Evolution

Let me rewind, and tell you how I reached my decision.

First, a brief description about my training background.  My residency rocks!  I could not have asked for a better residency program.  It was ridiculously busy, and we often ran around in clinic like chickens with their heads chopped off. However, thanks to this chaotic learning environment, I have become a competent, confident, and truly comprehensive ophthalmologist.  I feel comfortable handling almost anything that walks through my door.

My aspirations one year ago were the complete opposite of what they are today. Having had a modicum of success playing poker throughout medical school, I wanted to work part-time as an ophthalmologist, while I pursued a full time professional poker career. Starting a solo practice did not even cross my mind. I just looked for an associate position in an area where live poker was easily accessible.

As I began to operate more, I discovered how rewarding it was to help restore vision to people.  I thought twice about my priorities.  I eventually changed my mind, and decided to become a full-time ophthalmologist.  However, I still was not ready to give up my passion for poker.

I ended up receiving a job offer in Las Vegas.  How convenient!  I verbally accepted the offer in no time.  It was a fantastic practice with great people, and it was in the best location for my purposes!  My patient volume was going to be immediately strong.  I had the potential to perform 300-400 cataract surgeries a year in no time.  I would have had much support, and the financial potential was very strong.  Odd thing is, once I had the bird in hand, poker seemed less and less important to me.  Instead, I started to fixate more on the nuances of this practice opportunity.

I ultimately turned it down.

My future employer wanted to limit my scope of practice because he didn’t want me to “step on the toes” of his referring specialists.  I did not like the fact that I would be unnecessarily forced to refer MY patients out even though I was plenty capable of providing the same quality care for them.  He was also concerned that I would introduce additional liability to his practice, which is understandable.

I became an ophthalmologist so that I could develop meaningful lifelong relationships with my patients.  Unnecessarily referring them out would limit my ability to build these sorts of connections.  Don’t get me wrong though.  I am far from a cowboy.  I know my limits, and I would never let my ego compromise my patients’ well-being.  At the end of the day, I still want what’s best for my patients regardless of who does what.  However, if I am able to provide a similar service with the same standard of care as a specialist, why should I have to refer a patient out for the sole purpose of retaining a referral source, and ultimately gaining more business?  Of course, I’m not completely naive either.  Our profession is still a business, and in order to serve our patients, the practice needs to stay afloat.  However, I believe that there are other ways to keep a practice alive besides using patients as a bargaining chip.

The other problem with this practice was that there was a relative low Korean-American patient population in the area.  Throughout medical school and residency, I was active in the Korean-American community, volunteering at health fairs and other community service events and activities.  I wanted to continue serving the Korean-American community as a practicing ophthalmologist.

I was back to square one.  I ended up interviewing all over the country.  In total, I had three job offers.  I turned them all down.  Each practice had it’s own attributes, and I would have been more than happy with the compensation each had offered.  However, I couldn’t help but focus on the “deficiencies” of each practice.  They were too restrictive on my scope of practice; they still believed in practicing 1986 medicine; the facilities were antiquated and the equipment was lacking for my needs; or the volume or structure of the practice was more reminiscent of an assembly line rather than one conducive to developing a genuine doctor-patient relationship.

So, 3 months until residency ends, and I still have no job.  Should I just go ahead and play poker professionally since I can’t settle for any associate position?  Probably not.  The inspiration came one day when I randomly e-mailed an ophthalmologist in Queens, NY asking to see if he would be interested in hiring a Korean-speaking ophthalmologist (80,000 Korean-Americans live in the Queens borough).  He replied: “whether I hire you or not, you should open a practice here.”  And that’s what did it! This incidental remark gradually consumed me, and here I am today.