EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/78710
December 2011 EW NEWS & OPINION 25 surance or Medicare will pay, David Brigham, M.D., St. Louis, said he found it helpful when talking to patients to liken premium lenses to hearing aids or dental implants, both of which patients pay top dol- lar out-of-pocket to have. Most at- tendees agreed that patients are not shy when it comes to asking a physi- cian about costs associated with extra tests or premium lenses. Physi- cians, however, may come across as awkward or even unknowledgeable, especially since there are so many different kinds of insurance plans, and the physician often doesn't know the status of the network or the individual patient's co-pay or deductible structure. "Medicare and insurance make it really difficult to have these dis- cussions," said Jay Montgomery, M.D., Clinton, S.C. "We don't know what it's going to cost the patients a lot of the time. If we tell them what we charge, it may be way more than what the patients end up paying." Obviously, a physician needs to work with the patient to get the best outcome. That outcome, admittedly, might vary depending on the pa- tient's economic resources, but physicians shouldn't guess at their patients' financial capacity, accord- ing to several who spoke at the breakfast. The physician never knows what kinds of financial re- sources the patient might have, such as a family member who can absorb care costs. This leaves the physician free to make the best recommenda- tion for his or her patient on clinical grounds, so that financial considera- tions and how they might affect that clinical recommendation can be discussed and considered as the need arises. Surgeons also discussed the issue of geographical location and how it may pertain to discussions with pa- tients. Some physicians work in areas where the patients may have more money but also are very de- manding of their physicians. In other areas of the country, they said, patients may be happy wearing glasses, eliminating the need to dis- cuss premium lenses. What could be better? Breakfast attendees agreed that cer- tain features of the payment system in the U.S. are difficult to manage— for example, the differences in what 97 -989 9733-989-1600ÊU ÊÊ800-2255-1195 UÊ800-22 -1 1195 U www.katena.com ™ they charge and what they get paid. They discussed charging a flat fee for certain services, with one surgeon saying he often gives discounts to patients whose healthcare plans have changed causing them to be out-of-network. Regardless, patients "get" the value of a sight-saving procedure, said Leon C. Lahaye, M.D., Lafayette, La. "Good healthcare is expensive, but cataract surgery is the best buy in medicine," he tells patients. EW Editors' note: The doctors mentioned have no financial interests related to their comments. Fe Fechtner E X X- P R ES Marker echtner EX-PRESS SS ® M a r er K3-8977 Designed by Robert D. Fechtner, MD and Albert Khouri, MD of Newark, NJ r r r r r For exact device placement! arking U-shaped 2.75mm marking pattern delineates flap perimeter Ultra-thin lines for accurate traceability p perime ter urate Side marks indicate insertion site - even with flap lifted nserti on fted Produced in titanium for maximum durability fo r Handle set at 45º angle for proper approach and visibility gle for visibilit y EX-PRESS® is a registered trademark of Alcon® Alcon® Watch it!