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Presidential address of DR.R.Kandiah, M.S., D.O.
Venue : 59th Annual TNOA conference at Thirunelveli on 5th August 2011 |
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Dear Friends,
First of all let me take this opportunity to thank each one of you for this great honour you have bestowed on me, in choosing me as your President for the year 2011-2012. I assure you that I will fulfil my responsibilities to the best of my abilities and will strive to maintain the honour and dignity of our beloved fraternity & TNOA.
At the outset, I bow before the almighty to seek His blessings, for the successful completion of my presidential term. I remember with respect my late parents, and thank my affectionate and supportive wife and my loving children for their support in all my endeavours. My gratitude to my teachers, colleagues and friends who moulded my career and blessed me to rise in the field of Ophthalmology. I am very much indebted to my students for their trust and confidence which inspire me to teach & serve them better. Their encouragement at each level of my progress has enabled me to scale new heights.
Let me, congratulate all the members of the organizing committee especially Dr Ramakrishnan, Organising Secretary and his team for hosting such a wonderful conference here. They deserve a round of applause.
Tamilnadu Ophthalmic Association will soon be celebrating its Diamond Jubilee in 2012. In retrospect I feel highly satisfied with the outstanding progress the association has made since its inception as Madras State Ophthalmic Society. The scientific activities of TNOA have shown phenomenal progress over the years and you can see the number of papers presented by doctors from all over India, here in our TNOA conferences. Also many of our members present papers and conduct courses in national and international conferences and have won many medals. Tamilnadu has emerged as a knowledge hub for ophthalmologists to exchange ideas, interact with experts and to expand our social circle.
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Dr. R. KANDIAH
President - TNOA |
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Ophthalmology has “Arrived”
In the last few decades our speciality has evolved a lot in the eyes of budding medical students.
Many decades ago budding ophthalmologists used to be asked “why did you take ophthalmology” by the more superior physician and surgeon colleagues. Then a couple of decades back the PG students themselves boldly thought to themselves “why not” I take ophthalmology. Today medical students are saying – “I will do” ophthalmology even in 3rd year.
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Observation as a Teacher
Having worked as a teacher in ophthalmology for 30 years, it is my observation that we should focus on three aspects
- Improving Ophthalmic Education at the Postgraduate levels
- Initiate senior faculty training programme
- Implement protocol of practice management.
At the PG level there is a dire need to revamp the syllabus, and method of training in PG institutes, A PG qualified person should be in a position to perform with ease and confidence, surgeries like, Glaucoma, Cataract including Phaco, Lid Squint and other Anterior segment surgeries. It should become mandatory for them to get exposed to all major investigative procedures and develop competence in interpretation and management. They should also be able to start a private practice and understand the medico legal and insurance aspects of practice. With regard to the pattern of examination, I would like to strongly suggest that we need to give a lot of emphasis on clinical, diagnostic and management based questions, as is the norm for the Royal college exams.
To teach students, we teachers also have to learn and, to make teaching interesting, there is a need to implement Faculty training program, with the increasing number of new medical colleges coming up across the country, there is a shortage of teaching staff especially at the middle cadre level. It falls on us to take the responsibility of imparting training to these teachers. Hence we are planning to have few workshops on faculty training through TNOA.
It is also necessary to impart Protocol training for practicing Ophthalmologists as part of standardization of Ophthalmic Practice across Tamilnadu. I hope the ARC & TNOA would take the initiative on this aspect of practice management.
The Indian medical council has been talking about making CME points mandatory and also about bringing in licentiate exams every 5-10 years. Before it comes into play, we need to be prepared for it by updating our knowledge.
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Challenges to our profession
1. Media and internet
2. Insurance companies
Media and internet exposure has significantly contributed to awareness of not only cataract and phaco, but also glaucoma and diabetic retinopathy. This is a win win situation. We get more patients to walk in for glaucoma and diabetic screening, which facilitates early diagnosis and treatment. It has been noted that nearly 30% of glaucoma and diabetic retinopathy goes unnoticed on the other hand over publicising should be avoided. This leads to increased expectation from patients.
Insurance companies are threatening to take control, of our profession. We are very dependent on them to get our hospital in to the approved list. We have to compromise on rates to be their preferred partner, but patient demands the best possible surgery. We all know what amount of skill experience and training is needed before we venture into surgery. The amount of investment on infra structure and instrumentation, AMC cost have also escalated and there are newer models coming up fast, and these instrument also don’t last life time and this puts additional pressure on the practitioner. We also need to keep updating surgical skills, which costs time and money. This needs immediate negotiation with insurance cos. We must aim to standardise rates and allow patients to co pay. Remember, quality cannot be compromised at any cost. We need to have unity among ourselves and try to represent our view points and reach an amicable settlement, beneficial to both partners.
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Corporate Hospitals have arrived
Corporate hitherto were confined to big cities now they have started establishing centres in tire 2 and 3 cities. This has increased awareness about eye diseases in rural areas and they have access to the best possible eye care. This has opened up more opportunities for ophthalmologists.
The budding Ophthalmologists now have: - More employment opportunities for junior colleagues, Better remuneration, Choice of jobs and places. But before starting ones career whether it is in private practice, or corporate, one must analyse the pros and cons and decide on the long term benefits. Do not be short sighted. |
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United We stand – Group Practice
We are entering a new era, where even retaining our old customers is a challenge and we all have to use innovative strategies to even show modest growth. My observation is that only about 40 to 50% patients come to us repeatedly, this may be a result of
- Change in family physician concept
- Logistics of travel and time at least for basic refraction
- Availability of specialist in neighbourhood
- The Gen Next preferring corporate hospitals.
- Media and internet access.
- Eye examination being part of annual Comprehensive medical exam and diabetic caution with eye tests.
In order to counter this continued Patient drain, and to reduce investments in machinery and place we can establish a group practice with various super specialists in our field and allied fields like diabetology. We can also join together and open a single theatre unit and investigative centres equipped with all the modern machinery, there by reducing the loan liability and increase the machine usage, and reduce the fee charged to patients. |
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What should be our Aim now?
We should aim to achieve perfection and excellence in the spheres of ophthalmology. Our ophthalmologists young & old should get an opportunity to achieve this excellence by keeping abreast of the new advances in the field of ophthalmology, by attending conferences and workshops and must subscribe to video films and scientific journals. It is sad that many of us do not like to spend money on such matters. Let us do it voluntarily, before we are compelled by MCI.
My advice to young ophthalmologists is that your future is bright you have outstanding institutions both in the private and government sectors where you can learn and improve your knowledge. The opportunities are all there and it is for you, to choose the best and make a carrier out of it.
As a poet has said,
"Those who thus can see again a world clear, crystal bright
will never cease to thank the man who gave them back this light".
Friends I am grateful to you for giving me a patient hearing. I hope with your co-operation and guidance, we will be able to achieve our goals. Let us rededicate ourselves to the cause of prevention of blindness and promotion of eye health. While it is out bounden duty to look after the development of the Science of Ophthalmology, we cannot escape our obligations and responsibility to the people.
With the boom in industrial and scientific sector, expectations of the people have also grown. We must live up to their expectations. Our profession has tremendous potential and we should harness its strength - to meet our obligations.
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PRAYER OF SERENITY
“God grant me the serenity
To accept the things I cannot change
Courage to change the things I can
And the wisdom to know the difference”
"ANON"
Thank You |
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