Senior ophthalmologists have tremendous institutional knowledge and life experience that can be beneficial to young ophthalmologists transitioning out of training. To help guide you toward a successful career, YO Info asked members of the Academy’s Senior Ophthalmologist Committee to reflect on their careers and share advice for the first years of practice.
1. Keep Up the Communication
It’s amazing to see the value of newly minted ophthalmologists talking with each other. Such was not the norm in the early 1980s, so continue the good work!
It would also be wonderful to take the communication one step further by “pairing” established ophthalmologists with YOs just setting out in their careers. Each group has so much extraordinary insight to share.
–Susan H. Day, MD
2. Make Referring Comfortable
After completing my fellowship at the Bascom Palmer Eye Institute, I returned to a referral cornea/refractive surgery practice at the California Pacific Medical Center in San Francisco. I often saw patients seeking second or third opinions, but many were reluctant to share information about their initial care or even the name of the referring doctor. These patients wanted to protect the doctor and prevent feelings of anger about pursuing another opinion.
At first, it was awkward to deal with this issue. But over the years, I learned to emphasize that patients have the right to ask for a second opinion — therefore they shouldn’t worry about hurting anyone’s feelings or putting anyone on the defensive. I also learned to tell patients that their care is paramount. It’s their eye and their cornea, and we, as physicians, will always support their right to seek out additional advice.
–Richard L. Abbott, MD
3. Be More Proactive
Looking back, I would have been more assertive about my career decisions and set more distinct goals using a five- to 10-year plan rather than a “see what happens” approach. I would also suggest learning more about business in general, whether that be how to manage your money or run a successful practice.
–Samuel Masket, MD
Dr. Sadun during a Learning Lounge session on physician burnout during AAO 2017.
4. Don’t Forget Academia
After my training, I went straight into academics. This was a seamless transition from my fellowship since I was really just continuing on with teaching, research and patient care. In addition, my residency, fellowship and first faculty position all took place at the same institution, Massachusetts Eye and Ear Infirmary. As a result, my faculty and co-residents were now my colleagues and friends, and their support was invaluable.
The one thing I didn't anticipate though was that, despite training with the best teacher in my field, Simmons Lessell, MD, I was not yet a master clinician. It took me another decade in academia to be really good.
Hats off to those young ophthalmologists who transition from fellowship to private practice without the support of an academic environment — I don’t know how they do it!
–Alfredo A. Sadun, MD, PhD
5. Nurture the Patient Relationship
Remember you are treating the patient, not just the disease. When you enter the exam room, greet and shake hands with everyone in the room, especially small children. Give questions about the disease their due, but also ask and remember non-medical details: How’s the family? How’s your work? What trips are you planning on taking? Put these notes in the chart. The next time you see them, follow up and ask how their vacation went.
I’d also recommend reading the obituaries Your patients will lose loved ones and will treasure a note from you acknowledging their loss. If you master the challenges of taking care of the disease as well as the patients and their families, you will love your practice and be rewarded with great reviews.
–Thomas S. Harbin, MD, MBA
6. Stay on Time
Respect your patients’ need for prompt attention. Many young ophthalmologists are slow and patients end up waiting too long in the clinic. You need to learn how to impart key information efficiently and succinctly and use written material.
7. Manage All Aspects of the Patient’s Visual Life
Does the pinhole test indicate a need for a refraction and new glasses? Get that done even if it’s not on your list for that day. If the patient has reduced vision, provide a referral to the local low vision center and hand out a list of all the apps that can help low vision patients negotiate modern life. The family as well as the patient will love you for this.
8. Be a Real Doctor
Make sure your diabetic patients are keeping up with all aspects of their care. Emphasize the importance of diet and exercise and know the best consultants for a variety of conditions. Be prepared — patients will certainly ask who the best specialist is for any number of problems.
9. Tackle Problems Head on
Meet complications with honesty and compassion. Many malpractice suits come not from just bad outcomes, but from poor handling of bad outcomes.
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About the authors:
Susan H. Day, MD, was the Academy’s 2005 president and currently chairs the Senior Ophthalmologist committee. Dr. Day serves as senior vice president of medical affairs at the Accreditation Council for Graduate Medical Education International. She previously worked in private practice as a pediatric ophthalmologist at the California Pacific Medical Center.
Richard L. Abbott, MD, was the Academy’s 2011 president and currently serves as the secretary for global alliances and a SO committee member. Dr. Abbott works as a cornea specialist and Thomas W. Boyden health sciences professor of clinical ophthalmology at the University of California San Francisco. His is also a research associate at the Francis I. Proctor Foundation.
Thomas S. Harbin, MD, MBA, served on the Academy’s Board of Trustees from 1994-1996 and chaired the Young Ophthalmologist Committee in 1994-1995. Dr. Harbin currently serves on the SO committee and works as a glaucoma specialist at Eye Consultants of Atlanta.
Samuel Masket, MD, served on the Academy’s Board of Trustees from 1998-2001 and represented the American Society of Cataract & Refractive Surgery on the Academy Council from 1994-1997. Dr. Masket is a cataract and refractive surgeon at Advanced Vision Care in Los Angeles and a member of the SO committee.
Alfredo A. Sadun, MD, PhD, has previously served in numerous Academy leadership positions in the clinical education and annual meeting divisions. He also served as an Academy representative to the Council of Medical Specialty Societies. Dr. Sadun works as a neuro-ophthalmologist and optic nerve disorders specialist at the Doheny Eye Center UCLA and serves as a member of the SO committee.