One of the biggest challenges for ophthalmologists, especially in the field of refractive surgery, is to define ourselves (in professional terms) and set our goals.
To avoid the trap of repeating ingrained actions relating to goals that no longer represent our aspirations, it is important to implement a strategic plan and periodically analyse whether we are heading in the right direction. Are we being true both to ourselves and to our patients? Achieving this brings both professional and personal successes into our lives.
The examples below illustrate the ways in which truth comes into play for two types of ophthalmologists who differ in their professional personalities and business styles.
As a fully trained ophthalmologist, you wish to apply your knowledge to help people and to make money. Conservative in nature, you may be adverse to risk and/or a late adopter of new technologies. If you can identify with all or some of these traits, something you might need to examine is whether you are doing everything you can, to the extent of your knowledge, to serve your patients.
For example, are you able to admit to a patient that it is possible his or her illness could be better managed with a more specialised consultation? This means accepting that you are not the best in every aspect of your profession (and thus being true to yourself).
There is the danger than a certain level of laziness and/or greed could lead one to dismiss a patient with a standard ‘one size fits all’ approach. Or you could become so absorbed in your overwhelming professional tasks that you forget the real reason for running a business.
Thus, it is beneficial, from time to time, to ask yourself if an appropriate balance exists between your private life and profession. Do not be afraid to change your strategy or redefine your goals, if necessary.
Let’s say you are a refractive, private healthcare-oriented surgeon, offering and promoting election surgery. It could also be that you see yourself as a passionate early adopter of new technology. However, a problem you face is that it is not easy to position yourself at the forefront of technological innovation without huge financial resources or high-volume surgery.
In this case, the temptation could be that you enlarge the indications, neglect contraindications, or minimise side effects in order to enrol more patients. Or you might dive into new surgery without thorough training or despite knowing that your practice lacks appropriate diagnostic equipment.
As with the conservative type, you must first accept the truth to yourself, before revealing the situation to your patient. More often than you think, to negate a procedure to a non-eligible patient will bring more patients to your slit lamp. To admit that you do not have enough experience with a particular new procedure yet you think it would be beneficial for the patient will put you in a more positive light with your patient and keep your heart aligned with your mind.
After all, a lie to a patient is always a lie to yourself. At the end of the day, quality, not volume, of your job will define you to your community and, more importantly, to yourself.
Another tricky issue is revealing to patients that they will be the first to receive a new type of surgery. Although patients may not feel comfortable with being the first, you must ask yourself whether you will be transparent with them.
Consider this conversation at Dr Karl Oppenheirs’ ‘20/20 vision surgical centre’:
Dr Oppenheirs: “So, Mr Jones, it seems you are looking for a solution for your disabling presbyopia. I am glad to see that your far vision is perfect. Good for you, since you are a professional driver. I am in the position to offer you a brand new surgical procedure that seems to promise very useful near vision without affecting far vision.”
“How new is it?”
“I told you, brand new. It involves the implantation of a recently developed device. I have read the papers published during the experimentation period and no serious complications have been reported. Having said that, I cannot give you 100% assurance that you will not see any change in your far vision.”
“How many cases have you done?”
“None. You could be the first. You could be proud to be the first patient in your country to be operated on with this new exciting procedure. My experience with other kind of surgeries should lead my hand even with this new one.”
Another doctor enters the room: “Karl, who are you talking to? There’s nobody here but you!”
Dr Oppenheirs: “Noone – I was just practising. Let’s go back to work”.
So as a final thought for the reader, will Dr Oppenheirs follow through with this honest approach with his next, first patient? Will you when faced with a similar situation?