LASIK Marketing: Buyer Beware
"Is it not also true that no physician, in so far as he is a physician, considers or enjoins what is for the physician's interest, but that all seek the good of their patients? For we have agreed that a physician strictly so called, is a ruler of bodies, and not a maker of money, have we not?” -- Plato
Remember when the law prohibited doctors from advertising? The intent was to keep the profession pure, to ensure that healing was its foremost virtue. This is no longer true. LASIK represents a profound threat to the core values of medicine. Most LASIK patients with complications say that they were never adequately warned. This page looks at what happens when doctors become salesmen.
Doctors speak out against deceptive LASIK advertising:
Steve Arshinoff, MD: "I read the editorial on advertising in ophthalmology with great interest and wholehearted agreement. The seemingly progressive tendency to irresponsible advertising, particularly of laser in situ keratomileusis (LASIK), is becoming an embarrassment to all of us who wish to practice ethical medicine and do no harm to our patients." J Cataract Refract Surg. September 2004.
H. Dunbar Hoskins Jr., MD, American Academy of Ophthalmology Executive Vice President: "In medicine our role as professionals is to put the patient's interest ahead of our own. Professional societies have had ethical standards that underscore the importance of that principle. Historically this went unquestioned. It was a medical need that caused the patient to seek out the physician... Now this principle is being tested as we see increasing efforts to attract or even entice patients into practices. This is a continuation of an activity that began with cataract surgery some 10 years or so ago. It is the nature of a competitive marketplace. It also sends a strong message to the consumer: 'Let the buyer beware'." EyeNet Magagine, June 2000 Link to source
"Francis W. Price, MD: "It's a shame. I'll lay it all on the government and the lawyers. They gave doctors the right to advertise". EyeWorld, March 2001 Link to source
Hypocrisy
From the article: Dr. Lindstrom believes that it is also helpful for the surgeon to have undergone LASIK. “I think it’s an advantage for the physician to have undergone LASIK. I personally haven’t had LASIK, but every one of my partners who is myopic has had it done. I tell patients that I’ve performed LASIK on several of my partners and my family members, and I think it helps a lot,” he says.
While it may be ideal for a LASIK coordinator to have undergone LASIK, Drs. Lindstrom and McDonald agree that it is not imperative. It is crucial, however, for the LASIK coordinator to never wear glasses while at work. “They can wear contacts, but they can’t wear glasses. If they wear glasses, all the explaining in the world about why they are not candidates for LASIK is not going to make a difference,” Dr. McDonald says.
That's a big reason why Weiss, the glasses-wearing ophthalmologist, won't get Lasik even though she offers it to her patients. "I can read without my glasses and . . . operate without my glasses, and I love that," she said. "The second aspect is I would not tolerate any risk for myself. . . . Does that mean Lasik is good or not good? It means Lasik is good but not for everyone."
Shameful scare tactics
Doctor implies LASIK is safer than contact lenses...
From the article: “Many people who wear contact lenses have complications and infections,” said ophthalmologist Joseph Feder, M.D., of Aurora Health Care. “There are many options for people with these problems. This event will focus on LASIK, one of the treatment options.”
'Money Over Medicine' Mentality
The following comments sound like used car salesmen. Perhaps Dr. McDonald doesn't understand that you can't "trade-in" your LASIK-damaged eyes for a new pair in a couple of years.
Marguerite McDonald, MD: "Sometimes, listeners then ask me if they should wait for the next procedure. My favorite response involves an analogy to a car. I explain that they are hardly likely to wait 10 years to buy an automobile, because the currently available models function beautifully." Cataract & Refractive Surgery Today, May 2007
Michael W. Malley, LASIK Marketing Consultant: "Discussing long-term post-LASIK visual needs with a patient is probably not a good idea BEFORE they have the procedure." Ophthalmology Management, February 2007
Kay Coulson, LASIK Marketing Consultant: "Recommend what the patient should do. If a refractive counselor cannot commit to a patient that they are a candidate without having the surgeon review the chart, you have not set LASIK criteria appropriately for your staff. If you present patients with a full-distance vision vs. monovision LASIK option and send them home to think about it, you have lost the patient. The same for advanced surface ablation vs. phakic. Reason through the options silently while examining the patient and reviewing test results, but make sure that patient is very clear about what you recommend and aim to schedule the surgery at the time of consultation". Ophthalmology Management, November 2007
Shareef Mahdavi, LASIK Marketing Consultant: "What is interesting about the Baby Boomers is that they are now between the ages of 42 and 60. They are going to develop presbyopia and they are going to develop cataracts for the most part, and that is good news." OCULAR SURGERY NEWS U.S. EDITION September 15, 2006
FDA warns about 'slick' LASIK ads: If it sounds too good to be true...
"Be wary of eye centers that advertise, '20/20 vision or your money back' or 'package deals.' There are never any guarantees in medicine… Be cautious about 'slick' advertising and/or deals that sound 'too good to be true.' Remember, they usually are. There is a lot of competition resulting in a great deal of advertising and bidding for your business. Do your homework."
Deceptive LASIK advertising
Douglas D. Koch, MD:
"Ads imply that the result will be perfect, permanent, and/or complication free. Examples include "20/20 for $2995" or "20/20 promise" or "quick and pain-free way to eliminate your need for corrective lenses."... "In my view, an even more repugnant approach is the "money back guarantee." This implies that the procedure is somehow reversible and that there are no potential risks of sight-threatening or sight-disturbing complications. Getting one's money back does not make up for a lifetime of unhappiness about one's vision; it is not like returning a broken television... Primum no nocere: First do no harm. Do we practice medicine in the spirit of Hippocrates, or do we sell used cars?"
Source: Journal of Cataract & Refractive Surgery, August 2003
Refractive surgery advertising raising red flags in Washington
EyeWorld, August 2001
From the article: "With competition heating up in refractive surgery, more physicians and surgery centers are promoting themselves through advertising and marketing techniques that probably would have been anathema to the profession just a few years ago.
Physicians and other professionals have the legal right to advertise under U.S. law, but when they do, their advertising is just as subject to federal consumer protections as any other advertiser. What you don't know about the laws designed to protect consumers could hurt you if your ads are questioned.
Federal laws prohibit unfair or deceptive acts or practices in advertising, and false advertising of food, drugs, and services. The responsibility for enforcement of these laws as they apply to drugs and medical devices is shared by the Federal Trade Commission and the Food and Drug Administration.
According to FTC official Matthew Daynard, advertising is considered "deceptive" if it is likely to mislead "reasonable" consumers and if it is likely to affect consumers' conduct or decisions. A practice is "unfair" if it causes or is likely to cause injury to consumers that they could not reasonably avoid and that is not outweighed by the benefits."
FTC Guidance for advertising of LASIK and other forms of refractive surgery
An advertisement is deceptive under Section 5 of the FTC Act, and therefore unlawful, if it contains a representation or omission of fact that is likely to mislead consumers acting reasonably under the circumstances, and that representation or omission is material, that is, likely to affect a consumer's choice or use of a product or service. It is important to note that advertisers are responsible for claims that are reasonably implied from their advertisements, as well as claims that are expressly stated. These requirements apply to all objective claims, including those made through the use of consumer testimonials. In addition, under the FTC Act, advertisers must have substantiation for all objective claims about a product or service before the claims are disseminated. In the context of claims about the safety, efficacy, success or other benefits of RK, PRK, or LASIK, substantiation will usually require competent and reliable scientific evidence sufficient to support the claim that is made. Anecdotal evidence and consumer testimonials are not considered competent and reliable scientific evidence. Finally, under the FTC Act, deception can occur through omission of information when that information is necessary to prevent an affirmative representation from being misleading, or simply by remaining silent, if doing so constitutes an implied but false representation.