Welcome to Omgili,
Omgili ( Oh My God I Love It ;) is a search engine for discussions. With Omgili you can find answers and solutions, debates, discussions, personal experiences, opinions and more... To learn more about Omgili click here.
This is a complete preview of the discussion as it was indexed by Omgili crawlers. Use this preview if the original discussion is unavailable.
Click here to view the original discussion.
 |
|
 |
|
Is Refractive Surgery Patient Driven? - D'Eyealogues
I would like to pose the following question for discussion.
Is refractive surgery a patient-driven procedure or a marketing-driven procedure?
I'll lead with my opinion, which is that refractive surgery is patient-driven.
DrG
|
|
 |
|
 |
|
|
|
|
Quote: : I would like to pose the following question for discussion.
Is refractive surgery a patient-driven procedure or a marketing-driven procedure?
I'll lead with my opinion, which is that refractive surgery is patient-driven.
DrG Consumer demand for elective refractive surgery (as opposed to required refractive surgery), just as for any market/business/service, has to be 'grown'.
Market growth is driven by a variety of factors like, consumer awareness, service availability, availability of surgeons, price, patient referrals etc.
As the market grows it attracts more surgeons and corporations which exponentially increases advertising, market base, availability, the targeting of specific patients, overall consumer demand and on and on.
I don't think this is an 'either/or' question.
|
|
|
|
|
|
|
|
|
Quote: : I would like to pose the following question for discussion.
Is refractive surgery a patient-driven procedure or a marketing-driven procedure?
DrG My answer is, BOTH, plus a lot of other factors too.
And my answer would be the same if you had asked me whether mascara is a woman-driven product or a marketing-driven product.
It can be said of just about anything that we spend our discretionary income on.
p.s.
LOL, Cindy, sorry for the redundancy - I hadn't even read yours when I posted this
|
|
|
|
|
|
|
|
|
I say it's patient driven.
First, because people want this surgery.
They want it. Plain and simple.
You can't successfully market something people don't want.
Second, because I was never influenced by marketing.
In fact, I barely remember seeing ads until I started actively looking for a place to get Lasik done.
I was influenced by other people, primarily:
1) My chiropractor.
An ecstatics Lasikee.
Perfect vision, never a problem.
2) My audiologist.
Another happy camper.
Vision excellent, eyes dry until about the sixth month.
He loves not wearing glasses so much that if he had to put drops in or had suffered some minor problems, he wouldn't care.
3) My general practitioner.
Vision excellent, eyes drier at times, but not even to the point of putting drops in.
4) A cousin with more medical degrees than I can count.
She had it done 20 years ago, when it was brand new.
Still loves it. Never a problem and she is in her 60's now.
5) Many, many happy co-workers.
These people will tell you they had Lasik and tell you how happy they are.
This is what is driving Lasik, in my opinion.
Sit and listen to someone tell you how perfect their vision is, no more glasses, no more contacts and that has more effect than any ad in the newspaper.
At least, it did on me.
Figure in the cost of my glasses and contacts, and the cost of Lasik doesn't seem so high.
I NEVER heard one bad thing about Lasik (and believe me, I questioned a lot of people).
Oh, yeah, and my optometrist is going for it.
She TREATS patients like me, and it is not deterring her a bit.
She figures the odds are with her.
|
|
|
|
|
|
|
|
|
Since my wife has an MBA in marketing and has done marketing for various types of health care entities, I posed the question to her.
Her response was that marketing is the science of determining the needs of the customer.
Furthermore, she also opined that saturation of the marketplace with lasers was probably driving the volume as much as anything.
I do know that many of my patients are hearing - if not responding to - the siren's call of life without contact lenses, eyeglasses, and annual trips to the eye doctor.
My sense is that LASIK might one day become a "right of passage" for adults - like braces for their children.
Does anyone here have a crystal ball?
DrG
|
|
|
|
|
|
|
|
|
Quote: : Her response was that marketing is the science of determining the needs of the customer.
Furthermore, she also opined that saturation of the marketplace with lasers was probably driving the volume as much as anything.
Quite. The customer's perception is completely different when they see something available on every street corner than when it is only offered in a few places, even.
And availability is only one of the factors.
Marketing ferrets out the desires of customers as well as their limitations and psychological barriers.
Look at the impact of value-based airlines like Southwest, JetBlue and easyJet.
Whole new markets were created when they went into unserviced or lightly serviced areas.
People who never flew before (and never knew they needed or wanted to) began flying regularly because it became easily available and at a psychologically accessible price.
|
|
|
|
|
|
|
|
|
Quote: : I do know that many of my patients are hearing - if not responding to - the siren's call of life without contact lenses, eyeglasses, and annual trips to the eye doctor.
My sense is that LASIK might one day become a "right of passage" for adults - like braces for their children.
Does anyone here have a crystal ball?
DrG Yes, I have a crystal ball.
If you look closely those are cataracts staring back at you.
|
|
|
|
|
|
|
|
|
Quote: : I would like to pose the following question for discussion.
Is refractive surgery a patient-driven procedure or a marketing-driven procedure?
I'll lead with my opinion, which is that refractive surgery is patient-driven.
DrG It's market driven!
No one in their right mind would want this surgery (LASIK) if it weren't marketed as being a cinch with no mention of risks, complications, or contraindications.
It's all marketing hype.
|
|
|
|
|
|
|
|
|
Quote: : It's market driven!
No one in their right mind would want this surgery (LASIK) if it weren't marketed as being a cinch with no mention of risks, complications, or contraindications.
It's all marketing hype.
But it IS a cinch for a lot of people.
During an instructional course at ESCRS earlier today, there was a presentation of LASIK and LASEK results in a comparative study using the same laser.
What was really astonishing about it is that on nearly every count, in this particular set of patients, LASEK was better: Better UCVA, better BCVA, far fewer complications, better VQ and so on.
The only plus of LASIK, in fact, was that of the very few LASEK complications that occurred in that set of patients, there were some more seriously vision-threatening ones than in LASIK.
Yet the presenter's conclusion page said - Conclusion?
LASIK is the preferred procedure.
Why? "Because my LASIK patients are happier."
Convenience rules.
|
|
|
|
|
|
|
|
|
I think to truthfully answer this question, you have to consider the interplay between the patient/consumer and the industry (laser manufacturers, refractive surgeons).
Considering "us", the patient/consumer, we are accustomed to a culture which offers all sorts of technological marvels which make our everyday lives easier or more efficient.
Also part of our culture, and probably basic to human nature, is the desire to be better, healthier, more attractive.
The allure of a life without the hassles of contact lenses or glasses is very powerful.
Add to this mix endorsements by celebrities and glowing reports from friends with perfect results and even the harshest skeptic is enticed.
With the reported low percentage of poor outcomes, there is no perception of real risk.
I believe the sustaining force here is industry.
The greed that operates here is palpable, that's undeniable.
Just check out a newspaper advertisement for refractive surgery...you'd think these guys were selling discounted carpet!
When LASIK wasn't FDA approved, they charged top fees and took only cash.
When the FDA cleared the procedure and insurance coverage began horning in on their cash cow, prices began to drop.
Added competition also breeds price wars.
To perpetuate and protect the profits, poor outcomes are minimized and the reporting of complications has been less than diligent.
"Point in time" assignment of a complication also trivializes the toll.
Take dry eye for example.
The way it's presented you'd think it was an instant of dryness..."BAM" over, let's move on.
No consideration given to patient-years of suffering and treatment costs.
So what I'm suggesting is that you have "the perfect storm." Susceptable, trusting and yes, naive consumers crossing paths with a marketing goliath.
I only hope that real science will ultimately persevere and those Docs who have lost their way will take the ethical high road.
Uberdog
|
|
|
|
|
|
|
|
|
Quote: : Just check out a newspaper advertisement for refractive surgery...you'd think these guys were selling discounted carpet!
I would certainly take the position that advertising is a serious problem, for a number of reasons.
And on the positive side, I think this is an area that will be more amenable to being addressed through lobbying than some other issues, because in fact there are a great many laser surgeons who are dead against such advertising, or at least are against it in many of its current forms.
As an example (albeit on the other side of the pond), when we were in the earliest stages of getting a parliamentary panel set up to address issues with laser surgery, there was a small forum back in February during which about 10 people presented their case for whether & how to regulate the industry.
All the presenters were ophthalmologists, except for one laser manufacturer executive and yours truly.
In my own presentation I said little if anything about advertising, choosing instead to focus on certain other points.
So I watched while every last one of the independent surgeons who presented gave LASIK ads such a thrashing (producing actual copies of multiple concrete examples) that by the end of the forum it simply had to be acknowledged by all that this was an area that definitely needs addressing.
|
|
|
|
|
|
|
|
|
There is always an ebb and flow between consumer and marketing, and which is more powerful is often a matter of the specific detail that you are examining.
One must first acknowledge that refractive surgery is not the end product.
The end product of refractive surgery is a reduced need for corrective lenses.
If the only thing refractive surgery did were to slice and laser the eye, then nobody would want it.
It is the probable result of refractive surgery that people seek, not refractive surgery itself.
Refractive surgery is the "necessary evil" to achieve the desired goal: life without glasses.
Marketing is the consideration of product, packaging, pricing, positioning, and promotion to provide a consumer something the consumer will desire when exposed to the marketing, or already does desire before the marketing exists.
I think it is fair to say that everyone who requires corrective lenses would prefer to not require corrective lenses.
So if the issue is whether or not marketing refractive surgery creates consumer desire for refractive surgery, then refractive surgery is very clearly consumer driven.
Even without the existance of refractive surgery or refractive surgery marketing, the desire for life without glasses - and thereby the drive for what refractive surgery may provide - already exists.
Marketing can rapidly expand or diminish the growth of refractive surgery, widen or shrink the audience for which refractive surgery is acceptable, and even change consumer attitude toward refractive surgery, but I submit that marketing alone cannot make anyone desire surgery on their eyes.
The desire for a reduction of the need for corrective lenses must, and clearly does, already exist.
I submit that refractive surgery is consumer driven.
|
|
|
|
|
|
|
|
|
. . . I came into this without coaching and did not get talked into "it" by an OD.
I'm a mess and it all started with lasik.
Sorry to the nay-sayers, but prior to lasik, I was only "blind." A pair of glasses took care of that.
I'm wearing "small -1.75ish" but they don't help.
I wear them for the bifocals.
Someone mentioned "down the road" what problems might occur.
I am set for cataract surgery soon.
Whether I had the cataracts before lasik, lasik caused them, or caused them to mature sooner than they may have, or none of the above, I don't know.
It's a moot point now for me.
I'll stop before I get on my soapbox.
Have LASIK - then you, too can have cataract surgery a few years later.
You have the BONUS of hit and miss with calculations because it's apparently difficult after surgery, especially if you're a high myope like .
. . me....and Rebecca et al.
Damn, I feel like a pioneer.
A pioneer with sore eyes, dry eyes and blotchy, GASHY, smeared vision.
It will be interesting for someone to conduct a study (yeah, sure) on post RS cataracts.
Yes, people in late 40's plus are certainly more prone to cataracts.
In a lasik consultation it seems reasonable for a surgeon to tell a potential patient that "you are in the age group where cataracts may and do develop" and lasik would complicate cataract surgery.
If however you do not have lasik and do develop cataracts, this would solve any (or most) of your correction, your insurance would pay for it and your corneas would not be scorched.
I wish I could go back .
. .
|
|
|
|
|
|
|
|
|
Posting lasik warnings on unrelated bulletin boards is a GREAT idea.
Anything that gets the word out is a good thing.
Indeed, a number of complications were reported....
And it's great that they were discussed and viewed by a fresh group of people.
|
|
|
|
|
|
|
|
|
Also the networking sites--LinkedIn, Orkut, Friendster.
Did you know 4 million people are on Friendster now?
It's not a dating site, really.
Most people I know use it as an enormous eddress book.
If you want to promote something--a cause, a website, whatever--mentioning it in your user profile on one of those sites seems like a no-brainer.
Actually, some people create user identities not for themselves but for causes--I've seen "antiwar" and "samesexmarriage." Then other people who support that cause confirm it as a "friend." I just checked.
"samesexmarriage" has 495 first-degree friends on Friendster.
Let's see: I have 17 first-degree friends (about average on Friendster, I think), 316 second-degree (friends of friends), and 14,927 third degree (friends of friends of friends).
"samesexmarriage" probably has over 100,000 third-degree friends, which means that the 100,000 people on Friendster who know someone who knows someone who has linked to "samesexmarriage" will see the profile of "samesexmarriage" in their network.
|
|
|
|
|
|
|
|
|
Genius information disseminating tool, Kirsten.
We need to be doing this!
You are a vision-saving heroine, truly.
|
|
|
|
|
|
|
|
|
[Quote: =Glenn - USAEyes.org I submit that refractive surgery is consumer driven.[/Quote: ]
Start advertising truthfully and see how fast it dries up!!!
|
|
|
|
|
|
|
|
|
Generally, the Council for Refractive Surgery Quality Assurance does not advertise, but when we did we promoted the use of our objective and factually substantiated information regarding refractive surgery issues to make an informed decision about the potential benefits and risks.
We did not promote LASIK per se , but we promoted our balanced information about LASIK.
CRSQA does not provide refractive surgery of any kind.
I do not provide refractive surgery, as I am not a physician.
In fact, I have never privately or publicly told anyone that they should have refractive surgery.
That is a decsion only a candidate can make after being appropriately informed.
We do promote information.
|
|
|
|
|
|
|
|
|
What do you have to say about the fact that top doctors in the country have abandoned LASIK for surface treatments What does that tell you about the safety of LASIK I think it's time to update your site.
|
|
|
|
|
|
|
|
|
Quote: : What do you have to say about the fact that top doctors in the country have abandoned LASIK for surface treatments What does that tell you about the safety of LASIK I think it's time to update your site.
I know of surgeons who would be doing more surface ablations if it wasn't for the side-effect of hazing.
These doctors are also concerned about the routine use of mitomycin C and possible future complications.
Among surgeons, the issue is less black and white than it appears to be.
DrG
|
|
|
|
|
|
|
|