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Thank you for all you kind (and not so kind) responses to this website.

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Before we get to the mail, a few comments are in order:

First, as soon as the first edition of this website was placed online, I began to receive e-mail from numerous optometrists cursing me and claiming defamation of their profession. The fact is, this site is not an indictment of optometry as a profession (we'll save that for another site). This site is singularly dedicated to making public the ethical and legal issues involved with co-management of eye surgery patients. Of course, the truth is that "it takes two to tango". There are two sides to co-management relationships, surgeon and co-managing non-surgeon. Both sides are involved with the ethical and legal issues presented herein. So to my optometric readers... curse away if you must; but, if you read this site and it hits a little close to home, whose fault is that?

Second, a number of people have inquired as to my identity. I have been accused of being a gutless, pathetic coward. Others wonder if the content of this site can be trusted since the author has not revealed his identity. There are a number of reasons for my identity to remain anonymous. The primary reason is to keep the focus off of me an on the message. If you feel that the content presented is not compelling enough on its own, then ignore it.


To Whom It May Concern,

As the President of the American Optometric Association I object to your characterization that Optometrists refer patients to surgeons for LASIK to the highest bidder. We send patients to surgeons who are highly skilled in the LASIK procedure. To send a patient to a surgeon who "dabbles" in this surgery would be a disservice to our patients. It seems to me the people you are really upset with are your fellow Ophthalmologists who are more skilled and better trained than you in providing this surgical procedure. This, in my opinion, is not a battle between Optometrists and Ophthalmologists, but between Ophthalmologists some who are the have and others who are the have nots. Your accusations are invalid and not based in fact. The most interesting part of your "web page" is your unwillingness to put your name in print. Obviously you are embarrassed by what erroneous statements you have written. An anonymous author like you is one without conviction or conscious.

Respectfully submitted,

Harvey P. Hanlen, O.D., F.A.A.O.
President, American Optometric Association

Looks like I got somebody's attention. The skill of the surgeon is NOT the issue.  Fee-splitting is the issue.

Excellent! You may have seen me , Gary Vatter, on the Board of Trustees of the Surgical Eyes Foundation. I have researched this subject to death and am even in private litigation concerning medical malpractice AND "fee-splitting". Not only is "optometrist referral" unethical, I have found that post-operative care even suffers when a certified refractive surgeon OTHER THAN the original surgeon does the followup care. A few years ago I had refractive surgery on a Friday afternoon. By Saturday morning, the surgeon was in the Caribbean. The followup surgeon, 17 hours post-op, openly expressed bitterness about having to work the weekend to follow up the partner's patients - and denied me critical care on that basis!

I like what you are doing. If I can ever be of informational assistance, you may call me nights and weekends,

You can visit the Surgical Eyes Foundation Websie at

Your generalizations do a great disservice for all interested in refractive should be ashamed of what you wrote....but I imagine if you had any sense of shame you would not have written it in the first place.

The greatest service for those interested in refractive surgery is information.

I'm not saying I disagree with the views on your web page. A devil's advocate position would be that you may be a smaller volume doc who wants a piece of the pie that is increasingly being monopolized by the higher volume surgeons and/or centers that use the feeder system provided by ODs. Here's another wrinkle ...if someone does have a post-op complication...they end up going back to the MD anyway if the problem is severe enough. The co-managing OD still gets his slice.

It's not just post-op management is is pre-op.

The current standard of care is abysmal. Pre-op consults and evaluations fly at present because the patient has become the cost of doing business. There's enough money being made that the occasional PREVENTABLE screw-up is acceptable because it can be financially absorbed. No substantive help for the post-op with complications.

The biggest thing missing has been apprising people of the degree of risk with regard to their unique visual system and how a complication is manifest for the rest of your life. I was preventable had I been told the whole truth. I trusted an OD/MD team of whores. Science is at a mistress that doesn't lie and demands respect.

Well done! At last some honesty!

I just wanted to thank you for letting people know that "fee-splitting" exists. It lets people who are interested in this not to trust every Joe claiming to be a Dr. Vision is not to be tampered with. So don'tlet these people get you down. You are providing a service to people and letting them know to research their decisions to the fullest! Thank You!!!

Once again...The greatest service for those interested in refractive surgery is information. Don't worry,the words of others do not bother me in the least!

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