The Pascal photocoagulator allows retinal laser procedures like pan retinal photocoagulation (PRP) to be completed much faster than conventional lasers. Interviews with early-adopting practices found that the Pascal reduces PRP treatment time from 2-3 sessions totaling 37.5 minutes to a single session of 6-10 minutes. This time savings provides benefits like increased efficiency, improved patient experience with less pain and fewer return visits, and increased revenue and faster return on investment for practices.
Investing in Collaboration - Architectural Concepts for Machine Learning in Healthcare - Peter A D Steel, Weill Cornell Medicine and Yiye Zhang, Weill Cornell Medicine.
Machine learning (ML) has the potential to transform healthcare, utilizing big data to improve individual patient care and optimize healthcare systems. We examine applications of machine learning in clinical medicine, and the associated challenges, to elucidate the necessary culture, expertise, processes and infrastructure to ensure ML's value in healthcare is realized.
Fast and Efficient Practice: The Emergency Department Clinician on the Emerge...EmCare
Patient safety and satisfaction are the focus
within any emergency department. To streamline
navigation on the ED autobahn, i.e., flow, and
thus accomplish these goals most efficiently
can be accomplished by the consideration of
several factors and the application of several
key techniques.
Head-to-Head Comparative Study of Two Optical Biometric Devices in Modern Cat...SM2 Strategic
Today's cataract surgeon has adopted non-contact optical
biometry as the standard of care in performing IOL calculations.
While modern formulae incorporate multiple variables as part
of their calculations, Axial Length and Keratometry readings
continue to be the inputs that are most influential in determining
IOL power. Some of the newer generation formulas such as
Holladay 2 and Olsen now incorporate more elements to help
increase accuracy.
Investing in Collaboration - Architectural Concepts for Machine Learning in Healthcare - Peter A D Steel, Weill Cornell Medicine and Yiye Zhang, Weill Cornell Medicine.
Machine learning (ML) has the potential to transform healthcare, utilizing big data to improve individual patient care and optimize healthcare systems. We examine applications of machine learning in clinical medicine, and the associated challenges, to elucidate the necessary culture, expertise, processes and infrastructure to ensure ML's value in healthcare is realized.
Fast and Efficient Practice: The Emergency Department Clinician on the Emerge...EmCare
Patient safety and satisfaction are the focus
within any emergency department. To streamline
navigation on the ED autobahn, i.e., flow, and
thus accomplish these goals most efficiently
can be accomplished by the consideration of
several factors and the application of several
key techniques.
Head-to-Head Comparative Study of Two Optical Biometric Devices in Modern Cat...SM2 Strategic
Today's cataract surgeon has adopted non-contact optical
biometry as the standard of care in performing IOL calculations.
While modern formulae incorporate multiple variables as part
of their calculations, Axial Length and Keratometry readings
continue to be the inputs that are most influential in determining
IOL power. Some of the newer generation formulas such as
Holladay 2 and Olsen now incorporate more elements to help
increase accuracy.
The American Society of Caract and Refractive Surgery's magazine, EyeWorld quoted Dr. Dominick Maino extensively on his views concerning the role optometry and ophthalmology should play in the integrated practice.
Mandel Vision
211 E. 70th Street
New York, New York 10021
(888) 866-3681
http://www.mandelvision.com/
Patients have a higher level of confidence in choosing Dr. Mandel as he is the only exclusive laser vision surgeon in New York named in America’s Top Doctors by Castle Connolly, the most discriminating of the peer surveys, for twelve consecutive years. He is always at the cutting edge of laser eye surgery so patients in New York, New Jersey, and Connecticut can be assured of the highest quality of care.
The introduction of canaloplasty into the glaucoma surgical armamentarium was motivated by the desire of clinicians to enhance the quality of patients’ glaucoma care. Patients’ long-term adherence to topical glaucoma medical therapy is well known to be relatively poor. Laser therapy offers a safe alternative to medical therapy but often still requires the addition of topical medication. Traditionally, glaucoma filtration surgery has been reserved for more advanced, uncontrolled glaucoma for obvious reasons. Despite its definite role in glaucoma care, patients undergoing standard trabeculectomy are at significant risk for the development of postoperative infection, cataract, hypotony, bleb dysesthesia, astigmatism, and decreased visual acuity. These potential complications have driven surgeons to pursue surgical alternatives. Canaloplasty is a well-established procedure that has, for the past 3 years, demonstrated impressive efficacy and safety in peer-reviewed prospective studies. Despite growing evidence of its value and increasing performance of the procedure by ophthalmologists all over the world, misconceptions regarding its long-term efficacy as well as challenges in its adoption, surgical
technique, and patient selection persist. Several experienced and leading surgeons share their experiences and pearls for optimizing success with canaloplasty.
— Steven D. Vold, MD
Dr. Horn, with 54,000 Lasik procedures of which the last 10,000+ are All Laser Lasik, describes the modern Lasik procedure as he currently performs it.
An assignment for DH Theory 1 was to create an annotated bibliography for a research topic of our choice. This project was designed to challenge our critical thinking and decision making skills. I chose to research dental lasers and their effectiveness in the removal of oral lesions. It was interesting to compare different literature on this subject, and I had a lot of fun determining what articles were valid based on the evidence provided.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
Follow us on: Pinterest
Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Feedback from early users of the pascal photocoagulator
1. Feedback from Early Users of
the PASCAL® Photocoagulator
8 Shareef Mahdavi • SM2 Consulting • Pleasanton, CA 7
Along with the aging population and rising prevalence of Priced higher than a conventional laser, Pascal offers a new
ocular disease, technologies are being developed to give value proposition for physicians treating the retina to consider.
clinicians new and better tools to treat patients. As part of SM2 interviewed four practices who were among the first
ongoing evaluation of these technologies and their impact, to purchase the Pascal system in an attempt to learn how this
SM2 Consulting was asked by Optimedica Corporation (Santa impacts the practice from multiple perspectives. This report
Clara, CA) to interview a sample of practices that have summarizes their insights and, wherever possible, provides
adopted the Pascal system for use in commonly performed quantifiable metrics on changes to practice patterns from this
retinal laser procedures such as pan retinal photocoagulation new technology. The interview was open-ended, allowing these
(PRP), grid and focal treatment. Findings from those inter- users (see Figure 1) to describe what the impact of Pascal on
views are presented here as a means of helping physicians their daily practice has been like since acquiring the technology.
considering the technology to better understand and appreci-
ate the impact this technology is making in practices. Awareness and Interest in Pascal
Most physicians become aware of advances in technology
Introduction through lectures, articles, or promotional activities by manu-
Ophthalmic use of lasers dates back to the 1960s, with facturers. In the case of Pascal, a paper by Mark Blumenkranz,
many of the first applications developed for use on the retina. MD et al, one of the inventors of the technology, was published
PRP has remained a standard for decades in treating and pre- in March 2006 issue of Retina and referenced during the inter-
serving the vision of patients suffering from diabetic retinopa- views.
thy. Until recently, all lasers employed a single-spot approach: Dr. John Lehr had read that article, saw an online demo on
one foot pedal depression, one shot to the retina, requiring the company’s website, and wanted to try it. “Once I under-
physicians to spread out the PRP procedure over multiple ses- stood how it worked, I thought ‘this could be great for my
sions in order to achieve a complete treatment of 1,200 or more patients.’”
burns. When Dr. Eddie Ysasaga heard about the technology, he
In June 2006, Optimedica Corporation began shipping its knew he wanted to try it. “We serve the Texas Panhandle from
Pascal (Pattern Scan Laser) Photocoagulator for commercial use, Amarillo, and many patients come from several hours away.
offering for the first time a new delivery system using a mul- The concept of doing treatment in a single session was power-
tiple-spot pattern that can be scanned to the retina with a single ful: “Diabetic patients don’t like to come back.”
depression of the footswitch, up to 56 spots in less than 620ms. Other areas of interest described the improved reliability of
a solid-state laser, potential time savings and ability to see more
Fig. 1: Date of Acquisition
patients and/or end the workday earlier.
# of Retina When Initially skeptical, Dr. Howard Lazarus told the sales repre-
Name City Specialists Acquired
Houston Eye Associates Houston, TX 4 12/2006
sentative, “If you want to waste your time, bring it by. There’s
Rick Canady, no way I’d spend that amount of money on a laser.”
Executive Administrator
Rick Canady, Executive Administrator for Houston Eye
Magruder Eye Institute Orlando, FL 3 7/2006 Associates, concurred with the initial reaction to the cost of
John Lehr, MD and
Nader Moinfar, MD
the system. His practice sees 12,000 patients per month with
32 ophthalmologists (4 retina specialists) at 12 locations. With
John Kenyon American
Eye Institute Louisville, KY 1 11/2006 practice revenue growing at least 10% in each of the past 6
Howard Lazarus, MD years, Mr. Canady is continually seeking ways to make the
Southwest Retina Amarillo, TX 2 7/2006 practice more productive, which was the attraction of the Pascal
Specialists system. “When we amortize this,”he noted, “giving back 10
Eddie Ysasaga, MD
minutes on each procedure to the doctor would add up, espe-
1
2. cially given how many they do each day.” in how much faster may be attributed to surgeon experience.
While capital expenditures can be a critical factor in the “I’m changing my patterns and technique and am able to com-
decision process to acquire technology, all four practices pro- plete the treatment even faster than when I started with this
ceeded with scheduling an onsite demonstration and evaluation technology,” commented Dr. Ysasaga.
of the laser platform with the ability to treat patients during the This time savings can be realized in one or more ways:
day. Reactions by participating physicians are described in the additional patient slots during the week, ability to handle emer-
next section. gency treatments without upsetting the schedule, and ability
to finish the day earlier. Although each practice has a different
Consideration and Purchase philosophy on how to spend that time, they were unanimous in
Customers interviewed described a strong out of box experi- what it offered, as expressed by Dr. Lehr: “I can breathe during
ence when relating to their first impressions using the system. my workday.”
Drs. Lehr and Moinfar were impressed with the short learning
curve to perform a PRP. Dr. Lazarus said he was simply “blown 2. Patient preference The fast procedure time has led to
away” with how comfortable the Pascal was for the patient and patient reports of little or no pain with laser procedures, and
immediately saw practice-building potential for the technology. use of the Pascal has significantly reduced the need for ret-
Mr. Canady polled the practice’s retina specialists, whom he robulbar blocks prior to doing PRP treatment (See Figure 3).
described as skeptical until the moment they actually performed This is of huge benefit to gaining patient compliance, espe-
a procedure. “One admitted to me that he never would have cially among diabetics at risk of losing their vision. “Once
guessed the laser could do what it does, while another was patients saw the big needle, they didn’t want it,” explained
emphatic in saying, ‘if the other doctors don’t vote it in, I’ll buy Dr. Ysasaga. “I asked myself, ‘what would I want?’ and
it myself.’” the answer was simple: no needle at all.” According to Dr.
Collectively, these users report that the deciding factor for Lazarus, “the entire process is more palatable to the patient.”
them was the ability to use it in their offices. “You just have He further added, “I am more comfortable providing treat-
to use it. Once you get it in your office, you won’t go back,” ment at less advanced stages of retinopathy in accordance
remarked Dr. Ysasaga. His sentiment was echoed by Dr. with the recommendations of the ETDRS.”
Lazarus: “I went from being a complete skeptic to a customer Equally important is the convenience factor for patients, who
in one day.”
Fig. 3: Increased Efficiency Using PASCAL to Perform PRP
Impact on Practice Name Efficiency
From the interviews, impact on the practice could be catego- Houston Eye Associates 2x faster
rized in seven distinct areas, each meriting its own description:
Magruder Eye Institute 2-4x faster
John Kenyon American Eye Institute 3-4x faster
1. Time for the procedure The overall time to perform a PRP
procedure is significantly reduced, as Pascal’s multiple spot Southwest Retina Specialists 5-6x faster
application allows physicians to perform their laser procedures
anywhere from two- to six-times faster than using the conven- can receive in a single session what used to take two or three
tional single-spot approach (see Figures 2 and 5). The variability sessions. “For patients that drive several hours to see us, this is a
big deal,” said Dr. Ysasaga. Other practices believe wholeheart-
Fig. 2: Percent of PRP Patients Requiring
Retrobulbar Block Prior to PRP edly that condensing the number of treatment sessions means
greater compliance and, ultimately, more preserved vision.
Name Conventional Laser PASCAL Laser
Houston Eye Associates >50% 0%
3. Impact on revenue and ROI While physicians use different
Magruder Eye Institute >70% <10% scales for measuring return-on-investment (ROI) for the prac-
John Kenyon American 10% 0% tice, every practice interviewed has experienced a clear financial
Eye Institute
advantage. Houston Eye Associates, according to Mr. Canady,
Southwest Retina 10% 0% amortizes equipment purchases over a five-year horizon but
Specialists
expects a quick payoff from the Pascal. Drs. Lehr and Moinfar,
2
3. whose practice performs 20 or more laser sessions per week, 5. Staff Morale All practices indicated that staff is highly
saw an immediate boost in efficiency using the Pascal. The laser accepting of the technology because it helps maintain control of
schedule previously included many repeat (i.e., 2nd or 3rd ses- the daily schedule and keeps the clinic running smoothly. “Our
sion) visits to complete the treatment. The Pascal technology staff loves it because they don’t have to sell the patient on use
has enabled their practice to add 2-3 new clinic spots per day, of anesthetic block,” noted Dr. Lehr. This improved time man-
which translates to $50,000 - $75,000 of incremental revenue agement translates into doctors and staff being able to avoid
per year. In their view, the Pascal pays for itself in 1 to 1½ the crisis mode that typically hits with lengthy laser sessions or
years. “Now, I’d much rather be in the office doing PRPs than emergency patients.
at the hospital doing vitrectomies,” added Dr. Lehr.
Dr. Lazarus provided data that showed the effect of Pascal 6. Increased Efficacy Although larger studies are needed to
on his practice in the first 90 days after acquiring the technology. confirm their findings, each of the physicians believes the Pascal
In the quarter immediately preceding use of the technology, Dr. is generating better outcomes due to less energy being used
Lazarus performed 36 PRPs. In the first quarter using the Pascal, (leading to less thermal bloom and less collateral damage) and
he did 74 PRPs, more than double the prior quarter. This was the ability to perform a complete treatment (because of a more
the result of being more aggressive in his treatment due to less compliant patient). The potential side effects from traditional
resistance (as described earlier) and from increased volume due PRP have kept retinal specialists from treating sooner. “There
to his merger with an anterior segment practice that had previ- will likely be less reluctance,” predicts Dr. Lazarus, based on
ously referred out its retinal laser procedures (see Figure 4). The his clinical impression that the side effect profile will be signifi-
end result is a doubling of volume and revenue for what had cantly reduced.
been a time consuming procedure. This was achieved by a single
physician and without the need to increase staff. 7. Decreased Risk Clinically, Drs. Lehr and Moinfar stress that
the Pascal laser has helped them improve care by eliminating
Fig. 4: PASCAL's Impact on Revenue: Howard Lazarus, MD the gaps between sessions, which only increase the risk of fur-
ther deterioration due to vascular growth, at times then leading
Data from consecutive 90-day periods to more invasive (and hospital-based) vitrectomy. Further, they
PRP Procedure Volume Revenue believe strongly that the “ninety-first day” approach used by
Before Pascal & Pre Merger 36 $45,000
some clinicians to delay repeat sessions until they can be reim-
bursed is “not treating patients fairly. And, patients don’t like to
With Pascal & Post Merger 74 $91,200
come back.”
Delta +38 +$46,200 Another reduced risk is in the form of litigation from the
use of retrobulbar blocks. This is a salient issue for Houston
When Dr. Ysasaga first got the laser, he began doing side- Eye Associates, which has been at odds with anesthesiologists
by-side comparisons to help assess ROI but then stopped and over the classification of a block as in-office anesthesia. Use of
knew, “this is obviously a better laser for my practice and my the Pascal has helped them sidestep the entire potential conflict;
patients.” their experience to date has not shown the need to administer a
block by any of the four retina specialists in the practice.
4. The WOW Factor Once limited to describing the immediate
reaction of a LASIK patient, the concept of a WOW Factor
seems to apply to the presence of Pascal in the practice. “The
doctors love it,” proclaimed Mr. Canady. “There’s no com-
parison between the older technology and what this offers.”
Physicians remarked that patients who have prior conventional
treatment and now have it with Pascal will ask, “you’re done?”
Referring physicians are noticing as well. “You start getting
calls,” commented Dr. Ysasaga. Added Dr. Moinfar, “we
demonstrated this to a visiting optometrist and he was over-
whelmed by what we could accomplish.”
3