After health-care reform, ophthalmologists can turn to writing wedding vows

One "policy wonk" suggests that physicians are performing too many procedures (about 30% too many), and that if they no longer perform unnecessary procedures, money will be freed up to reform the health care system.

Key Points

"When I was younger, I hated going to weddings. It seemed that all of my aunts and the grandmother types used to come up to me, poking me in the ribs and cackling, telling me, 'You're next.' They stopped [doing] that . . . after I started doing the same thing to them at funerals."

My good buddy, an ophthalmologist, attended a wedding with his family a few years ago. The blissful couple had written their own vows, which reportedly were quite lengthy, and the ceremony was being videotaped. The couple expounded on their love for each other, going into considerable detail about how it was deeper than the deepest ocean, higher than the highest mountain, etc. After quite some time of this, my friend's son yelled out from the quiet audience, in an annoyed tone, "Yeah, yeah, yeah!" This commentary is captured on the wedding video, preserved for all time.

Thirty percent of ophthalmic procedures are unnecessary? That was news to me. "This character has no idea what she's talking about," I thought. The American Academy of Ophthalmology already projects a likely undersupply of ophthalmologists to care for the aging baby boomers, people with diabetic eye disease, and everybody else who will need eye care a decade from now. We have been thinking that we would be hard-pressed to keep up with the demand for our services. But, in fact, it now turns out that the wonks (or at least this wonk) have revealed that about a third of what we do is really unnecessary. Who knew?

Wedding vows was the other, unrelated news item of the program I was watching. Traditionally, vows were given to the couple by a minister or other official. But increasingly, tradition is being thrown out of the window and couples are concocting their own vows. That is a big responsibility, however, because the words written for wedding vows are meant to be extremely weighty and eternal (unlike the drivel I write in my columns). As a result, online wedding vow ghost authorship services will shoulder this important burden for the bride and groom.

The connection, of course, is obvious. If the policy wonks who might come to control health care in the United States demand a 30% reduction in procedures, and with ophthalmology being such a procedure-oriented specialty, a lot of ophthalmologists will be looking for something to do. Forced to stay out of the operating room, they could devote their talents to penning vows, such as "Our love is like a red, red retinal arterial macroaneurysm" and "My respect for you is greater than the largest chalazion."

Because so many ophthalmologists are good writers and some have senses of humor, this scenario could work out really well for couples tying the knot. But if you end up writing vows in a few years, have mercy on the young boys being forced to attend the ceremony, and keep them short.

Peter J. McDonnell, MD, director of the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, and chief medical editor of Ophthalmology Times.

He can be reached at 727 Maumenee Building, 600 N. Wolfe St., Baltimore, MD 21287-9278 Phone: 443/287-1511 Fax: 443/287-1514 E-mail: