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The Wal-Marts of eye surgery: speed, convenience lure seniors to high-volume centers.

Welcome to cataract express. At the McFarland Eye Surgery Center in Pine Bluff, they'll give you a free ride to the clinic, set you up with an in-house optometrist, diagnose your vision problem, make your next appointment and take you home.

And oh, yes: At your bidding, they will remove your cataracts in 15 minutes, using state-of-the-art techniques and equipment.

Do the patients like it?

You bet.

Do other eye surgeons hate it?

You bet.

Is there a quicker way to make $5,000?

Don't bet on it.

This freestanding surgery center is the largest of its kind in Arkansas. But several others have popped up across the state, and the ophthalmologists who run them are cutting into the business of their more traditional colleagues.

"I planned on losing money," says Mike McFarland, the ophthalmologist who founded the Pine Bluff clinic six years ago.

Well, he was wrong.

McFarland is hesitant to discuss his profit margins. He doesn't have to. The fact this surgery center makes a lot of money is apparent.

Your first hint is the fleet of customer vans parked in the driveway. There are 10 in all, but seven are dispatched on this day to bring in the elderly from across the state.

The second hint is the large number of parking spaces encircling the building -- about 150 -- and the percentage of them that are occupied.

The third clue is revealed behind the front door of the 12,000-SF building. People are everywhere. About 40 patients are watching a big-screen television, playing checkers, playing dominoes or reading magazines. Many are sporting sunglasses to protect their dilated pupils.

Yet they are no match for the staff. Seventy people work here, seemingly all of them bustling about in dusty, rose-trimmed outfits that match the building's decor.

Some hospitals seem understaffed by comparison.

A Busy Place

"We are very busy," says the administrator, Jan Bodie Danner. "We like it that way."

McFarland, a confident, deeply tanned man, says his success surprises him.

"I didn't start out to end up where I am now," he says.

McFarland began a small practice in Pine Bluff 11 years ago and opened the surgery center five years later after growing impatient with what he describes as an unprofessional hospital staff.

There are more than 800 such centers across the country.

McFarland and the other high-volume eye surgeons did not arrive at this point by being cautious.

"I've always done things differently than other people," McFarland says. "... I received a lot of criticism from other doctors."

They don't mention McFarland by name, but there are doctors who claim heavy advertising and free van rides are the marks of shameless mass marketers. Your name is in the phone book, they say. If people need help, they'll call.

Charles Henry, president of the Arkansas Ophthalmology Society, is concerned about current trends.

"Anytime you have advertising that tries to encourage more surgery, that is not good," he says. "You can practice good medicine without going on TV to advertise your services."

McFarland wonders what the fuss is about.

"The success of our practice is based on our care for patients," he says. "It's not advertising. It's not free van rides.

"It angers me that you can be criticized for giving a free ride to a doctor's office. I think they are just jealous of the fact that you are getting a large share of the business."

There are several factors weighing in favor of Arkansas ophthalmologists. Chief among them is that Arkansas has the nation's fifth-oldest population, and most cataract patients are between the ages of 70 and 75.

Gissur Petursson, professor of ophthalmology at the University of Arkansas for Medical Sciences at Little Rock, says half of the state's new ophthalmologists migrated from other states during the past decade to mine that source of retirees.

1.5 Million Procedures

According to the National Society to Prevent Blindness, 1.5 million cataract procedures are performed in the United States each year. One in seven cases of blindness in persons above the age of 45 is caused by cataracts.

Still, ophthalmologists say the industry's financial future is not certain. Cutbacks in Medicare and Medicaid payments have taken some of the profit out of cataract surgery, which boomed as a business in the 1980s.

For the typical ophthalmologist who uses hospital facilities to conduct surgery and often cannot perform back-to-back surgeries, the profit margin could be modest by medical standards. All Little Rock ophthalmologists fall into that category.

For the high-volume eye surgeon, however, it's a living.

McFarland, for example, performs up to 40 surgeries per week, his staff says. He could make $6,900 for removing cataracts from both eyes of a patient. In McFarland's case, the procedure rarely takes more than 15 minutes.

It's a meaningless mathematical exercise, but those figures imply a surgeon could make more than $27,000 per hour once he enters the operating room.

The figures are based on what Blue Cross & Blue Shield of Arkansas allows in physician and facility fees for each cataract surgery.

Only 18 percent of McFarland's patients rely exclusively on private insurance. Seventy percent of the patients use Medicare, which drops the allowable fee to $3,700. Seven percent of his patients have only Medicaid insurance, and 5 percent have no insurance.

Surgeons say overhead is high in freestanding clinics. But if it isn't well worth the expense, why would doctors bother?

The concept of the eye surgery center is catching on in Arkansas.

Larry Bone runs a similar operation called Eye Associates of Fort Smith.

Robert Landry and Thomas Stank perform cataract surgery at Eye Surgery Center of Arkansas at Jonesboro.

Other notables are Eddie Bryant's Doctors Surgery Center in West Memphis and the Lowry Medical Surgery Eye Center in Searcy, owned by Ben Lowry and Robert Lowry, who perform 700 to 800 surgeries per year.

Skepticism remains rampant in the traditional medical community concerning such large practices. They might, however, be the future of medicine as health costs continue to soar.

Petursson says there are thousands of uninformed patients in the state who can be manipulated by profit-oriented eye surgeons.

"The issue of rehabilitation has been lost," he says. "I don't like it. Take what they say with a grain of salt."

McFarland has a comeback.

"Cataract surgery is strictly an option," he says. "It's never imperative. I probably talk more patients out of surgery than into surgery."
COPYRIGHT 1992 Journal Publishing, Inc.
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1992 Gale, Cengage Learning. All rights reserved.

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Title Annotation:McFarland Eye Surgery Center
Author:Haman, John
Publication:Arkansas Business
Date:Aug 3, 1992
Words:1071
Previous Article:Is there a doctorate in the house?
Next Article:Willing and ABLE: Arkansas' senior workers get second chance with encouragement and training.
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