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Laser Vision Institute Exposed
(4 part series from Las Vegas KVBC News Station)

LAS VEGAS, February 27, 2002
Darcy Spears reporting

Can you see clearly without glasses or contact lenses? Many people can't. In fact, more than a million people turn to lasik surgery each year to correct their vision. One of the largest national chains of laser eye surgery centers has a booming business here in Las Vegas, but News 3 investigator Darcy Spears found that this discount center may be pulling the wool over your eyes as they put sight up for sale.

Can you put a price on perfect vision? One lasik center puts a very low price on their surgeries, and as the saying goes, you get what you pay for. Our hidden camera investigation exposes what some call a "money over medicine" philosophy that's leaving patients and former employees seeing red."She basically talked me into it, because it sounded good. Don't have to wear glasses to read or drive," says Gail Kennedy, consumer.
Gail Kennedy looked to the Lasik and Laser Vision Institute as freedom from her prison of poor sight. Gail had known people who had successful surgeries there. The problem is, she did not."It's been 11 months since my surgery and my eyes have hurt me every day, every night," says Gail.Gail says she still needs reading glasses and can't really see any better.
"It's almost like the nerve endings have been damaged and they're severely dry."

Dr. Jon Siems was the staff surgeon at LVI in Las Vegas for almost two years. He and at least five other staff members recently left because of what they call the money over medicine mentality."Salespeople had to meet certain quotas to maintain their jobs or else they'd get released. Optometrists had to see a certain number of patients every day, physicians were supposed to perform a certain number of surgeries a day," says Dr. Siems.
Internal records obtained by the News 3 investigators show LVI staff can get commissions depending on how many patients they sign up each week. LVI optometrist Dr. Lesa Davis acknowledges the pressure."The counselors are the ones under pressure to see as many patients as they can, or have me see as many patients as I can," Dr. Lesa Davis.
"It presents an issue of conflict of interest, doesn't it? If someone's reimbursement is based upon whether or not you decide to have the surgery or not, there's a potential risk that the counseling role might be tainted by that incentive," Dr. Wayne Bizer of the American Academy of Ophthalmologists.

We sent a producer with a hidden camera for the advertised free consultation. Here's what a salesperson, called a patient counselor, told her. Keep in mind, this person has no medical degree."For this consultation, what did this tell me? That I'm a candidate?" Asked our producer."You're basically a good candidate for the surgery. Obviously I can't determine it without seeing exam results, but based on your prescription and your age alone, yes, you're a very good candidate for the surgery. If you were not a good candidate for the surgery, I wouldn't let you go on," said the consultant.But just to see a physician, patients first have to put down a non-refundable $100 deposit, based on advice from a salesperson.
"The company's policy is that the only one that can make the decision as to whether or not somebody's a candidate is the physician," says Matthew Zifrony.No one from laser vision institute's corporate offices would go on camera. Their lawyer says the Las Vegas LVI staff was not following procedure."If the company's policies are not being followed and we have reason to believe that, then we will take the appropriate action to see that they are followed," says Zifroni.That's too little, too late for some."I think there's a lot of other people out there like me and I've wanted for a very long time for something like this to happen, because I think it needs to be heard," says Gail.

Gail Kennedy isn't the only Las Vegas LVI patient who's had problems. You'll meet more in the continuing coverage of this story. LVI's attorney asked us to point out that there are plenty of happy laser vision institute patients.During the last half of 2001, LVI performed procedures on about 1,000 patients.Eighty-one of those, or approximately 8 percent, filled out a patient satisfaction survey and almost all of them thought their treatment was good or excellent.

Local experts and ophthalmology surgeons we spoke to say that the industry standard is for patients to get a free eye exam from a doctor to determine candidacy before they start spending money on the lasik process.

PART II

LAS VEGAS, February 27, 2002
Darcy Spears reporting
What happens when corporations try to control medical care? A local surgeon says it becomes a "money over medicine" mentality. That's something that's thriving here in Las Vegas at discount surgery center, Laser Vision Institute.

Who would you want telling you whether you were a candidate for laser eye surgery? A salesperson? A corporate business executive? Probably a doctor. But we found that may not be the case at one center, where sight is for sale.

Having an eye operation is serious business. You want to make sure your doctor is in complete control.But lack of control is one of the reasons Dr. Jon Siems says he left Laser Vision Institute after almost two years."Really my primary concern that I had, as well as many other physicians that were associated with this institute, was an excessive amount of pressure that we had...to treat all patients that came in--and really patients that I deem not even proper candidates for the lasik procedure. They were trying to pressure me into treating those patients," says Dr. Siems.

We decided to put that pressure to the test with our hidden camera.
We start by having this News 3 reporter examined by local ophthalmology surgeon Dr. Paul Hiss."Amy has several reasons why she would not be a good candidate for a refractive procedure, especially lasik. Number one, she has extremely dry eyes. And she has very large pupils, which would increase her probability of getting a lot of glare from lights at night. But the most compelling reason is that she has warpage of the cornea," says Dr. Hiss.
Something he and a second expert diagnose as a degenerative eye disease.
"There isn't a surgery that can help her see any better," says Dr. Hiss.Armed with that information, she heads to Laser Vision Institute."With your prescription, I'm sure you know you're extremely high with a pretty high astigmatism. You do fit the parameters for the surgery," says the patient counselor, Jill.

The patient counselor passes her on to the next step. Amy has to pay $100 to secure her exam time and $200 more on exam day, where she spends two hours and sees three different people, including optometrist Dr. Lesa Davis."You've got a lot of astigmatism, you've got a lot of nearsightedness, you've got every strike against you for the surgery as far as the laser vision institute goes with prices," says Davis.Price seems to be the only problem Dr. Davis diagnoses."You happen to be in luck because you have thick corneas," says Dr. Davis.Remember what our expert said?"Operating on a cornea that already has instability would only add to more instability," says our expert, Dr. Hiss.But according to LVI, "you're a good candidate for the surgery. You're chances of needing an enhancement are fairly high due to your prescription though, so it may take two surgeries to get you to see perfect," says Davis on our hidden camera.There's no mention of Amy's condition or any medical concern at all. We sat down with Dr. Davis to ask why she approved Amy for surgery."She actually wasn't approved for surgery," says Davis in our interview.What about this?"You're ok to schedule for surgery, so follow me," the hidden camera footage says.Her explanation? They actually weren't done with Amy."Was she scheduled for a re-check prior to surgery?" Asked reporter Darcy Spears."She should have been," says Davis.She wasn't. She was sent to the desk to pay her $200 exam fee and schedule surgery."As soon as a patient gets to the front desk, I have no call," says Davis.This was the call she made at the front desk. Dr. Davis to front desk on hidden cam: "She's ok to schedule for surgery."Dr. Davis maintains Amy's condition would have been caught."Are you saying that after buying the medications, going through the prep, being out of her contacts, coming in the morning of her surgery, that day, someone would have said, "I'm sorry, we can't operate on you?" Asked Spears."Absolutely," says Davis."Isn't that too easy to say in hindsight?""You can always say that, but there has not been one patient who has slipped through who shouldn't have had the surgery under my care," says Dr. Davis.

LVI corporate attorney Matthew Zifrony says Dr. Davis doesn't have the authority to decide who should have the surgery. Zifrony says that whether a patient qualifies for lasik or not is up to the surgeon, who patients typically don't meet until the day of their surgery.
"Up until that time, the patient would not have been told or should not have been told that they are a candidate by anybody, because the company does not give anybody the authority to tell the patient that they are qualified other than the physician," says Zifrony.
That physician is Seattle-based surgeon Dr. Joseph King. In a memo just sent to News 3, he agrees that Amy should have been re-checked even though he never examined her. He says he may have decided to cancel Amy's procedure the morning of her scheduled surgery.

Dr. Siems says the doctors didn't have the last word. That, he says, came from the corporate office."If they looked through the charts and saw that they felt they thought this was a candidate, they would call us up and inform us, or at least ask us why this patient had not been treated because they felt they were candidates," says Siems."To my knowledge that has never happened and to my knowledge that will never happen because the company's interest is to keep the patient's well-being paramount to everything else. It is not to put the company's interests first and foremost," says Zifrony.Dr. Lesa Davis has only been licensed in Nevada for one year. She has a clean record with the state. There's LVI doctor who we found operating on the wrong side of the law.

We'll uncover that as our investigation continues on Friday.LVI's parent company has been in trouble with the Nevada attorney general for their advertising. On Friday, Darcy will also look at what the ads offer, versus what they deliver.

Click here for parts 2 to 4

Article from KVBC-TV Las Vegas