Dr. Dello Russo speaks about Laser Eye Surgery on CNBC News (1995)
The beginning of patients' examination starts with preliminary test. This examination is done to determine refractive prescription and check if you have glaucoma. Corneal topography, or mapping of the natural contours of the eye, is also a very important pre-op examination procedure that allows Dr. Dello Russo to determine the quality of vision. This test is done on each eye. Dr. Dello Russo says the eye health is a crucial factor in deciding if you are a candidate for Lasik eye surgery.
Dr Dello Russo Discusses Special Promotions
Dr. Dello Russo is one of the selective eye surgeons who clinically tested the laser surgery on defective and diseased corneas which cause blindness. The doctor uses computer-guided laser to sculpt down the cornea to a more ideal shape. The procedure is done under local anesthetic, and there is no pain at all. Ninety five percent of Dr. Dello Russo's patients are able to do without glasses completely after one treatment.
A doctor’s view of Electronic Health Medical Records
Many doctors in practice for a number of decades have seen many innovations in technology as well as patterns of practice. Some of these new ideas evolve from the scientist/MD sector. Not all of these innovations have been successful and some were discarded.
When a non-scientist imagines that a new technology or patterns of medical practice will be ‘better, less expensive to medicine, improve patient care’, success is less likely, in my opinion.
When it comes to EHMR, or electronic health medical records, there has already been some success in its application in certain branches of medicine and medical facilities. I have seen it myself and have been very impressed.
What I do find objectionable is the government mandating that all doctors and medical facilities must adopt EHMR starting in 2011. That may be very unfortunate from many points of view. First, not all branches of medicine will be readably adaptable to EHMR.
I cannot imagine how my medical practice would function without our present computer system, but we started very early when Medical software was developed for eye doctors and have had to upgrade the software many times. In addition to bringing a new expense with each upgrade, the old records on the previous computer were not always transferable. We had to start anew with each computer upgrade for each patient in our practice. How will we know years from now if the computer system we may implement today will be able to be adaptable for upgrades?
The government is convinced that EHMR equals better patient care as well as saving a lot of money for the government and for insurance carriers. Incidentally, EHMR will allow the government to look over our shoulders when we deal with patients. I can't imagine any benefit to patient care or cost savings with the government looking over our shoulders. Yes, I probably will adapt the EHMR for my offices but I do not expect the government in the future to foot the bill for upgrades or that it will allow for any cost savings unless it helps government deny patient care.
I hope for the best but am prepared for less.
Charles Connor, OD, PhD reported recently that a small group of women, who were intolerant to contact lenses due to dry eyes, were treated with testosterone eye lid cream. The result was that 80 percent of these women were able to wear their contact longer than before the cream applications.
Dr .Connor concluded that "transdermal testosterone eyelid cream promotes tear production as well as oil glands production, which decreases dry eyes."
There are many causes and treatments for dry eyes. This is a new one and time will tell if the study is extended.
Dr. Dello Russo Discusses Obamacare and The Death Panels
Obamacare, "death panels", cost containment, adding 30 million new recipients to the system, denial of care, no incentive for new developments to benefit to diagnose and cure diseases of US citizens. This is Socialized Medicine.
As a laser eye surgeon I am writing this post that has not only medical practice implications but what some may consider political opinions. As a practicing doctor for nearly forty years I have witnessed enormous changes, especially in eye care. Dramatic changes have occurred in my field - in fact I have personally been involved in almost all the main advances over the last forty years - as an early adapter to new technology, setting examples for other doctors who observed the success of the new devices that I adopted, devices which always became the standard of care.
I make the above statements so as to demonstrate that I am very familiar with how new technologies are developed, become accepted and eventually available to the public. In addition to the desire to find cures to old diseases, the process is lengthy and costly. Obamacare will kill the free development of technologies which can become its own form of “death panel” - killing new innovations. Let me briefly explain how Obamacare will kill innovation, based on my years of association with dramatic innovations.
New treatment or diagnostic tools do not occur by accident like Pasteur and his Petri dish. Major innovations do NOT occur at universities, medical centers, and certainly not at government labs. Let me describe how it most often happens. It is the old American way: first, a new idea may occur in the mind of an AA type practical doctor/scientist. There are many ideas that occur for any disease, but maybe only one will actually work. How is the one idea put in play? First a lot of discussions with other AA type associates takes place, who will then try to design the first device to take in order to indicate the potential for the new concept or device. This step has often started in the proverbial garage, but eventually money has to be raised to take testing to the next level, so called "angel money", usually coming from the original researchers, their friends and other associates.
If the original research findings are encouraging, the next step will be to construct the first true model of the device so as to test it on animal tissue.. The next step is trying out on humans, probably severely diseased eyes of people who volunteer. The next step is to apply to the FDA for permission to hold tests on living humans with the active disease that the device is supposed to cure. There are phase one, two and three. After all the tests are complete and the results evaluated by the now start-up company, it may take six to twelve months for the FDA to decide if it is safe and effective in treating the public (most research fails.)
The above is an abbreviated version of how new "discoveries" occur - not at universities or medical centers and not at government centers. This process takes maybe as long as ten years to get an application to people with the disease approved. It requires millions and millions of dollars from investors (not the government) who know that their money may never return to them, no less with a profit.. There is absolutely no guarantee over those ten years that the research will be successful. .This is the all American way of the free market entrepreneurial system by which we have developed ALL of the major innovations in medicine over the past forty years, as I have observed in eye care.
As altruistic as the researchers are, they need money to conduct the research and the investors deserve a profit from the very risky investment that they have made, since so few research projects succeed. What am I getting at? If there is no payoff for all the work done by the original researchers, staff and investors, then none of this research will occur. There simply must be a payoff. That is the American way of research in medicine or any other business field. If there is no profit there will be no research. No new cures? Less. Does it mean we cannot expect to see dramatic innovations to help future patients get well? Probably! Why?
After all the research is performed, the Obamacre civil bureaucrats will assign a dollar value to the use of any innovation. Obamacare will squeeze down tightly for cost-containment so that there will be no payoff for the investors and for all the researchers who started and continued the ten years of effort. Innovations own death panel. No financial benefit will be a disincentive, perhaps the death knell to research. This “death panel” for medical innovation will eventually deny solutions to curable diseases into the future.
Will we have any new research to cure curable diseases? Will even present research to help the public be discontinued? Some will.
Government has been squeezing doctors and medical companies financially for about ten years but suddenly Obamacare comes along with it is socialized medicine and financially crushing doctors. The public is not aware of what is in store for their local doctors or for their own future care that may not be there if innovations are stopped.
Why have you not heard doctors complaining? We are a small group, about 700,000 in the nation. We do not have a lobby that truly represents practicing doctors.
You may have heard that the AMA and the AARP got behind Obamacare. Surprisingly they do not represent doctors and the best care for the public. Let me first deal with the AARP. It does not represent practicing doctors as a professional society does, acting as a lobby for them. AARP is a insurance company. A company that sells medical insurance. Not a group of practicing doctors. They endorsed Obamacare so as to get a piece of the insurance pie. It is business which incidentally works against practicing doctors and the public.
How about the AMA? Unfortunately it does not represent practicing doctors. It is so dysfunctional that only a small percentage of the nation’s doctors belong to it. It does not represent most practicing doctors, who are usually associated with local, national and their specialty societies dealing with the branch of medicine that they practice.
So, here we are as doctors without representation who need to explain to the public what we as doctors are expecting to unfold and ruin the best medicine in the world. We fear for the public who is yet to realize what is about to befall them.
What will doctors do and what is in the future for the quality of medical students? Many elderly doctors may simply choose to close their doors, therebye denying care to their beloved patients who they may have had a long relationship with. This will be a difficult decision for doctors to make because they are doctors and love what they do. But what can they do if Obamacare does not pay them or allow them treat their patients and friends the way they should be treated.
In my opinion, Obamacare is not an altruistic effort to help the public but another grab for control as we observed over and over again in so many socialist-like states in history. Start by offering the public a benefit and using the carrot offer as a reason to seize power and control that sector of our country. Eventually, the public gets something that they did not expect , in a place that they did not expect.
Dr. Dello Russo – LASIK for $299?
Dr. Ronald Krueger states that the device is expected to "improve safety as well as visual results". It is very difficult to describe what components of this device will allow for better vision, but I will try. A cataract is the natural lens of the eye (like the lens in a camera) which with age may get cloudy. The surgery exchanges the natural now-clouded lens with a new artificial plastic lens. Studies so far appear to show that the greater precision of the laser will allow the doctor to place the artificial lens in a position in the eye that will make it most efficient, thus giving better vision.
Lasik is not as simple as some centers would imply. There are only a few LASIK surgeons in the nation who have had as high a degree level of experience as my son and I.
The way some LASIK centers market themselves, the public are likely fail to realize that it is a service, not a product that you can hold in your hands like a tube of toothpaste. It is a service and will only be as good as the service expert and his tools.
I am not bragging about my experience but simply noting that the more experience a surgeon has, the safer the LASIK will be. A doctor with limited experience has not seen all the possible challenges that may need to be addressed to deliver successful result to patients.
So, one of the ingredients to maximize the safest & most successful surgery is the experience of the surgeon who will actually perform the surgery. It does matter how much experience a group of surgeons at a center has in total, but the number of LASIKs that your surgeon has under his belt himself.
The other ingredient that maximizes the results of LASIK is the quality of the technology being used by an experienced surgeon. Over these past twenty years I have owned every laser sold in the U.S.A., about eight brands (except the Nydek). Each new laser offered an improvement over the previous one. Some proved to be disappointing but most were advancements. Unfortunately, with each new laser comes a bill of about $450,000. Incredible, isn't it? You bet, but I always wanted the best for my patients despite the cost. Also whenever the surgeon uses the laser on an eye, the company that made the laser still charges the doctor for a "user fee". Is that a surprise? You betcha! There are very few occasions for a surgeon to cut corners safely and to maintain quality lasik..
There are about 4,000 LASIK surgeons in the U.S. Only a very small number of surgeons are financially successful enough to be able to afford buying every new and improved laser innovation. Therefore, most surgeons do not have the lasers that my son and I use in our offices. They still have one of the older models. This is not criticism but some lasers may be as old as fifteen years. I am not disparaging these centers for not keeping up but to help explain the main theme of this article - the true cost of safe LASIK. $299? Really?
Anyone considering LASIK will become aware of differences in costs when talking about it with their friends or their doctor. WHY IS THERE A DIFFERENCE IN PRICE?
You and I have seen the ads for $299 for LASIK. Does any surgeon perform lasik for $299? No! Maybe $299 per month with financing. Should that make you suspicious of the ads and the centers that run them?
Let me bring this article to a sensible conclusion. When LASIK is done well on a good candidate, LASIK is safer than wearing contacts, as I've always said. There are two important ingredients in maximizing your chances for success - experience and technology.
The price can vary a great deal. Why? And how come some surgeons quote a surprisingly low fee? How can they make money since they have some basic overhead as the higher price surgeons? What is the difference? The higher priced doctors do indeed have higher costs they incur in order to offer the safest LASIK as well as greater experience. Are the other centers taking short cuts?
In addition to the office and salaries for highly paid LASIK technicians, there is the cost of paying off the newest laser technologies and then a royalty fee for each eye treated. So what is missing in performing LASIK at a low fee? I will not state the ways some centers are likely to cut corners. Do you feel comfortable with a surgeon who may be cutting corners?
Now let’s return to the experience of the surgeon into whose hands you are placing your eyes. You want to do LASIK right. If you think that another doctor is better but you don't have the money right now, maybe you should not do it now with a center who may be cutting corners. Save up your money for the doctor whom you feel most comfortable with. Don't you really want safety? Of course you do.
Remember: well-done LASIK on a good candidate is a very safe LASIK. If you are having surgery with a surgeon whose fee is quite low, will you go blind? Probably not but you cannot have the same assurance as with an experienced surgeon.
The hottest topic among eye surgeons today is the possibly soon to be introduced "laser" or femtosecond cataract surgery. The subject dominated the last few national professional meetings and is found in all of our publications.
Most people think that cataracts are already being treated with lasers however that is not true yet. About 3.5 million surgeries are performed each year nationally by 40,000 eye surgeons. Nobody uses a laser except for a small group of researchers like Dr. Stephen Slade, who said that "if we are going to give people the good vision that they are anticipating - we will need a device like the femtosecond laser to make our surgery even more precise". There are presently three laser companies with possible commercial release of their first laser device perhaps by the end of 2011.
As reported in Ocular Surgery News, Dr. Agarwal of India, convened a panel of cataract surgeons who have used one of the new laser (femtosecond) cataract devices. This is "likely to be the greatest paradigm shift in cataract surgery since the development of ultrasonic phacoemulsificaion", which is the present device used all over the world to remove cataracts.
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