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Strategies & Market Trends : The Art of Investing -- Ignore unavailable to you. Want to Upgrade?

To: Sun Tzu who wrote (313)	11/21/1998 2:20:00 PM
From: Michael Sphar	Read Replies (1) \| Respond to of 10713

Finally caught up, great thread. Laser eye surgery might not be new, but in it latest iteration - LASIK style surgery, has only been FDA approved for a couple years. For us, my wife and I, that was a major point. When she decided to look into the possibilities, she approached it as a consumer looking for the best deal. In this case that meant lowest risk of adverse consequences plus high degree of success anticipated, plus minimum of pain/recovery, cost was a consequence but not a factor. She found a local doctor first and evaluated him based on referrals and testimonials. She talked to about five former patients. The key thing that evolved from this was a realization, that one wants a skilled and experienced doctor. Someone who has literally done this type of operative procedure not just hundreds but thousands of times, someone who is a leading technologist in the field and someone who could if necessary deal with unexpected or unusual situations. You want the volume shop approach in this. This doctor, my wife found, had done in excess of 9000 eyeballs and per his resume was preeminent in his field, Yale pre-med, UCLA med, worked with FDA on several research projects, and taught the operative techniques to other doctors throughout the US. The equipment that he uses was dictated by his practice. So it was Visx by default. But in her research it turned out theirs was the only FDA fully approved unit on the market last year when she was doing her research. The Summit equipment though not a factor since the doctor was the key, was usable but didn't have that "seal of approval". Anyhow it was the doctor that was selected not the hardware. In retrospect, the brand of hardware is not too crucial. The primary three factors in order of importance to me are the doctor, the mapping technology and associated tool, and the cutting technology. The laser is a computer controlled light beam, its going to work pretty darn accurately from a human perspective. The laser equipment ranks fourth. The mapping technology I know the least about. Just that it was done on a PC with some sort of bright concentric lights beaming into my eyeballs. But this produces the data that sets up the excimer laser. So one would hope that the PC is running well, produces a valid/good file and has a sophisticated well thought out program driving it. The knife, aka microkeratome, is a mechanical apparatus that fits in a jig that is wedged over your eyeball between the brow and cheekbone. Three factors here. Potential for infectious contamination, proper centering/alignment and cutting limit, appropriate depth of cut. In the end one has to have faith in the doc. This is where those prior thousands of cuts come into play. Regarding the hardware, I've done some reading on the Visx and Summit and related companies threads here at SI. A lot of good technology and stock related discussion there. Recently there has been some significant partnering going on between the two, but I haven't followed it. The licensing or use fee is key. One laser can do a lot of patients. Total time in the O R for me was about 5 to 10 minutes, maybe 15 at most. While the equipment sits idle, it is not generating any revenue, obviously. At about a million a unit, these are not big revenue generators as capital equipment. I don't know how many units Visx has in the field but I would bet its on the order of dozens and not even a hundred. It is the licensing/use fee that is crucial. The laser is located in a different location for the doctor. I believe all the doctors share this equipment and have rights to different access windows. I noticed that our doctor seemed to do a lot of surgeries on Thursdays. After my wife's operation, she has tremendous instincts and I try to listen carefully when she speaks, she said something about buying the stock of the company that makes the laser. Naturally I hurried to my PC and starting researching. If only (ever heard those words before ?) I would act on half of what her gut expresses I would be a wealthy man. I am the preeminent contra-indicator. I sat and stared at Visx charts sitting at $21 per share last December/January conjuring up and wrestling with any number of excuses for not diving in and buying it immediately. Bottom line, I'm $44 per share poorer for that muffed decision. At 200 shares that would have more than paid for our combined surgeries. At 300 shares we'd also have covered shorterm cap gains taxes too! A penny saved may be a penny earned, but a risk not taken can be a fortune that is lost forever. And speaking of risk, how about this as a topic of discussion ? Note, I am a big fan of author Justin Mamis and his "The Nature Of Risk" subtitled "Stock Market Survival and The Meaning Of Life".