
                    THE RICH MAN, THE EYE AND THE NEEDLE

                              By ROBERT WALKER
                               Calgary Herald

     CALGARY - He's reputed to be one of the richest physicians
     operating in Canada.

     Last year, his Gimbel Eye Centre billed the Alberta government
     $1.6-million in health care premiums alone. Another $5 million was
     billed to patients directly.

        See <16health -nets> for comparison with average G.P. salary

     But Calgary ophthalmologist Dr. Howard Gimbel is not into medicine
     for the money, say friends and colleagues. The money he earns
     through his practice is more a byproduct of his religious and
     professional zeal, they say.

     ``Money is only a blessing if we use it to help others,'' says the
     mild-mannered Gimbel who is more likely to quote the Bible than the
     TSE Index.

     A devout Seventh Day Adventist, the eye specialist credits the Lord
     for the phenomenal growth of his practice.

     By taking a $1-million-plus plunge in 1984 and providing the first
     outpatient eye surgery suite in Canada, Gimbel was able to dedicate
     his time to what he does best - micro-eye surgery.

     The centre, in northwest Calgary, now occupies more than 1,850
     square metres of space and its staff has grown from eight to 80
     employees. Five days a week he moves relentlessly between the two
     operating rooms completing 22 operations a day.

     Each is videotaped through the microscope that Gimbel uses. A
     commentated copy is given to each patient after the operation. Now
     notching up 4,500 surgeries a year, Gimbel has performed more than
     30,000 operations on his patients' eyes during the past 25 years.

     He is allowed to charge a facility fee to compensate for the
     millions of dollars worth of state-of-the-art equipment used in his
     surgical centre. An excimer laser used to correct near sight cost
     the centre $500,000 - more than what most doctors earn in a year.

     A patient having cataract surgery for instance, pays $900 on top of
     the $563 billed to the provincial insurance plan. The fee is higher
     for more complex eye operations. Although the highest billing
     doctor in Alberta, the bulk of Gimbel's income comes from facility
     fees.

     Much, he says, goes towards financing his equipment. ``I would like
     to be known not only as a doctor who generates a lot of income but
     one who spends a lot of it on his patients and his staff,'' he
     says.

     ``Service has been our motive, not money. But the more we serve the
     more money we generate - and that helps us to serve better and to
     be able to buy this equipment the teaching hospitals say they
     cannot afford.''

     Gimbel's wife, Judy, is executive director of the centre and a
     driving force behind what she calls their Christian corporate
     culture.

     ``Any success we've achieved is because of His blessing and should
     be to His glory,'' says her husband. Both are vegetarians and
     abstain from caffeine and alcohol.

     In their 50s, they religiously work out every day. They give a 10th
     of what they make to their church and one in every 10 patients are
     seen for free - after submitting to a means test. Judy calls it
     their ``second tithe.''

     Gimbel's reputation among his peers as a brilliant surgeon is
     largely unquestioned. A world map on his office wall is peppered
     with pins affixed to 45 countries from where doctors have referred
     patients.

     An average of one eye specialist a week from around the world
     visits the centre to pick up tips on technique.

     Gimbel hosts a prestigious annual conference on refractive surgery
     at a resort in the Rockies and is guest speaker at an average of 10
     other international conferences a year.

     Five ophthalmologists and two anesthesiologists now work as
     associates at the centre, which sees 25,000 patients a year.

     Gimbel's success however, does not come without drawbacks and
     critics. Controversy over user fees prompts criticism that Gimbel's
     is a two-tier system, where some wait for free medicine and others
     pay.

     But Gimbel says given the choice people would rather spend their
     money on health, particularly when governments are cutting back.

     In another dispute Dr. Marvin Kwitko, a Montreal eye specialist,
     launched a bitter attack on Gimbel last fall for using the excimer
     laser before it had been cleared for use in Canada.

     The Alberta College of Physicians and Surgeons, the organization
     that polices the profession in the province, has looked into such
     criticisms and says it has no concerns about Gimbel's practice or
     his income.

     Gimbel, it notes, is very much the exception as far as physicians
     are concerned.
