Eyeworld

50 | EYEWORLD | WINTER 2026 ATARACT C communication," she said. Many people are focused on the clinical skills, and these are often the things you learn as you get into practice. When you're a new doctor, you're not usually fully booked, so building in time to visit other practices is important, she said. Commenting further on how young oph- thalmologists can think about referrals and reputation, Dr. Fram said checking back in periodically can be helpful. When you're first starting out, you want to do anything to make your referral sources' lives easier. Dr. Fram cautioned against limiting the types of cases you see early in your career. If you're starting out solo, having limits on what you'll see is going to constrain you. "I think you can morph your practice into what you want it to be later, but in the beginning, you need to be available for everyone to build your reputation as a compassionate, caring, and highly talented doctor," she said. The early career mistake that Dr. Fram said some young ophthalmologists make is to have a practice that's only surgical in a highly populated area. "I think if you're in a rural area or a less populated area, you could start your practice that way," she said. "But when you have 15 ophthalmologists within a mile of you, the thing that's going to make you stand out is your accessibility." Another early mistake she cautioned against is not having enough patience, which she noted she fell victim to. Dr. Fram said that she often felt like she needed to see as many patients as possible and hurry through. Give yourself some grace to figure out how to learn in those time periods; observe someone else's practice and how they are efficient in surgery, how they're efficient in clinic, how they set up their tem- plate, and how they train their team. Use the downtime in the beginning to really learn how to build a team and culture, she said. Identifying people who can mentor you is also critical, she said, adding that the ASCRS YES Program is a great resource. Dr. Fram shared a leadership skill that's had a big impact on her success: her ability to listen, pivot, and evolve. "If you can't evolve and you can't pivot, you will not be able to change. I think about the way we practiced 18 years ago versus how we practice now with the imple- mentation of EMR and AI; if we weren't able to open our minds to do that, we would never be as efficient in our processes. "You'll never have the practice that you want if you don't take the time to educate your staff," Dr. Fram continued, adding that it's on you to make sure your team knows what you want to convey and make sure everyone is on the same page with the patient experience. "I think it's important to have time set aside where you can educate," she said. "You have to make the time to communicate and to educate because you lose the pulse on what's happening in your practice when you're not connected." Dr. Fram noted that her practice is both team-centered and patient-centered, and she credited Dr. Thompson's approach for this. Dr. Fram said she wouldn't change her approach if she was starting out again today, noting her commitment and constant involve- ment in the practice, filling her downtime with watching procedures, going out to speak to other doctors and establishing consults and referrals, working on the practice website, etc. William Trattler, MD Dr. Trattler shared that building a successful practice begins with deciding where—and how—you want to live. For ophthalmologists early in their careers, finding the right oppor- tunity means considering both professional ambitions and life outside the office to strike the right balance between building a practice and building a life. continued from page 49 The core values in Dr. Fram's practice: compassion, responsibility, empowerment, integrity, and innovation Source: Nicole Fram, MD

• Cover