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February 14, 2020
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Adding a fellow to practice adds efficiency and invigorates the surgeon

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Robert J. Weinstock

ORLANDO — Setting up a refractive fellowship in his practice not only created more efficiency at work but also was “the most rewarding aspect” of his career, Robert J. Weinstock, MD, said at Cataract Surgery: Telling It Like It Is.

“As the landscape of cataract surgery has changed...it became very obvious to me that the training in residency, in terms of refractive surgery, particularly lenticular-based refractive surgery as well as cornea-based surgery, is not really adequate in residency training,” said Weinstock, who set up the fellowship about 5 years ago.

“[Adding a fellowship] is a complete win-win in both directions. It is amazing for the fellow because it would take over a decade to learn what they learn in that short amount of time,” Weinstock said. “And for the surgeon, it is invigorating to be teaching. It keeps you relevant and it also allows you to perform at a higher level.”

As Weinstock began to structure the fellowship, he reached out to experts such as Eric D. Donnenfeld, MD, Daniel S. Durrie, MD, and Vance Thompson, MD, who all used fellows.

“It is a two-way street because it has helped me tremendously, and not just the routine of not getting phone calls in the middle of the night,” he said. Using a fellow helps the surgeon manage the growing volume of patients in the practice, while still giving high-level care and a high level of attention.

The first step is to think of the fellow as “no less than an employee-doctor,” because they are board-certified and licensed, he said.

Fellows can be identified using the San Francisco Match (sfmatch.org) anterior segment fellowship track, according to Weinstock. An interested surgeon would need to enroll for about $300 per year and create a description of the practice and the offer. Those descriptions are sent out to all interested residents.

“From a practice operations standpoint, [the salary] is basically a PGY-5,” Weinstock said. “And you put them on your typical malpractice insurance. We are dual consenting our patients for surgery now.”

Weinstock said he has worked in how the fellow functions in the operating room as well as on the office schedule.

“We tend to channel more of the hands-on patients who need follow-up [to the fellow],” he said.

Weinstock offered himself as a resource to anyone considering adding a fellowship. – by Joan-Marie Stiglich, ELS

Reference: Weinstock RJ. Tips on how fellows make us more efficient. Presented at: Cataract Surgery: Telling It Like It Is; Feb. 12-16, 2020; Orlando.

Disclosure: Weinstock reports no relevant financial disclosures.