Think Fast! The Next Minutes Can Make or Break Your Early Career
By Allison Kufta, BS
Key Takeaways:
Be transparent with patient expectations and ensure careful and proper pre-op evaluation.
Stay calm and collected in the OR by having a specific protocol for common complications like posterior capsule rupture. After the case, stay connected to the patient and explain what challenges you faced and the game plan for the future
Listen, adapt, communicate carefully, and document when it comes to staff management in practice.
The early stages of a career in ophthalmology are critical for establishing your professional development and reputation. Most importantly, being able to adeptly handle various situations will help you provide effective care for your patients. Quick and thoughtful problem-solving is essential for long-term success and fulfillment in ophthalmology. Additionally, how you handle the beginning of your career can significantly influence your career trajectory and future opportunities.
On April 27th 2024, the session “Think Fast! The Next Few Minutes Can Make or Break Your Early Career” was hosted at the Spring 2024 RWO virtual meeting “Tell Me Your Secrets”. Moderated by Drs. Parekh and Gabriel, our panelists Drs. Christina Weng, Analisa Arosemena, Karl Stonecipher shared invaluable pearls on how to react quickly and appropriately in high stress situations. Handling these types of scenarios with a smooth, in-control mindset is essential to our profession, as we all inevitably make mistakes.
Think Fast! Managing Patient Expectations
Patient wants a multifocal but you find drusen, what now? You might face this situation, and not all patients qualify for advanced lens technology due to ocular conditions. To avoid broken promises from unexpected intraoperative findings, it's essential to perform a pre-op OCT before cataract surgery. In general, setting expectations and pre-screening carefully is important. Similar to delivering bad news, it is critical to be transparent and explain to patients why certain technologies may not be suitable for them. Be honest with patients about their options and consult a retina specialist when necessary.
In the following section, we address how to think fast once you are in the OR and afterwards.
Think Fast in the OR and Post-Op
Surgical practice requires the ability to troubleshoot and have a solid game plan when complications arise. Here are several pearls our panelists had to say regarding thinking fast in the operating room.
Breaking the bag is stressful, but it is important to stay calm and collected in the OR to ensure other surgical staff and most importantly your patient is not also panicking. Take 25-30 seconds to collect yourself if you have to. Once you have centered yourself, calmly execute a protocol you have to handle this problem. A few pointers, ensure the anterior capsule is maintained, and maintain clear communication with the team More specifically, don’t remove the FACO immediately after a capsule break. Keep the chamber formed with viscoelastic before removing instruments. If a lens drops, don’t "go fishing for the lens"—leave it to retina surgeons. Working as a team to provide the best care to the patient is critical, do not try to overreact.
Preventing further complications is also key, aim to minimize traction during surgery, stabilize the globe, and use triamcinolone to visualize vitreous clearly. When you start each surgery, try not to overreact, and understand that patient anatomy such as complicated cataracts and bad zonules can make a case more challenging.
After the case, document your complications thoroughly and always be truthful with patients about surgical outcomes. Empathy and transparency are essential to maintaining the patient-physician relationship. Delivering bad news is never easy, but do your best to explain the challenges you encountered and answer questions thoroughly, if able. Connect with these patients, providing extra reassurance and a game plan for the future.
Think Fast While Managing Staff in Practice
It cannot be overstated that staff relationships must be navigated carefully, especially as they have become more complex in the recent years. When you are new, listen before speaking to get a feel of the different dynamics. This will help you tailor your leadership and communication style accordingly.
When you are frustrated, be careful and take time before sending any texts or emails. If you need to enact disciplinary action, having a paper trail of the issue(s) at hand is critical. However, it is important to make sure that you have set clear expectations.
Promoting a healthy environment is important to a functional and safe practice, treat staff as part of a team and avoid imposing too strict a hierarchy. Each person brings a valuable contribution to the team for patient care.
Conclusions
Being early in your career is daunting, from navigating the OR to office dynamics. However, thinking fast is also about thinking slow, as in carefully considering your options and adapting to unexpected situations in a professional, appropriate manner. Building your community, both your staff and your patients, involves transparency and strong communication skills, even in more difficult scenarios. When in doubt, reach out to a trusted mentor or colleague!
Join the RWO community of young ophthalmologists to connect with peers, learn from experts, and enhance your understanding of key topics in ophthalmology. Save the date and secure your spot today!
Alison Kufta, BS
Allison joined the RWO graphic design team in Spring 2023. She is a third-year medical student at University of Illinois College of Medicine at Chicago and will apply ophthalmology next year. She is passionate about improving medical education through art and advocacy. In her free time, Allison enjoys painting animals and nature, going on walks with friends, and finding the best ice cream and lattes in the city.