, a 30-year-old rock musician with tattoos and a braided
ponytail, the payoff was a radical new glint in his eye. For Dr.
Maloney, who didn't charge for the procedure and has yet to interest
anyone in paying for it, the 20-minute operation yielded another
precious dose of public attention. Thanks to Dr. Maloney's publicist,
a television crew was on hand to film the surgery for a local Fox news
show.

The hunt for patients willing to pay thousands of dollars for surgery
not covered by medical insurance is thrusting more doctors into a new
world of hype and promotion. Plastic surgeons pioneered this terrain.
Now, like upscale hoteliers and retailers, eye doctors are also
depending heavily on marketing and word-of-mouth. As they jockey to
keep their names in public view, they are promoting unusual new
procedures like the JewelEye cosmetic implant, along with more
practical new ones like corrective lens implants.

The transformation of ophthalmology into a business requiring acute
consumer-marketing savvy was sparked by a single surgical innovation.
Nearly a decade ago, eye surgeons received regulatory approval to use
lasers to reshape the cornea so that patients would no longer need
their glasses. Since then, laser-assisted in situ keratomileusis
(Lasik), has become the most popular form of vision correction, or
refractive, surgery. Although insurance almost never pays for it, more
Lasik surgeries are performed every year than nose jobs, face lifts or
tummy tucks. More than eight million laser eye procedures have been
performed in the U.S. since 1995, including 1.2 million last year.
Partly as a result, the median compensation for ophthalmologists
jumped last year by nearly 18% to $300,020, the largest year-over-year
increase for any medical specialty, according to the trade group
Medical Group Management Association.

The 3,900 eye doctors who specialize in Lasik surgery, about 25% of
all ophthalmologists, have discovered that their practices behave more
like luxury-goods businesses than traditional medical practices.
Because insurers won't reimburse them, doctors must persuade consumers
to reach into their pockets for eye surgery instead of some other
discretionary purchase. And when U.S. consumer confidence plummets,
doctors have learned, so does the number of refractive surgical
procedures. Volume dropped sharply a few years ago, and many
laser-surgery chains went bankrupt. This year, volume has risen 18%,
according to Market Scope, a Manchester, Mo., market-research firm.

SELLING AGRESSIVELY
In coming years, as health insurers continue to press for more medical
costs of all types to be shifted to patients, more and more doctors
may need to learn how to sell their services as aggressively as Dr.
Maloney does.

Dr. Maloney, a 46-year-old eye surgeon who practices in the affluent
Los Angeles neighborhood of Westwood Village, graduated summa cum
laude from Harvard university and attended the university of
California at San Francisco's medical school after a Rhodes
scholarship. But then, he says, he came to a disquieting conclusion:
"I really didn't like sick people." He wondered whether he should even
become a doctor. Then he discovered the budding field of corrective
eye surgery, where he could treat healthy people willing to pay a lot
of money to see and feel better.

Even as a young faculty member at the university of California at Los
Angeles, Dr. Maloney had a knack for translating medical jargon into
snappy sound bites. After going into private practice in 1998, he
hired a publicist to get media exposure. Two years ago, he was invited
to join the cast of a new ABC television show, "Extreme Makeover," on
which cosmetic surgeons operate on volunteers.

At first, he says, he was concerned that a show devoted to glamorizing
plastic surgery would be "appalling." But after talking to the other
doctors who had signed on, including a cosmetic dentist whose spouse
Dr. Maloney had treated, he decided that participating might be fun.

He isn't paid for his cameos on the show. But in the first half of
this year, about 12% of his new patients reported choosing him because
of the show. "Extreme Makeover," says Shareef Mahdavi, an
ophthalmic-device consultant in Pleasanton, Calif., "is a one-hour
infomercial in prime time every week."

Dr. Maloney has concluded that it also pays to pamper his customers.
At one time, patients walked away from a trip to the eye doctor with
little more than oversized plastic sunglasses to protect their dilated
eyes. Today, Dr. Maloney's 25-person staff includes a suit-and-tie
clad concierge who serves pastries and coffee in the waiting room.
After his patients return home from surgery, Dr. Maloney sends a gift
box packed with gourmet chocolate chip cookies and a mug bearing the
invitation: "Wake up and see the coffee."

He is not the only eye surgeon vying for attention. Andrew Caster, a
refractive surgeon in nearby Beverly Hills, signed on with another
television makeover show, Fox's "The Swan." And Kerry Assil, who
practices a few miles away in Santa Monica, recently performed a new
surgical procedure on "Good Morning America," helped by his own
Hollywood agent.

Thirty years ago, doctors and lawyers who advertised were viewed with
disdain. But ETHICAL STANDARDS HAVE CHANGED, and advertising and
public relations are widely accepted now in both professions.
"Promotion is OK," says Bradley Straatsma, chairman emeritus of UCLA's
Jules Stein Eye Institute. "Part of our American medical system is to
inform the public of their options and to try to get information to
them that is valid and accurate."

When Dr. Maloney was training as an eye surgeon, many eye doctors
considered it barbaric to operate on a healthy eye merely to free
someone from glasses or contact lenses. But Dr. Straatsma, then
director of the Jules Stein Eye Institute, says he recognized that the
emerging technology was certain to become important. He hired Dr.
Maloney, who became one of the first full-time refractive surgeons at
a major university.

The university's public-relations people loved him. When they paged
him, he responded quickly, and he was always eager to talk to the
press. "I saw the effect of the stories," Dr. Maloney says. They
attracted patients, generated revenue for the department, and ensured
a flow of candidates for clinical research.

In 1995, the Food and Drug Administration approved laser
vision-correction surgery. Refractive surgery quickly became a huge
profit center at the UCLA hospital. To accommodate all of Dr.
Maloney's patients, the Jules Stein Eye Institute set up a new laser
surgical center. Patients coming in for corrective eye surgery would
no longer have to share waiting areas with patients suffering from
cancer, corneal ulcers and other eye maladies.

By 1997, the refractive surgery center was generating 40% of the
institute's revenue. But Dr. Maloney was chafing under the university
system. Unpolished medical students, he says, didn't provide good
enough service to his affluent customers. Dr. Maloney grew frustrated
by long waits for the approvals needed to launch research studies or
to print marketing brochures.

"Ophthalmologists weren't used to marketing," says Bartly Mondino, Dr.
Maloney's former boss and now the director of the Jules Stein
Institute. The university insisted that marketing materials be
fact-based and tasteful, and promote university services rather than
individual physicians. "We didn't want anything that might be
considered sexist," or that showed "beautiful people walking on the
beach," Dr. Mondino says.

Fed up with the hassles and eager to make more money, Dr. Maloney
says, he left UCLA in mid-1998 to launch the Maloney Vision Institute.
He says he now earns more than the $1.2 million in salary and bonuses
he made during his last year at UCLA, but he won't say how much more.

After hanging his shingle, one of his first moves was to retain a
part-time publicist. "When I started working with him, I didn't know
any other independent doctor who had their own PR person," says Gemma
Cunningham. She arranged interviews with trade publications,
newspapers and television reporters. Dr. Maloney had the resulting
articles framed and hung throughout his office alongside glowing
letters from celebrity patients like model Cindy Crawford, comedian
Drew Carey, and former Secretary of Defense William S. Cohen.

Dr. Maloney makes no apologies for such self-promotion. Along with
word-of-mouth referrals, it keeps patients and dollars streaming in
the door, he says. "To be a great surgeon, you have to do a lot of
it," he says. He doesn't do any advertising, because he says it
attracts customers who care more about price than performance.

Over the years, he has conducted clinical testing on a variety of new
products, including the implantable corrective lenses that recently
won FDA approval for treatment of nearsightedness.

Disappointing Devices

He has also promoted devices that turned out to be disappointing. In
1999, shortly after the FDA approved a new ring-like device designed
to change the curvature of the cornea without surgery, he invited
reporters to watch him implant the new product, called KeraVision
Intacs. The procedure, he claimed, had "the potential to help the more
than 22 million adult Americans that have mild to moderate
nearsightedness."

But the technology never took off, and Dr. Maloney stopped implanting
the devices because he didn't think the results were as good as Lasik.
Then, he says, he turned a profit by shorting, or betting against, the
stock of the manufacturer, which eventually sought bankruptcy
protection. Dr. Maloney says because he was not working as an
investigator or consultant to the manufacturer, and because his
financial interests were aligned with his responsibilities to
patients, the investment was proper. The technology was subsequently
acquired by another company for treatment of a different condition.

In 2001, he and another surgeon established a second office in Irvine,
about 40 miles south of Los Angeles. Several other corporations were
rushing to open Lasik centers. Price wars erupted, with some chains
advertising prices of as low as $499 per eye, far below the $2,400
that Dr. Maloney was then charging. To make matters worse, complaints
began surfacing about troubling side-effects to Lasik surgery,
including night glare and halo vision.

Then the economy tanked. More consumers faced hard choices about their
discretionary income. "Will I have Lasik, or take a trip to Hawaii, or
remodel the bathroom?" says Mr. Mahdavi, the ophthalmic-device
consultant, describing consumers' dilemmas. More people opted to skip
the eye surgery, sending many Lasik specialists into the doldrums.

Dr. Maloney's patient volume dropped by 42% between 2000 and 2002. His
dream of managing a chain of upscale, research-oriented centers died.
Many laser-surgery chains went bankrupt. A notable survivor was TLC
Laser Eye Centers, the company that employs golfer Tiger Woods as its
spokesman.

Despite the tough times, Dr. Maloney never cut his Lasik prices. He
now charges $2,800 per eye, a price at the highest end of the industry
range. Many people are willing to pay top dollar for surgeons with
"star quality," says David Harmon, president of Market Scope, the
market-research firm.

Today, with industry volume recovering, Dr. Maloney is excited about
the prospects for the new implants for correcting nearsightedness.
Among the other new technologies are surgical treatments to eliminate
the need for reading glasses and bifocals.

Dr. Maloney started offering JewelEye implants earlier this year after
talking to the Dutch eye surgeon who invented the procedure and is
selling the cosmetic implants. The thin platinum hearts, stars and
half-moon crescents are safe and don't threaten the structure of the
eye, Dr. Maloney asserts. He decided to get involved, he says, because
the jewels are "neat" and "I love innovating." He has set the price at
$3,900.

The American Academy of Ophthalmology issued a statement in April
warning that the JewelEye wasn't proven to be safe. "We can't really
say it's bad, because there aren't any studies," says Academy
spokeswoman Michelle Stephens.

It's a ticklish situation. Dr. Maloney is a member of the academy and
one of its designated spokespeople. He has performed surgery on many
colleagues, including Ms. Stephens. "Refractive surgeons definitely
know the value of publicity," she says.

Write to Rhonda L. Rundle at rhonda.rundle@wsj.com

Ragnar Suomi

2004-10-30, 2:07 am

While I think the idea of implanting "jewels" into the eye is absurd,
I'm not surprised its being done. Consider that people have breast
implants, butt implants, Earlobes, ear cartilage, noses, all parts of
the penis, the belly button, nipples, and tongues pierces.. it's just
a matter of someone thinging of some other way to adorn themselves.
Dr. Maloney seems to have a great deal of time to be fiddling about in
all these frivolous procedures. It ruins his credibility. He is
supposed to be one of the top ophthalmologists around though.

On 29 Oct 2004 17:00:13 -0700, gospa68@aol.com (Wizkid) wrote:

>MARKETING VISION - EYE DOCTOR TO ELITE BLAZES NEW TRAIL IN SELLING
>SURGERY
>
>IN A PATIENT-PAYS-ALL WORLD, DR. MALONEY TREATS LASIK LIKE A LUXURY
>PRODUCT.
>
>He 'Didn't Like Sick People'
>
>By RHONDA L. RUNDLE
>Staff Reporter of THE WALL STREET JOURNAL
>October 26, 2004; Page A1
>
>LOS ANGELES -- Robert K. Maloney, seated on a low stool, peered
>through a microscope as he operated on a man's left eye. "Chris, I'm
>just working to get it into position," Dr. Maloney gently reassured
>his patient.
>
>This wasn't an effort to save Christopher Robin's sight, or even to
>improve his vision. Dr. Maloney was implanting a tiny platinum jewel,
>shaped like a star, into the corner of the white of his patient's eye.
>
>For Mr. Robin, a 30-year-old rock musician with tattoos and a braided
>ponytail, the payoff was a radical new glint in his eye. For Dr.
>Maloney, who didn't charge for the procedure and has yet to interest
>anyone in paying for it, the 20-minute operation yielded another
>precious dose of public attention. Thanks to Dr. Maloney's publicist,
>a television crew was on hand to film the surgery for a local Fox news
>show.
>
>The hunt for patients willing to pay thousands of dollars for surgery
>not covered by medical insurance is thrusting more doctors into a new
>world of hype and promotion. Plastic surgeons pioneered this terrain.
>Now, like upscale hoteliers and retailers, eye doctors are also
>depending heavily on marketing and word-of-mouth. As they jockey to
>keep their names in public view, they are promoting unusual new
>procedures like the JewelEye cosmetic implant, along with more
>practical new ones like corrective lens implants.
>
>The transformation of ophthalmology into a business requiring acute
>consumer-marketing savvy was sparked by a single surgical innovation.
>Nearly a decade ago, eye surgeons received regulatory approval to use
>lasers to reshape the cornea so that patients would no longer need
>their glasses. Since then, laser-assisted in situ keratomileusis
>(Lasik), has become the most popular form of vision correction, or
>refractive, surgery. Although insurance almost never pays for it, more
>Lasik surgeries are performed every year than nose jobs, face lifts or
>tummy tucks. More than eight million laser eye procedures have been
>performed in the U.S. since 1995, including 1.2 million last year.
>Partly as a result, the median compensation for ophthalmologists
>jumped last year by nearly 18% to $300,020, the largest year-over-year
>increase for any medical specialty, according to the trade group
>Medical Group Management Association.
>
>The 3,900 eye doctors who specialize in Lasik surgery, about 25% of
>all ophthalmologists, have discovered that their practices behave more
>like luxury-goods businesses than traditional medical practices.
>Because insurers won't reimburse them, doctors must persuade consumers
>to reach into their pockets for eye surgery instead of some other
>discretionary purchase. And when U.S. consumer confidence plummets,
>doctors have learned, so does the number of refractive surgical
>procedures. Volume dropped sharply a few years ago, and many
>laser-surgery chains went bankrupt. This year, volume has risen 18%,
>according to Market Scope, a Manchester, Mo., market-research firm.
>
>SELLING AGRESSIVELY
>In coming years, as health insurers continue to press for more medical
>costs of all types to be shifted to patients, more and more doctors
>may need to learn how to sell their services as aggressively as Dr.
>Maloney does.
>
>Dr. Maloney, a 46-year-old eye surgeon who practices in the affluent
>Los Angeles neighborhood of Westwood Village, graduated summa cum
>laude from Harvard university and attended the university of
>California at San Francisco's medical school after a Rhodes
>scholarship. But then, he says, he came to a disquieting conclusion:
>"I really didn't like sick people." He wondered whether he should even
>become a doctor. Then he discovered the budding field of corrective
>eye surgery, where he could treat healthy people willing to pay a lot
>of money to see and feel better.
>
>Even as a young faculty member at the university of California at Los
>Angeles, Dr. Maloney had a knack for translating medical jargon into
>snappy sound bites. After going into private practice in 1998, he
>hired a publicist to get media exposure. Two years ago, he was invited
>to join the cast of a new ABC television show, "Extreme Makeover," on
>which cosmetic surgeons operate on volunteers.
>
>At first, he says, he was concerned that a show devoted to glamorizing
>plastic surgery would be "appalling." But after talking to the other
>doctors who had signed on, including a cosmetic dentist whose spouse
>Dr. Maloney had treated, he decided that participating might be fun.
>
>He isn't paid for his cameos on the show. But in the first half of
>this year, about 12% of his new patients reported choosing him because
>of the show. "Extreme Makeover," says Shareef Mahdavi, an
>ophthalmic-device consultant in Pleasanton, Calif., "is a one-hour
>infomercial in prime time every week."
>
>Dr. Maloney has concluded that it also pays to pamper his customers.
>At one time, patients walked away from a trip to the eye doctor with
>little more than oversized plastic sunglasses to protect their dilated
>eyes. Today, Dr. Maloney's 25-person staff includes a suit-and-tie
>clad concierge who serves pastries and coffee in the waiting room.
>After his patients return home from surgery, Dr. Maloney sends a gift
>box packed with gourmet chocolate chip cookies and a mug bearing the
>invitation: "Wake up and see the coffee."
>
>He is not the only eye surgeon vying for attention. Andrew Caster, a
>refractive surgeon in nearby Beverly Hills, signed on with another
>television makeover show, Fox's "The Swan." And Kerry Assil, who
>practices a few miles away in Santa Monica, recently performed a new
>surgical procedure on "Good Morning America," helped by his own
>Hollywood agent.
>
>Thirty years ago, doctors and lawyers who advertised were viewed with
>disdain. But ETHICAL STANDARDS HAVE CHANGED, and advertising and
>public relations are widely accepted now in both professions.
>"Promotion is OK," says Bradley Straatsma, chairman emeritus of UCLA's
>Jules Stein Eye Institute. "Part of our American medical system is to
>inform the public of their options and to try to get information to
>them that is valid and accurate."
>
>When Dr. Maloney was training as an eye surgeon, many eye doctors
>considered it barbaric to operate on a healthy eye merely to free
>someone from glasses or contact lenses. But Dr. Straatsma, then
>director of the Jules Stein Eye Institute, says he recognized that the
>emerging technology was certain to become important. He hired Dr.
>Maloney, who became one of the first full-time refractive surgeons at
>a major university.
>
>The university's public-relations people loved him. When they paged
>him, he responded quickly, and he was always eager to talk to the
>press. "I saw the effect of the stories," Dr. Maloney says. They
>attracted patients, generated revenue for the department, and ensured
>a flow of candidates for clinical research.
>
>In 1995, the Food and Drug Administration approved laser
>vision-correction surgery. Refractive surgery quickly became a huge
>profit center at the UCLA hospital. To accommodate all of Dr.
>Maloney's patients, the Jules Stein Eye Institute set up a new laser
>surgical center. Patients coming in for corrective eye surgery would
>no longer have to share waiting areas with patients suffering from
>cancer, corneal ulcers and other eye maladies.
>
>By 1997, the refractive surgery center was generating 40% of the
>institute's revenue. But Dr. Maloney was chafing under the university
>system. Unpolished medical students, he says, didn't provide good
>enough service to his affluent customers. Dr. Maloney grew frustrated
>by long waits for the approvals needed to launch research studies or
>to print marketing brochures.
>
>"Ophthalmologists weren't used to marketing," says Bartly Mondino, Dr.
>Maloney's former boss and now the director of the Jules Stein
>Institute. The university insisted that marketing materials be
>fact-based and tasteful, and promote university services rather than
>individual physicians. "We didn't want anything that might be
>considered sexist," or that showed "beautiful people walking on the
>beach," Dr. Mondino says.
>
>Fed up with the hassles and eager to make more money, Dr. Maloney
>says, he left UCLA in mid-1998 to launch the Maloney Vision Institute.
>He says he now earns more than the $1.2 million in salary and bonuses
>he made during his last year at UCLA, but he won't say how much more.
>
>After hanging his shingle, one of his first moves was to retain a
>part-time publicist. "When I started working with him, I didn't know
>any other independent doctor who had their own PR person," says Gemma
>Cunningham. She arranged interviews with trade publications,
>newspapers and television reporters. Dr. Maloney had the resulting
>articles framed and hung throughout his office alongside glowing
>letters from celebrity patients like model Cindy Crawford, comedian
>Drew Carey, and former Secretary of Defense William S. Cohen.
>
>Dr. Maloney makes no apologies for such self-promotion. Along with
>word-of-mouth referrals, it keeps patients and dollars streaming in
>the door, he says. "To be a great surgeon, you have to do a lot of
>it," he says. He doesn't do any advertising, because he says it
>attracts customers who care more about price than performance.
>
>Over the years, he has conducted clinical testing on a variety of new
>products, including the implantable corrective lenses that recently
>won FDA approval for treatment of nearsightedness.
>
>Disappointing Devices
>
>He has also promoted devices that turned out to be disappointing. In
>1999, shortly after the FDA approved a new ring-like device designed
>to change the curvature of the cornea without surgery, he invited
>reporters to watch him implant the new product, called KeraVision
>Intacs. The procedure, he claimed, had "the potential to help the more
>than 22 million adult Americans that have mild to moderate
>nearsightedness."
>
>But the technology never took off, and Dr. Maloney stopped implanting
>the devices because he didn't think the results were as good as Lasik.
>Then, he says, he turned a profit by shorting, or betting against, the
>stock of the manufacturer, which eventually sought bankruptcy
>protection. Dr. Maloney says because he was not working as an
>investigator or consultant to the manufacturer, and because his
>financial interests were aligned with his responsibilities to
>patients, the investment was proper. The technology was subsequently
>acquired by another company for treatment of a different condition.
>
>In 2001, he and another surgeon established a second office in Irvine,
>about 40 miles south of Los Angeles. Several other corporations were
>rushing to open Lasik centers. Price wars erupted, with some chains
>advertising prices of as low as $499 per eye, far below the $2,400
>that Dr. Maloney was then charging. To make matters worse, complaints
>began surfacing about troubling side-effects to Lasik surgery,
>including night glare and halo vision.
>
>Then the economy tanked. More consumers faced hard choices about their
>discretionary income. "Will I have Lasik, or take a trip to Hawaii, or
>remodel the bathroom?" says Mr. Mahdavi, the ophthalmic-device
>consultant, describing consumers' dilemmas. More people opted to skip
>the eye surgery, sending many Lasik specialists into the doldrums.
>
>Dr. Maloney's patient volume dropped by 42% between 2000 and 2002. His
>dream of managing a chain of upscale, research-oriented centers died.
>Many laser-surgery chains went bankrupt. A notable survivor was TLC
>Laser Eye Centers, the company that employs golfer Tiger Woods as its
>spokesman.
>
>Despite the tough times, Dr. Maloney never cut his Lasik prices. He
>now charges $2,800 per eye, a price at the highest end of the industry
>range. Many people are willing to pay top dollar for surgeons with
>"star quality," says David Harmon, president of Market Scope, the
>market-research firm.
>
>Today, with industry volume recovering, Dr. Maloney is excited about
>the prospects for the new implants for correcting nearsightedness.
>Among the other new technologies are surgical treatments to eliminate
>the need for reading glasses and bifocals.
>
>Dr. Maloney started offering JewelEye implants earlier this year after
>talking to the Dutch eye surgeon who invented the procedure and is
>selling the cosmetic implants. The thin platinum hearts, stars and
>half-moon crescents are safe and don't threaten the structure of the
>eye, Dr. Maloney asserts. He decided to get involved, he says, because
>the jewels are "neat" and "I love innovating." He has set the price at
>$3,900.
>
>The American Academy of Ophthalmology issued a statement in April
>warning that the JewelEye wasn't proven to be safe. "We can't really
>say it's bad, because there aren't any studies," says Academy
>spokeswoman Michelle Stephens.
>
>It's a ticklish situation. Dr. Maloney is a member of the academy and
>one of its designated spokespeople. He has performed surgery on many
>colleagues, including Ms. Stephens. "Refractive surgeons definitely
>know the value of publicity," she says.
>
>Write to Rhonda L. Rundle at rhonda.rundle@wsj.com