Ophthalmology Business

DEC 2012

Ophthalmology Business is focused on business topics relevant to the entrepreneurial ophthalmologist. It offers editorial, opinion, and practical tips for physicians running an ophthalmic practice. It is a companion publication of EyeWorld.

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Informed consent and the ophthalmologic marketplace by John Banja, Ph.D. O n a Sunday morning a few years ago I was sitting in a terminal at the Orlando airport waiting for a flight back to Atlanta. A Sunday newspaper was lying nearby, and I picked it up and began glancing through the pages. They say that Florida is an ophthalmologist's and urologist's paradise, and I recall being struck by the numerous, occasionally "brassy," ophthalmology ads. Now, I not only have nothing against physicians' advertising, but I believe physicians did themselves a disservice for decades by discouraging advertising. After all, advertising is a form of consumer education, 8 and someone's knowing about the existence of a particular physician practice can make an enormous difference in the quality of his or her life. The fundamental ethical concern regarding physician advertising is that such ads must be reasonably truthful and professional so as not to compromise the integrity of medicine and its practitioners. But what I took away from those ads was the extent to which certain kinds of ophthalmology services, especially anterior eye procedures like premium lens implants and LASIK, seemed to lend themselves almost naturally to the "marketplace." Perhaps this is not only because the cost of these services can be projected much more accurately Ophthalmology Business • December 2012 than other kinds of surgeries, but that payers understand LASIK and premium lenses as cosmetic interventions whose costs should be borne by buyers. Spectacles are the least costly remedy for correcting vision, so that if patients want something else for largely aesthetic reasons, they should pay out of pocket. Possibly then, the fundamental intuition that consigns certain anterior eye services to the marketplace is that one can argue that they are in the same category as rhinoplasties, Botox, and face lifts. If that's right, however, then informed consent becomes a strategic, and not just an ethical, feature in these marketplace arrangements. continued on page 10

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