Born and raised in Communist China before finding his way to Washington, D.C., with barely enough money to buy a few meals, Dr. Ming Wang has launched a medical career perhaps unrivaled in Nashville. He has a Ph.D. in laser physics. He received his medical degree after graduating from Harvard and MIT, magna cum laude. He is one of the city’s most prominent eye surgeons, professionally and socially. But despite such impressive credentials, Wang has marketed his practice in a way that some of his more discrete, and perhaps envious, peers view as tacky and even misleading.
In essence, Wang, often characterized by peers as “brilliant,” nevertheless may be on his way to becoming the “DUI Mike” of ocular surgery. At a time when many in the medical profession frown at the growing commercialization of their business, the otherwise mild-mannered Wang solicits patients using aggressive strategies—at times eschewing scientific caution for zesty promotion. His chief weapon is advertising, which, until recently, was as much a taboo for doctors as for lawyers. His face beams from ads designed to promote name recognition. He offers reporters and patients Top 10 lists about himself, defining his reputation as a “doctor’s doctor” and a “doctor who fixes problems,” and promoting his services with the can-do zeal of a personal injury lawyer.
“There is rapid development of technology,” says Wang, who doubles as an associate research professor of biomedical engineering at Vanderbilt University. “Healthy, objective advertisements can let patients know about the availability of these new technologies.”
Medical experts, however, claim that that there is no substantial scientific research to support Wang’s advertising claims. And while most industries are allowed some leeway when promoting their businesses, physicians generally are not.
Wang recently became the first surgeon in Tennessee to begin performing bladeless LASIK surgery, a relatively new procedure that replaces the manual cutting of the cornea with a laser. Due in part to his pioneering work with this technology, local media have spotlighted Wang in no fewer than eight different stories in the last four months, many of them virtual infomercials for his thriving West End practice, the Wang Vision Institute. Meanwhile, Wang himself is a relentless marketer, running professional-looking television commercials during Titans games and hosting a sharp-looking Web site with the motto, “My commitment to your vision,” running above an image of a pair of haunting brown eyes.
But if his shameless self-promotion isn’t enough of an issue, questions abound about whether Wang’s ads and frequent statements to the media represent the truth or whether they overstate the truth. Namely, some question his claim that his bladeless LASIK surgery is safer than conventional LASIK surgery. If Wang were advertising another service, it wouldn’t be an issue. But this is medicine, and the standards for ad copy are inherently higher. Moreover, Wang charges up to $2,750 an eye for this new procedure, much more than he bills for the traditional method.
In traditional LASIK surgery, which is surprisingly painless, the surgeon uses a blade called a microkeratome to cut a flap of the patient’s corneal tissue. The surgeon then uses a laser to remove the targeted tissue. The process can be completed in minutes, and while complications ranging from dry eyes to blurry vision to light sensitivity are rare, they can be serious. According to the American Academy of Ophthalmology, there are also rare incidents of persistent pain, cataracts and blindness.
With Wang’s bladeless surgery, a laser, not a microkeratome, cuts the flap of the patient’s corneal tissue. This procedure completely eliminates the use of a surgical knife. On his Web site, Wang says without qualification that this all-laser technology is safer and reduces chances for infection. It’s also more accurate, he claims, reducing the need for additional enhancement surgery. In an interview with the Scene, Wang again described the bladeless procedure as a superior technology than traditional LASIK: “Bladeless is not completely foolproof, but it’s much safer,” he says.
But local eye surgeons have cringed at Wang’s repeated assertion that his new technology is considerably safer than the one it threatens to supplant.
“Bladeless LASIK represents a potential improvement in an already successful procedure,” says Erich Groos, a local eye surgeon and a board member of the Tennessee Academy of Ophthalmology. “Nevertheless, data is lacking to show that it’s superior to current approaches.” Groos adds that nobody should promote bladeless technology as any safer than the traditional procedure—until there’s some evidence that says so.
“Thousands of bladeless procedures have been performed successfully, but they have not been collected and compared to the millions who have undergone LASIK with a blade,” he says. “In light of the lack of direct comparison data, it’s irresponsible to market this technology as superior and to charge a premium above standard LASIK for performing it.”
In addition, other medical experts outside of the market say that Wang can’t support his claim that his procedure is any safer. “There’s no study that I know that supports that,” says Dr. David Hardten, the director of refractive surgery at Minnesota Eye Consultants. “There have been complications reported with both techniques, and there has been no direct comparison that I know that says that one is safer than the other.”
However, Dr. Jonathan D. Christenburry, a LASIK surgeon in North Carolina who has done about 40,000 procedures since 1995, says he believes, like Wang, that the new bladeless procedure is, in fact, much safer. But he doesn’t point to scientific evidence, instead citing his own experience. “I’ve done about 5,000 [bladeless] procedures and have not had a single complication,” he says. “It’s been perfect every single time.”
Dr. Robert Maloney, a fellow with the American Academy of Ophthalmology, nevertheless says that right now, “We don’t know if a laser microkeratome (bladeless) is safer because so far nobody has compared it to a standard microkeratome side by side.” He adds, “It could be a positive, it could be a negative, we just don’t know.”
Maloney, who also works as an associate clinical professor at UCLA and has a private practice in Los Angeles, says that any claim that the bladeless procedure reduces the risk of infection is similarly unsubstantiated. “There is just no evidence that there is a lower risk of infection,” he says. “The risk of infection probably has to do with other variables besides the microkeratome.” Maloney also says that there’s no reason to believe, at this point at least, that bladeless is more accurate than the technology it threatens to replace.
Initially questioning Maloney’s credentials, Wang ultimately conceded that there’s not any large body of evidence to support his claim that his expensive new procedure is any safer or superior to traditional LASIK. “It’s definitely a newer type of technology, and the body of literature is not as large, and it’s also true that side-by-side comparison studies are ongoing.” Ultimately, Wang told the Scene that perhaps he should amend his claims to say, “Based on current information, the results so far that have been accumulated seem to indicate that this revolutionary bladeless all-laser LASIK technology appears to be safer.”
One friend of Wang’s says that while Wang may be one of the best LASIK surgeons in the world, his frequent and potentially misleading self-promotion undermines his stature. “I’ve told him a hundred times that he’s killing himself with the kind of advertising he’s doing,” says the friend and health care insider, who preferred to remain nameless. “He does good work, has helped charities here in town, but his weakness is his want for publicity.” This insider says that Wang is such a good surgeon, he should let his work speak for itself.
Larry Churchill, a professor of medical ethics at Vanderbilt University, says that when doctors advertise and promote their practice, they should be careful that they don’t take on a commercial relationship with their patients. Mainly, Churchill says, “It’s not that capitalistic forces can’t be a good thing, but they can’t be the predominant theme between the provider of services and the recipient of services,” he says. “If I’m a prospective patient, I don’t want to worry about if I’m being hooked in for a product by catchy advertising that I may or may not need.”
Churchill says that advertising can have its place if it truly educates people about new technologies that might be of use to them. But, he adds, it has to be about education, not promotion—a caveat that seems to apply to Dr. Wang. “There needs to be a way where we pay attention to boundaries.”
