By its very nature, the practice of medicine is intensely personal.  This goes for every part of the human body.  It especially goes for the eyes.  During the examination process, the chit-chat that we weave in and out of our testing reveals an amazing wealth of detail about you that helps us personalize the care we offer you.  Your struggle with your husband's alzheimer's, your college midterms, your career as a nuclear engineer, your hopes and dreams--it all creates a relationship of caring and trust between us that influences the choice of lenses we recommend for your vision correction, the medicine we prescribe for your dry eyes, or the surgeon we send you to for cataract removal.  The better we know you, the easier it is to fine tune your vision.

Among the layers of reasons that we oppose government control of healthcare, and any form of managed care like vision plans, the desire to practice personalized medicine is the core philosophy that drives our love of patient care.  As soon as we have to answer to an authority higher than you, the patient, we both lose.  It could be a managed care company like VSP, EyeMed, or Spectera who directly and indirectly enforce the type of optical products we prescribe, or circumscribe the types  of testing we can offer you; or it could be a government bureaucrat with the power to ration access to sight saving drugs; or it could be the faceless agency that has turned us into their eyes and ears in case you choose to live a lifestyle they deem unhealthy.  Whatever the case, care managed by anyone other than you and me creates a doctor vs patient relationship that is more antagonistic than mutually beneficial.

Nobel Prize winning economist Milton Friedman wrote a column in 1996 that was revisited in yesterday's WSJ.  Its a prescient message that speaks to our current reform debate.  See the whole thing here.