[optimal] Re: Workload Demands
- From: angiolith@xxxxxxx
- To: optimal@xxxxxxxxxxxxx
- Date: Tue, 27 Mar 2012 10:14:38 -0400 (EDT)
Wow! Great thread. My thoughts:
There are 3 different but interrelated issues here:
1. The future of ophthalmic photography as a unique profession
2. The changing workload for ophthalmic photographers
3. The medical ethics of who gets treated.
Regarding #1:The profession is definitely changing, and the OPS will probably
need to respond to the changes to remain viable. When the OPS was formed it
wasn't easy to know how to expose, develop and print the images we were taking
(in my opinion, a lot of people didn't learn the intertwined relationship
between exposure and processing until after they went digital). The technical
side is now all digital, so Mark's is right that the future may be in that
direction. A lot of ophthalmic photographers have already gone there (et tu,
Joe Warnicki, Tom Monego, etc?)
Sidebar: I tell patients who ask about my profession that I am the equivalent
of a blacksmith in 1913, the year the Model T rolled off the assembly line. I
have wonderful specialized skills that will soon be historical oddities.
#2: This is symptomatic of changes happening in medicine everywhere. The good
old days of patient and employee care are over. The future will be
"efficiency" and "cost control". There is a good chance that our employers
will be competitively bidding for the lowest charges, or that medicine will be
capitated (at which point 95% of the tests we do will evaporate). Which leads
to:
#3: This is the trickiest issue of all. We all want our 87 year old mother to
get an OCT and an FA, and lots of anti-vegF treatments if she has macular
degeneration - even if it only holds her vision to 20/400 instead of CF. We
just don't want YOUR mother to waste our tax money on these wasteful, useless
procedures. And that is the problem here; balancing the greater societal good
versus the individual good. Personally, I am willing to pay more in taxes for
high-tech care.
(My personal example: 18 month ago I blew out my back (totally debilitating,
not like the back problems I have had for 30 years). I had to lobby extremely
hard for an immediate MRI, and even harder to discuss surgical options. I was
lucky enough to get surgery only 10 days after the acute incident, and luckier
that it was successful, and unlucky enough that I was back at work in 2 weeks
after the surgery. General guidelines would have had me suffering on the floor
and probably missing work for several months - and possibly getting permanent
nerve damage. Which was the "right" course of action?).
By the way, I photographed the last generation of juvenile diabetics to go
profoundly blind (in the 70's), and I may be photographing the last generation
of ARMD patients to go to CF. But don't kid yourself; it ain't cheap.
Yesterday I did an FA on a 101 year old patient who has been held at 20/400
20/60 with treatments. He can still play bridge 3 times a week. Bring on the
death panels?
Marty Rothenberg
Chief Blacksmith
Angiographics, Inc
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Sent: Tue, Mar 27, 2012 1:09 am
Subject: optimal Digest V3 #63
optimal Digest Mon, 26 Mar 2012 Volume: 03 Issue: 063
In This Issue:
[optimal] Re: Workload Demands
[optimal] =?utf-8?B?UmU6IFtvcHRpbWFsXSBSZTogV29ya2xvYWQgRGVt
[optimal] Re: Workload Demands
[optimal] Re: Workload Demands
[optimal] Re: Workload Demands
[optimal] Re: Workload Demands
[optimal] Spectralis OCT & Drusen Volume
[optimal] =?utf-8?B?UmU6IFtvcHRpbWFsXSBSZTogV29ya2xvYWQgRGVt
[optimal] Re: Workload Demands
[optimal] Re: Workload Demands
[optimal] Re: Workload Demands
[optimal] Re: Workload Demands
[optimal] Re: Workload Demands
[optimal] Re: Workload Demands
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