| Glenn - USAEyes.org 2005-11-21, 5:59 pm |
| >Glenn Hagele operates a lasik referral service and has a history of
>promoting some of the worst surgeons in the industry:
The following is a repeat of previous information posted here, so if
you are a regular it is doubtful you will learn anything new.
This reply addresses each of the spurious accusations propagated by
anti-LASIK zealots Brent Hanson and Ariel Bershadsky one by one,
and also visits the history of the person re-posting these accusations
and the author of these accusations. Every issue raised has been
addressed multiple times before, but Hanson somehow thinks it is
necessary to post and repost inaccurate accusations.
CRSQA'S FOUNDER WEARS GLASSES
I'm the founder of the Council for Refractive Surgery Quality
Assurance (CRSQA, USAEyes.org) and I did wear glasses and contacts,
but I do not any longer. I had refractive surgery recently, but my
reason for not having refractive surgery was very simple. Previously
I was considered a poor candidate. New technologies, new techniques,
and modified requirements determined that I was now an appropriate
candidate and I decided to have surgery.
So I have had refractive surgery. What does that prove? No statistics
are affected. None of the information on our website is different.
The result of one person means almost nothing in relation to the
probability of someone else achieving what they want from refractive
surgery.
My result from refractive surgery is inconsequential to
someone else considering refractive surgery for him or herself.
Reasonable people can acknowledge that some people have excellent
results and others have poor results with many in-between. What is
important is the situation for the individual who is considering
refractive surgery.
Some anti-LASIK zealots attempted to use the fact I wore glasses as a
red herring to divert attention from the real situation. You cannot
say that because I had not had surgery others should not, nor can you
say that because I have had refractive surgery everyone else should
have refractive surgery.
The real situation is that every individual needs to evaluate their
own situation and make their own decision based upon objective and
accurate information that relates to their individual circumstances.
I do not condemn or applaud anyone's decision regarding refractive
surgery. Yes or no is the same to me and I wish them well no matter
what. Condemning someone because they decide NOT have refractive
surgery when they know they are a poor candidate is foolishness. I
find it even more ridiculous that this condemnation comes exclusively
from people who have had a poor refractive surgery result.
CRSQA CHARGES CERTIFICATION FEES
Every relevant certification and licensing organization charges fees.
That includes the American Board of Ophthalmology (ABO), the American
Board of Eye Surgeons (ABES), CRSQA, state licensing boards, the Drug
Enforcement Administration, etc. CRSQA may be nonprofit, but our
vendors and staff need to be paid. We believe it is perfectly
appropriate for CRSQA Certified Refractive Surgeons to pay for the
patient services we provide through their certification fees.
CRSQA is not paid for each patient referral, click through to a
website, number of impressions on a web page, or any such quid pro
quo. Whether or not a patient decides to or not to have refractive
surgery of any kind is of virtually no consequence to CRSQA's form of
funding.
We acknowledge that our funding structure creates an environment where
someone could be worried about mischief, so we are diligent in
treating all doctors equally and make the source of our funding very
clear. It think that those who visit our website will find that we
are very objective and balanced in our presentation of refractive
surgery issues.
DOCTORS USE CRSQA CERTIFICATION AS A MARKETING TOOL
CRSQA is the first patient/consumer organization to evaluate and
certify doctors based upon patient outcomes. There is no doubt that
some doctors who have achieved our certification will announce that
fact in their marketing - and they should. In fact, we encourage
this.
Who is independently evaluated is important information that every
potential patient should know. If the better doctors are being
identified by their CRSQA certification, then more patients will go to
the better doctors. IMO that is a good thing.
CRSQA certification itself is not going to convince someone to have
surgery, but it might influence where someone who has decided to have
surgery goes. That is what we want. Through our 50 Tough Questions
For Your Doctor, the balanced information at our website, and CRSQA
certification, we want patients to find there way to the better
doctors.
We do list CRSQA Certified Refractive Surgeons on our website (so does
the AMA, AAO, ASCRS, ABES, ABO and every other related organization).
DIFFERENT CERTIFICATIONS, DIFFERENT RELEVANCE
The American Board of Ophthalmology (ABO) does not provide any
evaluation specific to refractive surgery. Certification is valid for
a lifetime, or 10 years if recently certified. ABO certification would
be conspicuous by its absence, but not terribly important by its
presence.
The American Board of Eye Surgery (ABES) is an ophthalmic group that
provides procedure specific certification. They do have peer-reviewed
certification for LASIK, and RK, but not PRK, LASEK, CK, LTK or any
other refractive procedure. ABES LASIK certification is valid for
seven years.
The Council for Refractive Surgery Quality Assurance (CRSQA,
USAEyes.org) is a nonprofit consumer/patient organization that
evaluates a surgeon based upon actual patient outcomes. The doctor is
reevaluated every three months.
Any prospective patient should consider the relevance and value of
these and other certifications the doctor may have achieved.
CRSQA'S DOCTORS HAVE BAD OUTCOMES
There is absolutely no way that anyone can expect perfection from any
doctor whether they be CRSQA, ABES, ABO certified or not. This is
surgery performed on people by people. Even if the surgery is done
correctly, bad outcomes do happen.
We educate the public that about 3% of refractive surgery patients
have unresolved complications at six-months postop, with 0.5% having
complications that require invasive treatment or extensive management.
Our certification process is designed to determine if a doctor's
outcomes meet or exceed the national norms. We believe that this
would exclude about one-third of US refractive surgeons.
DOCTORS HAVE BEEN DECERTIFIED BY CRSQA
While we never state why a particular doctor is no longer certified by
our organization, one of the reasons we re-evaluate every CRSQA
Certified Refractive Surgeon every three months is to be certain that
the doctor continues to meet our requirements. If the doctor no
longer meets our requirements, that doctor will be decertified. Yes,
we have decertified doctors.
Hanson and his ilk make a big deal that a bit more than 3 years ago
Dr. Glenn Kawesch was a CRSQA Certified Refractive Surgeon. We
believe that this situation is one of the best examples of why
quarterly re-evaluation of all certified doctors is so important and
why CRSQA certification is viable to patients seeking refractive
surgery.
At the time the doctor applied to become certified, he met our
certification requirements. Every three months we reevaluate if the
doctor continues to meet those requirements. If the doctor does not,
the doctor is decertified.
The California medical board evaluated Dr. Kawesch and found that he
met their requirements to become licensed to practice medicine.
Later, when they determined he did not meet their requirements, they
removed his license.
The American Board of Ophthalmology evaluated Dr. Kawesch and found
that he met their requirements to become board certified. Although
the doctor's medical license in California has been revoked, he
continues to be certified by the American Board of Ophthalmology.
CRSQA determined that the doctor no longer met our requirements and he
was promptly decertified.
Two out of three of these organizations found that at one time the
doctor meet their requirements, and then responded when he did not.
We happened to be the first to respond in the case of Dr. Kawesch...by
about a year and a half.
CRSQA'S EXECUTIVE DIRECTOR GETS PAID
Most Executive Director's of larger nonprofit organizations receive
pay, and I am no exception. I do not apologize for being paid for the
services I provide. My personal pay is set by CRSQA's Board of
Trustees.
WHO'S BEHIND LASIKINFOCENTER AND WHY
LasikInfoCenter is owned by New York attorney Ariel Berschadsky who
for years attempted to hide his ownership of this anti-lasik website.
Berschadsky uses LasikInfoCenter to generate LASIK malpractice
referrals, although people using his LasikInfoCenter are not notified
that this is a purpose of the website or that they are being referred
by and to the same person. This duplicity may be considered by some as
a violation of the ethics rules of the New York State Bar Association.
Berschadsky has had published on this website over 75 copyrighted
articles from journals, magazines, and newspapers for which he has
never received permission to republish. This is an obvious violation
of copyright law. Ironically, on his website promoting his law
practice, Berschadsky lists copyright as one of his specialties.
Berschadsky even went so far as to publish on his website a letter
from the owner of one of the articles he filched, demanding that he
remove the item immediately. Berschadsky openly refuses to remove the
article, even though the rightful owner of the article has demanded
its removal.
Not surprisingly, Berschadsky represented Hanson when Hanson publicly
published several private email messages between surgeons without the
permission or knowledge of the surgeons or the association that
operated the private message center.
Several of the claims made by Berschadsky about CRSQA and me
personally are not facts and are false. Nothing considered by a
reasonably intelligent individual support these accusations.
WHO IS BRENT HANSON
The following is an account of Mr. Hanson's history taken from his
websites, information on several bulletin boards and newsgroups,
comments of those who know him, TLC, and legal documents.
In mid 1996 Brent Hanson, a Dallas resident, had PRK by a Canadian
doctor who was not affiliated with TLC. Later Hanson had multiple
enhancement surgeries by the same doctor. From all accounts, the
doctor provided substandard results and quite possibly substandard
care.
Two years after his initial surgery, TLC acquired the medical practice
of Hanson's doctor as a part of a merger with a large chain. It was
not long after TLC purchased the practice that the doctor was no
longer affiliated with TLC.
TLC acknowledged that Mr. Hanson had a poor outcome from the surgeon
whose practice they had acquired and agreed to help as they could and
to the degree that they believed they could improve his visual acuity.
Keep in mind, Hanson was not originally a TLC patient, but TLC agreed
to provide follow-up care.
This is where we apply the term, "No good deed goes unpunished."
Exactly which events caused Hanson to turn his venom on TLC is long
lost in the competing rhetoric, but both sides agree that TLC provided
corrective surgery for Hanson in only one eye. Because of the type of
corrective surgery, TLC provided this surgery in Canada and the
surgery was performed by TLC's national medical director. Although
Hanson insisted that he should have additional surgery on the other
eye - demanded it really - TLC's doctors did not believe that any
additional surgery would improve Hanson's visual abilities and that
the slight possibility of an improvement was not worth the risk. It
was about this time that Hanson went ballistic.
Hanson has continued to state that TLC will not honor its "Lifetime
Commitment" for him. I am a very strong opponent of using terms like
lifetime commitment in marketing and believe it is not appropriate.
Nonetheless, Hanson was not a TLC patient when he had his surgery. The
controversial TLC lifetime commitment policy did not exist when Hanson
had surgery. Even if Hanson had had surgery at a TLC facility with a
TLC doctor when the lifetime commitment policy was active, Hanson
would not have qualified anyway. TLC's lifetime commitment policy has
never directly applied to Hanson, however that is not all of the
story.
One of the big problems with Hanson's situation is that the company
that owned the medical practice where he had surgery also had a
long-term commitment policy. It is not clear whether or not Mr.
Hanson qualified and was a recipient of the predecessor's long-term
commitment policy. When TLC acquired the practice chain, they applied
their own policy at their discretion. Patients assumed, and arguably
were led to believe, that the policy at the previous company would be
honored by the new owner: TLC. Yet another example that the
"lifetime" in these kinds of commitments is subject to interpretation.
Frankly, I think TLC brought this on themselves. There is no way you
can advertise a lifetime commitment then try to limit that commitment
when the patient comes through the door without trouble. Somebody
will take exception. When you muddy the waters with the takeover of
another practice with a similar policy, the problems are compounded.
It was inevitable that a Brent Hanson was going to happen.
Hanson then used SurgicalEyes' bulletin board and the board at Dr.
Horn's website to rant and rave about the perceived injustice. Of
course, he then ranted and raved at the perceived injustices
perpetuated on him by SurgicalEyes and Dr. Horn.
Hanson created an anti-refractive surgery, anti-TLC website then
proceeded to secure several website addresses using the names of TLC
executives. Things like www.davideldridge.com would have railing
against the former TLC Executive Vice President for clinical affairs.
Eventually, TLC successfully gained control of the
offending websites.
BTW, Dr. Eldridge is a former CRSQA trustee, so consider the perceived
bias.
In my opinion, the saddest part about Mr. Hanson's history is that by
taking aim at TLC, the more important story of his medical situation
became lost. Of course, Hanson's doctor was gone and only TLC
remained to be blamed, but for refractive surgery candidates who are
considering LASIK, there is little that they will learn from Hanson's
rhetoric that can be applied to their circumstances - other than TLC
and LASIK have enemies.
If you read between the anti-TLC lines, you will see that in 1996
Hanson should never have had refractive surgery. He was a marginal
candidate with the techniques and technology at that time. So
marginal, in fact, that instead of having surgery in his native
Dallas, he had to have surgery outside the US in Canada. By having
the surgery miles away and in a foreign country, Hanson's options when
things went bad were limited. The transportation costs to Canada for
additional treatment were the patient's responsibility. Legal
recourse was severely limited. An American citizen suing for medical
malpractice in Canada is not a very good scenario for the patient.
Even though the medical practice chain had a branch near Hanson's
Texas home, it was the practice that decided where he would get
follow-up care.
In late 2000, Hanson was required to have a corneal transplant in one
eye. Anyone who has had a corneal transplant will be quick to tell
you it does not immediately restore vision. Recovery is very slow and
not often equal to vision on a virgin cornea. Whether or not
additional treatment can help his other eye is a matter of conjecture.
Hanson may seem to be a pain in the posterior on these newsgroups, but
he clearly didn't start this process with that intent. Like every
refractive surgery candidate then and today, he just wanted life
without glasses or contacts. Unfortunately, he received poor care an
environment that spun out of control.
Although Mr. Hanson's situation is one of an extreme, someone
considering refractive surgery should not think that parts and pieces
of what happened to Hanson couldn't happen to them. LASIK Candidates
today are subject to many of the same problems that Hanson faced six
years ago. Technology and techniques have limits, even if those
limits are wider than when Hanson had surgery. Doctors' abilities
vary greatly. Going a long distance from home for care is probably
not wise and presents a major problem if something goes wrong.
"Commitments" are only as good as the willingness and ability of the
company who professes to provide them and will last only as long as
that company desires to provide it. International surgery is subject
to laws and circumstances that are not always to the benefit of the
patient.
It is amazing to me that even with all of the potential that can go
wrong, 97% of patients are still happy with their refractive surgery
outcome.
Hanson attacks me personally and the organization I represent often
and I don't like it one bit. He uses tactics that are often
repugnant. That does not mean, however, that he does not deserve our
empathy as someone who has been put through the wringer. Even if the
messenger is distasteful, the message is important.
HANSON SUED CRSQA FOR LIBEL, AND LOST
In 2003 Hanson sued me for libel, claiming about $2,800 in damages.
Apparently even he recognizes the limit of the value of his
credibility. His meritless claim didn't last longer than our first
motion to dismiss.
Hanson has said publicly that he is going to re-initiate a libel suite
against me, but over two years have passed and nothing has happened
except Hanson making noise.
LAST POINT
I really, honestly, and truthfully hope that anyone and everyone who
considers Brent Hanson or Ariel Berschadsky as a reliable source of
information about refractive surgery issues does NOT seek the care of
a CRSQA Certified Refractive Surgeon...or any other surgeon, for that
matter.
Glenn Hagele
Executive Director
USAEyes.org
"Consider and Choose With Confidence"
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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