Letters

Recent Editorial Touches on a Pervasive Issue in Ophthalmology

To the editor:

Thank you for the recent editorial "What we owe our patients" by Larry Patterson, M.D. [Viewpoint, October 2007]. Unfortunately, Dr. Patterson's experiences are far from unique. Not a week goes by when I don't see several patients coming in for second opinions regarding their upcoming cataract surgeries scheduled to be done elsewhere, having been told, "You really need to get your cataract taken care of as soon as possible before it gets any worse," although I cannot elicit any significant handicap. Nine times out of 10, the patient was to have surgery at one of area "mega" cataract mills, where surgeons do 20 to 30 cases in a day, with most of the patients being referred by area optometrists.

The real reason for most of this is comanagment, and in my opinion, this practice is the worst thing that has happened to our profession in my lifetime. This form of legalized fee splitting has created gigantic referral networks that have corrupted many of our colleagues and compromised what is in the best interests of our patients for a busier surgical schedule. Too many of us have sacrificed ethics in exchange for referrals. I, for one, will never succumb to this philosophy of greed. I will, at least, go to sleep at night knowing that I did only what was in my patients' best interest.