Glenn Hagele operates multiple business operations from his home in
Sacramento California at 8543 Everglade Drive. Glenn Hagele's original
was
"Council for Refractive Surgery Quality Assurance", aka CRSQA, aka
USAEYES.
This is a fake patient advocacy organization which har***** LASIK patients
who have suffered bad outcomes. Due to his harassment and defamation of
patients, he is currently being sued by Dr. Lauranell Burch:
http://www.lasikpimp.com/docs/lauranell_burch_vs_hagele_and_usaeyes.pdf
CRSQA is just a cynical marketing ploy that "certifies" refractive
surgeons
willing to fork over $7,000 in the first year and $5,000/year thereafter.
In exchange, Glenn Hagele provides these surgeons with a bogus seal of
approval on his USAEYES.org web site to promote their practices. Don't be
fooled by Glenn Hagele's advertising claims - CRSQA's quality "standards"
are actually below industry standards. Glenn Hagele is not qualified to
issue certifications as he is not a doctor, but simply ahigh school
graduate
with a single college course in marketing. Out of 17,000 ophthalmologists
in the US, about 30-50 pay Glenn Hagele to market their practices. It is
somewhat difficult to tell exactly what ophthalmologists are members of
CRSQA at any one time, as Glenn Hagele hasdesigned his web site in such a
manner to implicitly suggest that 17,000 ophthalmologists are members. For
more information on this fraudulent organization, visit the following web
sites.
http://www.theglennhagelere****t.com
http://www.usaeyes.us
http://www.lasikpimp.com
http://www.lasikfraud.com
http://www.lasik-flap.com/forum/viewforum.php?f=21
http://www.lasikscam.com/viewforum.php?f=21
http://www.jackholladay.com/avoid_this_doctor.html
http://www.lasikdisaster.com
http://www.lifeafterlasik.com
Glenn Hagele has started a new organization known as "Cataract Free
America", which is designed to provide a new source of income, following
his
expected collapse of CRSQA, as a result of the lawsuit filed against him
against Dr. Lauranell Burch. On his new site he identifies himself as
"Cataract Expert", even though he only has a High School Diploma. Glenn
Hagele has published "50 Tough Questions For your Cataract Doctor" to try
to
convince seniors that he is an "expert" in cataract surgery.
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The 50 Tough Questions For Your Cataract Doctor will help guide you to the
best available surgeon.
Guide To Cataract Doctor Evaluation
Cataract Free America's 50 Tough Questions For Your Cataract DoctorSM is a
detailed guide to selecting a cataract doctor and to im****tant issue to
discuss with a potential surgeon. The primary key to a good cataract
surgery
outcome is a good doctor. Our Tough Questions help you evaluate a
potential
doctor.
If you are seriously considering cataract surgery, you need to first and
foremost consider the qualifications and experience of your potential
doctor. The doctor is even more im****tant than the medical devices used.
No
amount of technology can compensate for an inferior doctor.
Do not expect your prospective doctor to respond with our suggested
answers
for every question. Some are more im****tant measures of ability than
others.
Use your own common sense. Ask for proof of all claims. Measure the
willingness to respond as much as the response. The doctor should offer to
make arrangements for any requested test or examination that the doctor
does
not normally provide.
If you do not completely understand the relevance of any of these
questions,
search our website for more detailed information.
How long have you been performing cataract surgery?
Not less than three years.
How many cataract surgeries have you performed total?
Not less than 200 eyes.
How many cataract procedures have you performed in the last 12 months?
Not less than 75 eyes.
How many cataract procedures of the exact type you intend to use for me,
with the same equipment, and the same cataract error, the same intraocular
lens, etc., have you performed?
Not less than 25 eyes.
This is a very im****tant question. Even a doctor who has thousands of
surgeries behind him or her is a rookie when using new technology or new
technique. You don't want eye surgery from a rookie.
What percent of your cataract surgery patients receive Snellen Uncorrected
Visual Acuity (UCVA) of 20/40 or better?
About 90% is generally considered the norm. If the doctor gives a higher
number, ask for proof.
If you have uncorrected astigmatism, and especially high astigmatism
(greater than about 2.00 diopters), expect the probability of achieving
uncorrected 20/40 to be lower.
What percent of your cataract surgery patients receive UCVA of 20/20 or
better?
About 45% is generally considered the norm. If the doctor gives a higher
number, ask for proof.
If you have astigmatism, and especially high astigmatism (greater than
about
2.00 diopters), expect the probability of achieving uncorrected 20/20 to
be
lower.
What percent of your cataract surgery patients re****t unresolved
complications six months after surgery? This includes objective and
subjective complications such as inflammation, halos, starbursts,
infection,
etc.
Less than 2% is generally considered the norm, with less than 0.5% being
serious complications that require either extensive maintenance or
invasive
treatment.
If the doctor gives a lower number, ask for proof. Zero or a nebulous
"almost never" should be cause for concern. No doctor is perfect. No
surgical procedure is perfect.
Have you had a successful cataract surgery malpractice claim of greater
than
$30,000? Details if yes.
Not more than one for every 500 cataract surgeries. That's a 99.5%
"success"
rate. Not more than three in the last five years, even if the doctor has
performed tens of thousands of surgeries. Discuss with the doctor the
cir***stances of any malpractice case. Consider how they were handled and
how the cir***stances may apply to you.
Will you verify a history of diabetes?
The answer should be yes as diabetes can cause changes in the eyes that
may
make change the probability of an excellent cataract surgery outcome.
What percentage of your pervious cataract surgery patients have had lens
exchange surgery, piggy back lens implant, or phakic intraocular lens
implant surgery to resolve refractive error after cataract surgery?
Explain
your policy on these types of surgeries.
Under 5% is a ballpark number but the "why" is much more im****tant than
the
percent. The doctor should explain his/her philosophy on post-cataract
surgery adjustments. You don't want a doctor who will almost never perform
post-cataract adjustments, but you also don't want a doctor who must
perform
post-cataract surgery adjustments too often.
A complicating factor would be if you had previous refractive surgery like
RK, Lasik, PRK, LASEK, Epi-Lasik, etc., and the calculations for
intraocular
lens must be estimated.
Will you offer me a premium intraocular lens (IOL) like the ReSTOR®,
ReZoom®, or Crystalens®?
A premium intraocular lens is not appropriate for every individual and
nearly always will cost extra. All good doctors understand the limitations
of their tools and techniques and will recommend what they believe will
have
the highest probability of you receiving the desired outcome.
Will you perform laser vision correction surgery like Lasik, PRK, LASEK,
or
Epi-Lasik after cataract surgery to "fine tune" the results of my cataract
surgery?
Your doctor may not provide laser vision correction surgery, but should be
able to refer you to someone if necessary to fine tune the refractive
results of surgery.
Do you include laser vision correction like Lasik, PRK, LASEK, or
Epi-Lasik
after cataract surgery?
It would be highly unusual for a surgeon to include laser vision
correction
surgery in the global fee for cataract surgery. The exception to this rule
would be cataract surgery with a premium intraocular lens. In any event,
discuss the pricing should laser vision correction be recommended.
Will you perform Astigmatic Keratotomy (AK) surgery during cataract
surgery
to resolve astigmatism?
If yes, discuss this surgery, its effectiveness, and what additional cost
will be incurred, if any.
What is the worst cataract surgery outcome experienced by your own
patient?
How was it handled?
You want a doctor who knows how to get you out of harms way if something
unusual occurs. You want a doctor that is cool under fire and is willing
to
work with other ophthalmologists who may have specific expertise outside
of
your doctor's realm of experience. All doctors with enough surgical
experience have had a poor outcome. You need to feel comfortable that this
particular doctor can handle problems appropriately. If your doctor says
s/he has never had a poor outcome or a problem, you may want to politely
excuse yourself to the nearest exit.
Have you ever had malpractice insurance coverage denied?
Answer should be no.
Are you self-insured for malpractice?
Answer should likely be no, however in some cir***stances self insurance
may
be appropriate. Discuss the cir***stances with your surgeon.
Are you currently under investigation by the agency that provides the
license that allows you to perform cataract surgery? Has this license ever
been revoked, suspended, or otherwise restricted? Are you on any sort of
license probation?
Generally, the answer should be no, but if there are any licensing
concerns,
consider the cir***stances. As an example, a doctor who five years ago was
fined a few hundred dollars for an advertising problem may not need to be
automatically excluded. Surgeons new to that state may be on probation for
a
period of time. Discuss any licensure issues with the doctor and come to
your own conclusion about disqualification as a potential doctor.
Have you ever had hospital or surgical facility privileges revoked?
Answer should be no.
Have you ever had your Drug Enforcement Agency (DEA) certification
revoked,
suspended, or otherwise restricted?
Answer should be no.
Have you ever been convicted of a felony?
Generally, the answer should be no, but discuss the cir***stances and come
to your own conclusion about disqualification as a potential doctor. A
problem 20 years ago when a college student may not be im****tant today.
Have you ever been arrested for being under the influence of, or in the
possession of, any controlled substance?
Generally, the answer should be no, but discuss the cir***stances and come
to your own conclusion about disqualification as a potential doctor. A
problem 20 years ago when a college student may not be im****tant today.
Have you ever been treated for substance abuse or mental illness as an
adult?
Generally, the answer should be no, but discuss the cir***stances and come
to your own conclusion about disqualification as a potential doctor. A
problem 20 years ago when a college student may not be im****tant today.
Have your ever been refused participation as a provider in a health
insurance plan?
Answer should be no, except in the case of managed care, which excludes
doctors for reasons other than medical competency.
Is the medical equipment you will use specifically approved by the Food
and
Drug Administration (FDA) for the recommended procedure and intended
parameters? If no, explain why it is not FDA approved and/or off-label
use.
The equipment should be FDA approved (hardware and software), however the
specific parameters for its use for you may not be FDA approved. Surgeons
are legally able to use FDA approved tools beyond FDA approved parameters
in
some cir***stances. This is called off-label use and should be discussed
with your doctor if applicable to your cir***stances.
If an additional surgery is required, what will you charge for the
additional procedure?
Answer should be no charge for a directly related corrective procedure
within a specified period of time, usually about a year after surgery. If
there is a charge, consider the affordability if needed.
If another doctor will be comanaging pre- and/or postoperative care, can I
see you at any time without my comanaging doctor's authorization?
The answer should be yes. You should be able to go directly to the surgeon
at any time you feel it is appropriate.
What should I expect my vision to be like for the first few weeks after
surgery?
The answer should include an explanation of eye patching, minor
fluctuations, blurriness, minor halos, minor starbursting, glare, etc.
These
side-effects may occur, but commonly resolve during the six-month healing
process.
Will you perform a complete cataract examination including evaluating the
medical health of my eyes both before and after surgery?
The answer should be an unqualified yes and the medical component of the
exam must be performed by an ophthalmologist (medical eye doctor).
Will my vision fluctuate after surgery? How long is the healing period?
If the doctor says, "Twenty minutes and all will be fine" you may want to
move on. Cataract surgery is relatively quick but the healing and
fluctuations may continue for weeks or longer. Cataract surgery is more of
a
six-month process than a Two-Day Miracle even though it is possible you
will
have perfect vision within days after surgery.
Will you perform a contrast sensitivity test before and after the surgery?
The answer will probably be no, but should be yes. Contrast sensitivity
testing is not currently routine and not all doctors have the technology
available. Your doctor should offer to arrange for you to receive this
test
at your expense at another location.
Will you perform a glare sensitivity test before and after the surgery?
If your cataract is advanced, glare testing may not be necessary. Your
doctor should offer to arrange for you to receive this test at your
expense
at another location.
Will you perform an axial scan before the surgery?
The answer should be yes.
Will you perform a test to determine tear volume (Schirmer) and tear
breakup
test (TBUT) prior to making a recommendation about cataract surgery?
Answer should be yes. These tests help determine if you have unusually dry
eyes. Dry eyes are a medical condition that should be treated and managed.
Will you measure the size of my pupils when naturally dilated in a variety
of light variables prior to making a recommendation about surgery?
The answer should be yes for conventional intraocular lens and must be yes
for premium intraocular les. This is an im****tant test to determine if you
my have a higher than normal probability of postoperative problems in low
light environments and/or if you will achieve the desired near and
distance
vision with premium intraocular lenses. Dilation needs to be natural and
without medication.
Will you require me to be without contacts for a period of time before the
examination that will determine final calculations for surgery? What is
this
period of time?
The answer should be yes and for a significant period of time. We
recommend
several weeks without soft contact lenses, longer for hard contacts. Some
doctors feel a few days is enough, but we recommend longer. You want your
surgery calculations determined after your cornea has returned to its
natural state, no matter how long that takes.
If I had refractive surgery (RK, AK, Lasik, PRK, LASEK, Epi-Lasik, P-IOL)
will you contact my previous doctor for measurements to help determine the
appropriate power for my replacement intraocular lens?
The answer should be yes, but the needed information may not be available.
Many refractive surgeons record the measurements for intraocular lens
calculation before refractive surgery and this information can be very
helpful, however not all refractive surgeons perform this service and the
information may not be available, however your cataract surgeon's office
should attempt to gain this information.
Will a patient with more than eight diopters myopia be referred to a
retinal
specialist for evaluation?
A general ophthalmologist can perform an evaluation of the health of the
retina, however cataract surgery has more risk of retinal detachment the
higher the myopia. The greater the myopia, the more an evaluation by a
retinal specialist may be needed.
Keep in mind that even if you have had cataract surgery that corrects you
to
20/20, your eyes are still the same length as they were before surgery. If
you were more than eight diopters myopic before Lasik, you are still eight
diopters myopic even if your lens has been replaced and has reduced your
need for gl*****.
How often and when will you perform postoperative examinations?
Commonly will be 14 hours after surgery, 2-4 day after surgery, periodic
exams for 2-3 months, as needed with adverse event. These exams might be
performed by an eye care professional other than the surgeon.
When will you provide me with a copy of your written informed consent?
The doctor should offer to provide a copy immediately upon asking this
question. A week before surgery is adequate. You need to read and
understand
every component. This is not just a legal formality, but an explanation of
what can happen.
Will you provide contacts for me to wear to simulate monovision prior to
surgery? How long will you want me to wear these contacts before I make my
decision about monovision?
Contacts should be provided free with at least four weeks wearing time
before monovision decision must be made, unless the patient is already
accustomed to monovision.
Will you provide me the names and contact information of at least five
previous patients who have had the exact same surgery with similar
cataract
error?
Answer should be yes, and doctor should already have such a list compiled.
Don't expect to get a list of dissatisfied patients, but these people can
tell you what going through the procedure is like. You may want to talk
with
patients who had surgery recently and some who had surgery several months
ago.
Will you allow me to observe a surgery?
Operating suite access restrictions may preclude surgery observation,
however a simulation such as an animated video may be available.
Does my occupation, leisure activities, and hobbies have any bearing on my
candidacy for premium intraocular lenses?
Answer should be yes. People who require exacting and detailed vision or
rely heavily on good low light vision are possibly not good candidates for
some premium intraocular lenses and should be screened appropriately.
Does my general medical and medication history have any bearing on my
candidacy for cataract surgery?
Answer should be yes. Some conditions that have nothing to do with the
eyes
may complicate some types of cataract surgery.
Does using Hormone Replacement Therapy (HRT) have any bearing on my
cataract
surgery?
Guys, you don't get asked this one but all post menopausal women should
asked. Fluctuations in refractive error are often related to hormonal
changes.
Who will pay for multiple corrective lenses if I experience fluctuation in
visual acuity while healing?
Whatever the answer, consider this as a part of the cost of the surgery.
Are there any reasons why I would not have excellent cataract surgery
results?
This is a blanket question to provide you and your doctor an op****tunity
to
discuss in more detail what you can reasonably expect from the proposed
surgery. Whatever the answer, it needs to be the same as what you perceive
to be an excellent result. If you cannot reasonably expect to receive what
you consider to be a successful result, you may not want to have surgery.
What certification do you hold, if any, from the American Board of
Ophthalmology, American Board of Eye Surgery, or other organization? If
not
all, why?
It may be im****tant for you to know if the doctor desires the additional
oversight of these organizations. Some are more valuable than others
The American Board of Ophthalmology (ABO) does not provide any evaluation
specific to cataract surgery. Certification is valid for a lifetime, or 10
years if recently certified. ABO certification would be conspicuous by its
absence.
The American Board of Eye Surgery (ABES) is an ophthalmic group that
provides peer-reviewed certification for cataract surgery. ABES
certification is valid for seven years.
Consider the relevance and value of these and other certifications the
doctor may have achieved.
If I am unable to afford the normal $3,000 to $600 out-of-pocket expense
for
needed cataract surgery, will you work with organizations like Cataract
Free
America, Mission Cataract USA, or the Senior EyeCare Project to provide
the
waiver of some or all of your fees.
Be realist in what you expect as an answer. Almost all surgeons provide
care
with reduced or no compensation, but medicine is a business and this
particular surgeon may have already provided a significant amount of care
under these or similar programs. If your surgeon is not able to provide
the
care you need with out-of-pocket expense you can afford, then ask your
doctor to refer you to one of these organizations or contact them
directly.
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