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Focus On Improving Care | May 2015

No Man Is an Island

Enrich your professional experience by visiting other ophthalmology practices.

John Donne wrote, “No man is an island, entire of itself; every man a piece of the continent, a part of the main.” Donne emphasized the importance of our connections to one another and how those connections magnify the achievements and losses of society as a whole. This notion applies to the field of ophthalmology, where collaboration and knowledge sharing have always taken place. For me personally, connecting with other physicians by interacting with and observing them at their own practices has been one of the most valuable ways I have enriched and grown my practice.

Early in my training at the Naval Hospital in San Diego, I learned the value of observing how things are done in another setting. I was given the opportunity to spend of couple weeks at the Naval Hospital in Bethesda, Maryland. Even though the two programs had the same mission, were similarly staffed, and were governed by the same Navy regulations, they were vastly different in their approaches to teaching and caring for patients. Both had their strengths, and by observing the similarities and differences between the two programs, I ultimately benefited when I was on staff later in my career.


Over the past 25 years in practice, I have continually taken the opportunity to foster relationships with physicians at other practices who I believed could add a new dimension to what I was doing. The investment of time and energy has paid huge dividends over the course of my career.

When my practice transitioned from an open-use LASIK center to providing that service in house, I took my staff to Minneapolis to visit the Chu Vision Institute to learn how Ralph Chu, MD, had created a successful in-house LASIK practice in a very competitive market. The benefits of that visit and the bonds created continue to this day, 15 years later, as Ralph and I still share our thoughts and ideas with each other.

Another example of the insights to be gained by spending a few days in someone else's practice occurred in Houston. When Stephen Slade, MD, graciously invited me to come and see him use the new LenSx Laser (Alcon) he had just unpacked, I came as fast as I could. I learned more in that 1 day of surgery about laser cataract surgery than I possibly could have hoped to learn in 1 week at the American Society of Cataract and Refractive Surgery's annual meeting. There is no substitute for seeing the technology in use and discussing it one-on-one with an expert in a private setting. That visit solidified my decision to become involved in laser cataract surgery as early as possible, and our practice has benefited greatly ever since.

There is no doubt that a person can have a successful career without ever setting foot outside his or her own practice; I know many doctors who have done just that. It can be expensive to spend time away from the office, and many of us would rather spend whatever free time we have with family or pursuing other interests. The opportunities and rewards of fostering a relationship with another practice, however, are sometimes unexpected.

During a recent trip to the American-European Congress of Ophthalmic Surgery meeting in Europe, I decided to visit A. John Kanellopoulos, MD, at his practice in Athens, Greece. I thought it would be interesting to see how a practice functioned in a country much different than my own. John's practice, LaserVision.gr Eye Institute, hosts many visitors from all over the world. I had the opportunity to speak with a physician from China who was doing a mini fellowship with John. It was fascinating to talk with the Chinese physician about ophthalmology training in his country.

Laservision Eye Institute is also very active in cross-linking research. I talked with the research coordinator, George Asimellis, PhD, about the cross-linking studies they were conducting and then compared what I learned with what we were doing at my practice (Figure). Out of that visit came the opportunity for me to help with a project that was recently accepted as an article by the journal Cornea. I certainly had no expectations of becoming a coauthor of an article when I made my plans to visit Athens, but my experiences made the journey more than worth the effort.


The exchange of valuable information and ideas is a two-way street when it comes to practice visits. I would like to think that, on occasion, I have provided some useful insights to the practices I have visited, but I know for certain that I have gained so much from those who have come to visit us. Also, practice visits are an opportunity for benchmarking. Sometimes, we learn ways to do things better, and other times, we confirm that we are on track. Visits also establish relationships with other practices that can be helpful when we need outside advice for practice management issues.

As a center for laser cataract surgery, our practice now regularly hosts doctors, which has had many positive effects on the physicians and staff alike. Wanting to be a good host motivates us to seek excellence in what we do. We look at our surgical technique more closely, how we interact with patients, the physical appearance of our office, and the demeanor of our staff. All this, I think, makes ours a better practice in the long run.


“Because I am involved in mankind, and therefore never send for whom the bell tolls; it tolls for thee,” wrote John Donne. These closing lines of his poem “No Man Is An Island” express that, through connection, we all share in our triumphs and defeats, the theme of one of Ernest Hemingway's most famous novels, For Whom the Bell Tolls. In the practice of ophthalmology, we are all connected by the desire to improve the lives of our patients. Seeing how others go about this endeavor firsthand can be an enriching experience. n

Mark Kontos, MD
• senior partner at Empire Eye Physicians in Spokane, Washington
• (509) 928-8040; mark.kontos@empireeye.com
• Financial disclosure: None acknowledged

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