Medical Management

[medstudentmed]

Hi,

can someone give me a better idea of the bread and butter cases that are typically managed via medical management (as opposed to managing surgically)?

I understand that approximately 3-4 days out of 5 is usually devoted to non-surgery days and so was wondering if someone could shed some insight into the typical day one would have when not in the OR.

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[orbitsurgMD]

Hi,

can someone give me a better idea of the bread and butter cases that are typically managed via medical management (as opposed to managing surgically)?

I understand that approximately 3-4 days out of 5 is usually devoted to non-surgery days and so was wondering if someone could shed some insight into the typical day one would have when not in the OR.

For every cataract surgery you do, you will need four or five visits to the office during the pre to post-operative period. The patient will need an initial examination, biometry, preoperative counseling, and usually three postoperative visits, the last of which usually requires refraction. Similar patterns are true for other eye surgeries. So a significant portion of the office time is supporting the surgical side of the practice. Aside from that, there are patients who have emergencies and need examinations and treatment. Many neurological problems do not come to surgery, but need evaluation and management with followup. Laser procedures are done in the office, and those need pre-and post procedural services.

I do a lot of office minor surgeries and even some major procedures. I find that just as satisfying, and more remunerative than going to the OR.

 

[cme2c]

The makeup of an opthalmologists' clinical practice varies widely. My various practices within the same town have even varied. There is a lot of dry eye, glaucoma or glaucoma suspects, and diabetes out there. Of course there will be the occasional conjunctivitis, foreign body, uveitis, etc.

 

[Visionary]

I second cme2c. There is wide variability on the clinical side (and surgical side, for that matter), so it's difficult to describe a "typical clinic day." Sort of depends on how much you want to be involved in. A general ophthalmologist can cover routine eye care (glasses, contacts, red eye, etc.), as well as many aspects of subspecialty care, if he/she is comfortable with them. There are general ophthalmologists who manage a lot of glaucoma, cornea, plastics, and peds (both medically & surgically). Some do a lot of medical retina, even intravitreal injections (though usually not in areas with retina specialists). The newer grads tend to leave more to the subspecialists (true for more than just ophthalmology nowadays). It's all about what you're comfortable with after your training and how you want to fashion your practice. You may have had a lot of subspecialty exposure in residency, but you don't want to see kids or do blephs, for instance. That's one of the nice things about ophthalmology: you can, to some extent, tailor your practice to suit your interests.