the CONS.

[Pegasus82]

hey guys!

what do u feel are the cons of optho?

---

Members don't see this ad.

 

[OjoCinco]

hey guys!

what do u feel are the cons of optho?

Doc: "One or two?"
Patient: 'Two.'

Doc: "Two or three?"
Patient: 'Three.'

Doc: "Three or four?"
Patient: 'Four.'

Doc: "Four or five?"
Patient: 'Five. Wait. What are we doing again?'

 

[DOCTORSAIB]

Job market.

 

[MedicalDoctorV]

hey guys!

what do u feel are the cons of optho?

Like many things in medicine - cons are specific to individuals. A lot of people probably cherish the things I am going to mention.

1/ Super-duper-specialization.
It's getting really ridiculous in large cities (I am a resident in Manhattan).
Although I think division of labor is good for patient care - you have the people with the most experience taking care of specific problems, in my opinion it takes away a lot of the meaning of being someones physician. Did I really go to medical school to do only cataract surgery and refer all cases of uveitis out to someone else ?
2/ Little-to-no interaction with other services.
Sure some are going to fire back with yarns about some amazing case they did with ENT or some amazing systemic disease that had a presentation in the
eye, but largely I have found that due to the 9-5 largely clinic based and non-
emergent nature of the work you don't really end up being so integrated with the other departments in the hospital.
3/ Clinic. It's a clinic based field and if you're not made for spending upwards of 80% of your time in a clinic then you're in for a shock. Inpatient consults will likely never be dealt with once you're an attending. Once you're at the point of operating independently - it's still a majority of clinic based outpatient practice.
4/ You take care of the eye and not the patient.
Yes blindness contributes to morbidity and mortality of patients worldwide. Yes, I realize that dense cataract patients go from seeing hand motion to 20/20 vision. But the patient's 'doctor' remains those on the front lines: the family med, internist or pediatrician. Some people really like being consultants. Others lament the fact that they're not the quaterback - coordinating care or being the one to hold the patient's hand and guide them through some life or death crisis.

 

[200UL]

I know this is supposed to be the cons, but

Ophthalmology is one of the fields where nearly everything we do improves the patients quality of life. New glasses - pt is better. Cataract surgery - patient can drive again. Refractive surgery - patient can toss out glasses at the door. Cornea transplant - the most successful transplant procedure ever, period. Put retina back on - patient's vision is saved. Start glaucoma drop - oh wait - ophthalmology does have some areas that patients do not like.

The bottom line is, there is no other field in medicine that improves quality of life more than ophthalmology (hopefully the folks from medicare read this when they consider cutting ophthalmology services so they can cover that 35 years of statin therapy at $100 a month in order to delay that MI by 4.5 months). When I start thinking about the cons, I travel to the inpatient wards. This reminds me of the days when I was an intern. Success on the internal medicine ward was judged by how quickly we could get the patients back to a skilled nursing unit. Sure we run around the clinic like we are crazy but ophthalmologists improve patient's lives. Therefore, if one enters medicine, I cannot imagine a better field.

 

[GAA]

200UL, I have to agree 110% with your post!

 

[cme2c]

Only real con for me is that you are the doc that takes care of your patients. You can't be on call and tell your patient to go to the ER to get their post-op eye looked at. No one has a clue how to examine the eye. So you will also get your fair share of idiotic consults/ER referrals. Otherwise, it's a great field IMO.

Doc: "One or two?"
Patient: 'Two.'

Doc: "Two or three?"
Patient: 'Three.'

Doc: "Three or four?"
Patient: 'Four.'

Doc: "Four or five?"
Patient: 'Five. Wait. What are we doing again?'

That's why we hire technicians to refract

Like many things in medicine - cons are specific to individuals. A lot of people probably cherish the things I am going to mention.

1/ Super-duper-specialization.
It's getting really ridiculous in large cities (I am a resident in Manhattan).
Although I think division of labor is good for patient care - you have the people with the most experience taking care of specific problems, in my opinion it takes away a lot of the meaning of being someones physician. Did I really go to medical school to do only cataract surgery and refer all cases of uveitis out to someone else ?

4/ You take care of the eye and not the patient.
Yes blindness contributes to morbidity and mortality of patients worldwide. Yes, I realize that dense cataract patients go from seeing hand motion to 20/20 vision. But the patient's 'doctor' remains those on the front lines: the family med, internist or pediatrician. Some people really like being consultants. Others lament the fact that they're not the quaterback - coordinating care or being the one to hold the patient's hand and guide them through some life or death crisis.

1)
Then don't practice that way. No one requires you to refer uveitis, etc. If you want to be a true generalist, do it.

4)
I am just confused by this. Maybe you need to spend more time talking with your patients.

 

[Visionary]

Like many things in medicine - cons are specific to individuals. A lot of people probably cherish the things I am going to mention.

1/ Super-duper-specialization.
It's getting really ridiculous in large cities (I am a resident in Manhattan).
Although I think division of labor is good for patient care - you have the people with the most experience taking care of specific problems, in my opinion it takes away a lot of the meaning of being someones physician. Did I really go to medical school to do only cataract surgery and refer all cases of uveitis out to someone else ?
2/ Little-to-no interaction with other services.
Sure some are going to fire back with yarns about some amazing case they did with ENT or some amazing systemic disease that had a presentation in the
eye, but largely I have found that due to the 9-5 largely clinic based and non-
emergent nature of the work you don't really end up being so integrated with the other departments in the hospital.
3/ Clinic. It's a clinic based field and if you're not made for spending upwards of 80% of your time in a clinic then you're in for a shock. Inpatient consults will likely never be dealt with once you're an attending. Once you're at the point of operating independently - it's still a majority of clinic based outpatient practice.
4/ You take care of the eye and not the patient.
Yes blindness contributes to morbidity and mortality of patients worldwide. Yes, I realize that dense cataract patients go from seeing hand motion to 20/20 vision. But the patient's 'doctor' remains those on the front lines: the family med, internist or pediatrician. Some people really like being consultants. Others lament the fact that they're not the quaterback - coordinating care or being the one to hold the patient's hand and guide them through some life or death crisis.

Wow. If this is how you actually feel, you obviously chose the wrong specialty. Pity.

 

[OjoCinco]

Wow. If this is how you actually feel, you obviously chose the wrong specialty. Pity.

Right, and he did mention this was "individual specific" ... but to be clear for the OP and anyone else reading this, Ophtho8 is looking to switch out of ophthalmology during his residency. These are the cons from someone who really didn't like the field; he unfortunately only found out after starting his residency.

If you are interested in the cons of the field by the perspective of current practitioners or happy residents, I'd listen to the other guys (cme, visionary, 200ul, etc.).

For Ophtho8, I hope things worked out for you, man.

 

[Visionary]

Right, and he did mention this was "individual specific" ... but to be clear for the OP and anyone else reading this, Ophtho8 is looking to switch out of ophthalmology during his residency. These are the cons from someone who really didn't like the field; he unfortunately only found out after starting his residency.

If you are interested in the cons of the field by the perspective of current practitioners or happy residents, I'd listen to the other guys (cme, visionary, 200ul, etc.).

For Ophtho8, I hope things worked out for you, man.

I truly don't fault him for the way he feels or for posting his cons. That perspective actually gives the medical student readers of this site more information, so they can proceed eyes open. It is a pity, though. Hopefully, he finds greener pastures. It would be terrible to be trapped in a specialty you don't like.

It's unfortunate that exposure to certain specialties, such as ophthalmology, is so limited in medical school. Unless you arrange to spend time with an ophthalmologist on your own, you typically don't get a good feel until early 4th year, just before making your decision on a specialty. Some schools give you earlier exposure, but not many.

For insight on my perspective, I'll say I'm on the other side of the spectrum. I decided on medical school, more specifically ophthalmology (and most likely retina) 2 years into a 5-year PhD. Fortunately, it all worked out, because I can't imagine doing anything else.

 

[cme2c]

It's unfortunate that exposure to certain specialties, such as ophthalmology, is so limited in medical school. Unless you arrange to spend time with an ophthalmologist on your own, you typically don't get a good feel until early 4th year, just before making your decision on a specialty. Some schools give you earlier exposure, but not many.

That's why I can't understand why we still have an early match. Lots of the early matches have gone back to the NRMP. I think we would be better off with a later match, it would give more people time to experience the PROs of ophthalmology.

 

[MedicalDoctorV]

Only real con for me is that you are the doc that takes care of your patients. You can't be on call and tell your patient to go to the ER to get their post-op eye looked at. No one has a clue how to examine the eye. So you will also get your fair share of idiotic consults/ER referrals. Otherwise, it's a great field IMO.




That's why we hire technicians to refract



1)
Then don't practice that way. No one requires you to refer uveitis, etc. If you want to be a true generalist, do it.

4)
I am just confused by this. Maybe you need to spend more time talking with your patients.

No i didn't say anyone required it - I live in Manhattan - that's how it is here. Pretty much everyone here jokes about how there's going to be a right eye and left eye Ophthalmologist soon.

It's not specific to Ophtho - specialization is overrunning big east coast/west coast cities.

I talk to my patient's plenty, in fact I talk more to them than most DBags around me that just 'DROP EM and get them out of their room ASAP so they can move onto the next dilate. Ophtho just doesn't deal with multiple body systems. That's all I was saying. It's not really your problem if the patient has some systemic disease that doesn't affect their eyes.

 

[MedicalDoctorV]

I truly don't fault him for the way he feels or for posting his cons. That perspective actually gives the medical student readers of this site more information, so they can proceed eyes open. It is a pity, though. Hopefully, he finds greener pastures. It would be terrible to be trapped in a specialty you don't like.

It's unfortunate that exposure to certain specialties, such as ophthalmology, is so limited in medical school. Unless you arrange to spend time with an ophthalmologist on your own, you typically don't get a good feel until early 4th year, just before making your decision on a specialty. Some schools give you earlier exposure, but not many.

For insight on my perspective, I'll say I'm on the other side of the spectrum. I decided on medical school, more specifically ophthalmology (and most likely retina) 2 years into a 5-year PhD. Fortunately, it all worked out, because I can't imagine doing anything else.

Sorry - I wasn't trying to be obnoxious about it. I just think "cons" in any field are personal. And yes, I am looking to get out of Ophthalmology. I wrote those things because I didn't realize many of those things while I was in medical school - you have to give people things to chew on that they may have never considered.

Obviously if you want to take care of critically ill patients - like I do now -Ophthalmology is not going to be the field to do it in. Similarly if you want to take care of children - you don't go into Geriatrics.

I think it's really hard to get an accurate perspective on the cons of ANY field from people that really love the field. At worst they'll talk about reimbursement (or hours, but let's face it - ophtho isn't going to suffer from violating any work hour rules).

I agree with the person that listed all the great things about ophtho.