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Counting My Blessings

Larry E. Patterson, M.D.

Thornton Wilder once said, "We can only be said to be alive in those moments when our hearts are conscious of our treasures."

With the holidays upon us and a new year approaching, I thought this would be a good time to reflect on my 20 years of practice and to consider the changes in our profession for which I want to give thanks. So in no particular order, here they are:

■ Continuous curvilinear capsulorrhexis. I don't miss my old can-opener capsulotomies. Thanks again, Drs. Gimbel and Neuhann.

■ Suture free wounds. That last 15 minutes of suturing seemed to take forever. Remember the saying, "It's not the suture that breaks; it's the jerk at the end"? Thank you Drs. McFarland and Fine and so many others in this ongoing development.

■ No more wound burns. Ten or more years ago, this was an uncommon but potentially devastating complication of phaco. Thanks to all the manufacturers who have made this problem almost obsolete.

■ Topical anesthesia. I can barely remember doing block after block on each and every patient. It's down to less than 1% of my cases now, with block complications having all but vanished.

■ LASIK trumping RK. Sure, LASIK has its problems too, but I think we all agree we'd never go back.

■ Endoscopic cyclophotocoagulation. Now that I'm using it routinely in all my cataract patients with co-existing glaucoma, most can get rid of at least one glaucoma drop, with the same or lower pressure than preop.

■ My surgery center. I don't even know where to start rejoicing. Forget the extra income. It's very nice avoiding the bureaurocratic nightmare of hospital politics. For my patients, it's more convenient, less expensive and safer. And to quote Mel Brooks, "It's good to be king."

■ My optical dispensary. I opened it in my seventh month of practice, not to make money but to fill the needs of my requesting patients. It turns out in the face of declining surgical reimbursements, it helped significantly with income as well.

■ Patients who choose premium IOLs. These patients are so delighted to see without correction — it brings me a whole new level of satisfaction.

■ Patients who do not choose premium IOLs. Because they had the option to see without correction and chose against it, they no longer complain that they can't see 20/15 uncorrected — it just never comes up anymore!

My Glass is Half Full

Yes, there's a lot to complain about in medicine these days, but overall, as an ophthalmologist, I find that I have a whole lot more to be thankful for. I'd like to wish all of my colleagues happy holidays and a healthy and prosperous 2008. Thanks for reading Ophthalmology Management — please keep the comments coming.