Monthly Archives: April 2014

Don’t Toss Out The Baby With The Bath Water

 half_rim_glassesWhat do eye glasses have to do with optometry’s future?

Eyeglasses received about a quarter of all votes in a poll asking readers to pick the top medical device of all time. Image from Wikimedia Commons.

Eyeglasses are the top medical device of all time, according to a survey of Qmed readers, which to date has received 739 votes. At the time of writing, eyeglasses had received about a quarter of all of the votes. In any case, corrective glasses are certainly one of the most widely used medical devices. The Vision Council of America estimates that 64% of U.S. adults use glasses regularly. Glasses are also one of the oldest medical devices. Simple meniscus lenses were described by the Ancient Egyptians in the eighth century BCE. The idea of using a lens to magnify text is thought to date to the first century AD, when Seneca the Younger wrote, “Letters, however small and indistinct, are seen enlarged and more clearly through a globe or glass filled with water.” The Roman Emperor Nero reportedly watched gladiator matches while looking through an emerald lens. Centuries later, Abbas Ibn Firnas helped pioneer the use of glass to correct vision by devising a way to convert sand into glass. Reading stones were one of the most widely used applications of lenses until the debut of wearable eyeglasses in approximately 1284 by Salvino D’Armate. Innovations in eyeglasses have occurred at a steady clip every since, culminating in bifocals, trifocals, and, more recently, progressive lenses. The first electronic prescription eyewear was announced in 2011. Known as Empower, the technology from Aspex enables users to toggle between two prescription levels of their lens by swiping a finger along the arm of the glasses’ frame, giving them more flexibility than conventional bifocals. Runners Up Hypodermic needle.  Read more……………..



No one seems to know what ACOs will finally look like but our government has planted the seeds in a soil of legal definitions and bureaucratic requirements. What will grow and Aco or a Ufo?

The AOA has created a fantastic website dedicated to describing these issues.  Our board member Dr Ami Ranani pointed this out to all of us and I highly recommend reading the story on this website.   Here is the link!  Rethink Eye Care

I must admit I find fault with the governments plan.  I believe politicians are always working too hard to get elected and so pleasing their constituents and big financial donors shapes too many of their decisions.  Here below is an interesting chart from the AOA article with my annotations in Red.  Think about it for yourself as you read the article.  Though I would never get elected to political office as I tend to speak my beliefs rather than what people want to hear, Patient Accountability is, in my opinion, missing from this chart as is controlling the excesses of documentation which turns doctor’s offices into free accounting service giveaways to insurance companies!  See this interesting story from Forbes which describes this problem!

MODIFIED 8 essential aco elementss Screenshot from 2014-04-19 07:00:00

Note my comments are in red and the box with the obese patient was added by me to the  aco diagram.

If the real goal it to keep health care costs low then we need prevention and not pills.  If patients walk into your office 30 seconds before their legs arrive they are time bombs for their family and our financial future as a nation.  Patients must be held accountable.  If patients smoke, take drugs and hang glide, their insurance costs are greater or they may be uninsurable !   This should apply to health care!  Giving them a pill to lower cholesterol while watching them put on 20 lbs a year is a joke and we all know it!

As for keeping costs down, READ the Forbes article.  The author observes that in the PCPs office there are 3 people doing insurance paperwork and one person assisting the PCP.  It is ABSURD that insurance companies can push their paperwork off on doctors who  are not paid to do it!   Accountable Care Organization, ACO?  I call it an Unidentified Flying Object UFO!   That’s why another author said ObamaCare is like building a plane in the sky while it is flying.  The current structure that requires the absurd amount of  data entry  by doctors offices needs to be fixed before it gets started!  Congressmen who want their campaigns financed  and voters support are not likely to do it.  There are hard questions to deal with hiding behind euphemisms,  like ACO,  for real health care reform  the ACOs I am seeing so far is not the path to take.

Some of the issues that need to be tackled if we are to keep patients out of the ER and Hospitals that are truly bankrupting our country, in my opinion, are:

  • FARM SUBSIDIES: Subsidizing the farming of  cheap high carbohydrate foods like, corn, soy, wheat etc. This is the first time in HUMAN HISTORY that poor people are fat and as a result diabetic!  1/3 of all kids in school are obese!  This is the Big Issue!
  • PATIENT ACCOUNTABILITY: Not holding patients financially accountable for their own health care!   Doctors alone cannot otherwise offer preventive care!
  • FOOD MANUFACTURERS:  There is a clear need to make “processed foods”  that are causing diabetes, obesity, hypertension, heart attack and strokes  making some people an endangered species!   If your great grandmother could not recognize it as food, it probably isn’t!
  • CHEMICALS IN FOOD:  In the middle ages the black plague killed millions of people.  It was later noted that the people drank out of chalices made of LEAD and ate a popular dessert pie made of lard, sugar and flower.  Their bodies were susceptible to disease as they were diseased!  The very likely had heavy metal poisoning and arteriosclerosis.  Each generation has its challenges due to culture and technology.  We have plastics and electromagnetic radiation.  BPA in water bottles and lining cans is undoubtedly an issue.  Preservatives in food, kill of the natural gut bacteria that keep us healthy.

Real health care reform has lots more to deal with than accountable pcps.