Surgeon-patient relationship: LASIK

Lamont Ericson, M.D.

by Lamont Ericson, M.D. | August 16, 2010 @ 02:00PM

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Generally, I don't think discussing medical nightmares is good for public forums. I am uncomfortable with sensationalism of another person's pain. I make an exception in this case for two reasons: 1.) I think the woman to whom this happened was genuinely unaware of the risks she was taking, and 2.) This sort of thing will become more frequent if we don't increase public awareness. I am speaking about "discount eye surgery" mishaps.

The patient I am discussing is a young mother who was presented to the Davis Hospital emergency room on a Saturday night in severe pain. She had recently undyaergone LASIK eye surgery in a foreign country the previous Thursday. She had researched this non-US based company and felt it was reputable. A day following her surgery, she had a surgical complication that required additional surgical intervention. Nevertheless, she flew home to Utah.

She awoke the next day in severe pain and saw the optometrist who was co-managing her care for this laser company. He was uncomfortable managing the complication he saw, and tried to refer her to several ophthalmologists who were unfortunately "out of town." She was refused care by another ophthalmologist in Ogden because of the liability risk involved in treating a patient who had surgery across national borders. Her optometrist gave her anti-inflammatory drops and hoped she would be doing better in the morning. Her pain drove her into the emergency room that night.

It was in the emergency room that I saw her, and found that she had a strep infection of the cornea that was causing the cornea to melt. I have tried for a week to reverse this process without enough success. She is in severe enough pain to require morphine three times a day. She will never see well out of this eye. Most of the problems could have been salvaged by early intervention by someone trained to deal with surgical complications. Despite the "quality" of this discount laser company, they cannot care for their patients from a thousand miles away.

If my profession has been so successful at marketing that they have convinced you that laser eye surgery is not surgery, then shame on us. If you have believed it, then shame on you. There is no such thing as "discount eye surgery." Profit margins in different companies are preserved in similar ways. You must either do high volume, pay less for your equipment, use less trained personnel, re-use equipment, or pay the surgeon less. On who would you wish to compromise?

There is no substitute for a surgeon-patient relationship. I implore you not to meet your surgeon for the first time on the operating table! I encourage you not to have to hunt for someone after your surgery that can or will manage your follow-up. I ask you to consider whether you truly believe that one company can do the "same" procedure for half or a third as much as a neighboring company and still maintain the same quality of care. Compromise five hundred dollars on something else. Your vision is forever. 

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