RE: Pictures

I think the pictures would be a good addition to the powerpoint presentation. I take it we will all have powerpoint slides to "talk to" correct?

-Zoe-

Some pictures for power point

Locations

Lasik Surgery Major General Environmental Trends

The general environment is composed of dimensions in the broader society than influence an industry and the firms within it. We group this dimensions into six environmental segments: demographics, economic, political/legal, socio-cultural, technological, and global. Firms cannot directly control above segments and each element within them. It is for that reason that, successful companies gather the information required to understand each segment and its implications for the selection and implementation of the appropriate strategies (Hitt, Ireland, & Hoskisson, 2005).
The demographic trends can be a powerful underlying force in a market and it can be predictable. Among the influential demographic variables are age, income, education, and geographical location (Aaker, D. 2001). In the case of LASIK surgery, the generation X those born roughly between 1960 and 1965, represent a target market due to the perception that they are more concern about their appearance, lead more dynamic life styles due to their current age, and are more atone with technology. The non-use of glasses or contact lenses could be appealing to this people. The average Lasik patient is about 39 years old with an income of about $88,000, said Dave Harmon, president of Market Scope, a company that tracks the industry. “Their education level is significantly higher than average,” Harmon said. “Very few people in their 20s have it done. Very few people in their 50s have it done.” (MSNBC, 2005, After a decade, lasik surgery is still a luxury, Retrieved November 19, 2006).
Another consideration would be targeting minority groups. Ethnic population is rising rapidly and support whole firms and industries. Hispanic population, for example are growing about five times faster and are gaining in income as well. Besides Hispanic population is up 79.7 % since 1970, in the Pacific Northwest according to 1980 Census data. (Eric ed. Gov site, Hispanics in the Pacific Northwest, Cook, A., 1983. The older demographics group is of particular interest, because is blessed with not only resources but also the time to use them and have the means to pay for this kind of surgery who is not covered by health insurance carriers. Economic trends are the prospects and inflation outlets for the countries in which the firm operates. Inflation rates and interest rates determine largely the buying power of consumers when it comes to having elective surgery done. Unemployment rate is another issue that needs to be taken into account.
Political/legal trends are competition and anti-monopoly laws, taxation laws, and deregulation philosophies. What changes in regulation are possible and what will their impact be? What tax or other incentives are being developed that might affect strategy? What are the political risks of operation in a governmental jurisdiction? The addition or removal of legislative or regulatory constrains can pose major strategic threats and opportunities. For example ban of certain surgical procedures, justification to invest in expensive equipment in the medical industry specifically eye care treatment.
Socio-cultural trends relates to workforce diversity, women in the workforce, concerns attitudes about quality, concerns about the environment, and shifts in preferences regarding product of work life and service characteristics. Cultural trends can present both threats and opportunities for a wide variety of firms (Aaker, D., 2001). For example the fact that in the case of LASIK surgery, U.S Patients choose their doctors by word of mouth, Harmon said. (MSNBC, 2005, After a decade, lasik surgery is still a luxury, Retrieved November 19, 2006).

Technological segment encompasses product innovations, applications of knowledge as well as new communications technologies. To what extent are existing technologies maturing? What technological developments are affecting or could affect the industry? These are some of the questions firms need to deal with. It is often easy to compile a list of technologies in the wings; the hard part is sorting out the winners from the losers. Ray Burke, a retail expert from Indiana University, drew upon a variety of research sources to develop a set of guidelines for separating winners from losers. Although his context is retailing, any firms exploring new technologies can benefit from considering each of the guidelines: Use technology to create an immediate, tangible benefit for the consumer. Make the technology easy to use. Execution matters: prototype, test, and refine. Recognize that customer’s response to technology varies. (Aaker, D., 2001)
In the case of Lasik surgery there are two new technologies. One allows the patients to heel faster and the other, results in better vision for some patients. One is called “blade-free” with the use of a laser named IntraLase, the other, is called wavefront-guided Lasik, and recently was approved by the Food and Drug Administration for both nearsightedness or astigmatism, expanding the number of people eligible for the surgery by about 1 million. It has also been approved for farsightedness (MSNBC, 2005, After a decade, lasik surgery is still a luxury, Retrieved November 19, 2006).
Global trends are important political events, critical global markets, newly industrialized countries and different cultural and institutional attributes. A global trend called medical tourism, once a fringe concept limited to niche specialties, is on the rise around the world. It is not just Americans going to Costa Rica for rhinoplasty or to Canada for Lasik. The cost of surgery in India, Bolivia, Thailand or South Africa can be one-tenth of what it is in the United States or Western Europe, and sometimes even less. A heart-valve replacement that would cost $200,000 or more in the U.S., for example, goes for $10,000 in India—and that includes round-trip airfare and a brief vacation package. Similarly, a metal-free dental bridge worth $5,500 in the U.S. costs $500 in India, a knee replacement in Thailand with six days of physical therapy costs about one-fifth of what it would in the States, and Lasik eye surgery worth $3,700 in the U.S. is available in many other countries for only $730. Cosmetic surgery savings are even greater: A full facelift that would cost $20,000 in the U.S. runs about $1,250 in South Africa." (Webcitation University of Delaware, 2005)


Juan Arevalo







References

Aaker, D. (2001) Developing Business Strategies, Sixth ed., New York: John Wiley & Sons, Inc.
Eric ed. Gov site, Hispanics in the Pacific Northwest, Cook, A., 1983, Hispanics in the Pacific Northwest, Retrieved November 20, 2006 from
http://eric.ed.gov/ERICWebPortal/Home.portal?_nfpb=true&_pageLabel=RecordDails&ERICExtSearch_SearchValue_0=ED237305&ERICExtSearch_SearchType_0=eric_accno&objectId=0900000b80104a81
Hitt, M., Ireland, D., & Hoskisson, R. (2005) Strategic Management: Competitiveness and Globalization: Concepts. Sixth ed. Ohio: Thompson South-Western.
Webcitation University of Delaware, July 25, 2005, Medical growing worldwide, Retrieved from
http://www.webcitation.org/5Ig0CGpSv
http://www.healthcareitnews.com/story.cms?id=4766

SWOT review

At the time the article was written, PCLI had been operating for almost twenty years. For some companies this is a great deal of advantage. We can say that PCLI has passed the survival stage long ago. However, between 1999 and 2002 the competition has been so fierce that it threatens the continuation of service for our case company. The following is a SWOT analysis to understand better the current situation of the company and probably figure out how PCLI’s competitors are taking a better advantage of the market, business strategies, and technology.

Strengths
Business outstanding reputation for many years
Highly qualified team composed of seven surgeons that specialized in the various forms of eye surgery
Company creates value for customers through surgical excellence approach and consideration
Effective use of science, technology, and Christian principles
Constant communication with patient and patient’s optometrist
Shared knowledge with patient’s optometrist for better results
Modern facilities located in a single region
Development of a network of 150 family ODs in a region
Motivation through high compensation for surgeons
Ownership of two aircrafts used to fly the surgical team between the centers
Great finance team that help patients with medical insurance claims and financing arrangements
Enhanced software calibration unique to PCLI developed by one of its own surgeons
Development of s system to track eye movements by the founder of the company

Weaknesses:
Unsuccessful marketing strategies, inability to capture new segments of the population (did not advertised aggressively)
Extreme capital cost of the equipment to perform LASIK procedures
Less time in the market performing laser surgery
Only three of PCLI’s seven surgeons specialized in LASIK and related procedures
Infrastructures located only in the northwestern United States.
High royalties paid for specialized equipment in the US only
Unable to open more facilities closer and more convenient for other patients
Inability to provide for patients’ continuity of care at the same location by the same doctor
Unable to provide for patients’ basic eye care needs
FAD tight and adverse regulations that delay the use of advanced technology
High salaries compare to their competitors
Inflexible marketing strategies: not allowing patients to see their own OD and be referred by them
Presentation of a whole package at high prices
Inability to participate in discount plans like other companies to attract more clients
Lack to communicate PCLI’s clients of the company’s innovative technology and achievements
Relay on referrals from independent optometrists (network only)
Inflation rate benefiting competitors from Canada

Opportunities:
Capture a bigger share of the market
Expand company facilities in other states and increase revenues
Expand the types of services such as basic eye care needs, continuity of service pre- and post-operation, cataract surgery, etc
Partner with small clinics in different regions (out of network)
Research and use of new methods to improve vision: Intraocular lenses
Partnership with employers to offer laser surgery benefits
Exploring services for additional members of the family: surgery for pets in the future

Threats:
Increasing competition and reduction of share of the market
Surgeons leaving the company and opening their private office and collaborating with competitors
Employee low morale
Reductions of salaries
Suits for mal practice
National competition
Loss of revenues due to excessive royalties

Trends:
People traveling to other countries for surgeries
Innovative equipment becoming less expensive
Laser surgery to correct other problems: e.g., cataracts
People caring more about pets’ health (pet surgery)

mariat

Juan's Introduction

Juan:

I read your introduction and it is good!

-Zoe-
I agree too; it is good content.

Maria

Zoe's portion formatted

Industry/Competitive Analysis

Forces driving the industry and competitive analysis for Pacific Cataract and Laser Institute: Competing in the LASIK Eye Surgery Market include:

- Competitors from Canada

- Surgery being offered at lower prices by competitors

- Various degrees of treatments

- Locations of eye surgery centers

- Types of competitors – General ophthalmologists, surgery centers, and

specialized LASIK clinics

- Before and after surgery procedures

Threat of new entrants

PCLI (Pacific Cataract and Laser Institute), a firm who operated a total of eleven clinics throughout the northwestern Unites States, faced threats of new entrants into the laser eye surgery field from Canada and firms within the United States. The largest of these firms was TLC Laser Eye Centers, Inc., based in Mississauga, Ontario, who also had 56 clinics in the U.S. and 7 in Canada. New entrants also specialized solely in LASIK surgeries, and the largest of these firms was a Canadian competitor called Lasik Vision Corporation (LVC), based in Vancouver, British Colombia. LVC operated 15 clinics in Canada and 14 in the United States and was growing rapidly.

Bargaining Power of Suppliers

PCLI ‘s clinic provided medical and surgical eye treatments, including laser vision correction, and based the organization’s success on surgical excellence and compassioned concern for its patients and the doctors who referred them. Clinics in Canada, offering the same services as PCLI, were advertising laser eye surgery at a lower price and soon PCLI found themselves in competition. Since most medical insurance programs covered only a small portion of the cost of this procedure people were swayed by the low prices and would travel to Canada to have the procedure performed. Procedures for setting up the surgery date also differed from PCLI and in some cases a simple call to a toll-free number was needed to schedule a time to have the surgery performed. The patient was in and out of the clinic within three days, whereas, PCLI’s clinic would partner with the prospective patient’s doctor of Ophthalmology, who would provide information about LASIK and PCLI to the patient, the OD would perform a pre-exam to make sure the patient was a suitable candidate for the surgery, forward the exam to the doctor at PCLI, PCLI would then discuss payment options, have the risks of the surgery explained, meet with the surgeon and then the operation was performed.

While the recuperation and follow-up to surgery (24 hrs., one-week, one-month, three months, six-months and one-year for PCLI vs. 24 hrs., one-week, and three months in Canada) procedures were somewhat identical the process in Canada was designed to accommodate the patient and differed significantly from PCLI’s services. PCLI did all the follow-up appointments for the patients and Canada was letting their patients see the OD for the follow-up visits.

Bargaining Powers of Buyers

The bargaining power of the buyers was that they could go to clinics in Canada, or their affiliates, in the United States and have the LASIK eye surgery done for half the price as PCLI or at a significantly lower price. They were provided with information regarding these clinics through advertisements and even provided a toll-free number to call for information.

Threat of Substitute Products

Clinics in Canada, their affiliates in the United States, and other low-cost eye surgery clinics provided a threat to PCLI in terms of offering services at a lower price. This was accomplished by not having to pay a royalty to the manufacturers of the equipment, paying lower fees to the surgeons in Canada, the weak Canadian dollar vs. the U.S. dollar, and speculation among U.S. clinics that some low-priced Canadian clinics were making a variety of care-compromising quality tradeoffs, such as not performing equipment calibration and maintenance as often as recommended by the manufacturer, and reusing the blades used to make the initial incisions.

Rivalry Between Competing Firms

PCLI built its reputation by establishing eight core values that were based on the principles of practicing the art of healing through love, kindness and compassion and providing the best possible “co-managed” services to the profession of optometry.

Soon PCLI and other U.S. clinics found themselves in competition with firms who were compromising quality service and patient care for lower prices. To remain in competition and prevent the loss of customer’s subsidiaries to parent companies were created and offered lower prices for laser eye surgery. This was accomplished by employing their own surgeons or the parent companies providing only the facilities and equipment, and contracting out with independent surgeons to perform the procedures.

Internal Analysis

PCLI’s Tangible Assets

1). Staff of fully trained doctors

2). Eleven clinics

3). Aircraft to travel between facilities

4). Resident optometric physicians

5). Support staff for each clinic

6). Patient counselors

7). Financial team of experts

PCLI’s Intangible Assets

1). Practicing their art through Christian principles of love kindness & compassion

2). Ability to provide a range of medical and surgical eye treatments including

laser vision correction

3). Organization success based on surgical excellence and compassioned

concern for its patients and the doctors who referred them.

4). The ability to operate eleven clinics in a very coordinated manner.

5). Successful co-management with patients optometrist or OD (doctor of

optometry)

6). The quality of service that patients remember—the excellent surgery,

exceptional patient care, and professional cooperation with their family eye

doctors. Retrieved from: http://www.pcli.com/company/index.html, November

17, 2006

As a result of the tangible and intangible assets the company possesses and integrating these resources they are able to provide the ability of:

Reaching customers

PCLI reaches its customer basis by working closely with a patient’s optometrist or Doctor of Optometry in co-managed eye care. When surgery was needed the family OD referred patients to ophthalmologists (e.g. PCLI’s eye surgeons). PCLI also operates eleven clinics throughout Washington Oregon, Idaho and Alaska.

Richness Dimension

The richness of PCLI revolves around the ability of the doctors and staff to provide the depth and detail of information to their customers on what they can expect regarding lasik eye surgery. Through the operation of their eight core values and the compassion showed their customers the success of their co-managed business provided a relationship of mutual trust and respect built through shared learning, constant communication and commitment to providing quality patient care.

Affiliation

Through interactions with their customers PCLI is able to help their patients make informed decisions regarding lasik eye surgery. Working with patient’s, developed through a network of family OD’s, also provided insurance mutual values existed, between PCLI and the OD’s in the regions where PCLI had clinics.

References

http://www.pcli.com/company/index.html, November 17, 2006

http://www.pcli.com/ - accessed, November 19, 2006

Hitt, Ireland, Hoskisson – Strategic Management, Pacific Cataract and Laser Institue: Competing n the LASIK Eye Surgery Market, 238 -307

From Zoe

Here is what I put together so far. I want to go to the library and see if I can get some information on Pacific Cataract and Laser Eye Surgery's financial status.

-Zoe-

Industry/Competitive Analysis

Forces driving the industry and competitive analysis for Pacific Cataract and Laser Institute: Competing in the LASIK Eye Surgery Market include:

- Competitors from Canada

- Surgery being offered at lower prices by competitors

- Various degrees of treatments

- Locations of eye surgery centers

- Types of competitors – General ophthalmologists, surgery centers, and specialized LASIK clinics

- Before and after surgery procedures

1). Threat of new entrants

PCLI (Pacific Cataract and Laser Institute), a firm who operated a total of eleven clinics throughout the northwestern Unites States, faced threats of new entrants into the laser eye surgery field from Canada and firms within the United States. The largest of these firms was TLC Laser Eye Centers, Inc., based in Mississauga, Ontario, who also had 56 clinics in the U.S. and 7 in Canada. New entrants also specialized solely in LASIK surgeries, and the largest of these firms was a Canadian competitor called Lasik Vision Corporation (LVC), based in Vancouver, British Colombia. LVC operated 15 clinics in Canada and 14 in the United States and was growing rapidly.

2). Bargaining Power of Suppliers

PCLI ‘s clinic provided medical and surgical eye treatments, including laser vision correction, and based the organization’s success on surgical excellence and compassioned concern for its patients and the doctors who referred them. Clinics in Canada, offering the same services as PCLI, were advertising laser eye surgery at a lower price and soon PCLI found themselves in competition. Since most medical insurance programs covered only a small portion of the cost of this procedure people were swayed by the low prices and would travel to Canada to have the procedure performed. Procedures for setting up the surgery date also differed from PCLI and in some cases a simple call to a toll-free number was needed to schedule a time to have the surgery performed. The patient was in and out of the clinic within three days, whereas, PCLI’s clinic would partner with the prospective patient’s doctor of Ophthalmology, who would provide information about LASIK and PCLI to the patient, the OD would perform a pre-exam to make sure the patient was a suitable candidate for the surgery, forward the exam to the doctor at PCLI, PCLI would then discuss payment options, have the risks of the surgery explained, meet with the surgeon and then the operation was performed.

While the recuperation and follow-up to surgery (24 hrs., one-week, one-month, three months, six-months and one-year for PCLI vs. 24 hrs., one-week, and three months in Canada) procedures were somewhat identical the process in Canada was designed to accommodate the patient and differed significantly from PCLI’s services. PCLI did all the follow-up appointments for the patients and Canada was letting their patients see the OD for the follow-up visits.

3). Bargaining Powers of Buyers

The bargaining power of the buyers was that they could go to clinics in Canada, or their affiliates, in the United States and have the LASIK eye surgery done for half the price as PCLI or at a significantly lower price. They were provided with information regarding these clinics through advertisements and even provided a toll-free number to call for information.

4). Threat of Substitute Products

Clinics in Canada, their affiliates in the United States, and other low-cost eye surgery clinics provided a threat to PCLI in terms of offering services at a lower price. This was accomplished by not having to pay a royalty to the manufacturers of the equipment, paying lower fees to the surgeons in Canada, the weak Canadian dollar vs. the U.S. dollar, and speculation among U.S. clinics that some low-priced Canadian clinics were making a variety of care-compromising quality tradeoffs, such as not performing equipment calibration and maintenance as often as recommended by the manufacturer, and reusing the blades used to make the initial incisions.

5). Rivalry Between Competing Firms

PCLI built its reputation by establishing eight core values that were based on the principles of practicing the art of healing through love, kindness and compassion and providing the best possible “co-managed” services to the profession of optometry.

Soon PCLI and other U.S. clinics found themselves in competition with firms who were compromising quality service and patient care for lower prices. To remain in competition and prevent the loss of customers subsidiaries to parent companies were created and offered lower prices for laser eye surgery. This was accomplished by employing their own surgeons or the parent companies providing only the facilities and equipment, and contracting out with independent surgeons to perform the procedures.

INTERNAL ANALYSIS

PCLI’s Tangible Assets

1). Staff of fully trained doctors

2). Eleven clinics

3). Aircraft to travel between facilities

4). Resident optometric physicians

5). Support staff for each clinic

6). Patient counselors

7). Financial team of experts

PCLI’s Intangible Assets

1). Practicing their art through Christian principles of love kindness & compassion

2). Ability to provide a range of medical and surgical eye treatments including laser vision correction

3). Organization success based on surgical excellence and compassioned concern for its patients and the doctors who referred them.

4). The ability to operate eleven clinics in a very coordinated manner.

5). Successful co-management with patients optometrist or OD (doctor of optometry)

6). The quality of service that patients remember—the excellent surgery, exceptional patient care, and professional cooperation with their family eye doctors. Retrieved from: http://www.pcli.com/company/index.html, November 17, 2006

As a result of the tangible and intangible assets the company possesses and integrating these resources they are able to provide the ability of:

Reaching customers

PCLI reaches its customer basis by working closely with a patient’s optometrist or Doctor of Optometry in co-managed eye care. When surgery was needed the family OD referred patients to ophthalmologists (e.g. PCLI’s eye surgeons). PCLI also operates eleven clinics throughout Washington Oregon, Idaho and Alaska.

Richness Dimension

The richness of PCLI revolves around the ability of the doctors and staff to provide the depth and detail of information to their customers on what they can expect regarding lasik eye surgery. Through the operation of their eight core values and the compassion showed their customers the success of their co-managed business provided a relationship of mutual trust and respect built through shared learning, constant communication and commitment to providing quality patient care.

Affiliation

Through interactions with their customers PCLI is able to help their patients make informed decisions regarding lasik eye surgery. Working with patient’s, developed through a network of family OD’s, also provided insurance mutual values existed, between PCLI and the OD’s in the regions where PCLI had clinics.

Financial Analysis

The typical cost of surgery through PCLI ranged from $1750 and $2000 per eye for corrective laser surgery and most medical insurance programs covered only a small portion of the cost of the procedure.

Lasik stats

http://www.lasikbenefitsusa.com/lasik-vision-correction/lasik_vision_correction.html


LASIK Vision Correction History and Statistics
Statistics
Number of LASIK vision correction procedures performed world wide through 2004: 17.8 million
Number of LASIK vision correction procedures in the US through 2004: 8.1 million
Number of US surgeons in 2004 who performed refractive surgery: 3,985
Number of excimer lasers world wide October 2004: 4,700
Number of excimer lasers US October 2004: 1,400
Number of procedures referred by an optometrist 2004: approximately 176,000
(Source: October 2004 Annual Report, Market Scope)
LASIK Vision Correction History
Researchers have been exploring surgical techniques to treat refractive errors for more than a century. LASIK vision correction is the culmination of that work.
1975:
First excimer laser is produced. It is known for its precision and was used by IBM to etch circuits into computer chips.
1983:
Scientists explore use of excimer laser on corneal tissue. It was discovered that the excimer laser could remove corneal tissue without affecting the area outside of the target zone.
1985:
German ophthalmologist uses excimer laser for first time on human eyes.
1988:
U.S. surgeon uses excimer laser to correct refractive error on a normal sighted eye during FDA clinical trials.
1990:
An Italian ophthalmologist combines the microkeratome and the excimer laser to create LASIK vision correction. He used a microkeratome to create a flap of corneal tissue and the laser to reshape the tissue of an inner layer of the cornea.
1991:
First LASIK vision correction performed on a sighted eye for FDA clinical trials.
1995:
FDA approves first excimer laser for PRK (Photorefractive Keratectomy).
1999:
FDA approves first excimer laser for LASIK (Laser-In-Situ Keratomileusis) vision correction.
1999:
One million LASIK vision correction procedures completed in the United States. FDA approved first “flying spot” laser.
2001:
LASIK vision correction is the most common elective surgical procedure in the United States.
2002:
FDA approves first customized wavefront-guided LASIK vision correction application.
2003:
CustomLASIK becomes widely available in the United States.
(Sources: Alcon, Inc.; VISX, Inc.; and “Laser Vision Breakthrough” by S.Brint,D.Kennedy, & C.Kuypers-Denlinger)

Case introduction

Introduction

The following case analysis takes into consideration not only Pacific Cataract and Laser Institute, but also its competitors, businesses, and the current business environment as well. The use of SWOT analysis is important to identify ways to minimize the effect of Pacific Cataract and Laser Institute’s weaknesses while trying to maximize its strengths and at the same time recognize ways to exploit its opportunities and respond to its threats.
Additionally, the use of Porter’s five-force model helps analyze the entire lasik surgery industry because the five competitive forces (i.e., supplier power, buyer power, potential entrants, substitute products, and rivalry among competitors) affect Pacific Cataract and Laser Institute’s business strategy. These forces may create opportunities and threats relative to differentiation, low cost, and focus being implemented.
This analysis case takes into account competitor’s current strategies, strategic intent, capabilities, and core competencies. This data is useful to Pacific Cataract and Laser Institute in formulating a good strategy and predicting competitor’s possible responses.
Pacific Cataract and Laser Institute (PLCI) is a privately held eye care clinic specializing in refractive eye surgeries. Founded in 1985, with locations in eleven cities in the Pacific Northwest, the clinic is facing some stiff competition from other laser eye surgery centers in Canada as well as other larger publicly traded laser eye care centers in the United States who charge less for lasik surgery. Dr. Ford founded PCLI on the principle that doctors must go beyond science and technology to practice the art of healing through the Christian principle of love, kindness, and compassion. The organization had defined eight core values based on those principles. Those core values guided PCLI’s decision-making, as it attempted to fulfill is stated mission of providing the possible “co-managed” services to the optometry profession. As the lasik surgery continuous to rapidly expand, PCLI realizes it is losing potential U.S. patients to lower-priced clinics and that in order to be competitive and maintain a strong market share in the Pacific Northwest operations, it must reevaluate its market efforts and its services operations process.

This case will require that we examine how U.S. medical insurance practices and government regulations are more restrictive. How the exchange rate difference places U.S. clinics in vulnerable position. Obviously, we need to show how U.S. eye surgery clinics can compete using non-price strategies in growing market.

Team Assignment

Juan Arevalo

• External Environment
• General Environment

Zoe

• Industry Competitive Analysis
• Internal Analysis

Maria Tapia

• SWOT assessment
• Current situation of contemporary market
• PowerPoint presentation

Anabel

• Discuss Major Issues

All members will get together for conclussions and final presentation 10-15 minutes

mrt

Laser Surgery in Canada

Copyright Rogers Publishing Limited Feb 15, 1999
Doug Bezpalko began wearing eyeglasses as a rambunctious eight-year-old growing up on a cattle ranch near Elk Point in northeastern Alberta. He lost them in the mud, they were trampled on by calves, and they were always expensive to replace. Finally, in 1997, Bezpalko, an engineering technologist in Calgary, was ready to have his eyes operated on. He was 38 and still active--enjoying water skiing and racquetball--but loathed seeing his glasses fog up with maddening regularity and having to take diligent care of contact lenses. Like many other Canadians, he turned to laser eye surgery. For $4,800, an ophthalmologist nicked the cornea of Bezpalko's eye with a diamond-edged scalpel and then reshaped it with a laser beam, giving him excellent vision. "I'm elated," says Bezpalko, who has not had to wear glasses now for close to a year and a half. "I can't say enough."
There are no precise figures available on how many Canadians have had laser eye surgery to correct nearsightedness (myopia), farsightedness (hyperopia), and astigmatism (caused by an irregularly shaped cornea). But Dr. Patricia Teal of Fort Erie, Ont., past president of the Canadian Ophthalmological Society, estimates that more than 100,000 patients have undergone the procedure since its introduction to Canada a decade ago. And as success stories like Bezpalko's are told, laser eye surgery's popularity seems to be growing, despite the fact that neither medicare nor most private medical plans pay for the expensive procedure. But along with the potential for remarkable results, the procedure entails risks that have to be weighed carefully.
Results vary from case to case. Sometimes, the procedure merely means the patient uses a weaker corrective lens instead of getting rid of it entirely. And in rare instances there have been serious complications, including damage to a patient's vision that cannot be corrected even with glasses. "People should be wary of being swept along by hype," or by the lower prices some eye clinics are offering across Canada, says Teal. "It's not like picking up a dress on sale. You're actually having someone permanently change the shape of your eyes."
There are two main types of laser eye surgery: the older, more established PRK technique; and the LASIK procedure, which has come to the forefront in the past two or three years. Both alter the shape of the cornea, the eye's clear front surface. Both use an excimer laser, a so-called cold laser of ultraviolet light that removes successive layers of the cornea. Each layer is the thickness of about one micron--1/1,000th of a millimetre (or 1/100th the diameter of a fine human hair). Typical procedures remove 50 to 70 microns from the 500-micron thickness of a cornea. The excimer laser does not burn, but instead breaks the molecular bonds of cells in the cornea, in effect vaporizing them, sending up a plume of water and cellular debris that the patient does not see, says Bezpalko's ophthalmologist, Dr. Robert Mitchell, head of the Mitchell Eye Centre in Calgary.
The patient does not feel the laser during either procedure because the eyeball is anesthetized with drops (there are no needles involved). A metal or plastic device then holds the eyeball in place. With PRK, the laser strikes the surface of the cornea, carving away a prescribed amount of tissue. Recovery is somewhat painful, and the patient's vision does not clear for at least a week. Full recovery requires three to six months.
With LASIK, a technique commonly referred to as "flap and zap," the surgeon nicks the cornea with a computer-operated scalpel, then folds part of it back like a hinge. The laser then trims tissue from the interior of the cornea. Once the LASIK treatment is completed--in about 30 minutes for both eyes--the flaps are closed and remain in place without stitches. Vision clears in as little as a day and there is virtually no pain during recovery.
As with all surgeries, there are possible negative consequences. "It's possible," Teal says, "that you could be left permanently with an inability to see 20/20--no matter what anybody does." Other potential side-effects include reduced night vision, seeing haloes around lights at night and infections that can cause scarring. Health Canada warns that anyone whose work depends on night vision should be cautious about having laser eye surgery, and that there is no information about possible lifetime risks associated with the relatively new procedures.
Ironically, laser eye surgery in some cases creates a need for glasses in situations where the patient did not previously require them. Specifically, nearsighted patients over the age of about 45 will almost certainly need reading glasses once their distance vision is corrected. That is because, generally speaking, nearsighted people can read without glasses but need them for seeing further away. After the surgery, the horizon comes into focus unaided. The ability to read without glasses, however, is lost because the corneas have been reshaped in such a way that "it's as if you have your glasses on all the time," Teal says. "What you're doing is trading your uncorrected near vision for uncorrected distance vision." Younger patients do not need the reading glasses because their eye muscles are more supple and therefore adaptable.
There is a way around the problem. Mitchell in Calgary offers all of his patients over 45 what he calls "mono-vision," in which one eye is corrected for distance, while the second is carved just enough to allow a person to read, though not so much as to create a perceptible imbalance or alter depth perception. "As a result, the brain uses one eye for distance, the other eye for near," Mitchell says, "and the patient is usually unaware of which eye they're using."
Another unwelcome possibility is regression--a spontaneous return of the eye to less than perfect vision (though usually better than the eyesight that the person started out with). Early PRK procedures, for example, often required a second or even a third operation. But newer lasers have improved PRK's effectiveness. Because of the dearth of national statistics on laser eye surgery, it is hard to say how many patients suffer unwanted side-effects. But Health Canada estimates that they can occur in as many as five per cent of all operations. If the corrective work is minimal, Teal says, the risks diminish to less than one per cent of cases.
Meanwhile, improvements in software and hardware are happening rapidly and new lasers are constantly becoming available. In Canada, the medical devices bureau of the Health Protection Branch regulates the sale of lasers and requires testing and clinical trials before each model goes on the market. "The technology is just incredible," says Dr. Fred Lapner, an adviser with the medical devices bureau. Still, Lapner says a laser remains no more than a surgical tool. "The outcome," he adds, "depends on the skill of the ophthalmologist."
Bruce Waugh, a Toronto lawyer who has had the PRK procedure three times, is looking forward to trying LASIK this month. Three years ago, he paid $4,500 to correct nearsightedness and a significant astigmatism. Six months later, his eyesight regressed to the point where he needed to wear glasses again, although his vision was significantly better than it had been. Two more operations--at no charge--yielded similar results. "People going into this should realize that some people will need it twice," says the 49-year-old Waugh, "and a smaller percentage will need it more than that." As Teal notes, laser eye surgery has improved the vision of thousands of Canadians. But, she cautions, "It's something you want to go into with--so to speak--your eyes wide open." *** END OF DOCUMENT ***

Microkeratome delivers 80-µm flaps for thin-flap LASIK

From Maria
Copyright Advanstar Communications, Inc. May 15, 2006
[Headnote]
Good surface, edge quality
[Headnote]
Flaps created with device are reasonably accurate and predictable with a high safety profile
Reviewed by Ernest W. Kornmehl, MD
San Francisco-Thin-flap LASIK with the K-4000 microkeratome (Becton Dickinson) is safe and delivers flaps that are significantly thinner than with other available heads. Thin-flap LASIK is the preferred choice with the K-4000 microkeratome, according to Rupal S. Shah, MD.
The microkeratome head creates 80-µm flaps and Dr. Shah has been using it for about 18 months, she reported at the annual meeting of the American Society of Cataract and Refractive Surgery. In this study she and her colleagues compared the results obtained with the 80-µm head with those obtained using the 130-µm head.
The prospective study included 20 eyes of 10 patients. One eye of each patient was randomly assigned to the 80-µm group and the other eye to the 130-µm group. The investigators evaluated the flap thickness, the postoperative visual acuity, and the safety of the procedure.
Standard ultrasound pachymetry was used to measure the flap thickness. Corneal pachymetry was performed before cutting the flap and immediately before lifting the flap, she explained, to nullify the effect of any trauma to the cornea because of flap formation, and on the stromal bed immediately after the flap was lifted.
Dr. Shah, clinical director of New Vision Laser Centers, Baroda, Gujarat, India, reported that at the beginning of the case, the average pachymetry value was 506 µm in the 80-µm group and 503 µm in the 130-µm group.
"After the flaps were cut, there was swelling in both groups, likely because of trauma to the cornea. After lifting the flap the average pachymetry value in the 80-µm group was 435 µm and 404 µm in the 130-µm group. The average thickness in the 80-µm; group was 86 um (standard deviation, 11 µm; range, 77 to 105 µm) and in the 130-µm group 119 µm (standard deviation, 14 µm; range, 110 to 135)," Dr. Shah reported.
Regarding the thin flaps, she pointed out that they were difficult to handle but worked well.
"The flap created with this microkeratome does not fall back on itself. The surface quality and the edge quality are quite good," she commented.
The visual recovery was more rapid with the 80-µm head compared with the 130-µm head. The mean visual acuity within 1 hour after the end of the surgery, according to Dr. Shah, was 0.78 in the 80-µm group and 0.66 in the 130-µm group.
On the first postoperative day, the mean visual acuity in the 80-µm group was 1.12 and in the 130-µm group it was 1.07. Three months after the surgeries, 94% of the eyes from both groups had 20/20 or better vision. Dr. Shah described the results as very encouraging.
No flap-related complications occurred with either head. In addition, there was no increased incidence of flap striae.
"An 80-µm cutting head with the BD K-4000 microkeratome creates flaps that are reasonably accurate and predictable with a high safety profile," Dr. Shah said. "Patients who have a thin stromal bed who previously were not candidates can probably be treated. The 80-µm head can probably be the head of choice in conjunction with the K-4000 microkeratome in these patients."
FYI
Rupal S. Shah, MD
E-mail: vadodara@nevwisionindia.com
Dr. Shah did not indicate a proprietary interest in any of the products or companies.

Swot list

Here is part of my SWOT analysis in list form. I will be revising this info before putting all our pages together.
Regards

Maria

Strengths
Excellent surgeon team
Modern facilities in one place
Credible reputation



Weaknesses:
Marketing strategy
Less experience performing surgery
Unable to move to small cities
Inconvenience for clients to go to big cities
FAD tight regulations
High salaries compare to their competitors
Unflexible marketing strategies
High prices
Infrastructure
Unable to partner with local doctors




Opportunities:
Capture the a bigger share of the market
Increase revenues
Partner with small clinics all over the country
Surgery for pet in the future


Threats:
Share of the market getting smaller
Surgeons living the company
Low morale
Reductions of salaries
Suits if surgery fails
National competition

Trends:
People caring more about pets, pet surgery
People traveling to other countries for surgical procedures
Eye surgery to correct not only vision but other problems like cataracts

Five Competitive Forces model Porter

Five Competitive Forces model Porter

Laser visionaries

Since its introduction a decade ago, more than 100,000 Canadians have undergone laser eye surgery to correct vision problems. However, the procedures have risks that need to be weighed before the surgery takes place.
Full Text (1267 words)
Copyright Rogers Publishing Limited Feb 15, 1999
Doug Bezpalko began wearing eyeglasses as a rambunctious eight-year-old growing up on a cattle ranch near Elk Point in northeastern Alberta. He lost them in the mud, they were trampled on by calves, and they were always expensive to replace. Finally, in 1997, Bezpalko, an engineering technologist in Calgary, was ready to have his eyes operated on. He was 38 and still active--enjoying water skiing and racquetball--but loathed seeing his glasses fog up with maddening regularity and having to take diligent care of contact lenses. Like many other Canadians, he turned to laser eye surgery. For $4,800, an ophthalmologist nicked the cornea of Bezpalko's eye with a diamond-edged scalpel and then reshaped it with a laser beam, giving him excellent vision. "I'm elated," says Bezpalko, who has not had to wear glasses now for close to a year and a half. "I can't say enough."
There are no precise figures available on how many Canadians have had laser eye surgery to correct nearsightedness (myopia), farsightedness (hyperopia), and astigmatism (caused by an irregularly shaped cornea). But Dr. Patricia Teal of Fort Erie, Ont., past president of the Canadian Ophthalmological Society, estimates that more than 100,000 patients have undergone the procedure since its introduction to Canada a decade ago. And as success stories like Bezpalko's are told, laser eye surgery's popularity seems to be growing, despite the fact that neither medicare nor most private medical plans pay for the expensive procedure. But along with the potential for remarkable results, the procedure entails risks that have to be weighed carefully.
Results vary from case to case. Sometimes, the procedure merely means the patient uses a weaker corrective lens instead of getting rid of it entirely. And in rare instances there have been serious complications, including damage to a patient's vision that cannot be corrected even with glasses. "People should be wary of being swept along by hype," or by the lower prices some eye clinics are offering across Canada, says Teal. "It's not like picking up a dress on sale. You're actually having someone permanently change the shape of your eyes."
There are two main types of laser eye surgery: the older, more established PRK technique; and the LASIK procedure, which has come to the forefront in the past two or three years. Both alter the shape of the cornea, the eye's clear front surface. Both use an excimer laser, a so-called cold laser of ultraviolet light that removes successive layers of the cornea. Each layer is the thickness of about one micron--1/1,000th of a millimetre (or 1/100th the diameter of a fine human hair). Typical procedures remove 50 to 70 microns from the 500-micron thickness of a cornea. The excimer laser does not burn, but instead breaks the molecular bonds of cells in the cornea, in effect vaporizing them, sending up a plume of water and cellular debris that the patient does not see, says Bezpalko's ophthalmologist, Dr. Robert Mitchell, head of the Mitchell Eye Centre in Calgary.
The patient does not feel the laser during either procedure because the eyeball is anesthetized with drops (there are no needles involved). A metal or plastic device then holds the eyeball in place. With PRK, the laser strikes the surface of the cornea, carving away a prescribed amount of tissue. Recovery is somewhat painful, and the patient's vision does not clear for at least a week. Full recovery requires three to six months.
With LASIK, a technique commonly referred to as "flap and zap," the surgeon nicks the cornea with a computer-operated scalpel, then folds part of it back like a hinge. The laser then trims tissue from the interior of the cornea. Once the LASIK treatment is completed--in about 30 minutes for both eyes--the flaps are closed and remain in place without stitches. Vision clears in as little as a day and there is virtually no pain during recovery.
As with all surgeries, there are possible negative consequences. "It's possible," Teal says, "that you could be left permanently with an inability to see 20/20--no matter what anybody does." Other potential side-effects include reduced night vision, seeing haloes around lights at night and infections that can cause scarring. Health Canada warns that anyone whose work depends on night vision should be cautious about having laser eye surgery, and that there is no information about possible lifetime risks associated with the relatively new procedures.
Ironically, laser eye surgery in some cases creates a need for glasses in situations where the patient did not previously require them. Specifically, nearsighted patients over the age of about 45 will almost certainly need reading glasses once their distance vision is corrected. That is because, generally speaking, nearsighted people can read without glasses but need them for seeing further away. After the surgery, the horizon comes into focus unaided. The ability to read without glasses, however, is lost because the corneas have been reshaped in such a way that "it's as if you have your glasses on all the time," Teal says. "What you're doing is trading your uncorrected near vision for uncorrected distance vision." Younger patients do not need the reading glasses because their eye muscles are more supple and therefore adaptable.
There is a way around the problem. Mitchell in Calgary offers all of his patients over 45 what he calls "mono-vision," in which one eye is corrected for distance, while the second is carved just enough to allow a person to read, though not so much as to create a perceptible imbalance or alter depth perception. "As a result, the brain uses one eye for distance, the other eye for near," Mitchell says, "and the patient is usually unaware of which eye they're using."
Another unwelcome possibility is regression--a spontaneous return of the eye to less than perfect vision (though usually better than the eyesight that the person started out with). Early PRK procedures, for example, often required a second or even a third operation. But newer lasers have improved PRK's effectiveness. Because of the dearth of national statistics on laser eye surgery, it is hard to say how many patients suffer unwanted side-effects. But Health Canada estimates that they can occur in as many as five per cent of all operations. If the corrective work is minimal, Teal says, the risks diminish to less than one per cent of cases.
Meanwhile, improvements in software and hardware are happening rapidly and new lasers are constantly becoming available. In Canada, the medical devices bureau of the Health Protection Branch regulates the sale of lasers and requires testing and clinical trials before each model goes on the market. "The technology is just incredible," says Dr. Fred Lapner, an adviser with the medical devices bureau. Still, Lapner says a laser remains no more than a surgical tool. "The outcome," he adds, "depends on the skill of the ophthalmologist."
Bruce Waugh, a Toronto lawyer who has had the PRK procedure three times, is looking forward to trying LASIK this month. Three years ago, he paid $4,500 to correct nearsightedness and a significant astigmatism. Six months later, his eyesight regressed to the point where he needed to wear glasses again, although his vision was significantly better than it had been. Two more operations--at no charge--yielded similar results. "People going into this should realize that some people will need it twice," says the 49-year-old Waugh, "and a smaller percentage will need it more than that." As Teal notes, laser eye surgery has improved the vision of thousands of Canadians. But, she cautions, "It's something you want to go into with--so to speak--your eyes wide open." *** END OF DOCUMENT ***

Eye-Surgery Chain Lasik Vision Closes 28 Offices in North America.
From: Knight Ridder/Tribune Business News Date: April 4, 2001

By Luke Timmerman, The Seattle Times Knight Ridder/Tribune Business News
Apr. 4--Lasik Vision, a discount laser-eye-surgery chain based in Vancouver, B.C., has shut down its 28 North American offices, including one in Bellevue.
The abrupt shutdown leaves Lasik's patients looking for alternatives on post-operative care, and leaves many customers wondering whether they'll get refunds for treatment they never received.
The shutdown was announced last week by Icon Laser Eye Centers, a Toronto-based chain that acquired Lasik Vision in February. In a statement, Icon explained its management was discussing what to do with the "deteriorating financial situation" at its new subsidiary, and that it was temporarily suspending Lasik Vision's operations because it couldn't afford to pay its employees.
The statement gave no indication if or when the offices might reopen under a new company banner. An Icon spokesman declined comment.
The financially troubled Lasik Vision had been offering laser eye surgery for $1,000 for both eyes, and it required patients to pay the full cost of the procedure before being examined. Refunds were promised within 21 days if the surgery couldn't be performed for medical or other reasons.
At the time of the shutdown, Lasik Vision estimated it took such surgery deposits from about 2,000 patients nationwide who never got surgeries, according to a report in The Washington Post.
James Watson, a spokesman for Lasik Vision, told The Post that Lasik considers paying refunds to those patients "of paramount importance."
For patients who still want the surgery, the alternatives won't be cheap. The average rate for laser eye surgery in the United States is $2,400 to $4,000 for both eyes, depending on the amount of correction needed for the patient, said Kristina Bainter of Pacific Cataract & Laser Institute in Bellevue.
Bainter said most eye-surgery providers require same-day payments for surgery, not advance payments.
In a statement released yesterday, Icon Laser Eye Centers assured patients that its clinics will remain open to Lasik Vision customers. Icon said it "sympathizes with Lasik Vision patients affected by the operating interruption at Lasik Vision clinics" and that it will provide more information to patients later. Icon has no offices in Washington. The nearest is in Beaverton, Ore., according to the company's Web site.

Lasik Demographis

http://www.halevision.com/statistics/lasikDemographics.html


Statistics
Lasik Demographics
Number of individuals in the United Stateswith each of the following refractive conditions:
Refractive Condition:
No. of Cases
Nearsightedness only
18 million
Nearsightedness and astigmatism
32 million
Nearsightedness and presbyopia
9 million
Nearsightedness, astigmatism and presbyopia
16 million
Farsightedness only
37 million
Farsightedness and astigmatism
50 million
Farsightedness and presbyopia
18 million
Farsightedness, astigmatism and presbyopia
24 million
Astigmatism only
8 million
Astigmatism and presbyopia
4 million
Presbyopia only
19 million
No refractive error at present
27 million
Current number of LASIK procedures
8.2 million (Aug. 2004)

laser surgery more affordable...why?

Comments: open this and post to blog
Record: 1
Why popular laser eye surgery to correct your vision is becoming more affordable. By: Turner, Rob. Money, Feb2000, Vol. 29 Issue 2, p157, 2p, 2c; Abstract: Reveals that the cost of laser eye surgery is becoming easier to handle as prices fall and employee-benefits programs start discounting this procedure. Description of the most popular method of laser eye surgery, laser-in-situ keratomileusis (LASIK); Average cost of the procedure; What patients contemplating the procedure should consider before having it done. (AN 2677508)

Persistent link to this record:
http://search.ebscohost.com/login.aspx?direct=true&db=hbh&AN=2677508&site=ehos t-live

Cut and Paste:
Why popular laser eye surgery to correct your vision is becoming more affordable.

Database:
Health Business FullTEXT
Section: Saving & SpendingWHY POPULAR LASER EYE SURGERY TO CORRECT YOUR VISION IS BECOMING MORE AFFORDABLE
IF YOU'RE ONE OF the millions of Americans on the fence about having laser eye surgery to improve your vision, chances are two things are holding you back. One is the uneasy thought of someone applying an ultraviolet laser to your eyeball. The other is the thousands of dollars you'll spend to have this done. While the first may play a larger role (and we have tips for approaching the surgery), we'll focus on the latter. After all, this is MONEY. And we have some good news: The cost is becoming easier to handle as prices fall and employee-benefits programs finally start discounting this increasingly popular surgery
The method of choice. While there are several kinds of laser eye surgery, the most popular by far is LASIK, or laserin-sire keratomileusis, which is used to correct nearsightedness, farsightedness and astigmatism. Nearly 95% of the Laser Eye Surgery continued approximately 750,000 people expected to undergo the surgery this year will have this procedure. According to A1 Kildani, an analyst who tracks eye-care companies for Pacific Growth Equities in San Francisco, the recent price for LASIK ranged from $999 to $2,750 per eye, averaging $2,176. Kildani adds that because of increased competition, prices are widely expected to fall.
The benefits picture. Until recendy, only a few small eye-care benefits providers helped with the cost of surgery. As of Jan. 1, two of the nation's largest managed-care vision benefits firms, Sacramento-based Vision Service Plan (VSP) and Cleveland-based Cole Managed Vision, began to offer laser eye surgery discounts to their combined 79 million members (including dependents), at no additional cost to the employers or workers. Analysts expect more eye-care benefits companies to offer similar plans.
With VSP's Laser VisionCare plan, you'll pay no more than $1,800 for the LASIK procedure as long as you use a vsPapproved surgeon, vs? has partnered with TLC Laser Eye Centers, the largest network of laser eye surgeons in the U.S., and with more than 150 other smaller centers to offer members a 25% discount. (In addition, vsP is marketing a plan that calls on employers to help pay for the surgery; which could appeal to firms that already pay for hundreds of dollars worth of glasses or contacts annually)
Cole has formed an exclusive alliance with LCA-Vision centers, the nation's third largest laser vision network, to offer members a 15% discount on LASIK. Larry Rapp, LCA's chief financial officer, says that more than half of LCA's 19 centers offer a LasikPlus plan that costs $2,995 for both eyes. A 15% discount would bring the price down to $2,446, or $1,273 per eye.
Blurry tax rules. Even at this lower cost, laser eye surgery still entails a hefty outof-pocket expense. Is it tax deductible as a medical expense? Probably While the Internal Revenue Service hasn't issued a regulation on the matter, the agency did okay a deduction for similar surgery in a 1996 private-letter ruling. The IRS defines deductible medical expenses as those that "alleviate or prevent a physical or mental defect or illness." Mark Luscombe, the principal federal tax analyst for tax law publisher CCH, believes that laser surgery meets that definition. In fact, Todd Ransom, a spokesman for H&R Block, the country's largest tax preparer, says his company advises clients that laser eye surgery is deductible.
However, in order to deduct it, your unreimbursed medical expenses for the year must exceed 7.5% of your adjusted gross income. So you may want to put off surgery until a year when you are incurring other big medical expenses.
Looking beyond price. No matter the price, experts caution that finding an experienced, reputable surgeon should be your first priority. A small percentage of patients report problems, including overor undercorrection. Irving Arons, a Peabody, Mass consultant on ophthalmic technology, points out that with an experienced surgeon, the complication rate is less than 2%. So ask for an outcome analysis report, which details how many procedures the surgeon has done (500 is a good minimum) and how many patients have had complications.
While price alone is no measure of skill, Arons notes that rock-bottom prices are often an indicator of less experience. "I wouldn't recommend somebody go to a deep discounter to get work on your eyes," he adds. "You've only got two of 'em." --ROB TURNER
ILLUSTRATION
ILLUSTRATION
~~~~~~~~
By Rob Turner
Copyright © Time Inc., 2000. All rights reserved. No part of this material may be duplicated or redisseminated without permission.The link information above provides a persistent link to the article you've requested.Persistent link to this record: Following the link above will bring you to the start of the article or citation.Cut and Paste: To place article links in an external web document, simply copy and paste the HTML above, starting with "http://support.epnet.com/contact/askus.php or call 800-758-5995.This e-mail was generated by a user of EBSCOhost who gained access via the SAN MATEO MEDICAL CENTER account. Neither EBSCO nor SAN MATEO MEDICAL CENTER is responsible for the content of this e-mail.

cheers Maria

PCLI website

Hello my friends,
check this website. PCLI has lots of good recent info. Today, they only charge $1400 per eye. Not bad. That is the point when technology is new, every thing is so expensive. Now, after several years they can offer their services for more affordable prices. Good for the patients.
Maria
http://www.pcli.com/lasik/cost_pay.html

Time and experience...advantages

I was reading the article on PCLI and learned interesting things about the same company, its competition, and some history on LASIK.
Dr. Mark Everett attributes its competitor’s success to some factors such as favorable exchange rate and regulatory environment. But, he also implies that the very low prices that the Canadian companies charge compromise service quality.
We have to understand one thing: Laser surgery has been in the market for over ten years. According to the article laser was performed in Europe and Canada for several years before it was introduced in America. These many years of practice and research gave these competitors and advantage over America. They were able to develop better machines, and contracts with their provider so that they can apply this technology at a reduce price. It is like every new gadget in the market. The first time you see it prices are outrageous, however a year after introduction prices go down and more affordable. This is probably what Canada is doing. Management for these big companies understands that they cannot charge the same high price for a procedure that has become standard and simple. The article says this procedure does not take more five minutes per eye. I cannot imagine people wanting to pay thousand of dollars when they can pay a third of that amount for the same service. It is true it is a health issue and people have to be informed of advantages and disadvantages. But I don’ think these Canadian companies are operating people on a dropping basis without considering these health issues that could develop in the future. I would think that because they have been in the market for a longer time they understand better the implications of this kind of business and they are able to apply these strengths in their business model. They know and understand that millions of people are uninsured or underinsured but they still have a chance to improve their vision without having to go broke.
What we probably need to find more about is how they advertise, what is the rate of success for their operations, and what is the rate of health issues that were compromised with their procedure. By Exhibit 4 we know that some of these companies have achieved great revenue because they were able to do more procedures and were able to negotiate royalties with their providers.
Like I mentioned before, I don’t think people want to pay high prices for a type of technology that is becoming standard specially when they cannot afford that much. US businesses – health industry- have to realize this concept. If they want to increase their revenues, they have to make the same kind of service available to more people and now only focus on those who have excellent health insurance or those who can afford to pay from their own savings account. They have to negotiate with the government to speed up the regulatory process; they have to use technology when it is available for all.
mt

Requirements for Advertising Under the Federal Trade Commission Act

http://www.lawpublish.com/ftc-eyecare2.html
Marketing of Refractive Eye Care Surgery: Guidance for Eye Care Providers"

The Federal Trade Commission staff has received numerous inquiries concerning the promotion and advertising of radial keratotomy (RK) and photorefractive keratectomy (PRK) using the excimer laser systems recently approved by the U.S. Food and Drug Administration (FDA). The FDA and FTC staff issued a joint communique on PRK promotion and advertising on May 7, 1996. The FTC staff takes this opportunity to provide further guidance to eye care providers concerning the requirements of Section 5 of the Federal Trade Commission Act that may apply to the marketing of these, and other, refractive surgical procedures.
Requirements for Advertising Under the Federal Trade Commission Act
The FTC enforces the Federal Trade Commission Act (FTC Act), which among other things prohibits deceptive or unfair practices in or affecting commerce. 15 U.S.C. §§ 45, 52-57. An advertisement is deceptive under Section 5 of the FTC Act, and therefore unlawful, if it contains a representation or omission of fact that is likely to mislead consumers acting reasonably under the circumstances, and that representation or omission is material, that is, likely to affect a consumer’s choice or use of a product or service. It is important to note that advertisers are responsible for claims that are reasonably implied from their advertisements, as well as claims that are expressly stated.
In addition, under the FTC Act, advertisers must have substantiation for all objective claims about a product or service before the claims are disseminated. In the context of claims about the safety, efficacy, success or other benefits of RK or PRK, substantiation will usually require competent and reliable scientific evidence(1) sufficient to support the claim that is made.(2)
Finally, under the FTC Act, deception can occur through omission of information when that information is necessary to prevent an affirmative representation from being misleading, or simply by remaining silent, if doing so constitutes an implied but false representation. Not all omissions are deceptive, even if providing the information would benefit consumers. An omission is considered deceptive only if the absence of the information causes the advertisement to convey an inaccurate impression about a material fact.
Under FTC law, therefore, advertisements, promotional brochures, informational tapes, seminars and other forms of marketing of RK or PRK to consumers should not contain express or implied claims that are false or unsubstantiated, or omissions of material information. In particular, claims that convey an inaccurate impression about the safety, efficacy, success or other benefits of PRK would raise deception concerns. For example, an unqualified claim for PRK that patients can “throw away their eyeglasses” would be suspect because the FDA has approved the excimer laser only for the treatment of mild to moderate nearsightedness and not to treat other refractive vision deficiencies. Likewise, the same claim made for RK would also be questionable because published, multi-center studies indicate that RK does not eliminate the need for corrective lenses for all refractive vision deficiencies. Even a more limited claim, suggesting only that patients who are nearsighted, with no other refractive vision deficiencies, can “throw away their eyeglasses” may also be deceptive, without further qualification, if, after surgery, a significant number of patients require eyeglasses for best vision, for reading, or under particular circumstances, such as for night driving.
Similarly, claims regarding success rates, long-term stability or predictability of outcome would also need to be substantiated by competent and reliable scientific evidence. It is important to keep in mind that the fact that the FDA has approved the excimer laser for use in PRK does not by itself necessarily provide adequate substantiation for all specific claims about the success of the procedure.
Finally, representations made about the safety or efficacy of RK or PRK, may, in certain circumstances, require disclosures of material information about health risks or limitations associated with the surgery to prevent deception. For example, an advertisement containing express or implied representations that the surgery is safe may also need to contain information about any significant risks associated with the surgery, and, for PRK, with the particular laser in use.
Questions about this letter may be directed to the FTC’s Service Industry Practices, Bureau of Consumer Protection staff at (202) 326-3319 (Walter Gross) or (202) 326-3291 (Matt Daynard) or the FTC’s Boston Regional Office staff at (617) 424-5960 (Paul Block or Colleen Lynch).
(1)“Competent and reliable scientific evidence” means tests, analyses, research, studies, or other evidence based on the expertise of professionals in the relevant area that has been conducted and evaluated in an objective manner by persons qualified to do so, using procedures generally accepted by others in the profession to yield accurate and reliable results.
(2)The substantiation must also be examined in the context of the entire body of evidence, particularly if it produces results that are contrary to that body of evidence. Further guidance on the deception and substantiation standards are set forth in the Commission’s Policy Statement on Deception (Cliffdale Associates, Inc., 103 F.T.C. 100, 176 (1984), reprinting as Appendix letter dated Oct. 14, 1983, from the Commission to The Honorable John D. Dingell, Chairman, Committee on Energy and Commerce, U.S. House of Representatives) and its Policy Statement on Advertising Substantiation (48 Fed. Reg. 10,471 (1984) reprinted in Thompson Medical Co., 104 F.T.C. 648, 839 (1984), aff’d, 791 F.2d 189 (D.C. Cir.1986), cert. denied, 479 U.S. 1086 (1987).

http://www.wright.edu/~michael.kemper/CaseQuestions.htm

Pacific Cataract and Laser Institute
1. Perform an analysis of the GENERAL ENVIRONMENT of the refractive eye surgery industry. Consider trends in technology, demographics, economics, political/legal, sociocultural, and global.
2. Perform a Porter's Five Forces Model on the refractive eye surgery industry. Then indicate whether you think the industry is an attractive industry for those companies already in it and for possible new entrants.
3. Perform a competitor analysis (i.e. Who are some of PCLI's main competitors in the LASIK eye surgery business and describe what their assumptions about the industry and themselves; their current strategy; their future objectives; and their capabilities)?
4. Perform a SWOT analysis on PCLI.
5. What are some of PCLI's most significant resources and capabilities? (See Chapter 3.)
6. What are some of the key result areas that PCLI should focus on? (Hint: Focus on Strategic Management, Capacity Utilization, Cost Control, and Marketing.)

Hello Everyone:

Are we suppose to add our name's to the team member's profile?

Rosaura Anabel

Lasik Eye @ ndnu

Hi Zoe, Maria and Juan:

This is just to test our blogger. It seems to be working fine.
Talk to you soon.

Rosaura Anabel

Lasik Eye @ NDNU

http://laser-eye--ndnu.blogspot.com/
Hello again. I am testing and posting from a different computer and I think it works....if you can read this. Is anybody OK with our blog?
mt