Choosing a Surgeon

Introduction

For most patients, the decision to have corrective eye surgery is filled with tremendous excitement and anticipation. However, the process of choosing a surgeon or laser eye center to perform the procedure can be difficult and confusing, as very few vision correction patients have ever "shopped" for medical services before.

Perhaps the hardest part of choosing a surgeon is the lack of objective data to assist in the decision making process. Eyes are, of course, more important than cars, but consider for a moment the amount of information available to new car buyers versus that available to vision correction candidates.

Almost any automotive performance statistic from horsepower to acceleration, braking or handling is readily available from enthusiast magazines. Reliability data can be obtained from Consumer Reports or J.D. Power. The government and the insurance industry publish safety information. The EPA publishes comprehensive fuel efficiency ratings, and detailed pricing information is widely available on the Internet.

For laser vision correction, actual outcome statistics, complication rates and detailed pricing information from individual surgeons or centers are rarely available, so in order to make a smart decision, surrogate factors must be considered.

Reputation: The collective opinion of other members of the community may provide some insight into a surgeon's skills, but it is important to remember that most people who claim that a surgeon has "a good reputation" in reality know very little about the surgeon's true skills. A better approach would be to speak with actual patients who have undergone surgery, and the best would be to find a nurse or scrub technician who has witnessed the surgeon's work firsthand and is willing to provide an unbiased opinion.

Board Certification by the American Board of Ophthalmology: A board-certified surgeon has passed a rigorous two-part examination given by the American Board of Ophthalmology designed to assess his/her knowledge, experience and skills. (Similar accrediting agencies exist for surgeons in other countries.) To be fair, only a small portion of the board examination covers the sub-specialty of laser vision correction. Most of the test covers the diagnosis and treatment of medical eye diseases. However, board certification is still the gold standard for overall competence and remains an important consideration.

Experience: Studies have shown that complication rates decrease dramatically with increasing surgeon experience, so the number of years a surgeon has practiced in the field of laser vision correction and the number of cases he or she has performed are important.

However, there are a few caveats. Some surgeons count cataract procedures in their numbers, so it is important to ask specifically about laser vision correction. Also, in the strictest sense, the absolute number of cases performed is a potentially poor indicator of quality, as surgeons in high volume corporate centers may perform thousands of cases without participating in the preoperative evaluation process or postoperative care. Those surgeons would therefore lack the overall knowledge and skill level of surgeons who have provided comprehensive care to fewer patients.

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