To the Editor.
—The Special Article by Sacks,1 in the December issue of the Archives was an excellent one and succinctly demonstrates how ophthalmology has reached its present, unenviable situation. However, I believe there are several other factors that might also be considered in the equation. The first is the Federal Trade Commission's ruling that the American Medical Association's prohibition of advertising by members constituted restraint of trade. This has encouraged the most economically motivated ophthalmologists, who are not necessarily the most capable, to unabashedly hawk their surgical wares in the marketplace, contributing to neither cost nor quality control.Second, when the US Congress passed the budget bill with a rider (coincidentally introduced by a congressman who is also an optometrist) that legalized fee-splitting between ophthalmologists and optometrists, it encouraged the "dollars for referrals" mentality of the members of both the ophthalmological and optometric professions who are willing to
Hattenhauer JM. Society and Ophthalmology. Arch Ophthalmol. 1990;108(5):633. doi:10.1001/archopht.1990.01070070019001
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