Laser/optics medical patients wooed by discounts

NEW YORK, NY—A June 26th article in The New York Times reported that, while physician associations generally frown upon remuneration of patients to help promote medical services, many cosmetic surgeons now openly offer “thank you” rebates and discounts to patients who post videos of their operations or are willing to be taped enthusing about the capabilities of their physician.

Aug 15th, 2008

NEW YORK, NY—A June 26th article in The New York Times reported that, while physician associations generally frown upon remuneration of patients to help promote medical services, many cosmetic surgeons now openly offer “thank you” rebates and discounts to patients who post videos of their operations or are willing to be taped enthusing about the capabilities of their physician.

As an example, the article cited Dr. Emil Chynn of New York’s Park Avenue Laser, who has provided laser assisted sub-epithelial keratomileusis (LASEK) patients with DVDs of their surgeries in hopes that they will post the ten-minute videos on YouTube, along with an endorsement and a link to Chynn’s Web site. As an incentive, Dr. Chynn offers a free Botox injection worth $400 or a $100 discount on the LASEK operation.

The increasingly common practice has raised concerns among medical ethicists and consumer advocates, the article said. Videos—which usually do not disclose the fact that the endorsement is paid—can either be home-grown or produced by marketing companies offering package deals.

Along similar lines, STAAR Surgical Company, maker of the Visian ICL (Implantable Collamer Lens), has announced plans for a consumer awareness internet campaign based on surgeons’ practices. According to the company’s press announcement, “Prospective Visian ICL patients will be invited to submit a one-minute video on why they opted for Visian versus other options, potentially including LASIK, earning them the possibility of winning a no-charge procedure.”

STAAR said that web sites for the campaign were being developed for leading Visian ICL physicians around the country and that local contests would begin in July 2008. “Finalists from local practices will be entered in a national internet-based contest in which the winning submission will be selected based on the most votes from site visitors,” the news release said.

Whether these practices are acceptable depends on who you ask. Certainly the post-surgery endorsements carry more weight than the prospective customer ones, meaning more potential trouble. The New York Times article notes that in one case, a dissatisfied patient (who asked to remain anonymous) posted his video and received the rebate before he realized his results were disappointing. The article quotes the patient as saying, “Regardless of whether I’m happy—that’s not going to stop me from posting. It’s money in my pocket.”

The New York Times interviewed 15 doctors for its article, and reports that none of them saw anything ethically wrong with the discount/rebate practice. Dr. Chynn noted that “It’s really not a conflict of interest,” because the discounts are relatively small.

—Barbara Goode

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