optoblog.com

Hairstylists and eye doctors have a few things in common. There are independent and chain salons. Some charge more than others and quality can differ widely between low end and high end salons. Beauty shops provide services and also sell products related to their services. To contrast, of course becoming an eye doctor has a lot more schooling, and nobody ever died or went bald because their hairstylist didn’t perform adequately (right?) But what really sticks out to me is that there is no Haircut Insurance.

Little old ladies sometimes get their hair done on a weekly or bi-weekly basis. I can’t imagine what their budget must be for their hair care, and yet some people aren’t willing to invest in their eyes once a year!

I’ll bet the next big idea in the insurance industry is going to be Hair Insurance. You see, everyone needs a haircut, but not everyone actually gets a haircut, so that is the theory behind vision and haircut insurance. Yup, the hair stylists are going to have to suffer like the rest of us eye doctors. Actually, everyone will suffer, but first let me tell you how the insurance agents would sell hair insurance.

For a very affordable monthly premium, each hair-insured individual will get:

• A routine haircut on a monthly basis (with a co-pay), and when utilizing a participating salon, any additional haircuts will be 50% off (plus the co-pay).
• Any “extras” like coloring, bleaching, perming, etc will be contracted with participating salons to offer you these services at a 40% discount.
• A “Nail Care” rider can be added to your policy for a modest premium increase.
• Each policy will have a “product benefit” that allows them to get certain brands of shampoo, gel, etc. every other month (additional products may be purchased more frequently from participating salon for 30% off the retail price.
• For low risk individuals, baldness protection insurance can only be obtained by an in-person interview with the insured, both parents, and both sets of grandparents, and a blood test. High risk individuals can get follicle transplant surgery at a participating provider for an amazing discount.

Here is what the hair insurance companies will tell the stylists:

• If you become a participating salon, we will drive a lot of traffic to your door.
• We will reimburse you for half your usual fees, but you still get the co-pays and plus all this traffic we’re going to drive to your door, and sometimes people get their hair cut more than just once a month and you can collect up to 60% of your usual fees for any haircuts more than the benefit.
• You won’t make any money from the reimbursement on the first sale of shampoo, gel, etc, but since we are driving so many people to your door you can up-sell lots of people to additional premium products but only at 65% of your retail price.
• Since we are an insurance company, you will have to start keeping detailed records of every haircare encounter. If you do not keep the records exactly the way we want (and we are not allowed to tell you how we want them), then we have the right to refuse payment and fine you until you go bankrupt.
• If a client complains about a lowsy haircut, we will withdraw payment for services rendered until dispute mediation has occurred.
• If you do not send in the hair cut insurance claim forms with the proper procedure and billing codes, then you will not be reimbursed. If you call and ask why your procedure and billing codes were incorrect, we will tell you that by law we are not allowed to suggest the proper codes. If you try submitting random codes in the hope that you’ll find one we accept, then we’ll make sure you go to jail. We will not notify you for at least 30 days when we receive an incorrectly submitted claim form. We will not reimburse for properly submitted claim forms if they are received more than 30 days after the date of service.

Now here is what will happen to the market when haircut insurance becomes available:

• Clients will be forced to sign a paper before their haircut stating they will not sue if they think they get a bad haircut. Any dispute will be handled by 3rd party mediation.
• Hair care product cost and haircut fees will immediately double (and justifiably so because reimbursement is so poor and now they have to keep detailed electronic records of each haircut (client c/o hair being too long; wants to know if receding hairline and thinning crown area are good candidates for FRS [follicle replacement surgery]. Client desires “his usual #1 fade.” From previous notes I reminded him that he usually gets a #2 fade. He still persisted about wanting a #1, so after he signed the waiver, I proceeded with a #1 fade. I left areas around the crown slightly longer to compensate for thinning. I suggested combing forward to help with the crown. Advised against certain OTC hair re-growth Tx since they can lead to complications. I will refer him to the FRS specialist for consult. Co-pay is $10 and balance billed to Hair Insurance.)
• Most big box salons will not be allowed to be participating salons, so they will undercut everyone’s prices to attract those without hair insurance.
• Most people will just go to whatever salon that accepts their haircut insurance, but the salons that do accept it will go out of business because the insurance company rules are confusing so they never get paid.
• The salons that accept insurance and stay in business specialize in coloring, perming, and bleaching because that’s the only way they can turn a profit while still accepting insurance.
• Little old ladies will now only get their hair done once a month “because that’s all my insurance covers.”
• Most men will have flakes in their hair from the gel they use, but they’ll put up with it “because that’s the gel my insurance covers.”
• Most women will have dry, damaged hair because their shampoo and conditioner combination is cheap, but they’ll use it because “it would have cost more to upgrade to the good stuff. I don’t want to waste the insurance benefit for which I pay all those premiums.”
• Most people will go around with a bad haircut.
• Hair follicle replacement surgery will be advertised in the funny pages.
• Upscale salons won’t accept haircut insurance, and they will be the only ones that thrive because they center their business about the quality of their work, their salon environment, and their excellent service.

I lurk at Optiboard.com, and someone posted a message about how they don’t diagnose or treat glaucoma:

No, we haven’t been diagnosing and treating glaucoma in the office for the last 5 years. There are were so many changes in instrumentation that we thought we’d let the MDs pay those leases, and we refer everything suspect.

What the c—? If you say you refer “everything suspect,” then I suspect you either over refer or under refer.

Over referrals do your patients a disservice by increasing their healthcare expenditures. They have to become a new patient at some else’s office, repeat a lot of tests, and pay more since EyeMD fees on average are higher than EyeOD fees. Then they somehow get the idea that ophthalmologists must be the experts because my optometrist is too stupid to find out if I have glaucoma or not. They probably get this idea from their ophthalmologist telling them in the exam room, “I’m glad you came in to see me because optometrists are too stupid to diagnose and treat glaucoma, and you know this is true because a representative from that trade sent you over to me.”

I could also see how it would be very easy to under refer in that scenario, “well, it’s borderline, but I don’t want them to waste a lot of money seeing Dr. Expensive Ophthalmologist since they don’t have insurance, so I’m just going to decide that it’s okay. Besides, if it’s glaucoma, it could take years before they notice it.”

Obviously, neither scenario is acceptable. I wrote the following reply to that thread on the web board:

That makes me sick. For the sake of the optometric profession, practice to the fullest extent.

This is why some of us should have a special designation called “Board Certified Optometric Physician” and then the rest of you not interested in patient care can be called Optometric Lens Flippers.

Actually, I would like to add that optometry and optometrist are good names. Shame on those who disgrace them by not practicing basic eyecare.

I think the days of an ophthalmologist marketing him/herself in the yellow pages as “the glaucoma specialist in the valley” are coming to an end. All eyecare providers should be glaucoma specialists. If we don’t have certain instrumentation, we can work it out to send the patient to another office only for that particular test.

Can you imagine an optometrist saying “I don’t diagnose cataracts”? It’s the same thing with glaucoma. We diagnose and treat it, and send the patient to someone else only when necessary to do something outside the current scope of practice (ex. glaucoma or cataract surgery).

I did not know this before, but apparently New Zealand measures the overall safety of different professions. You guessed it, optometry is the safest profession in New Zealand. I would guess that it has less to do with actual safety and more to do with the fact that the reporting is inaccurate. We optometrists aren’t very big complainers.

That broken back from leaning to reach the phoropter? It’s not bad enough to complain about, and it seems to be stable- the same amount of pain over the last few years.

That stomach ulcer? Hardly related to the stress at work. I’m sure it’s just from eating pizza, and it seems to go away for a few minutes if I down enough Ca++ carbonate.

What do I have to complain about anyway? Do I complain about insurance companies discriminating against me by not letting me on their panels, even though I am fully qualified? Well, actually, THAT I do complain about. Ticks me off to no end.

I think New Zealand probably forgot to measure the safety of being an ophthalmologist. They have their techs do refractions, office and optical managers do everything else, and they don’t have any problems being paneled. What a charmed life!

I’ve known about the president’s weekly podcast from his weekly radio address for a while, but I was blown away when I found out that the Dept. of Health and Human services has a daily podcast called Daily Healthbeat Tip. Today’s 1 minute episode was about glasses safety.

E-mail is a relatively simple Web 0.5 application that almost anyone can use. So what is the deal with people still not learning what BCC means? I just got an E-mail announcing OOGP’s new and improved website (and believe me, they needed the improvement).

Well, good job for updating your site, OOGP, but how come a 4.333 page list of e-mails were sent using “TO:” instead of “BCC:”? What’s the deal? If I were an ophthalmic vender, I would give Dave Langford a call to get a copy of that 4.333 page list. Maybe offer him some cash since that list would have to be full of active e-mail accounts for real eye doctors using OOGP.

Yup, give me a call, Venders. I’m waiting. I’ve also got school and business loans to pay off.

Now, you might say, “Well, spam filters frequently trash e-mails with BCC.” To which, I would say make an RSS feed on a blog/announcement page and ask your members to subscribe. That way everyone who wants it gets the content and announcements.

Someone made a list of Utah bloggers and left me out. 😥 Optoblog.com gets no respect.

See the comments section. Steve added me lick-i-dy split. Nice guy.

An alert blogger spotted a DVD on the market that helps kids be excited about wearing an eye patch. Check out the doctor puppet. Doctor sure looks kind of scary, but other than that, this DVD by Bjort & Company could be a good idea.

If anyone is in need of an optometrist in Smithfield, UT, then please see Summit Vision Center located at 136 E 800 S, Stc C, Smithfield, UT 84335. Their phone number is 435-563-2020. Summit Vision Center will open the first of June 2006. Hours will be:

Mon 9am to 5:30pm
Tues 9am to 7pm
Wed 9am to 5:30pm
Thurs 9am to 5:30pm
Friday 9am to 5pm
Saturday 9am to 3pm

Summit Vision Center wishes to become the primary eyecare provider of choice for Smithfield, Hyde Park, Amalga, Clarkston, Richmond…in short, all of northern Cache Valley. Of course, we welcome anyone living anywhere.

The optometrist, David J Langford, O.D., is from Idaho, but has roots in Cache Valley. He served in the U.S. Public Health Service at an Indian Health Service hospital for 2 years before arriving in Smithfield. Summit Vision Center’s philosophy is to provide excellent service and value in your eyecare and eyewear.

I know that contact lens reps give us pamphlets all the time about their products, but I think it’s cool that they also have them online. I would much rather have it online since I usually just read it once then toss the very nice, cardstock, glossy paper away.

Here is an example of B&L PureVision. I originally got the link in a mass e-mailing from Review of Optometry.

Someone wrote about allowing patients to schedule on-line using the new Google Calendar.

Aside from any HIPAA issues, I think on-line scheduling done by patients themselves is a very bad idea. As one commenter mentioned, triage is a very important issue regarding when/how soon you get someone it. Also, practice consultants have various scheduling schemes to help us maximize our time for seeing full exams, follow-ups, special testing, etc. Given that we pay for their advice, why would we place control of scheduling into the hands of the general public?