Revenge of the greedy opthalmologist...................

[Chris Ryser]

Revenge of the greedy opthalmologist...................A true story that happened this week

Place:
One of the fancy ophthalmic clinics in North Naples Florida, no names mentioned.

Patient:
Chris Ryser, Canadian citizen belonging to Canadian medicare system, getting paid medical services at home. Snowbird spending winter in Naples.

Reason for visit:
Advisory by State of Florida that Florida drivers license will expire at end of January. Canadian Snowbirds have always been granted the right to have a Florida drivers license without having to give up their Canadian one.

As patient.........myself............... has a not fully developed cataract in my left amblyopic eye that originated by an arthritic inflammation some 20 years ago, will not pass visual test at drivers license bureau, a medical attest is required. This procedure has been done several times over the last 15 years.

Actual Story, (and I have been a guy that has been around this profession all my life)

After checking in, filling the papers with all the medical information why your body starts falling apart, I got called up by a nice girl in the clinics uniform who gave me her first name.

We went into the first examination room with the autorefractor and the "puff puff eye pressure gage" that had a hard time finding my eyeballs automatically and was restarted about 5 times.

Then on to one of the 40 exmination rooms equipped with a phoroptor and a slit lamp. The phoroptor changed lenses 3 times for each eye. Took about 60 seconds total.............no reading test was performed. A 30 second look through the slit lamp at each eye and we were finished, (about 7 minutes total examination time) and I got guided into the Ophthalmologists examination room.

Doctor checks record and snaps at me that he had told me 2 years ago to have the cataract removed. He does not know that we have a backlog of 7800 catarct cases waiting in Montreal and doctors taking every 3rd month off because of salary caps by the Quebec government.

He tells me to have it done here ..............and at my counter question for how much, he says he does not know. I should ask the surgery coordinater out front. Then he dilates the pupils does slit lamp test and some indirect opthalmoscopy and we are done. I then get guided into the office of the surgery coordinater, a nice older women.

She wants to book me for next Tuesday morning..................and I put a stop to it by asking.........."what do you charge anyhow?"

She takes a clinics business card and marks on it $ 4950 and if you do both (not need, other eye is fine} $ 9750.00. I said I have to think about and will call you.

On the way out you have to pay, the bill was $ 145.00 , but there was no RX and no letter for the reason of the visit, stating my right eye was OK to drive.

After a lot of arguments the doctor, no more visible, produced the sealed letter for the license office.

I left the clinic swearing never to return there and drove to the license office where they opened the doctors letter. The employee behind the counter took the letter and consulted another person in a back office. Then came back and said that the opthalmologist had suggested that I should re-do the drivers test and they had to follow the order.

Having been rated as a safe driver for all these years I felt insulted, but did choose to take the test right then and there under threat of loosing the Florida and Quebec license if I would not pass.

30 minutes later the Inspector taking me for the test said, "YOU PASSED",
plus, "you are a heck of a better driver than me."

Morale of this story:

Never say NO to an opthalmologist if he wants to operate you for $ 5000, or better............... on both sides for double.................or you might loose your drivers license and privileges in the great State of Florida.

:hammer: :finger: :hammer: :angry:

[chip anderson]

Welcome to our new improved system of commercial medicine. After all you do know that a spectacle Rx is no longer concidered part of "a complete eye exam." That would probably have cost you between $100.00 and $200.00 more and you would probably had to have had it filled there. What really matters is the bottom line. And you do know that most cataract surgery cost at least 15 min. per eye of the the doctor's time. Shurely that's worth five grand.

Chip

The other side of the coin is, I just had a complete exam myself with included with about 30 min of the doctor's time, spectacle Rx, dilated exam, indirect opthalmscopy, slit-lamp, puff and direct pressure, etc. No charge for exam, good bit of friendly exchange, I did have to fill out enough paper to have applied for a job at the CIA before the exam.

[fjpod]

Chris,

Sorry about your terrible experience in our healthcare delivery sytem.

I hope you don't mind if I discuss your bad experience, but while I was reading your post, I couldn't help but think why someone would go to a surgical practice for something like a DMV form. Even if your intent was to get a good routine check-up, there are better ways to do it. In theory, you should be able to do this without being taken advantage of, but unfortunately, as Chip said, medical practice here has been totally commercialized.

I know you think I am pro-optometry and I know old habits die hard, but your experience is emblematic of a need for change in the thinking of the consumer. The type of care that you were looking for would have better been obtained by a primary provider of eyecare, not a surgical practice. I'm not condemning them necesarily, but ophthalmologists position themselves as full scope eyecare providers nowadays...from surgery to routine exams to dispensing. While they can be this, most are really trying to be the gatekeeper to shepard patients along to surgery, and some, like the one you were unfortunate enough to select, are just plain greedy.

Next time you need an exam and you are in the NYC area, send me a PM, and we will give you one for free to make it up to you. Seriously.

fjpod

[Fezz]

I agree with fjpod on this one. I have heard this type of story over and over again. We are always getting comments at our office, from patients who previously were ophthalmology devotees, about how thorough or exams are. It is a real shame. Sorry you had to go thru it.

Sidenote: Does the Florida State Driver dept. require an exam and signed form by an ophthalmologist and only an ophthalmologist?

[akeroptical]

Fezz,

No the DMV form can be filled out by an OD as well. I have also heard of similar experiences with MD's in Florida.

[Chris Ryser]

Sidenote: Does the Florida State Driver dept. require an exam and signed form by an ophthalmologist and only an ophthalmologist?

Fezz,.................. actually it does not, they accept Florida residing optometrst's statements as well.

However that would bring me to the original story which I did not talk about.......how I got to go to that eye clinic.

Here it goes .............when I bought my first condo 20 years ago I learned that having a Florida drivers license is a good piece of identity to have and they would just give it to you by showing your Candian license plus passing the eye test, and it would then be valid for 7 years. (Now valid for only for 12 month).

So I went and of course failed the visual test because of my bad binocular vision. Went to the optometrist around the corner next to K-Mart (both are not there anymore), explained my case and also told him that I owned an optical company, had studied optometry some long time ago, and was promised a discount. He did a good job and gave me 25% discount and I had my paper. When at the driver license office I found out that he had marked that I should go back within one year, So they gave me a license valid 1 year instead of 7.

One year later the notice came to re-apply for a new licenses again withan eye specialists paper. So I went back to the same optometrist who then ..............started out by giving me a visual field test on a brand new Zeiss instrument he had just received. Following that he did all the regular tests and gave me the paper plus a charge of a straight $ 300.00 .

At the license office I find out that he had given them another limit of 12 month. Envelopes have to be remitted un-opened so I could not check.

That was the end of my admiration of the optometrist around the corner.

When the next 12 month were over I found the eye clinic which was heavily recommended. Went through the testing, then got seen by a young female opthalmologist (since then moved on), who said I had the start of a cataract and should have taken care of it in a few years, gave me a paper giving me the regular 7 years of license validation. The charge was $85 in the year 2000.

Thats how I ended up in that eye clinic..............

[AWTECH]

Chris Ryser said:

Went through the testing, then got seen by a young female opthalmologist (since then moved on), who said I had the start of a cataract and should have taken care of it in a few years, gave me a paper giving me the regular 7 years of license validation. The charge was $85 in the year 2000.

Sounds like the Opthalmologist who moved on was interested in realisticly solving the total problem. The new Opthalmologist was only interested in maximizing short term gain. (Patient satisfaction was not considered)

I would consider this a misuse of a medical license with an attempt to punish the patient for not spending enough with the practice.

Today many businesses, medical professionals and others are only focused on short term gain. Long term gain requires doing a good job for the customer, even if it does not produce the most money today. If you do this over the long term you have a satisfied customer who will continue to provide revenue, and they are your best form of advertising.

Chris is not a very good ad for this Eye Clinic. He could have been an excellent ad for the Clinic with his friends in south Florida. His friends know he has been in the optical business all of his life, what better person to have as a reference. A good example of short term focus by a Medical practice.

[MarcE]

Chris Ryser said:

Sounds like the Opthalmologist who moved on was interested in realisticly solving the total problem. The new Opthalmologist was only interested in maximizing short term gain. (Patient satisfaction was not considered)

I would consider this a misuse of a medical license with an attempt to punish the patient for not spending enough with the practice.

Today many businesses, medical professionals and others are only focused on short term gain. Long term gain requires doing a good job for the customer, even if it does not produce the most money today. If you do this over the long term you have a satisfied customer who will continue to provide revenue, and they are your best form of advertising.

Chris is not a very good ad for this Eye Clinic. He could have been an excellent ad for the Clinic with his friends in south Florida. His friends know he has been in the optical business all of his life, what better person to have as a reference. A good example of short term focus by a Medical practice.

Why focus on long term patient satisfaction if you are a surgeon. There are only 2 cataracts to remove per patient. If you got em in the chair, get them out NOW, before the patient has a chance to think about it or get a 2nd opinion.

Sorry about your bad experience w/ the MD. The reason I don't think patients should refer themselves to an OMD is because they are NOT primary care physicians. They are speciallists - and specialists expect to make over $1000/hr to focus on a specific problem. They need a referral from a primary care physician or else they will do a complete work-up and charge you for a 99XX5 exam. Even though you only had a 7min exam - I bet he documentated 13 systems reviewed.

Our OD, and every other one in our county that I am familiar with probably still would have chastised you for not getting the cataract removed. But even so, for $70-85 you would have spent 15 minutes w/ the tech and 15 w/ the OD and left with a signed DMV form and a new Rx.

[Ory]

Our OD, and every other one in our county that I am familiar with probably still would have chastised you for not getting the cataract removed. But even so, for $70-85 you would have spent 15 minutes w/ the tech and 15 w/ the OD and left with a signed DMV form and a new Rx.

not fully developed cataract in my left amblyopic eye that originated by an arthritic inflammation some 20 years ago

No one should be chastised for ignoring a 20 year old cataract in a poorly seeing eye. This OMD did not have Chris' best interests at heart.

[For-Life]

Canadian health-care will remove Chris' cataracts when deemed ripe at no charge. Before that they will not remove them.

If Chris desires to go to a private clinic in Canada the Canadian government (or at least Ontario) will remove them as part the cost and Chris would pay the less. Nonetheless it would be considerably less than $10,000.

[npdr]

Chris,

I'm taking a bit of an alternative view. Curious. Why do you think you deserve a longer extension?

[gemstone]

One year later the notice came to re-apply for a new licenses again withan eye specialists paper. So I went back to the same optometrist who then ..............started out by giving me a visual field test on a brand new Zeiss instrument he had just received. Following that he did all the regular tests and gave me the paper plus a charge of a straight $ 300.00 .

At the license office I find out that he had given them another limit of 12 month. Envelopes have to be remitted un-opened so I could not check.

The charge was $85 in the year 2000.

..........

$385 a year for a drivers license? I think I'd have to take my chances. I bet a lot of people have no choice.

[For-Life]

Also sounds to me that *a few people are trying to capitalize on the snowbird situation.

[Chris Ryser]

I'm taking a bit of an alternative view. Curious. Why do you think you deserve a longer extension?

Good question..............................up to 2004 the normal time span for a Florida drivers license was 7 years.

Then they changed it for 2 years and now I just learned that it is 12 month until renewal, at least for aliens...........and I am one of them.

What I did not like was having to take the drivers license on the order of the doctor. I passed with flying colors but just the idea of what he tried to do is actually disgusting.

[Fezz]

just the idea of what he tried to do is actually disgusting.

More and more, I see the decline of morals in many things. When you step out and look at a bigger picture, it is truly very, very sad.

[LKahn]

Chris

Part of the rules change relate to post 9-11 paranoia and an effort to actually have a government agency meet each alien in person. The issue is not the driver. The issue is a photo id issued by a government agency. This is a big deal at DHS, Department of Homeland Security. As of Jan 1, 2007 US citizens need to use a passport for Mexico and Canada in a number of situations. I use to cross back and forth to Canada with just a driver license or sometimes an airline ticket. The system is nuts.

Before you go back North to Montreal we should have lunch. I can run down to Naples.

Best Regards

[gemstone]

More and more, I see the decline of morals in many things. When you step out and look at a bigger picture, it is truly very, very sad.

I knew a lady. She was a solid worker. Showed up every day, always had the best interest of the office in mind. The kind of worker you'd love to find. She got incremental pay increases along the way, always at thedecresion of the boss. This just finally made her a target when they "downsized". They did not actually uliminate her position. They just hired someone for less $$ and stopped providing benefits for the new hires. It wWAS an ophthalmoligst office. I sure hope he makes a lot of money.. The problem with this type of conduct is it takes away incentive for the employee to prosper.

[Jacqui]

I think ophthalmoligsts should have thier eyes examined. Most seem to be terribly myopic.

[chip anderson]

This kind of reminds me of a patient of mine, a gastorinterologist herself, who went in to an opththalmologist seeking and exam and spectacle Rx in Texas. Said the doctor spent 45 min trying to sell her on refractive surgery to the point, she had to tell him to shut up and get on with the exam.

Another patient contact lens patient of mine in Chris's area of Florida I tried tried to find an ethical (One who would give her an Rx and exam to return to us) ophthalmologist for. I even wrote Duane Broe who is a past president of CLSA (who did not even reply) asking if he knew someone.

Was unable to find such an animal in the area.

Chip

[gemstone]

This kind of reminds me of a patient of mine, a gastorinterologist herself, who went in to an opththalmologist seeking and exam and spectacle Rx in Texas. Said the doctor spent 45 min trying to sell her on refractive surgery to the point, she had to tell him to shut up and get on with the exam.

Another patient contact lens patient of mine in Chris's area of Florida I tried tried to find an ethical (One who would give her an Rx and exam to return to us) ophthalmologist for. I even wrote Duane Broe who is a past president of CLSA (who did not even reply) asking if he knew someone.

Was unable to find such an animal in the area.

Chip

Then there is this.
http://www.lasikmemorial.com/

[Johns]

Gemstone:

Interesting website...

[Jacqui]

Gemstone:

Interesting website...

Very interesting

[DocInChina]

Chris,
Next time you need an exam and you are in the NYC area, send me a PM, and we will give you one for free to make it up to you. Seriously.fjpod

Next time you are in China, send me a PM and we will give you a free one, too! I'll throw in a big, Chinese dinner too.

Doc

[Chris Ryser]

Thank you all for the comments. This thread should maybe continued a bit longer as it touches very much on the question of medical ethics versus greed................and there could probably at lot more similar cases or worse ones...............

I was only convicted to do an unnecessary driving test for not coughing up 5 grand while back home I can get it included in my medicare.

[k12311997]

He does not know that we have a backlog of 7800 catarct cases waiting in Montreal and doctors taking every 3rd month off because of salary caps by the Quebec government.

Chris sorry about your experience and not to hijack the thread but I had to pull this quote out of your story. I agree that the M.D. in your story is a greedy S.O.B., but socialized medicine is not the way to go. generic dr. " your cataract is ripe and your BVA is 20/80 the government will take care of you." generic pt "great when can I have it done" generic dr. " the wait is 18 months" generic pt