Eyeworld

57 OPHTHALMOLOGY BUSINESS June 2018 digital.ophthalmologybusiness.org EyeWorld: What are your thoughts on financial responsibility, early-, mid-, and late-career? Dr. MacDonald: Think about the life you want to lead, what your val- ues are, how much time you want to spend with family, how much time you want to spend taking care of yourself, doing volunteer work, and just being the person you want to be. You have to track that all back to the financial decisions you're making. EyeWorld: What's the best way to interact with industry? Dr. MacDonald: I think it's a com- plex relationship, but it is critical to have ophthalmologists actively part- nering with industry to develop new technologies and pressure test these technologies to make sure they are valid and applied to the care of our patients. Ethically, I think physi- cians should be compensated for their time when they are involved with contributing to industry knowledge, but I think physicians need to be transparent about it. Your word is pristine; keep your word pristine and be ethical scientists and researchers and an ethical speaker by speaking the truth. EyeWorld: How would you suggest maintaining a healthy work-life balance? Dr. MacDonald: Everyone says life is short, I say life is long. There are many choices that you're going to make, and every time you make a choice for work, that time is going to come out of family time, partner time, exercise time. You need to focus on what your values are and mentors who will help introduce you to opportunities and take you onto projects that you might not be able to start on your own. EyeWorld: What advice would you give about becoming a great teacher? Dr. MacDonald: When you're teaching residents, I think it's im- portant to make a personal con- nection with them and understand that they need to be encouraged, but they also need honest feedback. I think it's important to take the time to model for them what you want them doing and also have an opportunity to have a discussion with them. Try to simplify and make sure your points are made in under 5 minutes, break down those steps, and be able to talk with the residents afterward to critique their performance. The best way to do that is by videotaping. EyeWorld: How do you stay up to date? Dr. MacDonald: Young ophthal- mologists, when you're choosing a practice, keep these questions in mind: Am I joining a group of early adopters? How are we going to learn from each other? You're going to spend a lot of time with your part- ners and your faculty members and you want to encourage each other to adopt new techniques that will benefit your patients. You can also stay current reading journals. ASCRS has EyeConnect, and there are a lot of interesting discussions that take place there. Going to meetings is a great way to stay up to date. Sign up for wet labs. Another way is to value your extenders not only in the office but in the home. There's no reason for a physician to do laundry, but there is great reason for the physician to be at their child's baseball games or theater performance. You need to outsource everything that isn't essential to your life balance and be willing to pay for that. Consistent child care is essential as you can't call the OR and cancel for a child's illness and can't be focused on sur- gery when you don't have someone you trust to help and love the child in your absence. I also think couples should schedule at least one vaca- tion a year for just the two of them and one more for the family togeth- er. These respites go a long way to helping achieve balance. EyeWorld: Any final thoughts for early career ophthalmologists? Dr. Arbisser: Be critical of yourself and be counting your outcomes. There's a saying that those who don't count, don't count. Just as- suming your outcomes are up to par isn't good enough. You've got to be collecting and looking at the data. Susan MacDonald, MD Associate clinical professor, Tufts University School of Medicine Boston EyeWorld: What would be your advice for success in academic medicine? Dr. MacDonald: At all schools of medicine, there is an office of educational affairs and faculty de- velopment. I would recommend to anyone who is pursuing an academ- ic position to meet with this office. Some offices have websites with [professional enhancement] oppor- tunities. I also think it's important that every time you give a presentation or publish a paper, you cut and paste the essential information from that into your CV. In the future when you need to present it formal- ly, at least you'll have that informa- tion in one place and you can easily edit it. I think it's important to ask yourself who your mentors are. Identify someone who you want to model your career after. It's the going to fill a need. [My husband, Amir Arbisser, MD, and my] goal with the patient first in mind was to create a practice that was both needed and would survive us and continue to serve the community after us. EyeWorld: What's the best way to interact with industry? Dr. Arbisser: I never took any signif- icant money from industry. I had an occasional unrestricted grant to do clinical research or travel, which of course you divulge. Independence allows you to decide what's best for your patient from the wide world of available options. I'm always doing my best to evaluate information and equipment in order to find what works best in my hands, but the point is you don't know what's best without being an insider [who is] able to see it and try things. The problem is cyclical, however, in that the higher volume you are, the more you get industry opportunity and attention, and it's hard to get that volume at the beginning. In the future, surgeons may be more bur- dened by the need for their services from an aging population rather than vying for bigger volume. We take the Hippocratic Oath and we have to believe in that and not be cynical. We must be very clear about this, but we cannot take care of our patients without indus- try. There is virtually nothing that we do that industry hasn't created or developed for us. I think healthy relationships between industry and physicians are critical to good patient care. EyeWorld: How would you suggest maintaining a healthy work-life balance? Dr. Arbisser: Medicine is one of those fields that cannot be perfect- ly balanced. Call is, however, one of the most intrusive parts of the profession for balance. My husband and I allowed partners to buy in at a much lower cost than the practice valuation in exchange for taking call. In our later years, with more partners, we decided it was most fair to pay handsomely for call. Decid- ing one can live happily within their means with less income can help strike the proper balance. " Don't compete. Collaborate. It's so much easier to collaborate with each other and give each other opportunities. " —Susan MacDonald, MD continued on page 58

• Cover