Things I’ve Learned the Hard Way

Training to be a great clinician or surgeon is an arduous task. Through medical school, internships and residencies, you accumulate thousands of hours of lectures and countless clinical and surgical interactions to hone your ophthalmology skills. Over the past 12 years, I’ve worked directly with more than 100 resident physicians and I am truly impressed with their enthusiasm and mastery of ophthalmology. But that’s the easy part. I’m not sure that young ophthalmologists are being quite so well prepared for the challenges that they will face in their practices, their business decisions, and their lives. It’s often said that experience is the best teacher; here’s what I’ve learned the hard way.

Lessons in Practice

It is essential that we preserve our moral compass and that we give all patients the same high level of care that we would want for our own eyes. As simple as this sounds, it can be a challenge to balance scheduling, technology, insurance restrictions and patient desires with sound clinical judgment, but I am confident that every ophthalmologist can meet this requirement, especially if it is reinforced regularly to medical students and resident physicians.

While the future can’t be predicted, you can adapt for certain possibilities. In planning your career progression, be sure to have some flexibility and a back-up plan in case things don’t turn out as expected. Be passionate about ophthalmology and enjoy being able to give patients the gift of sight – it’s a powerful gift that truly changes people’s lives. But remember that all ophthalmologists, even master surgeons, have complications. The key is to appropriately manage these complications and work with the patients to maximize their outcomes. The difference between a complication and a lesson is taking the opportunity to learn from it.

Keep an open mind about new surgical procedures and products; you never know which one will revolutionize ophthalmology. The difference between perceived madness and genius can simply be the acceptance of peers, something that we’ve learned from the pioneer of phacoemulsification, Charles Kelman.

Sometimes physicians can be like crabs in a bucket: they step on each other to get to the top, and when one finally reaches it, the others grab him and pull him back down. Aim to outdo yourself, instead of outdoing your peers. The best minds in medicine are in competition with themselves, not with their colleagues. Respect your colleagues and give them the benefit of the doubt.

Lessons in Business

In business, I’ve learned that I’m great at working hard and earning drop by drop, but unfortunately I’m also an expert of losing money by the bucketful. Sadly, it seems that there are plenty of business sharks out there, actively seeking out prey. Doctors are notoriously easy targets for them because we have minimal business training and at our core we are trusting people who put the interests of others ahead of our own. The largest business venture of our life (besides marriage) is usually joining a medical practice. It’s great if it all works out fine, but recall what I said about not being able to predict the future, and have a back-up plan.

If a business opportunity seems amazing, ask yourself why the proprietor is not asking his own family to invest in it. Too often, seemingly savvy business people lie, cheat and steal in the pursuit of money. I’ve learned that it’s better to pursue happiness and my passions first and that the best investment that you can make is in yourself. The best decisions aren’t the ones that are most financially lucrative but the ones that make the most sense. Spending time teaching surgery to residents, lecturing at ophthalmology meetings, and writing are all rewarding for me, but they’re not the most profitable business decisions.

I have no idea how the business of ophthalmology will evolve in the future but I am certain that if I continue to hone my clinical and surgical skills, I will have the ability to help thousands of people see better. And with our aging population there will always be a need for a good ophthalmologist. Now if only I could find a balance between my profession and my personal life…

Lessons in Life

I tell my kids that every year life will get harder and harder. And it sure rings true when they’re comparing eighth grade to sixth grade, but I think that it still applies when you are in your forties. In my case, I wish that I was more skilled at juggling many things at once and learning to compartmentalize.

I also know that nothing lasts forever. Good times are balanced out with bad times so if you’re on top of the world and your life seems unbelievably good, enjoy it while it lasts but be prepared for the bad times that are not too far ahead. Similarly, if you’re down in the dumps, hang in there because the good times are just around the corner. Sometimes you will fail, and it will hurt. Realize that things aren’t always fair and that life is not a meritocracy. Just believe in yourself and never give up. In these tough times, you’ll find out who your true friends are: strengthen your bonds with them because, along with your family, these friends will be the source of your greatest happiness.

For me, happiness is finding pleasure in my everyday life. And that’s a blend of surgery, teaching, writing, traveling, and most of all spending time with those I love. Be a conscientious doctor, invest in yourself, and enjoy your life. It really is that simple.

Uday Devgan is in private practice at Devgan Eye Surgery in Los Angeles, a partner at Specialty Surgical in Beverly Hills, and Chief of Ophthalmology at Olive View UCLA Medical Center, Los Angeles, California, USA.