Eyeworld

ASCRS responds to the Wall Street Journal EW NEWS & OPINION 14 September 2011 for a precisely sized CCC for a perfectly centered CCC Capsulorrhexis rrXXXLBUFOBDPN ™ K5-5071 Utrata, straight K5-5074 et, Mask aulted vaulted gure 1 ne two introduces Katena used be can which surfaces used is and tip the from (gure tip the from 5.0mm landmar with forceps rhexis capsulor w ne . y capsulotom 5.0mm a gauge to used while 1), (gure radius the measure to used the measure to used be can 2) (gure anterior the on ks landmar 2.5mm is line st r The at line second the while the of diameter verall o gure 2 gure 1 (gure tip triangular delicate The rhexis. ell as to grasp the tag during the procedure. capsular tear as w or a perf f 2) used be can forceps the of tips triangular ell as to grasp the tag during the procedure. ectly or a perf ed center centered initial the create to used ell as to grasp the tag during the procedure. ed CCC circular centered perfectly A tips the aligning y b created is k mar circular K3-7850 ellen Capsulor K K3-7852 ellen Capsulor K king non-mar four of tips 6.0mm , er k rhexis Mar ellen Capsulor 5.5mm , er k rhexis Mar ellen Capsulor agement, and the Georgia Hospital Association. He is a former board member of the Commission for Case Manager Certification. His current research interests include the study of empathy in healthcare relation- ships and analyzing ethical dilem- mas occurring in clinical and translational research environments. His most recent book, Medical Errors and Medical Narcissism, was pub- lished by Jones and Bartlett Publish- ers in 2005. EW ABOUT THE AUTHOR John Ciccone is director of communications for the American Society of Cataract & Refractive Surgery. Contact him at 703-591-2220. ASCRS continued from page 13 Edward J. Holland, M.D., ASCRS President says WSJ got it wrong. Here's why. O n August 11, the Wall Street Journal ran the arti- cle, "Three Simple Ways Medicare Can Save Money," by John Good- man. Regarding physician reimburse- ment, Mr. Goodman wrote that Medicare has a list of 7,500 tasks that it pays physicians to perform and that Medicare sometimes gets it wrong as to the valuation of a par- ticular service provided by a physi- cian and cited the following as an example: "A post at the Health Affairs blog compares a 25-minute office visit with a primary care physician (PCP) to a 10-15 minute cataract re- moval by an ophthalmologist. The authors note that in examining symptoms such as a persistent cough, the PCP must draw on the whole of medicine in order to diag- nose the condition and treat the pa- tient. By contrast, cataract removal is a 50-year-old procedure, and many of the doctors who do it oper- ate in assembly-line fashion de- signed to maximize their income. This year, Medicare is paying $111.36 for the PCP visit. The oph- thalmologist, meanwhile, is raking in $836.36 (including the patient co- payment). Medicare is paying 7.5 times more for cataract removal than for a primary care visit. If we measure according to the time spent to earn the fee, Medicare is paying the ophthalmologist 15 times what it pays the PCP. Is there any wonder why the shortage of primary care is reaching crisis proportions in many parts of the country, while cataract removal is available at the drop of a hat?" Mr. Goodman's article can be found at: http://professional.wsj. com. Edward J. Holland, M.D., ASCRS President, responded by say- ing that Mr. Goodman's case was overly simplistic and that the cataract surgery example was simply wrong. "Reimbursement for medical procedures under Medicare (CPT codes) is determined by the Re- source-Based Relative Value Scale (RBRVS). These values are reviewed every 5 years by the American Med- ical Association/Specialty RVS Up- date Committee, commonly referred to as 'RUC.' Its recommendations for Medicare values are based on surveys and extensive analysis of work, which is based on time and inten- sity, practice expense, and malprac- tice relative to all codes. These are all

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