Building your Practice and Reputation

By Rob Melendez, MD

After finishing my first year of practice, I reflected on ways in which I could improve as an ophthalmologist. Below are observations that I have made from mentors during medical school, residency, and now with my new colleagues in private practice. I hope this collection of pearls will inspire all of us to be better physicians to our patients and in dealing with our staff and colleagues.

Interactions with patients

When meeting a patient for the first time, introduce yourself as “Doctor” and address them as “Mr.” or “Mrs.” Ask permission to call them by their first name. For instance, “Good Morning, Mr. Amsler” or “Do you prefer to be called Marc or Mr. Amsler?” and make a note of it in the chart. Remember the small details about your patient (child going to college, marriage, etc.) Tape a sticky note to the chart for reference for the next visit or make a note in your electronic file. Patients requiring more time to discuss their issues should be scheduled at the end of the day (complicated cases, difficult personalities, or patients with family members seeking information). Let them know that you want to provide enough time to spend with them in order to answer all of their questions. It’s all right to say, “I don’t know, but I’ll find out.” Send emails to your patients on website references, or articles related to their specific eye condition. Send birthday cards to patients after obtaining the patient’s permission to receive mail or e-mail from the practice. Strive to improve your surroundings (reorganize the exam rooms; develop an educational video for your patients, etc.). Call patients the evening of their surgery.

Interactions with staff

Greet all the staff in the morning. Seek for ways to make your staff more efficient. Ask often, “What can I do to make your job easier?” I like to say, “I’m like Play- Doh®: I’m giving you permission to mold me into a better physician.” Speak evil of no one, and listen attentively. Write clearly in your charts. Refrain from having people call you by your first name. Maintain a high level of respect for your staff and vice versa by having them address you as “Doctor” in front of the patient.

Interactions with Colleagues

Never be afraid to ask for a consult (help) or admit when you are wrong. Strive to learn from the patients you refer in order to improve your own skills. Ask for a follow-up on the status of a patient that you referred. Don’t be a “know-it-all.” Provide new information to your colleagues with gentleness and respect. Remember, they still may be using older terminology (For instance, Background Diabetic Retinopathy instead of Mild, Moderate and Severe Non-Proliferative Diabetic Retinopathy; Penetrating Keratoplasty (PKP) instead of PK; Age-Related Macular Degeneration (ARMD) instead of AMD). Always be the ultimate team player and willing to help. Remember colleagues’ birthdays and special family occasions. It is time to think beyond you and consider the needs of others above your own. Use the word “we” more often than “I.” Get involved in your state ophthalmology society.

Interactions with Consulting Physicians

Introduce yourself to all of the optometrists, ophthalmologists, and physicians in your area. This will help build your practice. Dictate letters not only for Consults, which is required, but also carbon copy (cc) the letter to all doctors involved in the patient’s care. Provide information in your consult letter that is educational. Thank the individual in the letter for the consult and call them personally when possible. Producing a high quality letter will build your reputation. Attend many community functions to meet the public. Volunteer to speak at community organizations and health fairs. Coordinate a lecture series involving a broad spectrum of physicians, from the podiatrist to the ophthalmologist, discussing various topics such as diabetes and the latest diagnostic and treatment modalities.

On-Call Issues

Be respectful of everybody, even when it is 2:30 in the morning. Remember, we have a specific skill that a person needs. Be grateful for the opportunity to serve the public. Create a special on-call bag with all the instruments and drops you may need. Be prepared for any ophthalmic emergency. Obtain CPR certification and know the basics of emergency care (ABCs). Remember, we are physicians first.

Personal Time

Spend time and get reacquainted with your family and friends now that you are done with your formal training. Begin financial planning for you and your family. Do not over-commit; remember, studying for the boards is top priority.

Remain enthusiastic; after all you are practicing ophthalmology.