• 3 Surprising Tips for Patient Care from 2017 Academy President Cynthia A. Bradford, MD

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    Cynthia A. Bradford, MD
    Dr. Bradford addresses AAO 2016 attendees during the opening session in Chicago.

    As a resident at the University of Oklahoma, ophthalmologist Cynthia A. Bradford, MD, got some memorable advice from her residency program director, Jim Richard: “Know what you are doing — and be efficient and meticulous when doing it.” Taking that pearl to heart, Dr. Bradford began carefully cleaning the Betadine off her young patients’ faces after surgery and approaching the children’s parents with a smile — small efforts that brought a lot of reassurance.

    Throughout the arc of her career, Dr. Bradford has served her patients in a number of capacities: as a professor of ophthalmology at the University of Oklahoma College of Medicine, as Academy senior secretary for advocacy and, now, as Academy president for 2017.

    To this day, she still cleans the Betadine off of each and every patient’s face and comforts them with a smile.

    What advice does the 2017 Academy president have for residents and physicians new to practice? In an interview with YO Info, she shares her tips for helping patients thrive both in and out of the clinic.

    Tip #1: Understand What Your Patients Expect — It’s Not Always Surgery

    “Just because I am in your chair does not mean I want surgery.”

    Dr. Bradford said she commonly hears that from patients. In her experience, patients are told elsewhere that they need cataract surgery, so they’ll make an appointment with Dr. Bradford for an evaluation. Often, once she’s examined the patient and talked with them about their visual issues, Dr. Bradford explains that removing the cataract won’t solve the problem. “Many of these patients give a sigh of relief,” she said. “They didn’t want surgery!”

    At the same time, she said it’s also best to avoid clinging to those patients who demand a procedure. “Responding to the patient’s perceived ‘need’ for surgery — or exercising your own personal desire to increase your surgical volume — is not the way to build a practice,” she said. “If a patient pushes for surgery and I know it’s not needed, I simply tell them that if they want surgery, they can find someone to do it tomorrow, but it won’t be me.”

    Most often, such patients refuse this simple offer for referral. “In the end, your confidence will be perceived by the patient,” Dr. Bradford said.

    Tip #2: Get Involved Politically and Advocate for Your Patients

    In 1988, Dr. Bradford was working at the Dean McGee Eye Institute in Oklahoma when a patient came in for a second opinion about her blurry vision. She had previously undergone laser surgery for narrow-angle glaucoma.

    “The laser was performed by an optometrist,” said Dr. Bradford, “and looking back through the records of the laser surgery, the best documentation for the need for surgery was that the patient’s insurance covered it. There was no indication of narrow angle or symptoms of angle closure.”

    The patient asked Dr. Bradford, “Was I harmed?” She didn’t have any complications from the laser, but she also didn’t require the procedure and her distorted vision persisted.

    This started Dr. Bradford thinking. Was this actually harmful? After all, the state was supposed to protect its citizens by ensuring that medical providers were adequately trained and authorized to care for patients. “I learned a lot about the importance of political advocacy from this experience,” she said. “Someone has to stand up for patients at the legislative level.”

    At the time, Oklahoma optometrists were performing laser surgery without any statutory or board authority. After a lengthy legal, board and legislative struggle ensued, Oklahoma in 1998 granted optometrists authority to perform eye laser surgery.

    So Dr. Bradford reviewed all of the legal documents and realized that optometrists had a plan. “If ophthalmologists weren’t going to stand up and educate policymakers about how optometrists were trained differently,” said Dr. Bradford, “how could state legislatures make informed decisions?”

    Thus began her long and impactful career in advocacy.

    Tip #3: Train the Next Generation

    Dr. Bradford’s care and advocacy for patients extends beyond those whom she personally treats. As director of medical student education at the Dean McGee Eye Institute, she’s also training the next generation of ophthalmologists to treat and advocate for patients as she does.

    Andrew Melson, MD, is a member of the Academy’s Committee for Resident Education who trained with Dr. Bradford at the University of Oklahoma. He’s experienced firsthand what YOs can expect from the new Academy president.

    “Despite her personal and professional success, Dr. Bradford always remains dedicated to the most difficult and courageous tasks in ophthalmic education — especially teaching residents how to perform their first cataract surgeries,” said Dr. Melson. “Through patience and determination, she helps every resident grow to overcome any challenges they might face.”

    He’s also worked with her at Congressional Advocacy Day during the Mid-Year Forum. “As part of the contingent from Oklahoma, I had the opportunity to witness her poise and charisma as she advocated convincingly on behalf of our profession,” said Dr. Melson. “She really is a strong and compassionate leader who will help us make headway on the issues that are most important to both our patients and our practices.”

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    About the author: Mike Mott is a former assistant editor for EyeNet Magazine and contributing writer for YO Info.