Eyeworld

OPHTHALMOLOGY BUSINESS 108 February 2018 by Liz Hillman EyeWorld Staff Writer Gaining patients' trust and confidence when you're young Experts share tips for handling patients' comments, building practical surgical skills, and facing complications when you're new in practice "H ow many sur- geries have you done?" "How old are you?" "I think I'll get a second opinion." When you're new in practice—and perhaps look it—gaining a patient's confidence in your surgical acumen can be a struggle. The good news for young oph- thalmologists is they're not alone. Nearly every physician has been in this position. Sumit "Sam" Garg, MD, medical director, Gavin Herbert Eye Institute, Irvine, California, and chair of the ASCRS Young Eye Sur- geons Clinical Committee, Jennifer Loh, MD, Loh Ophthalmology, Cor- al Gables, Florida, Radha Ram, MD, Texan Eye Care, Austin, Texas, and Lorinna Lombardi, MD, director of comprehensive ophthalmology, Or- egon Health and Science University, Portland, Oregon, spoke to EyeWorld about their early experiences in practice and how they gained pa- tients' trust and increased their own self-confidence. Even after almost 7 years in practice, Dr. Loh said she still receives comments from patients regarding her age. At the begin- ning of her career, she found these comments offensive but has since reframed her thinking. "I realized several years ago that perhaps I have it wrong," she said. "Young surgeons think people are saying it as a criticism, but actually, I think they're saying it as a com- plement. They're impressed that we look so young and have achieved so much." Dr. Garg also said he has expe- rienced such situations, sometimes overtly. "Especially when there is some- one prominent in the practice, it was not uncommon for patients to ask who was going to do their sur- gery," he said. "Most patients were quite up front, but some scheduled surgery and later changed to a more senior provider after the fact." When people questioned his ex- perience outright, Dr. Garg said that he generally referred to the strength of his training to make them more comfortable. "I always mentioned to them (and still do) that they have to be comfortable with their surgeon and encouraged them to get a second opinion if they wanted," he said. "Generally, patients liked that I was OK with them seeking alternate opinions—[it] came off as confident but not arrogant." Dr. Ram said she thinks her youthful appearance, short stature, and gender do at times surprise patients, but it isn't necessarily a disservice to her. "Because of my non-intimidat- ing appearance, patients are more open with me, which can be both advantageous and disadvantageous," she said. "Patients have said every- thing from 'You could be my grand- child,' to 'Sorry I look so shocked, I was expecting a man. And someone a lot older. Your name sounds like a man's name.' I have found that smiling and maybe adding a 'Thank you' or 'I know' is sufficient, polite, and enough to refocus attention on the patient's chief complaint." Dr. Lombardi said frank and honest conversation can do a lot to gain a patient's trust. "Physicians have been training for years to become an ophthalmol- ogist, and it is important to remind your patients about [that]. You can talk about the number of years you YES connect Early in practice, gaining patients' trust and confidence is an art that is not typically taught during training. During residency and fellowship, we benefited from the credibility and reputation of our mentors. When we forge ahead on our own, many of us expe- rience the challenge of earning patients' trust. Some patients may be apprehensive about their surgery being performed by a doctor who has just completed training, and occasionally these patients voice these concerns directly. How should we address their concerns? Is it helpful to alter our ap- pearance or behavior in a way that makes patients feel more confident in us? As young eye surgeons, how can we present our relative youth as an advantage? This month, we focus on our shared early experiences in practice. We called upon several of our peers—young eye sur- geons across the country—to find out how they successfully bridged this transition. Sumit "Sam" Garg, MD, Jennifer Loh, MD, Radha Ram, MD, and Lorinna Lombardi, MD, share their thoughts. Naveen Rao, MD, YES connect co-editor

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