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    Some say eye surgery rule would add to cost of care

    Optometrists say the measure burdens patients by limiting postoperative care to medical doctors.


    © St. Petersburg Times, published April 3, 2001

    TALLAHASSEE -- Lobbyists have jokingly christened it the Battle of the O's -- ophthalmologists versus optometrists -- but both sides agree the safety of eye surgery patients is a serious matter.

    Ophthalmologists, led by Broward County doctor Alan Mendelsohn, want lawmakers to restrict postoperative care to them or other medical doctors. This has upset optometrists, who say they've cared for eye surgery patients for 25 years and are better qualified to do so than family doctors.

    It has been one of the more colorful issues before the Legislature this year. Mendelsohn has shown graphic slides of infected eyeballs, and optometrists have accused Mendelsohn and other ophthalmologists of trying to increase their income.

    The measure got a step closer to passing Monday as members of the Senate Committee on Banking and Insurance approved it, though not without expressing concerns about whether it could increase the costs of eye surgery. The companion bill continues to work its way through House committees.

    So what would the bill do? Mendelsohn and other supporters of the bill, sponsored by state Sen. Daniel Webster, R-Winter Garden, say it will end patient dumping by out-of-state doctors who come to Florida, perform surgery, then refer patients to optometrists for followup care.

    It will force ophthalmologists to provide the followup care "which they should have to do, and should have to do on their own dime, in my opinion," said former Secretary of State Sandra Mortham, now a lobbyist for the Florida Medical Association.

    Opponents of the bill say it will increase health care costs and force elderly cataract patients to drive out of town needlessly to see their ophthalmologist, even when the surgery was free of complications and a local optometrist could monitor their eyes.

    "This is really a fight between ophthalmologists and ophthalmologists, and optometrists have gotten caught in the middle," said optometrist Howard Braverman.

    "You will see the ultimate cost of eye surgery go up," he added.

    In their analysis, state staffers warned the bill could increase health care costs and left little doubt who would benefit: "This bill would economically benefit ophthalmologists . . . (and) would economically harm optometrists."

    At the center of the battle is Mendelsohn, who in recent years has become a prolific fundraiser for the Republican Party, hosting gatherings in his home for political heavyweights such as House Majority Leader Mike Fasano. He and family members have donated thousands of dollars to state lawmakers, some of whom subsequently signed up as co-sponsors of the bill.

    Mendelsohn says he doesn't stand to gain any money if the bill passes because he has always overseen his patients' post-operative care. Those who know him say his interest in politics is motivated by his desire to ensure patients get the best care possible.

    "He's very passionate about his issue. He believes people who deliver medical care should be licensed and experienced," said Broward County Republican Party Chairman George LeMieux.

    It's the belief that doctors haven't participated fully in the political process to the detriment of their patients that drives Mendelsohn, LeMieux and others said.

    "He does hold fundraisers in his house, but it's not an Alan Mendelsohn fundraiser" -- it's for the Florida Medical Association, said Steve Hull, who handles public relations for the Florida Society of Ophthalmologists.

    "What we've tried to do over the years is raise money for candidates who are pro positive medical issues."

    But optometrists don't see it that way. They say Mendelsohn's growing political influence has given them little chance in this fight for their livelihood.

    "I think it has a lot to do with his fundraising capabilities," said Ronald R. Foreman, the president of the Florida Optometric Association. Promises made earlier in the legislative session to oppose the bill are not being kept when committees vote, Foreman said, although he declined to name any legislators.

    "I think it's hurt the democratic process," Foreman said.

    -- Times researcher Kitty Bennett contributed to this report.

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