One year since COVID-19
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Just more than a year ago, we had a nationwide shutdown to attempt to curb the spread of COVID-19. This deeply affected our medical practices where clinic and surgical volume plummeted, and we stopped doing elective procedures for months.
It also affected each of us on a personal level, with social isolation and distancing measures being just a small part of the effect. Now, 1 year since the emergence of the COVID-19 pandemic, we can look back and see the profound changes that this crisis has caused in our professional and personal lives.
Professional impact
Our staff members in our clinics and surgery centers are more than just employees — they are critical team members who are more like family. We learned to take care of each other, leave no one behind and hang in there together to weather the storm. Our staff takes care of us, and we take care of them.
We implemented respiratory precautions that will likely continue into the foreseeable future. When examining a patient at the slit lamp microscope, our faces are just about a foot away from our patients. Having plastic shields helps to a degree, but adding face masks provides more protection.
We have even implemented video and image capture systems on our slit lamp microscopes so that we do not always have to look through the oculars. We can double or triple the distance between the patient’s face and ours, while seeing high-definition imaging on a video monitor.
All physicians have been doing universal precautions for blood- or fluid-based pathogens for decades, and now we have added universal respiratory precautions that will likely stay, even in the rare chance that COVID is eradicated.
We have eliminated less necessary visits to our clinics and switched some follow-up appointments to video visits. For routine postop cataract patients, seeing them on postop day 1 is helpful, but do we really need a postop week 1 visit and then a month 1 visit and then a month 3 visit? Perhaps doing just two or three postop visits is sufficient for many patients because the possible need for a physician intervention is primarily at postop day 1. This is the time at which a retained lens fragment would be noticed, the IOP may be spiking or the inflammation level may be high.
The part of ophthalmology that I miss the most is seeing colleagues in person at the local, national and international meetings. This in-person, face-to-face interaction is hard to replicate with video conferencing. Fortunately, these meetings are starting up again, and I anticipate attending at least a few of them this year.
In terms of learning, we have made a large change: Instead of going to live lectures, we are now able to stream the content that we desire at any time of the day and from anywhere. My own teaching website, CataractCoach.com, has more than 1,000 edited, narrated surgical videos with a new one added every day. When I have a tough surgery coming up, I am more likely to watch a video online than look up the topic in a book. Streaming, on-demand surgical learning is here to stay and will get even more popular.
Personal impact
The first few months of the pandemic were a time for introspection and reflection, to prioritize different aspects of life. We are taught to measure success by job title, income or even surgical volume, but is that what really matters most? Perhaps a better measure of success prioritizes health, relationships and time for enjoyment while still finding the balance to devote energy to our medical and surgical practices (Figure 1).
Source: Uday Devgan, MD
For me, the pandemic was a time to truly focus on my health, both mental and physical. Daily exercise and healthy cooking helped me get back into shape. The exertion of weightlifting really helps to clear my mind, and it is more for sanity than vanity. My favorite activity, hiking in the beautiful mountains of Southern California, improves both my physical and mental health simultaneously (Figure 2).
When I see a nonagenarian patient in my clinic, I ask what has been the most important aspect of their 90+ years. The answer is invariably the personal relationships with friends and family. There is so much wisdom in that, and I am working hard to prioritize those relationships.
Our most valuable asset in life is time, not money. We can always make more money, but it is tough to make more time. Having dedicated time to spend on personal enjoyment is very important. This time can be spent doing hobbies, enjoying the outdoors, reading a book or even binge-watching television. The key is to have the time.
I am not sure when or even if we will contain or eradicate COVID, but I am certain that we are resilient and will overcome the issues. While we cannot always predict the future, we can definitely adapt to it. And that is probably more important.
- For more information:
- Uday Devgan, MD, is in private practice at Devgan Eye Surgery, Chief of Ophthalmology at Olive View UCLA Medical Center and Clinical Professor of Ophthalmology at the Jules Stein Eye Institute, UCLA School of Medicine. He can be reached at 11600 Wilshire Blvd. #200, Los Angeles, CA 90025; email: devgan@gmail.com; website: www.CataractCoach.com.
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