Once upon a time, there was a famous photographer who was invited by a prominent socialite to a party. As he entered, the socialite greeted him effusively saying, “I have been an ardent admirer of your photographs for years! You must have a superb camera.” When it was time to leave, the photographer profusely thanked the hostess saying, “Thank you for the delicious meal – you must own an excellent stove!”
I recently heard this short story and it really got me thinking. How often do we brag to our patients that we have the latest microscope or phaco machine – or that the IOL we are inserting is “the world’s best”? Are we guilty of leading our patients into believing that the “camera” is responsible for their excellent postop vision, rather than the “photographer”? As eye surgeons, we labor long and hard to hone our skills. Unfortunately, many of us also learn to extol the virtues of our equipment to attract patients. But there are twin dangers of doing this. Firstly, we come under pressure from the ophthalmic industry, buying equipment we can ill afford, and using IOLs we may not wish to use because of practices like IOL bundling. Then, before we’re finished paying for one piece of equipment, we may find ourselves pressured to upgrade! Secondly, we make ourselves easy targets for insurance companies looking to continuously reduce the amount payable for surgery; after all, we’re telling our patients that the surgery takes just 10 minutes and requires little human ‘touch’ as we’re using fancy ‘robotic’ and laser equipment. The attitude may be most damaging to younger ophthalmologists entering private practice. Without the means to afford the best high-tech equipment, they may struggle to compete with more senior colleagues and feel forced to turn to expensive advertisements and alternative ways of promoting themselves. Senior figures then bemoan the lack of ethics amongst the juniors...
I believe we need to stop the trend of pushing our cameras and stoves to the foreground. In short, we must restore dignity to our profession. And though there’s no quick-fix solution, there are some things we can do. It’s important that from our first contact with a patient, we reassure him or her that we have the skills needed to improve their vision. If we have trained under a well-known guru or at a distinguished institution, we should let our patients know. We need to remind patients and insurers that eye surgery is an art that requires years of training – it isn’t the expensive equipment that restores vision, it’s our expertise. My advice to younger ophthalmologists is to consider going into group practice. Get together with like-minded colleagues and reduce your individual investments – in unity, there is a great deal of strength. If you are practicing in a smaller town, it’s imperative to have a collegiate relationship with your neighbors – foster harmony and avoid backbiting and competition. If you take a ten dollar note and fold it up, cover it in mud, or pour water over it, then take it the store, the shopkeeper will still sell you ten dollars’ worth of groceries. Similarly, let no one – whether it’s a patient or a colleague – reduce your self-esteem. Each of us is unique (just like diamonds) and we should always remember that our self-worth does not rely on our equipment. We must remain dignified and ethical, and convince patients that we are fully capable of helping them see better with the resources we have available to us, because it is our skill that matters, and nothing else.
