What to Expect During Cataract Surgery

You found out you have cataracts, they are ready to be removed and you’ve scheduled your cataract surgery. What should you expect now? What should you expect on the day of your surgery?

On the day of your surgery, you will arrive at the hospital at the time you scheduled. You should be met with a friendly receptionist who will let the nurses know you have arrived. A nurse will come into the waiting room and call you to come back with her. Since you are unable to drive yourself you have come accompanied and they should be able come back with you or remain in the waiting room. The nurse will get you ready for surgery; she will talk with you, answer any questions she is able to, begin putting drops in your eyes and in general make sure you are comfortable.

Once it is your turn and you are taken into the O.R. you will be met by a team of surgery nurses who will continue to get you ready for surgery. Your doctor will be in the O.R. with you and will be able to answer any last minute questions you forgot to ask. You will be awake during the procedure, however, you will be given local anesthesia that will numb your eye and help you relax. Your doctor will talk to you during the entire surgery, letting you know what’s going on and how great you are doing. Before you know it, the procedure will be over and you will have a protective shield covering your eye.

It is at this point you will be taken back to a room and your doctor will come with you. He will let you and those with you know how you did. A nurse will come in, ask you what you would like for a snack and go over with you how and when you are to use your drops. After your snack, you will be ready to go home and take a nap. Your doctor will see you the next day in the office for your post-op visit.

There is usually little to no discomfort after cataract surgery, however, if there is any, over the counter Tylenol will relieve it. Your glasses prescription will most likely have to be changed following cataract surgery and after several weeks, once your eye has healed, you will be ready for an updated prescription.

Hopefully now you know what to expect when you have cataract surgery. If you should still have questions your doctor or technician here at The Eye Care Institute will be able to assist you by answering them.

What’s Wrong With Our Health Insurance System?

During October, it was reported that Humana’s quarterly income is up by 90% due partly to higher Medicare membership and because Humana did not have to spend about $68.9 million that it had set aside for medical claims.

Meanwhile, the reimbursement formula under which the government calculates Medicare fees paid to doctors will result in a 10.1% payment cut effective January 1, 2008. Further, most private insurance carriers, such as Humana and Anthem, use Medicare’s payment to doctors as their starting point for deciding how much they pay doctors. Therefore, we expect reimbursements from those private insurance carriers to fall, as well.

So, while the federal government allows insurance companies like Humana to have a 90% increase in profits, partly due to Medicare, it is cutting the fees it pays directly to doctors by 10.1%. You may think that is no big deal since “everybody knows doctors are rich,” but did you ever stop to think about the risks, costs and lost opportunity to become a doctor? For instance, the 5 doctors at The Eye Care Institute have a combined 56 years of postsecondary education! While our doctors enthusiastically chose to complete this education, they did not do so expecting to take a 10.1% pay cut. In fact, a trade organization to which I belong, reports that, adjusted for inflation, average eye doctor salaries are down about 3% since 2002. During that time, government regulations mandated upon us have been huge.

Even if you are in a field of employment where your income has not grown, consider these points:

• The now retired CEO of Anthem, Larry Glasscock, received a $42 million bonus during 2004. No practicing physician anywhere has ever received a $42 million bonus!
• Insurance carriers are not required to tell us how to submit insurance claims so they are paid. Insurers may use “black box” edits to deny or bounce some claims, and it is our job to figure out the rules to get paid.
• Doctors, and other professionals, are often forced to pay the highest taxes possible, as Professional Service Corporations (PSC’s) are often the only logical form of business setup for doctors. What does this mean? Companies like Wal-Mart are typically in lower tax brackets than physicians.
• Overhead costs forced on us by the government are growing at a staggering rate. For example:
• In early 2008 prescriptions for Medicaid recipients will need to be written on tamper proof Rx pads. Tamper proof paper is infinitely more costly than regular paper.
• PQRI is a “voluntary” data reporting system within Medicare for which we may possibly (the program is in place, but there is no way to tell if we are using it correctly) receive a 1.5% bonus…and, doctors who don’t participate are forced to pay their pro-rata share of the bonus funds for the doctors who choose to participate.
• Electronic Medical Records, rather than paper medical charts, are soon to be imposed on medical practices our size. We estimate our costs will increase about $6 per office visit as a result of this mandate. No patient care improvements, or other benefits, have been proven. We are just forced to comply with this extra burden, without additional reimbursement.

This op-ed piece is not intended to solve how we can have more and better care for Americans. My purpose in writing this is to demonstrate that those who believe a 10.1% pay cut to doctors is okay, surely have acute tunnel vision. These people will be truly disappointed if the fee cutting trend continues to the point where medicine is no longer a profession chosen by many of the brightest students; when doctors retire early to enter easier careers; or when medical practices stop participating with Medicare. You probably won’t take a 10.1% pay cut next year – but if you care whether good doctors will be around to care for your children and grandchildren, please help us out by writing your Congressman and asking them to reconsider this short-sighted move.

Finally, I welcome your comments regarding my opinion. Feel free to send them by regular mail, or by email to info@EyeCareInstitute.com.

Stress and Benefits of Laughter

A recent study showed that pre-school-aged children laugh up to 400 times per day, but the average adult only laughs 17 times per day. Research has shown that laughter strengthens the immune system and helps to relieve stress. Laughter reduces stress hormones and increases the level of health-enhancing hormones like endorphins. This means a stronger immune system and fewer physical effects of stress.

Chronic stress can affect your quality of life as well as your physical and mental health. Stress can contribute to angina (chest pain), arrhythmias (irregular heart rhythms) and even heart attacks or strokes. Stress can worsen conditions such as type 2 diabetes, asthma or gastrointestinal problems.

The good news is that stress is manageable. There are different types of stress just as there as different types of people. If you learn simple relaxation techniques (like having a good belly laugh), identify the causes of your stress and change your thinking about stressful situations, you can reduce your stress and lessen its effects on your body.

So, the next time you’re feeling stressed, stop and laugh out loud or to yourself. You will not only reduce your stress level, but you may help reduce the stress level of those around you.