The whole story of Integrity Eye

Integrity Eye formed because of the concern of how cataract care—and eye care in general—was being delivered in some practices. There seemed to be an emphasis on upselling patients into cash based services.

Patients often presented after having cataract surgery at other practices and reported spending thousands of dollars extra for their cataract surgery despite having medical insurance. This was because they were encouraged to choose “premium” lenses or laser surgery for their cataract surgery. These are not covered by insurance. In many cases patients felt dissatisfied with their results and experience, and felt pressured into choosing these options because of the way their choices was presented to them. For many retired people on fixed incomes, spending thousands of dollars on cataract surgery upgrades was financially stressful. Many were led to believe that these options were essential—when in reality, they were optional and did not significantly improve their outcome.

There were other trends that we observed in the community that bothered us. In some practices surgical counselors or other non-physician staff were the people who counseled patients into more expensive upgrades. They sometimes were financially incentivized. Patients trusted that they were getting medical advice, but what they were often receiving was a sales pitch. In some practices that owned femtosecond lasers for cataract surgery, femtosecond laser-assisted cataract surgery was promoted as “safer”. This is not what over a decade of medical evidence reported. In the hands of qualified surgeons, there was no advantage advantage of “laser” cataract surgery over traditional modern small incision cataract surgery. We would also see the overuse of multifocal lenses. Where these lenses were placed in patients with underlying eye conditions that should have ruled them out as good candidates—leading to suboptimal results that could have been avoided with “standard” insurance covered lens implants. This was not the kind of medicine we trained for or wanted to practice.

To be clear we do offer elective cataract surgery upgrades. However, in our practice we are mindful to not overly promote the benefits of these technologies. Although there are advantages of “premium” intraocular lenses, there are also disadvantages. Furthermore, there are individuals who are happy wearing eyeglasses, or prefer using monovision, and upgraded lenses offer little improvement in their quality of lif0e after cataract surgery. There are also situations where upgraded lenses are not beneficial to patients because of underlying ocular disease and they are better served with “standard” lenses. Contrary to marketing strategies, new and expensive doesn’t always mean better, and not everything that’s marketed as cutting-edge is the right choice for every patient. Cataract surgery isn’t one-size-fits-all. Every patient comes with a different history, goals, and needs. Those factors—not marketing or margin—are what guide our conversations.

Integrity Eye’s roots date back to Hidden Valley Eye Associates, which was founded by Howard Krausz MD, PhD in North County San Diego over 40 years ago. Arvind Saini MD, MBA, who shared a similar care philosophy as Dr. Krausz, then purchased Hidden Valley Eye. Our practice has evolved by adding locations, new team members, and new doctors. There has been a lot of ups and downs on the way (think COVID, and plenty of other things). There has been lots of hard work, risk and sacrifice to build, design, and move into our offices. There certainly have been growing pains as we have refined our process, but we did this to create the type of practice we believe in. We have not forgotten our principles of providing the highest quality, honest, patient centered care. We provide comprehensive eyecare for conditions such as glaucoma, diabetes, and macular degeneration. We are leaders in cataract surgery and other advanced surgeries such as corneal transplants, corneal cross linking, and refractive surgery. Our goal is to be a place where patients can get clear, honest information about their eye health and surgical options—without pressure, confusion, or hidden financial motives. We only make diagnostic and treatment recommendations based on accepted standards of care, not anticipated insurance or patient payments. We try to communicate patients out of pocket expenses with their insurance before their visits. We do not send shockingly inflated bills to our uninsured patients, rather we charge what we expect to be paid by insurance. We don’t sell glasses to patient’s who won’t benefit from them, or recommend surgery when its not time. We try to prescribe medications with good insurance coverage as first line agents. We simply aim to provide care with quality, fairness, clarity, and compassion.

However, this kind of care isn’t easy to maintain these days. The costs of running a practice continue to rise every year with inflation, expensive and time consuming regulatory rules, and the payments we receive from government and private insurance continue to decrease. There is growing pressure across the industry to shift costs to patients, and private equity is rapidly consolidating eye care practices that have to sell or throw in the towel. We often have to do more with less—and that comes with trade-offs. Sometimes we can’t answer your call in real time, and your call may go to voicemail. Our handouts might not be the glossiest.  And yes, we do need to collect co-pays, insurance contracted deductibles, and co-insurance in order to keep our doors open and our care accessible. Still our team works hard to meet your expectations—and exceed them in the ways that matter most: in our integrity, our clinical care, and our commitment to treating you like we would want our own family to be treated.   

At Integrity Eye, our name signifies our purpose of always putting our patient’s interests first.  We are here to skillfully take care of you and your family and provide honest, compassionate, and technologically advanced eye care. Because integrity isn’t just our name—it’s our foundation.