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    Evidence-based ophthalmology

    Comparing notes over practice variations for global physicians

     

    Over a second delicious beverage, we discussed why it is that ophthalmologists who read the same papers in the same journals have such widely varying approaches to the management of a very common eye problem.

    Not everyone gives the same credence to the same publications. Some ophthalmologists train with professors who are vehemently opposed to the use of corticosteroids while others had professors who used steroids frequently.

    One colleague told an amusing story; his professor forbade the use of steroids by residents for patients in the university clinic but used them liberally in his private practice.

    “I have to keep my private patients comfortable and happy,” he confided to his junior colleague.

    The variation in practice among very well trained ophthalmologists frequently surprises me, given that we all acknowledge the importance of scientific evidence to guide our practice and read the same journals.

    I dream of a future time when every patient with a certain problem receives the same effective treatment based upon the most current scientific knowledge, no matter which doctor he or she happens to see.

    Peter J. McDonnell, MD
    He is director of The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, and chief medical editor of ...

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      That is simply the result f what we call the "art of medicine". It also make the point that none of us are quite as smart as we think we are.

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