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American Journal of Ophthalmology Dec 2020
Topics: COVID-19; Humans; Internship and Residency; Ophthalmologists; Ophthalmology; Pandemics; SARS-CoV-2; Scholarly Communication; Stress, Psychological
PubMed: 32971027
DOI: 10.1016/j.ajo.2020.07.028 -
American Journal of Ophthalmology Dec 2020
Topics: COVID-19; Humans; Internship and Residency; Ophthalmologists; Ophthalmology; Pandemics; SARS-CoV-2; Scholarly Communication; Stress, Psychological
PubMed: 32961117
DOI: 10.1016/j.ajo.2020.07.017 -
La Clinica Terapeutica Apr 2022This work describes what are the regulations in the field of safety and prevention in the workplace, with particular regard to the legal medical aspects of the doctor in... (Review)
Review
This work describes what are the regulations in the field of safety and prevention in the workplace, with particular regard to the legal medical aspects of the doctor in charge of Occupational Medicine in correlation with ergophthalmological examinations. The main subjects of this treatment are the employees videoter-minalists. The first part of this work aims to analyze the compliance, as well as laws and legislative decrees governing the obligations and duties of the employer to its employees, regarding the compliance of workplaces and equipment with the instrument that are routinely used by employees videoterminalists. The discussion continues by focusing on the specific aspects of the ergophthalmological examination. It also describes the different phases of the eye examination, starting from the identification of the employee and then to the collection of anamnestic data, which are an integratedpart of the medical-legal act and are also a useful tool for the final diagnosis. The discussion of the various phases of the ergophthalmological examination concludes with a description of indirect ophthalmoscopy with its crucial points, which are important points in any ophthalmo-logical examination. Given the considerable diffusion and the great amount of tech-nological innovations in the field of display screens, we conclude the discussion with a historical overview of the display screens that have been habitually used by employees in their workplace, describing the mechanism that underlie their operation through some hints of Physics.
Topics: Humans; Occupational Health; Occupational Medicine; Ophthalmologists; Physicians; Workplace
PubMed: 35385044
DOI: 10.7417/CT.2022.2415 -
JAMA Ophthalmology Jan 2018Understanding the distribution of patient complaints by physician age may provide insight into common patient concerns characteristic of early, middle, and late stages...
IMPORTANCE
Understanding the distribution of patient complaints by physician age may provide insight into common patient concerns characteristic of early, middle, and late stages of careers in ophthalmology. Most previous studies of patient dissatisfaction have not addressed the association with physician age or controlled for other characteristics (eg, practice setting, subspecialty) that may contribute to the likelihood of patient complaints, unsafe care, and lawsuits.
OBJECTIVE
To assess the association between ophthalmologist age and the likelihood of generating unsolicited patient complaints (UPCs) among a cohort of ophthalmologists.
DESIGN, SETTING, AND PARTICIPANTS
Retrospective cohort study with variable duration of follow-up. The study assessed time to first complaint between 2002 and 2015 in 1342 attending ophthalmologists or neuro-ophthalmologists who had graduated from medical school before 2010 and were affiliated with an organization that participates in Vanderbilt University Medical Center's Patient Advocacy Reporting System. Participants were stratified into 5 age bands and were followed up from the time of their employment to receipt of their first complaint. Trained coders categorized UPCs into 34 specific types under 6 major categories.
MAIN OUTCOMES AND MEASURES
Time to first recorded complaint. Multivariable Cox proportional hazards model was used to measure the association between time to first complaint and ophthalmologist age after adjustment for predetermined covariates.
RESULTS
The median physician age was 47 years, with 9% who were 71 years or older. The cohort was 74% male, 90% held MD degrees, and 73% practiced in academic medical centers. The mean follow-up period was 9.8 years. Ophthalmologists older than 70 years had the lowest complaint rate (0.71 per 1000 follow-up days vs 1.41, 1.84, 2.02, and 1.88 in descending order of age band). By 2000 days of follow-up (or within 5.5 years), the youngest group had an estimated UPC risk of 0.523. By 4000 days (>10 years), participants in the older than 70 years age band had an estimated risk of UPC of only 0.364. The 2 youngest age bands were associated with a statistically significant shorter time to first complaint. Compared with those aged 71 years or older, the risk of incurring a UPC for those aged 41 to 50 years was 1.73-fold higher (hazard ratio [HR], 1.73; 95% CI, 1.21-2.46; P = .002). Similarly, participants aged 31 to 40 years had a 2.36 times higher risk of incurring a UPC (HR, 2.36; 95% CI, 1.64-3.40; P < .001).
CONCLUSIONS AND RELEVANCE
This study suggests that older ophthalmologists are less likely to receive UPCs than younger ones. Although limitations in the study design could affect the interpretation of these conclusions, the findings may have practical implications for patient safety, clinical education, and clinical practice management.
Topics: Adult; Aged; Female; Follow-Up Studies; Humans; Male; Malpractice; Middle Aged; Ophthalmologists; Patient Safety; Patient Satisfaction; Physician-Patient Relations; Practice Patterns, Physicians'; Quality Indicators, Health Care; Reproducibility of Results; Retrospective Studies; Risk Factors
PubMed: 29192303
DOI: 10.1001/jamaophthalmol.2017.5154 -
American Journal of Ophthalmology Case... Dec 2022Cat scratch disease (CSD) frequently has ophthalmologic manifestations. The ophthalmologist's approach to treating neuroretinitis is familiar, but few eye care providers...
PURPOSE
Cat scratch disease (CSD) frequently has ophthalmologic manifestations. The ophthalmologist's approach to treating neuroretinitis is familiar, but few eye care providers are comfortable answering the next question of "what do I do with my cat?" Published guidelines are often vague in answering the complexities of real-life conundrums that can lead patients and their doctors to believe that risk mitigation should involve removal of the animal. Here, we present demonstrative scenarios informed by clinical practice and provide updated recommendations.
OBSERVATIONS
A 10-year-old boy presented with reduced vision in the right eye. Funduscopic examination identified optic nerve head edema with subretinal fluid, and a macular star developed one week later, consistent with the diagnosis of neuroretinitis. Serology confirmed antibodies and a diagnosis of CSD. The father disclosed that the family has recently adopted three kittens, who have scratched the boy and the patient's younger sister. The physician and patient's family find themselves at a loss regarding best practices for what should be done with the kittens.
CONCLUSIONS AND IMPORTANCE
. has been detected in a variety of mammals and can be transmitted via vectors such as fleas. Even well-appearing animals can transmit the bacteria, months to years after their initial infection. Symptoms, clinical and laboratory findings will depend on bacterial load and strain virulence, as well as the physiological/immunological status of the host, with people at the extremes of age and the immunocompromised being at greater disease risk. Flea control is crucial to minimize transmission risk. Our veterinary expert (EBB) recommends testing (with serology and PCR) and treating infected animals (with doxycycline and a quinolone). Patients should be counseled to speak with their pets' veterinarian. When addressing the concerns of our CSD patients in clinical practice, ophthalmologists should be aware of the strategies for minimizing transmission risk, and cognizant of the One Health approach for managing zoonoses.
PubMed: 36147775
DOI: 10.1016/j.ajoc.2022.101702 -
Graefe's Archive For Clinical and... Mar 2024Proliferative vitreoretinopathy (PVR) remains the main cause of failure in retinal detachment (RD) surgery and a demanding challenge for vitreoretinal surgeons. Despite... (Review)
Review
Proliferative vitreoretinopathy (PVR) remains the main cause of failure in retinal detachment (RD) surgery and a demanding challenge for vitreoretinal surgeons. Despite the large improvements in surgical techniques and a better understanding of PVR pathogenesis in the last years, satisfactory anatomical and visual outcomes have not been provided yet. For this reason, several different adjunctive pharmacological agents have been investigated in combination with surgery. In this review, we analyze the current and emerging adjunctive treatment options for the management of PVR and we discuss their possible clinical application and beneficial role in this subgroup of patients.
Topics: Humans; Vitreoretinopathy, Proliferative; Ophthalmologists; Retinal Detachment; Surgeons
PubMed: 37843566
DOI: 10.1007/s00417-023-06264-1 -
Cureus Sep 2023To evaluate the accuracy and bias of ophthalmologist recommendations made by three AI chatbots, namely ChatGPT 3.5 (OpenAI, San Francisco, CA, USA), Bing Chat...
PURPOSE AND DESIGN
To evaluate the accuracy and bias of ophthalmologist recommendations made by three AI chatbots, namely ChatGPT 3.5 (OpenAI, San Francisco, CA, USA), Bing Chat (Microsoft Corp., Redmond, WA, USA), and Google Bard (Alphabet Inc., Mountain View, CA, USA). This study analyzed chatbot recommendations for the 20 most populous U.S. cities.
METHODS
Each chatbot returned 80 total recommendations when given the prompt "Find me four good ophthalmologists in (city)." Characteristics of the physicians, including specialty, location, gender, practice type, and fellowship, were collected. A one-proportion z-test was performed to compare the proportion of female ophthalmologists recommended by each chatbot to the national average (27.2% per the Association of American Medical Colleges (AAMC)). Pearson's chi-squared test was performed to determine differences between the three chatbots in male versus female recommendations and recommendation accuracy.
RESULTS
Female ophthalmologists recommended by Bing Chat (1.61%) and Bard (8.0%) were significantly less than the national proportion of 27.2% practicing female ophthalmologists (p<0.001, p<0.01, respectively). ChatGPT recommended fewer female (29.5%) than male ophthalmologists (p<0.722). ChatGPT (73.8%), Bing Chat (67.5%), and Bard (62.5%) gave high rates of inaccurate recommendations. Compared to the national average of academic ophthalmologists (17%), the proportion of recommended ophthalmologists in academic medicine or in combined academic and private practice was significantly greater for all three chatbots.
CONCLUSION
This study revealed substantial bias and inaccuracy in the AI chatbots' recommendations. They struggled to recommend ophthalmologists reliably and accurately, with most recommendations being physicians in specialties other than ophthalmology or not in or near the desired city. Bing Chat and Google Bard showed a significant tendency against recommending female ophthalmologists, and all chatbots favored recommending ophthalmologists in academic medicine.
PubMed: 37885556
DOI: 10.7759/cureus.45911 -
Ophthalmology Sep 2022To evaluate differences in Medicare reimbursements between male and female ophthalmologists between 2013 and 2019.
PURPOSE
To evaluate differences in Medicare reimbursements between male and female ophthalmologists between 2013 and 2019.
DESIGN
Retrospective cohort study.
PARTICIPANTS
Ophthalmologists receiving Medicare reimbursements between 2013 and 2019.
METHODS
The Centers for Medicare and Medicaid Services Physician and Other Supplier Public Use File was used to determine total reimbursements and number of services submitted by ophthalmologists between 2013 and 2019. Reimbursements were standardized to account for geographic differences in Medicare reimbursement per service. Data from the American Community Survey (ACS) were used to determine socioeconomic characteristics (unemployment, poverty, income, and education) by zip code for the location of each physician's practice. A multivariate linear regression model was used to evaluate differences in annual reimbursements by sex, accounting for calendar year, years of experience, total number of services, ACS zip code data, and proportion of procedural services.
MAIN OUTCOME MEASURES
Annual Medicare reimbursement and use of billing codes (e.g., outpatient office visits and eye examinations, diagnostic testing, laser treatment, and surgery).
RESULTS
Among 20 281 ophthalmologists who received Medicare reimbursements between 2013 and 2019, 15 451 (76%) were men. The most common billing codes submitted were for outpatient visits and eye examinations (13.8 million charges/year), diagnostic imaging of the retina (5.6 million charges/year), intravitreal injections (2.9 million charges/year), and removal of cataract with insertion of lens (2.4 million charges/year). Compared with men, female ophthalmologists received less in median annual reimbursements (median, $94 734.21 [interquartile range (IQR), $30 944.52-$195 701.70] for women vs. $194 176.90 [IQR, $76 380.76-$355 790.80] for men; P < 0.001) and billed for fewer annual median services (median, 1228 [IQR, 454-2433] vs. 2259 [IQR, 996-4075, respectively]; P < 0.001). After adjustment for covariates, female ophthalmologists billed for 1015 fewer services (95% confidence interval [CI], 1001-1029; P < 0.001) and received $20 209.12 less in reimbursements than men (95% CI, -$21 717.57 to -$18 700.66; P < 0.001).
CONCLUSIONS
Female ophthalmologists billed for fewer services and received less in reimbursement from Medicare than men over time and across all categories of billing codes. Disparities persisted after controlling for physician and practice characteristics.
Topics: Aged; Centers for Medicare and Medicaid Services, U.S.; Female; Humans; Intravitreal Injections; Male; Medicare; Ophthalmologists; Retrospective Studies; United States
PubMed: 35588946
DOI: 10.1016/j.ophtha.2022.05.006 -
JAMA Ophthalmology Oct 2021Individuals with perceived experience and expertise are invited by editorial boards to provide commentary through editorials. Female representation among editorialists...
IMPORTANCE
Individuals with perceived experience and expertise are invited by editorial boards to provide commentary through editorials. Female representation among editorialists is not yet defined.
OBJECTIVE
To determine female representation as editorial authors in 3 high-impact general ophthalmology journals.
DESIGN, SETTING, AND PARTICIPANTS
This cross-sectional study investigates the proportion of female authorship in editorials published between 2005 to 2009 and 2015 to 2019 in 3 journals: Ophthalmology, JAMA Ophthalmology, and American Journal of Ophthalmology. Data were collected from April to June 2020.
MAIN OUTCOMES AND MEASURES
Proportions of female first and senior (last or solo) authors between 2005 to 2009 compared with 2015 to 2019. Secondary outcome measures include representation by sex across degree types and subspecialties. Comparisons were made for all editorialists and ophthalmologist editorialists.
RESULTS
Of 814 editorial articles, there were 1179 (first and senior) authors identified. Women held 301 (25.5%) of these authorships, including 116 of 365 first authorships (32.9%) and 185 of 814 senior authorships (23.9%). Overall, female first and senior authorships grew by 68.0% between 2005 to 2009 and 2015 to 2019 (85 of 469 [18.1%] vs 216 of 710 [30.4%]; difference, 12.3%; 95% CI, 7.4-317.2; P < .001). Between 2005 to 2009 and 2015 to 2019, first and senior authorships by women increased (first: 33 of 133 [24.8%] vs 83 of 232 [35.8%]; difference, 11.0%; 95% CI, 1.4-320.6; P = .03; senior: 52 of 336 [15.5%] vs 133 of 478 [27.8%]; difference, 12.3%; 95% CI, 6.8-317.9; P < .001). JAMA Ophthalmology most substantially contributed to the increase in female first and senior authorships (13.8% and 16%), although the test for homogeneity among the 3 journals was not significant. The proportion of female ophthalmologist first authors was greater than the proportion of American Board of Ophthalmology-certified female ophthalmologists (81 of 281 [28.9%] vs 123 of 672 [18.3%]; difference, 10.6%; 95% CI, 5.3-315.9; P < .001).
CONCLUSIONS AND RELEVANCE
The proportion of female senior authors increased by 68.0% between 2005 to 2009 and 2015 to 2019, but female authors represented only 25.5% of editorialists. Compared with male ophthalmologists, female ophthalmologists were more commonly first than senior authors. Additionally, female authors were more likely to be nonophthalmologists or to hold nonmedical, non-PhD degrees. While the swelling rank of female editorialists has paralleled the rising proportion of female ophthalmologists over time, parity by sex has yet to be attained. Greater awareness of disparities and strategies to mitigate them may help equalize representation.
Topics: Authorship; Cross-Sectional Studies; Female; Humans; Male; Ophthalmologists; Ophthalmology; Periodicals as Topic
PubMed: 34383002
DOI: 10.1001/jamaophthalmol.2021.3027 -
Indian Journal of Ophthalmology Jul 2021
Topics: COVID-19; Humans; Mucormycosis; Ophthalmologists; SARS-CoV-2; Steroids
PubMed: 34146077
DOI: 10.4103/ijo.IJO_1143_21