Deductible: a burden of the US Healthcare System

Deductible: a burden of the US Healthcare System

The US Healthcare system is the most expensive per capita in the entire world yet the Global Burden of Disease 2015 of study of healthcare ranked Canada 9th and the United States well behind at 28th based on the UN General Assembly's Sustainable Development Goals. As if the cost of the premiums isn't bad enough, patients have to pay up front at the beginning of each year until they reach their deductible...an amount that in other countries could cover the full cost of healthcare for a family for the entire year...

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The decline and decline of the US Healthcare System Part 1 (E pluribus unum)

The decline and decline of the US Healthcare System Part 1 (E pluribus unum)

You would think that a developed country like the United would have the best access to medical care in the world. Sadly though it's a failure and getting worse. This from my perspective of having practiced in Canada and the United States. There are fundamental flaws in healthcare here...

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Does maximizing utilization of "resources" lead to an improved patient experience in glaucoma care?

Does maximizing utilization of "resources" lead to an improved patient experience in glaucoma care?

Whether in private practice or a hospital setting, nobody wants to be throwing money away on ancillary testing devices and staff salaries so we usually try to make sure we use our resources to their fullest. With the cost of equipment such as perimeters to perform visual field testing or Ocular Coherence Tomographers for nerve fibre layer scans in the $25-125K range, and technicians to perform the tests drawing salaries of $20-$40 per hour, you can understand why those making the purchasing and hiring decisions would not want to see any idle time. But, does maximizing utilization of resources lead to an improved patient experience in glaucoma care? You need an abundance of resources to have smooth patient flow which leads to a positive patient experience and improved staff morale.

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Retained lens fragment and subluxed IOL chafing induced post-op glaucoma

Retained lens fragment and subluxed IOL chafing induced post-op glaucoma

Patient presents 2 weeks following cataract surgery with retained lens fragments, iris chafing from subluxed IOL, broken bag, IOP of 51 and has had lens fragments supposedly removed already along with multiple paracenteses to attempt to bring the IOP down (along with being placed on multiple glaucoma meds.) Case is discussed and the surgery I performed is presented.

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Guilty by association: sponsorship and perceived endorsements

Guilty by association: sponsorship and perceived endorsements

We are guilty by association when we speak in public. Whether you're a physician, academic, business person, or just somebody trying to get your message heard, you and your message are inseparable from their context.​ You are associated with event sponsors, academic institutions, Board of directors,  your colleagues, and they are all associated with you. We do not speak in a vacuum devoid of our surroundings.

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Uveal prolapse 3 months s/p Ahmed Glaucoma Valve revision

Uveal prolapse 3 months s/p Ahmed Glaucoma Valve revision
Rather unexpectedly, this 78 year old gentleman showed up for a follow-up visit, almost three months since surgery, with uveal tissue prolapsing out his suture line.
 
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