Eyeworld

EW NEWS & OPINION April 2015 15 Editors' note: Dr. Noreika has practiced ophthalmology in Medina, Ohio, since 1983. He has been a member of ASCRS for more than 30 years. precise size optimizing quality, value and patient satisfaction. The history of central planning does not instill confidence. Buttressing common sense with mathematics, Mr. Ellenberg's book examines the irrationality of gambling, specifically lotteries. He extends his analysis to owning a small business. Conceding the two aren't identical because business owners have some control over destiny whereas the gambler is ruled by fortune's wheel, he maintains, "for most people, opening a business is a bad bet." Failure is the rule, and if successful, eking out a living is far more likely than yacht club pros- perity. Doctors joining big delivery systems may intuitively get this. But owning a practice is far more than the metrics of economic success and failure. Intangibilities of ownership resonate within the physician-entre- preneur. It's your baby; you're more likely to work harder and longer to satisfy the needs of your patients, pay wages and taxes, and take some- thing home. Private practice won't perish. Some generalists have already reject- ed the corporate yoke by joining the concierge practice movement. The rare eye surgeon does not participate in insurance plans. Physicians are self-selected to be smart, analyti- cal. The most innovative will leap through the window of opportunity that transformation opens. Even the most illustrious examples of Big Medicine are doomed to regress to the mean. Government can tempo- rarily provide economic "luck" but regression can't be avoided; therein lies the opportunity. Can quality and cost in health- care be meaningfully correlated? It depends on how the government chooses to define the terms. Woody Allen observed, "more than any oth- er time in history, mankind faces a crossroads. One path leads to despair and utter hopelessness. The other, to total extinction. Let us pray we have the wisdom to choose correctly." As the ASCRS reconvenes, I believe ophthalmologists will elect wisely. Just avoid linear thinking. EW References Burwell. Setting Value-Based Payment Goals – HHS Efforts to Improve U.S. Healthcare. NEJM, January 29, 2015; pp. 1–3. Ellenberg J. How Not To Be Wrong: The Power of Mathematical Thinking. The Penguin Press, NY; 2014. NEJM, January 29, 2015; p 2. The specialists in single-use. www.malosa.com • LASIK / LASEK / ReLEx / PRK • Phaco • Oculoplastics • IVT • Strabismus • Sub-Tenons ... "Malosa's single-use instruments and procedure packs provide optimal patient safety and brand new, flawless instruments for every eye." Prof. Dan Z Reinstein, MD MA(Cantab) FRCSC DABO FRCOphth FEBO - The London Vision Clinic • Brand new instruments, every time. • Zero cross-contamination risk. • Increased patient throughput. View our online brochure. Complete range of Instruments and Procedure Packs for all Ophthalmic specialties. Over 350 Instruments & 400 Packs for all specialties. Contact information Noreika: JCNMD@aol.com

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