To the editor:
With regard to your February editorial, I would like to suggest that everyone try to use the proper term regarding the combination of traditional Western medicine and what many people call Holistic medicine. Using the word "alternative" implies either/or, which does not accurately describe the new paradigm that is adopting both forms to address the health care crisis. The appropriate words should be "integrative," which I prefer, or "complementary," which is also acceptable.
I have been preaching for many years that we have the responsibility to our patients to provide them with the best information to make prudent choices when buying certain products or services such as contact lenses, spectacles, pharmaceuticals, nutritional products and supplements.
Many years ago, the American Academy of Ophthalmology stated that it was unprofessional, if not unethical, to sell products like contacts and glasses in our offices. It was obvious to me that they were not living in the world of reality where patients were constantly getting ripped off by incompetent contact lens fitters and "highway optical stores." I created the first practice in Bergen Co., N.J., called the Bergen Eye Institute in 1975, where the three "Os" served patients under the same roof. We did not force patients to buy from us, but we unconditionally guaranteed their satisfaction, which they appreciated. I was challenged by the American College of Surgeons, which told me to cease and desist or face elimination from the College. I responded by telling them that if they did remove me from their ranks of Fellows, they would immediately receive a letter from my lawyer, who would implement the necessary action to stay that action with appropriate suits. I never heard from them again. Thereafter, I began to notice a lot more clinical "institutes" rather than academic institutes, which offered the same type of services to their patients. Looking at the AAO and other of our major organizations' programs reveals many courses teaching members how to incorporate contacts and eyeglass dispensing in their practices.
In the past few years, once again the Academy has taken the unrealistic position of telling us not to "sell" vitamins or supplements in our offices. Incredibly, the Board of Medical Examiners in the State of New Jersey forbids physicians to sell any product in their office by which sales they made a profit more than the cost of the product. Needless to say, that law did not hold up for very long before it was reversed.
One of the reasons that most physicians don't feel comfortable about advising their patients which "supplements" or foods to buy is because we have never learned about nutrition in medical school or thereafter. What a ridiculous state of affairs!
"We are what we eat" has always been my motto. Good nutrition is the key to prevention of disease. That is why holistic medicine is so important to incorporate in the new paradigm.
I agree with you that it is virtually impossible to regulate the billions of dollars the public is spending on pure and unadulterated junk. The person behind the counter at so-called health food stores provides false and self-serving information to our patients, so their customers (our patients) buy their products by the billions of dollars. When I was in practice, I told my patients to ask that person behind the counter to cite double-blind scientific studies at universities to prove the value of what they are suggesting. I've performed that simple exercise myself, and most of the time, they don't even know what I'm talking about and get very defensive or outright belligerent. End of story.
I predict that sooner rather than later, it will be our responsibility to legally provide our patients meaningful information about what supplements and nutritional products to buy whether in our offices or outside. The analogy to the sale of contacts and glasses is obvious. This will compel us to learn what we need to know so we can provide them with valid and useful information. This will obviously be an uphill fight because much resistance will be encountered.
In 1968, I was one of the first surgeons who inserted an IOL at the time of cataract surgery. As a result of performing one of these early cases in New Jersey, I was charged with deviating from accepted\community standards in that state.
Fortunately, I won a landmark case. Fast forward to 2005, when a surgeon who does not insert an IOL at the time of cataract surgery can now be sued for that deviation from community standards. Even after winning the case, it took those of us who were performing this "radical" surgery another six to eight years to convince the rest of our academic and clinical worlds that the operation was a major breakthrough to improve the quality of life of all patients.
Herve M. Byron, MD
Englewood Cliffs, N.J.
To the Editor,
I would like to comment on a nice review of video editing software by Michael L. Nordlund, MD and Eric Redder in the January 2005 Review of Ophthalmology. ["Break into the Movies (And Keep Your Day Job") p. 28]
Their review covered the basics on video editing with particular attention to Microsoft Windows-based PCs. However, for those looking for an inexpensive, integrated software suite, the iLife suite of programs for the Apple Macintosh (apple.com) offers comprehensive video capture and editing solutions. iMovie is the video-editing program which allows non-linear editing of both audio and video. If you wanted to import photographs into the video, the use of iPhoto (also included in the iLife suite) organizes and edits photos and is directly linked to iMovie. If you wanted to create a professional DVD after editing the movie, iDVD (again part of the iLife suite) allows creation and burning of DVDs with menus which are compatible with any home DVD player. The best thing about the iLife suite is price; this software comes free with all new Macintoshes, and the newest Macintosh, the Mac Mini starts at $499, which is cheaper than $600 quoted for Adobe Premier or $500 for Pinnacle's Liquid Edition. Furthermore, as the authors mentioned, the Macintosh computer is optimized for video work; a Firewire port for importing video from a digital video camera is built in, and there is no need certify the hardware or chipsets. As a bonus, the Macintosh makes an excellent second computer; it is known to have no virus problems and its system is bulletproof from crashes.
A final note: No matter what software or platform used to edit the video, it is advisable to save the final video in Quicktime (.mov) format rather that Windows Media Video. Quicktime is a friendlier format across all computer platforms, Windows and Macintosh.
(The author has no financial interest in the products discussed in this letter.)
C. Robert Bernardino, MD