Eyeworld

OPHTHALMOLOGY BUSINESS 156 April 2016 by Liz Hillman EyeWorld Staff Writer One change Dr. Schor had to make was learning femtosecond laser-assisted cataract surgery. "I definitely had to catch up with that and start figuring out a way to apply it to my practice," he said. Practicing in a different region or city could make a difference as well. In the D.C. region, for exam- ple, Dr. Kang mentioned the multi- tude of ophthalmic subspecialists. This leads physicians in the region to only conduct procedures in their particular subspecialty. In more rural areas, though, ophthalmologists are likely more comprehensive in their practice. There could also be differences coast to coast. "Preferred practice patterns in California may differ from those in Washington, D.C.," Dr. Kang said. "While cataract surgery is cataract surgery, trends in accepted practices and standard procedures can vary." Not every difference that comes up in a transition period is a chal- lenge to be overcome. "Having new people join your practice is an excellent opportunity to bring in new ideas and energy. Often, after practicing for some time, physicians become mired in the routine. New physicians allow us to reassess the reasoning behind our practice patterns and constantly "Even though I'm not a partner, I go to all the partner meetings, and all the discussions are had openly ei- ther via email or in person," he said. "Definitely some things are decided by the partners, but having that input has been a good change." What to expect when making a move There is no shortcut to transitioning into a practice or adjusting to bring- ing on someone new. To start, there's the process of getting a medical license in the ap- propriate state, obtaining Medicare numbers, and getting on the prac- tice's insurance panel for reimburse- ments, the whole of which could take 6 months to a year to complete. Technology and surgical style is another difference that may take some getting used to from practice to practice. "You may have been trained in one way, but that doesn't necessar- ily mean the same technology or practice patterns will be available to you in a particular practice. Do not assume the way you learned or prac- ticed previously is universal among ophthalmologists," Dr. Kang said. "In the operating room, everything from phaco machines to operating microscopes may differ and require a transition." "shift work" and a "team" approach to medical care. "The millennials who are coming out of training now, their approach to how they want to practice may be quite different from the ones who are hiring right now, and many are very content being associates without clear aspirations of becoming partners or owners," Dr. Yeu said. Alongside the generational dif- ferences, Dr. Yeu said that younger surgeons may also inherently place greater value in the input and care provided by the staff members because of the "team" mindset, and this can have a positive impact in the work environment. The same younger surgeons may also want greater input, with an equal voice in the decision-making process as the senior clinicians within the practice or department. This was a factor that encour- aged Kenneth Schor, MD, Eye Doctors of Washington, who has been practicing since 2011, to make a practice transition. After being with a New York City-based practice for 3 years, Dr. Schor said it was frustrating when his input was not sought, even after he had estab- lished himself there. At Eye Doctors of Washington, Dr. Schor found the equality that he sought. Whether you're just starting out or switching practices mid-career, prepare for change Y ou're fresh out of residen- cy, joining a new practice, and you find the technol- ogy once available to you in a teaching setting is no more. Perhaps you're an estab- lished physician transitioning from one practice to another, and you find your patient base is not what you're used to. Or maybe you're at a practice that just brought on a new physician and you want to make the transition as seamless as possible for everyone involved. Sound familiar? No matter the stage of your ca- reer or your position, you've proba- bly experienced a practice transition or two. Being malleable and keeping in mind a few key pointers could help ensure a smooth experience. "In some senses, it's almost like an arranged marriage. You throw 2 people together, you don't really know that much about each other, and it's a lot of give and take on both people's parts to make sure that it goes smoothly," said Paul Kang, MD, who experienced a practice transition himself about a decade ago and now onboards at least 1 surgeon a year as the medical direc- tor of an ambulatory surgery center (ASC) and partner at Eye Doctors of Washington, which has multiple locations in the D.C. metro area. Anticipating generational differences Going from training into an aca- demic setting or private practice is the first and biggest transition most physicians will experience, said Elizabeth Yeu, MD, assistant profes- sor, Department of Ophthalmology, Eastern Virginia Medical School. Dr. Yeu, who practices at Vir- ginia Eye Consultants in Norfolk, Virginia, also said there has been a huge cultural shift in the way medi- cine is practiced by those in the field now and the millennials coming out of training. The latter, she said, grew up under the 60-hour work week mandate, which has resulted in a mentality shift, with more of a Smoothing out practice transitions

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