How did you come to choose cataract and refractive surgery as a profession?
I was going to be a cosmetic plastic surgeon until I took an ophthalmology course as an elective to finish my medical school education, because I had heard I could get off early and play tennis. The first time that I saw cataract surgery performed, I thought it was the coolest procedure. It was love at first sight, a romance story.
What is unique about the way you run your practice in Chicago?
My practice is limited to fee-for-service care, and I see 1/3 to 1/4 of the patients that most Medicare-tethered ophthalmologists are forced to see. As a result, I run a much more customer service-oriented practice. I get to develop relationships with my patients. I choose to run my practice in this way, because I do not want to have to see 90 patients a day. Typically, I see about 20 to 25 patients a day. This gives me the luxury of getting to know them. Good things can happen when I am not waving at patients through the doorway and when I spend the necessary amount of time with them. It is a very different transaction when patients pay a physician than when the insurance company pays a physician. In the latter scenario, the doctor is like a Kleenex. If patients do not like the one they have chosen, they just pull out another. Because my patients pay me, that means they trust me, they are concerned about me, they invest in me, and I invest in them.
What is your advice to the next generation of cataract and refractive surgeons?
Establish a fee-for-service practice as quickly as possible outside of Medicare. It will not be easy at first, but you will be thankful down the road. In other words, determine a value for yourself and create value within the marketplace, because reimbursements from the government are not going up anytime soon. They are only going down; it is inevitable. Everybody is now paying more out of pocket due to Medicare cuts. The money has to come from somewhere, and the most politically expedient place for it to come from is physicians. There are only about 800,000 physicians in the United States. That is not enough to vote a senator into Connecticut. Trust me. We are toast.
In what ways do you think cataract and refractive surgery will evolve in the future?
Cataract and refractive surgery will become more automated with the development of femtosecond lasers. If this technology works as planned, cataract surgery will become technically easier to perform. It is going to be like cleaning up a tiny spill. It will be very achievable. As a result, ophthalmologists will at some point in the future undergo an assault by paramedical professionals like optometrists or nurse practitioners who will want to perform these procedures, and their economics will be favorable from the standpoint of government payors and private insurance companies.
What is something most people are surprised to learn about you?
I am a racecar driver, but I retired early so that I could spend more time with my family. I raced Porsches (Porsche Cars North America, Inc., Washington Crossing, PA) and competed for 4 years. I started when a good friend of mine who was involved in it invited me to join him. At first, I thought it was for a bunch of guys who imagined that they were actually talented, but once I started to race, I realized it was a heck of a lot of fun.