What it is in ophthalmology: Shadowing Dr. Aizuss
As a medical student, have you ever wondered what it is like to specialize in ophthalmology? Meet David H. Aizuss, MD, ophthalmologist and physician featured in AMA’s “Shadow Me” Specialty Series, which offers advice directly from physicians on life in their specialties. Check out his ideas to help you determine if a career in ophthalmology might be right for you.
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Learn more with WADA about thedoctor specializing in ophthalmology.
“Shady” Dr Aizuss.
Practice setting: Multispecialty in private practice.
Years of practice: 36.
A typical day and week in my practice: I arrive at my office at 7:45 am. I review e-mails, postal mail, patient records or messages, and any test results that may have arrived. I start patient phone calls to return any leftover messages that arrived after I left the office or if I was not in the office.
My morning patient schedule then begins at 8:15 am and consists of approximately 25-30 patients for comprehensive eye exams, return office visits, glaucoma check-ups and other tests. If I’m on time, I end the morning at 1 p.m. I eat breakfast at my desk and review messages from morning patients, return patient phone calls, and prepare for afternoon patients. I start seeing patients again around 2pm, which again is a 25-30 patient schedule and usually end my day around 6pm. I usually see about 200 patients per week.
Wednesday is my major surgery day, in an outpatient surgery center next to my office building. There, I perform anterior segment surgeries, mainly cataract extraction with intraocular lens implants. I do ten procedures between 7 a.m. and 1 p.m.
After my morning surgery is over, I return to my desk for lunch at my office, followed by laser vision correction procedures such as LASIK or PRK – photorefractive keratectomy. I usually finish my Wednesday at 3 p.m. and use the afternoon for exercise and recreation or phone calls for organized medicine.
The most stimulating and rewarding aspects of ophthalmology: The most difficult aspect of patient care in my specialty is the recognition that sight is an essential part of the quality of life for our patients.
As ophthalmologists, we perform very technical and complex surgical procedures that can easily go wrong if there is not extraordinary and constant attention to detail. An error inside one eye can lead to severe visual loss, so the surgery is very stressful for the patient as well as the doctor.
However, it also brings up the most rewarding aspect of ophthalmology, patients tend to be extremely happy with their surgical results and very happy after their procedures. In general, patients tend to be very appreciative of their doctor’s skills, the attention they receive, and the teamwork of office staff that ensures they receive superb care.
How does life in ophthalmology has been affected by the global pandemic: Ophthalmology was one of the specialties most affected at the start of the pandemic, and the first physician death linked to the pandemic was an ophthalmologist in China. Because of our proximity to patients during exams, ophthalmologists and their staff were at very high risk.
Most outpatient surgery centers have closed, as have hospital surgery units for surgeries deemed elective. We were advised to close our offices for more than a month at the start of the pandemic. In order to reopen, we have restructured the whole way we receive patients.
Special screening began before allowing patients to enter the office. Chairs have been removed from waiting rooms to ensure physical distancing. Patients who were previously moved from room to room for testing and assessment were kept in one examination room and professional staff came to them.
Slit lamps (biomicroscopes) have been modified with large plexiglass screens to reduce exposure to air while sitting directly in front of the patient. Additional staff have been hired to screen and clean the examination rooms and each waiting room chair as soon as its occupant leaves.
As a result, our patient schedules had to be drastically reduced and our overhead costs skyrocketed. Fortunately, we were able to get the PPP [Paycheck Protection Program] ready to carry out our practice as well as HHS [Department of Health and Human Services] subsidizing amounts that have allowed our staff to keep their jobs and pay for many of the needed changes in patient flow.
The long-term impact of the pandemic on ophthalmology: The most significant impact is on our ability to use telehealth to treat minor issues via FaceTime or equivalent, saving our patients a visit to the office. Unfortunately, due to the specialized instrumentation required to examine an eye, much of what we do does not lend itself to telehealth. But a lot of research is underway to create new instruments that will improve our ability to provide more effective remote care.
Three adjectives to describe the typical ophthalmologist: Happy, fulfilled, compulsive.
How does my lifestyle match or differ from what I imagined: I enjoyed most of my medical school internships, so I had a hard time choosing a specialty. Ophthalmology was presented as a specialty with a good lifestyle, a good work-life balance and good for raising a family. All of these things are true. However, I take calls every day and my patients know that if they need to reach me, they can easily do so.
Some subspecialties in ophthalmology, such as the retina, have more emergencies than others. Eye care and practice have evolved to the extent that even emergency retinal detachment surgery can often be scheduled, rather than done in the middle of the night. Real emergencies such as ruptured globes or perforated corneal ulcers should always be treated urgently.
I run an incredibly busy practice and am scheduled weeks in advance with patients. Therefore, if I have to be away from the office, I have to cancel patients who may have been waiting for an appointment for a while, so I take this very seriously.
The skills that every physician-in-training should have to ophthalmology but will not be tested by the jury: Attention to detail and stable hands without shaking are essential to be able to perform ophthalmic surgery. Most physicians pay attention to detail, but few know if they have a microtremor and how their stability will be affected by stressful microsurgery.
Good interpersonal relationships are also important. Patients come back to you not because they know your surgical skills or sharp intelligence, but rather your ability to connect with them by listening, empathizing, and caring for them and their families. families.
A question physicians-in-training should ask themselves before continuing ophthalmology: Why did I enter medicine and how would this specialty be fulfilling? I tell everyone that ophthalmology is a family eye practice. Unlike many surgical specialties, in ophthalmology, you provide years of routine care to your patients and their families.
I take care of great-grandparents through their great-grandchildren and maintain multigenerational relationships with my patients. My specialty allows both medical and surgical therapy and is sufficiently discreet so that we can achieve mastery of the subject.
Books that any medical student interested in ophthalmology should read:
- Basic Ophthalmology: Essentials for Medical Students, published by the American Academy of Ophthalmology, provides an excellent overview of ophthalmology for medical students.
- Basic principles of ophthalmic surgery, published by the American Academy of Ophthalmology, provides an excellent introduction to the concepts and key elements of eye surgery.
- Basic and clinical sciences courses is a multivolume educational resource published by the American Academy of Ophthalmology. This is a comprehensive resource for residents and ophthalmologists that provides an in-depth review of every aspect of our specialty.
The online resource for students interested in ophthalmology should follow: The American Academy of Ophthalmology website is priceless. They also have EyeWiki, an encyclopedia written by ophthalmologists and surgeons.
A quick rundown I would give to students considering ophthalmology: I strongly encourage medical students to get in touch with a member of the ophthalmology faculty, do a research project, write a case report, and do a clinical rotation to get a better idea of the specialty.
Mantra or song to describe life in ophthalmology: “Green eyes», By Coldplay.