Aug
A Stitch in Time, Article by Dr. Stephen G. Slade
It is not the number of good cases you do, it is the number of bad cases you don’t do. I frequently think of this pearl Lee Nordan MD told me years ago, as I began practice. It was great advice then and as the years have gone by, has become even more valuable. While a happy patient might add referrals, it seems the unhappy ones are the biggest talkers. Clearly, in today’s ophthalmic practice, we surgeons have more reasons and place more pressure on ourselves to avoid bad outcomes. Everyone’s primary goal is simply to avoid the tragedy of significant vision loss in any of our patients. I am even more affected by any bad outcome now than earlier in my career, if that is possible.
As your practice matures, we are dealing more with friends, or friends of friends. Perhaps the patients simply become closer and more personal to us. Maybe after years of seeing how fragile our sight is, and how vital to us, we learn to more fully appreciate this gift. And patient expectations are higher than ever. As the baby boomers become cataract patients, they seem to keep their view of eye surgery as what they learned from PRK or LASIK. They expect rapid results, excellent uncorrected vision and truly do not expect even a slight loss of quality of vision, let alone a frank vision loss. Finally there are medical malpractice risks, and the potentially devastating effect on everyone involved.
Luckily, we have help to prevent, avoid and manage complications. We are blessed with better and better technology, as always in Ophthalmology, such as femtosecond lasers. Just as femtosecond lasers added to LASIK surgery, I believe they will add precision, efficacy and safety to cataract surgery. Less manipulation, less fluid, less phaco power in the eye should translate to lower endothelial cell loss and less vitreous loss rates. I am also extremely enthusiastic about the newer generation of microscopes. Not only can we see better to operate, but with HD cameras on the scopes, laptop editing, easily learned non linear laptop editing, we can learn from our own cases as well as share with others. We used to describe cases to each other in the hallways of meetings with hand gestures, now we email HD video. Amazing! Think of all the other education and sharing tools we have like EYETUBE, webinars, chat lines, and the wide variety of excellent, focused specialty meetings.
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