January 2009




Goals for the New Year ...


This month’s column, the work of the EyeWorld editor-in-chief, Erem Latif, deviates from our usual presentation by being both introspective and futuristic. I think it will provide a lot of thought, reflection, and anticipation on the part of our readers. Happy New Year to all!

I. Howard Fine, MD, Column Editor


Given these changing times, we are taking a step back, to allow us to take several steps further. As cataract surgery continues to evolve, we look back to see how far we have come—from improving procedural time and techniques, to reduced recuperation times and visual outcomes. We have made great strides in the field of ophthalmic surgery. And still, we continue to learn of the most innovative and exciting techniques and equipment currently available. Yet it becomes imperative that we also take the time to consider “What else?”.

What else is needed, as surgeons, to ensure you can become better … better equipped, better prepared, better informed, quite simply, just better. In the coming months, we plan to explore various avenues of improvement which can easily be overlooked during the ‘daily grind’ of seeing patients, performing surgeries, and managing an office. We hope, at the end of the year, that we will contribute to helping you achieve the greater goal of being “all you can be” as a cataract (or refractive) surgeon in these challenging times.


The key to improving the professional world around you is by surrounding yourself with superb staff.

If you have yet to achieve this, work towards this deceivingly simple goal. If you have achieved attaining a superb staff, work to maintain them. In this difficult economy, the smaller things done to ensure the happiness of our staff, collectively go a long way. From gas allowances to education reimbursements, we need to ensure the individuals in our offices are fulfilled.

Also commonly overlooked, recruiting good younger doctors into your practice. First of all, you serve to ensure the longevity of all the time and energy invested by you into your practice. Second of all, by teaching, you serve to perpetuate the knowledge … the field in which you have invested. Final-ly, you provide an opportunity for these younger doctors to be exposed to the most cutting edge techniques and devices as you, the established ophthalmic surgeon, has already gained access to these tools.

Coalescence of practice

This is a somewhat novel concept, transforming individual medical offices, into one cohesive medical health “home”… allowing physicians of various specialties to work together synergistically, exchanging ideas and collaborating with comprehensive treatment paradigms in order to maximize outcomes for individual patients. This collaborative effort, allowing a team of experts to approach individual care, is the current trend in medical practice. In this era of economical hardship, it may also serve an additional benefit by allowing shared practice costs. In the coming months, we will present ophthalmic practices that have moved into this type of care in order to evaluate the true advantages versus disadvantages.


Given the cost of performing outpatient procedures, ambulatory surgical centers (ASC’s) offer many more advantages than a typical hospital environment. Hospital outpatient facilities are embroiled with budgetary issues and paperwork. Access to technology can be limited by funding, space, and initiative of hospital administration. Individual ASC’s allow academicians a certain degree of freedom: access to innovative technology, state of the art facilities, and certain amount of autonomy. All of this translates into offering the best options to the patient. Going further, the business decision to invest in an ASC becomes even more advantageous for the ophthalmic surgeon. We will explore what forces prohibited the development of ASC’s originally, as well as the differences between both surgical environments and the challenges uniquely associated with each.


Once residency and fellowships are completed, continuing medical education remains the primary form of continued education. How-ever, as annual symposia and congresses continue to strive for record registrations and record-breaking numbers of attendees, some of the more solid educational efforts are achieved on a smaller scale. This past July, the University of Wisconsin School of Medicine and Public Health, the UW Department of Ophthalmology and Visual Sciences, and the Office of Continuing Professional Development, held the inaugural Extraordinary Ophthalmology meeting. During this two-day conference, topics focused on truly comprehensive areas, including Advances in Clinical Management and Technology; Frontiers of Vision Science, including stem cell therapy, nanotechnology, and therapeutic targets; and Global Health Ophthalmology. By promoting “outside the box” thinking and discussion, attendees were given unique perspectives and tools with which to return to their practices and realign their treatment paradigms.

Age, ethics, and retirement

Given the increasing demands (of ophthalmic care) by the baby boomer generation, it becomes vital to address the age issue. In order to ensure competency, every ophthalmic surgeon needs to acknowledge their own “mortality”. Measures should be taken to review mental status, ability to practice medicine, and run a business. Furthermore, most ophthalmic surgeons spend many hours seeing patients and performing procedures. When the decision to retire is finally made, what is next for the doctor who has devoted his/her life and a great deal of his/her time to the practice? Retirement coaching is a great avenue available to physicians as they approach that age or state in their lives and need help channeling their extra time and energy.

Future of ophthalmology

Where will the practice go next? Just as the older generation of ophthalmologists must decide how and when they will retire, a younger generation of ophthalmologists must be ‘cultivated’. EyeWorld will examine the future of specialized medicine, including ophthalmology, by exploring choices being made by medical students today. What are their goals and ambitions? Where do they focus their time and energy? Having graduated, what medical residency slots are being filled? Which fields are left looking sparse? Given changing economical times, it is vital that energy, time, and commitment be re-invested into a field where so much has already been achieved over the past 20 years. h

Goals for the New Year ... Goals for the New Year ...
Ophthalmology News - EyeWorld Magazine
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