EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
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E W MEETING REPORTER March 2014 1 59 concept in research ethics that states that researchers should have the welfare of the research participant as a goal of any clinical trial." "We all think in terms of effectiveness in how we measure success," Dr. Donnenfeld said. However, in today's society, you also have to consider cost effectiveness. Some- thing much less costly and almost as effective is considered as benefi- cence, too, and you have to take t hat into account. The discussion shifted to stan- dard of care, and Dr. Banja said that although this evolves, it does not necessarily do so in a clean and logical way. Standard of care is also influenced by socioeconomics and technology, he said. Another discussion centered a round prescribing drugs and insur- ance, which is getting more expen- sive. "Be sensitive to what is covered by insurance in your area, and be sensitive to the pocketbook of the patient," Dr. Donnenfeld said, adding that when he prescribes a name-brand medication, he also gives the patient a back-up generic choice. In those cases, he provides a handout with the correct dosages of each. Too much time was being spent going back and forth with patients and pharmacies because of costs, he said. "Everything is listed for them, and it eliminated the callbacks and solves these time problems," Dr. Donnenfeld said. Dr. Banja said that some of the patients' anger at insurance coverage should be directed at themselves. "In a lot of instances, patients could purchase a more generous plan, but didn't," he said. "They bought a jalopy Ford plan, but expect Cadillac benefits." Dr. Donnenfeld said many employers have switched to high deductible plans, which means people are paying much more out of their own pockets. "The good side is people now know what they are paying for," he said. Dr. Donnenfeld addressed working with optometrists, instead of against them. "The most ethical thing to do is what's in the patient's best interest," he said. Dr. Donnenfeld is in favor of allowing certain optometrists to come to the ASCRS•ASOA Symposium & Con- g ress, especially those who work in a practice with ophthalmologists. "If you give someone the ability to treat your patients, you're morally obliged to make sure they have the best training possible," he said. The panelists agreed that because of ophthalmologists' deep medical t raining, optometrists wouldn't be the best choice to perform surgery. Still, they said working with op- tometrists is in everyone's best interest. "We need to have a more collegial relationship," Dr. Donnenfeld said. "I call them my partners—I say they work with me, n ot for me." E W Editors' note: The speakers have no financial interests related to their presentations. Roger Steinert, MD Nancey McCann Brock Bakewell, MD Robert Osher, MD 149-159 MR WU2014_EW March 2014-DL2_Layout 1 3/6/14 4:22 PM Page 159