Eye Surgery by Bureaucrats: What Could Go Wrong?

Examiner (Washington, D.C.), The, March 21, 2018 | Go to article overview

Eye Surgery by Bureaucrats: What Could Go Wrong?


Eye surgery is a delicate business. It involves operating within an orb the size of a large marble to remove a cataract or repair a retinal detachment.

Not only is superb eye hand coordination a must, but also an awareness of the myriad other medical issues in the elderly population most in need of eye surgery.

Traditionally, patients undergoing cataract surgery had a preoperative medical evaluation, including blood work, chest x-ray, and EKG, to determine their suitability for surgery. This is a remnant from the days when cataract surgery was a long operation with a week of hospitalization and bed rest.

Today, it’s a much quicker procedure, performed with minimal anesthesia. Patients return home an hour after surgery. It’s no surprise that researchers from the University of California, San Francisco found that routine preoperative testing before cataract surgery is neither necessary nor cost effective.

Case closed, right? Not so fast. Enter the bureaucrats. The Joint Commission and Centers for Medicare and Medicaid Services require all patients undergo “A comprehensive history and physical assessment” prior to their surgery -- including for post-cataract YAG laser procedures that take only minutes to perform. This usually means a referral to another doctor. But even worse, the bureaucracy mandates that the preoperative physical be performed “No more than 30 calendar days prior to date the patient is scheduled for surgery in the [ambulatory surgery center].” Also, it must be done then “Regardless of the type of surgical procedure.” This means that a healthy 68 year old, who had her annual physical six weeks ago, needs to repeat the process in order to have a two-minute laser procedure.

Note that if the same patient were undergoing a molar extraction or a root canal -- both longer and far more invasive surgeries -- needs none of this. …

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