Dr. McDonnell asserts that one exceptional ophthalmologist can contribute to the overall success of a department or practice by elevating the overall quality of the work of colleagues, residents, and fellows.
The main topic of discussion among ophthalmologists these days is the dispute between Rosie O'Donnell and Donald Trump. The debate centers around allowing Miss USA to keep her title and enter a rehab program. Around water coolers in our ophthalmology departments and practices, and in the hallways during breaks in CME meetings, we debate. Who is responsible for this fight? How will it all end? We lament over how two such mature, thoughtful, and talented people could fail to appreciate each other and work well together to better society.
But in my day, the debate that raged involved two different people: Larry Bird and Earvin "Magic" Johnson. For those of you who are much younger than I am or are not fans of basketball, these athletes were the East and West Coast stars, respectively, of the National Basketball Association-and on-court nemeses-for several years. Great scorers, amazing passers, and excellent rebounders each, they led their teams into contention for the championship year after year. Naturally, fans came to argue over which of these players was the greatest.
Everyone had an opinion, backed up by one telling statistic or another. Heated arguments were common but rarely changed anyone's mind. The comment that put things most into perspective for me came from a much less well-known teammate of Bird's on the Boston Celtics.
I found this argument highly compelling. For example, as much as I respected Dave Cowens and Robert Parrish (centers for Boston), neither of them were superstars of the caliber of Kareem Abdul-Jabbar (center for Los Angeles). Bird's teammates were not as gifted physically as were Magic's, but playing with Bird made them more successful.
Recently, when one of my faculty members retired, I was reminded of this tribute to Larry Bird. W. Richard Green, MD, is a superstar in the field of ophthalmic pathology, with more than 700 published papers and textbooks. He has received just about every prestigious award and delivered practically every named lectureship in ophthalmology. A graduate of my department who practices in Atlanta recently spoke about Dr. Green's accomplishments. Ignoring publications, honors, and awards, he instead commented that after Dr. Green began his career at the Wilmer Eye Institute, the overall quality of the research and papers coming out of the institute increased.
Dr. Green's most important contribution, according to this speaker, was that he improved the work of his faculty colleagues, residents, and fellows, so that they produced more and higher-quality research and papers, did a better job caring for patients, and learned more. I am convinced this observation is true.
What has this to do with anything? Ophthalmology departments and private practices around this country include many brilliant ophthalmologists and stellar surgeons. Our medical school training emphasizes individual achievement and responsibility ("the surgeon is captain of the ship"), and we tend to think in terms of our own volumes, outcomes, complication rates, charges, collections, number of papers, etc. But how many ophthalmologists have the ability to make us, their colleagues, more successful or better ophthalmologists than we would be otherwise?
It is easy to measure some things, such as the rate of vitreous loss for a cataract surgeon, but it may be very difficult to measure how one ophthalmologist makes his colleagues "better" and contributes to the overall success of the group. A close friend in California makes looking for this quality a top priority when adding to his retina group and believes he has been uniformly successful so far. From what I can tell, he's right.
Do your ophthalmologist partners make you better? Whether it is easy or hard to find such people and measure their contributions to the overall success of the group, those of you who run practices and departments know they are worth their weight in gold.
Peter J. McDonnell, MD is director of The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, and chief medical editor of Ophthalmology Times. He can be reached at 727 Maumenee Building, 600 N. Wolfe St., Baltimore, MD 21287-9278 Phone: 443/287-1511 Fax: 443/287-1514 E-mail: email@example.com