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Valuing Physician Services
Dr. David Chang is to be commended for drawing attention to the issue of balance billing and shared patient responsibility for physician services as described in “Is It Time for Balance Billing?” (Feature, November/December).
What must not be lost in the discussion is this simple fact: Physician services do have a value that remains extraordinarily important to society despite the continual threat of lowered payments and new systems of payment designed to dramatically reduce physician revenue. This value is not determined by insurance companies or government but is defined by improvement in the health of patients—which thereby promotes their livelihoods and their quality of life.
As such, the economic value for these services must not be allowed to drop below a reasonable threshold. Otherwise, as Dr. Chang aptly points out, the system will contract and ultimately collapse as physicians will no longer take the risks and expend the resources necessary to provide services that are so poorly valued by insurance companies and government.
Steven Thomas Berger, MD
Help in an Emergency
I have become aware of three relatively new developments in emergency ophthalmic care about which there is a scarcity of U.S. ophthalmological literature.
An informal survey of my ophthalmic colleagues reveals that knowledge of the following three options is limited at best. I think it is of the utmost importance (if just from a medicolegal standpoint) that ophthalmologists have a working knowledge of these agents.
In all three of these entities, time is of the essence in providing effective care. Ophthalmologists need to be aware of these agents so they can consider offering them when presented with these relatively rare conditions.
Mitchell J. Wolin, MD
1 Velez, L. I. et al. J Med Toxicol
2 Hattenbach, L. O. et al. Am J Ophthalmol
3 Langefeld, S. et al. Der Ophthalmologe
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