On 2014 Mar 06, David Keller commented:

Cataract pre-ops are driven by the ophthalmologists

The American College of Cardiology and the American Society of Anesthesiologists are in agreement that the routine pre-operative examination is not necessary for stable patients. That is good, but you will not see a decrease in the number of these exams until the ophthalmologists sign on to that agreement. Here is how it works in private practice: an elderly patient shows up in their internist's office one day, after skipping their routine follow-up appointments for way too long, perhaps to the point where their internist has been mailing them reminder letters and enlisting the patient's pharmacist to remind the patient to follow up soon. Finally, the patient shows up with a note from their ophthalmologist requesting certain specific blood tests, an EKG and "clearance" for the cataract procedure. If these instructions are not followed by the internist, the patient's cataract extraction will be postponed, and the internist may lose the patient to a more user-friendly PCP. To improve its impact, this article should be co-published in JAMA - Ophthalmology.

On 2014 Mar 06, David Keller commented:

Cataract pre-ops are driven by the ophthalmologists

The American College of Cardiology and the American Society of Anesthesiologists are in agreement that the routine pre-operative examination is not necessary for stable patients. That is good, but you will not see a decrease in the number of these exams until the ophthalmologists sign on to that agreement. Here is how it works in private practice: an elderly patient shows up in their internist's office one day, after skipping their routine follow-up appointments for way too long, perhaps to the point where their internist has been mailing them reminder letters and enlisting the patient's pharmacist to remind the patient to follow up soon. Finally, the patient shows up with a note from their ophthalmologist requesting certain specific blood tests, an EKG and "clearance" for the cataract procedure. If these instructions are not followed by the internist, the patient's cataract extraction will be postponed, and the internist may lose the patient to a more user-friendly PCP. To improve its impact, this article should be co-published in JAMA - Ophthalmology.