OOs urged to reveal fees to laser patients

The urgent need for transparency was made at a specially convened House of Commons public hearing last week. MPs called a number of sources to attend after concern over last year's refractive surgery headlines which claimed that some treatments might be unsafe.
In Parliament's committee room 16, key representatives of the sector acknowledged there could be a conflict of interest regarding referrals, and told MPs that significant sums were changing hands.
The forum, to debate whether laser eye surgery was safe, also heard informed patient consent to treatment equated to the recent endowment mortgage scandal (see 'Laser surgery in the dock', page 8).
The need for transparency had arisen after the traditional routes of referral through a GP had been bypassed, Moorfields consultant ophthalmologist Julian Stevens said. 'In many ways that's a very welcome thing but when large amounts of money are changing hands it does tend to change the directions that patients are referred.'
He told MPs the fees were 'very significant' and under the banner of 'care management'.
'The key issue is that patients are unaware that they are being sent in a preferred pathway in association with financial reward.'
He told the forum that fees in contracts between optical practices or chains and laser providers should be declared to the patient. 'It is absolutely mandatory in the financial services industry that commissions and fees have to be declared.'
Sheraz Daya, medical director at the Centre for Sight clinics also said there must be more openness in optometrists' financial arrangements. 'They need to follow ethical principles of referral by giving patients a choice, be transparent in their dealings with centres to which they refer to and work ultimately in the best interests of patients.
'The ethics of surgical centres within optical stores also need to be debated,' he said. 'Two thirds of the providers are commercial chains which have heavy investment by venture capitalists and others. Their business model is based on volume.'
Dr Catharine Chisholm, City University, called for better training for the growing number of optometrists involved in helping refractive clinics. 'I have certainly heard stories of optometrists who have never even met the surgeon [they are referring to] or very rarely see them. And that's a problem.'
Christopher Neave, chairman of the Eye Laser Association, told the hearing that it was in his members' interests that patients were satisfied. 'Referral accounts for the biggest single possible route and share of future treatments and so our future depends on this procedure having an excellent reputation and being performed well,' he said. 'The ELA will deter entry into the sector of any providers that wish to cut corners or lower standards.'
david.challinorrbi.co.uk MPs have been told that optometrists' fees for referring individuals to laser eye clinics must be made known to the prospective patient.
The urgent need for transparency was made at a specially convened House of Commons public hearing last week. MPs called a number of sources to attend after concern over last year's refractive surgery headlines which claimed that some treatments might be unsafe.
In Parliament's committee room 16, key representatives of the sector acknowledged there could be a conflict of interest regarding referrals, and told MPs that significant sums were changing hands.
The forum, to debate whether laser eye surgery was safe, also heard informed patient consent to treatment equated to the recent endowment mortgage scandal (see 'Laser surgery in the dock', page 8).
The need for transparency had arisen after the traditional routes of referral through a GP had been bypassed, Moorfields consultant ophthalmologist Julian Stevens said. 'In many ways that's a very welcome thing but when large amounts of money are changing hands it does tend to change the directions that patients are referred.'
He told MPs the fees were 'very significant' and under the banner of 'care management'.
'The key issue is that patients are unaware that they are being sent in a preferred pathway in association with financial reward.'
He told the forum that fees in contracts between optical practices or chains and laser providers should be declared to the patient. 'It is absolutely mandatory in the financial services industry that commissions and fees have to be declared.'
Sheraz Daya, medical director at the Centre for Sight clinics also said there must be more openness in optometrists' financial arrangements. 'They need to follow ethical principles of referral by giving patients a choice, be transparent in their dealings with centres to which they refer to and work ultimately in the best interests of patients.
'The ethics of surgical centres within optical stores also need to be debated,' he said. 'Two thirds of the providers are commercial chains which have heavy investment by venture capitalists and others. Their business model is based on volume.'
Dr Catharine Chisholm, City University, called for better training for the growing number of optometrists involved in helping refractive clinics. 'I have certainly heard stories of optometrists who have never even met the surgeon [they are referring to] or very rarely see them. And that's a problem.'
Christopher Neave, chairman of the Eye Laser Association, told the hearing that it was in his members' interests that patients were satisfied. 'Referral accounts for the biggest single possible route and share of future treatments and so our future depends on this procedure having an excellent reputation and being performed well,' he said. 'The ELA will deter entry into the sector of any providers that wish to cut corners or lower standards.'
david.challinorrbi.co.uk