We (handle) mostly, cataracts, Lasik and corneal transplants. We do a lot of eyelid surgery. We're a large group practice with six doctors - four eye surgeons and two optometrists. We have one doctor who spends a lot of time in the Branson office, and we have a major office in Joplin as well, so we have one doctor who's there full-time. We have small satellite offices in Neosho, Bolivar, Monett, El Dorado Springs, Houston and Marshfield. I've been here since 1996.
Describe your efforts to help bring Lasik to the Ozarks.
We started doing laser eye surgery, before Lasik, in 1996. We began doing the all-laser, no blade Lasik with the intralase ... about five years ago. Everywhere does it now. But for many years, a lot of the practices in the area and around most of the state, still used a blade to cut flap ... for the Lasik. We saw good results early on, using the laser to create the flap.
What does your practice encompass?
I do a lot of refractive and cataract work and a lot of Lasik. And I do a lot of corneal transplants in the region. ... The technology for that has changed dramatically in the last few years. I began training back when transplanting the cornea was a big process - (a lot) of stitches (and) a year or more to heal. Now we just transplant layers of the cornea - the layers that have gone bad, and you can do that without stitches. It heals much faster and is much easier on the patient.
I began training for (corneal transplants) in 2002, when it was still done by hand, and now we have machines that do it and make it much easier and faster. I actually performed (my) first all-laser corneal transplant ... last year.
What's the purpose of the state Board of Healing Arts?
The board's mission and main focus is to protect the citizens of the state of Missouri in any issues regarding medical personnel, doctors, physical therapists, even tattoo artists and sports trainers - all of those are under the Board of Healing Arts. Optometry has its own board and nursing has its own board, so we don't regulate some of those professions. We handle licensing, monitor the continuing medical education requirements, and (handle) disciplinary actions and investigate complaints. There are quarterly meetings, and then, in between each meeting is a large conference call. A lot of things are able to be done (online) as well, and it's a lot easier than having to travel to Jefferson City constantly.
What drew you into ophthalmology?
I originally thought I was going to be an orthopedic surgeon and do sports medicine. That was what led me to medical school. I played football in college, so I dealt with doctors a lot with injuries. But when I was in school, I was assigned to the Riley Children's Hospital in Minneapolis and did lots of pediatric eye muscle surgeries and thought it was fascinating.
What do you think are some of the most overlooked issues in eye health?
The most overlooked - though it's improving as both hospitals in town have had a major push in the last couple of years - is to focus on getting diabetic patients their annual screenings. That is an area where we see a lot of people ignore recommendations. The family doctors have really pushed in the last couple of years to try and get everyone to do their annual screenings, because diabetic eye disease is very treatable if it's caught early. But if it's let go for a long time, the results are not so good. (The second most overlooked is) probably yearly glaucoma screenings. They are very important, because we see many patients who have never had an eye exam but have significant glaucoma damage that's not reversible.
Is access to care a challenge for your discipline?
The majority of our patients are Medicare age, so for the most part they're covered.
We do have a very high portion of Medicaid patients in this part of the state, and for major eye diseases, for the most part, they're covered. We're seeing a much bigger number of patients who come in without insurance and are just self-pay. One of the advantages that we have, with our own practice, is being able to do our own surgery - we have a surgery center across the hall - and we can work with those patients on a cash price that's a little more reasonable for them.
