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18 | EYEWORLD DAILY NEWS | MAY 17, 2020 DAILY NEWS ASCRS VIRTUAL ANNUAL MEETING can do is make yourself as anti-fragile, as resilient, as adaptable as possible. 5) Elevate our team beyond their comfort level. "You have to give your team an oppor- tunity and allow them to make mistakes so that they get better," he said, leading him to #6. 6) Quit building an upside down pyramid. Dr. Berdahl said his tendency is to do this, but he said it's not a sustainable, growth-oriented model. "We have to elevate our leaders and our team- mates and empower them to make those decisions," he said. 7) Realize working 20% less for 30% less pay is proba- bly a good trade. Doctors in America are some of the hardest working people and what for, he asked. "I know we serve the people that have needs, but we have a responsibility beyond just our profession to our families and this is our one swing at life," he said. "I love working, but what's the right bal- ance?" 8) Really believe this world is ours and we're responsible for it. Dr. Berdahl said we need to take care of each oth- er and start with a place of trust, a thinking that people are making decisions based on what's right. 9) Focus on the essentials. "Be a good steward of what really matters. Time with family, time with your team, expertise for your patients, creating a viable business that's not just there to maxi- mize the bottom line, but it's there to leave this world that we own a little better place." Watch these presentations and more in SYM-4. Editors' note: Drs. Shah, Yeu, and Berdahl have no financial interests related to their presentations. experience for quite some time to some degree," Dr. Yeu said. "But it will allow for some more sophisticated approach to that remote and virtual educa- tion piece." John Berdahl, MD, Sioux Falls, South Dakota, presented on "It took a pandemic for me to … "—and he filled in the blanks: 1) Get a puppy. Dr. Berdahl said the pandemic slowed life down enough that "we can seek out whatever it means to be kind of a normal family." 2) Walk with my wife daily. He said that being a doctor is the best profession on earth and ophthalmology is "cer- tainly the best subspecialty in medicine." It, however, takes every bit that you're willing to give it. "But we also have responsibilities to our family, and I'll tell you that my daily walk with my wife and the hour that we spend connect- ing with each other with no electronics is probably the single biggest grounding thing that I do in my life," he said, explaining that as you grow in your profes- sion, there are fewer people willing to speak truth like a spouse will. "So we need to listen to them," he said. 3) Start to learn guitar. Dr. Ber- dahl said over time he feels he's been unidimensional. "There's more to being hu- man than just being oriented toward one thing," he said. 4) Realize and apply first prin- ciples. He explained that the rules and laws that governed the world weren't designed for a pandemic. Some of the first principles that he's been drawn to are: • Leaders eat last—we need to put our team and those that are most vulnerable first. • We are in an infinite game— the goal is not to win, the goal is to keep playing and keep playing better, he said. • Become anti-fragile—all you "Long gone, I do believe, are the days when we will have caregivers and loved ones in the exam lanes for every visit. I certainly think that we will always have to have some level of decreased face-to-face time and interaction. And the 3-hour exams are going to be a thing of the past," Dr. Yeu said. New norm #3: Clinic visits will have to be shortened and telemedicine will be more common. Dr. Yeu said this will require identification and mit- igation of limiting factors and schedule clogs (i.e., doctor-pa- tient chair time, diagnostic testing). She said this might mean more frequent, split visits. Dr. Yeu said that it's likely higher-risk populations might be tested before exam- ination. Finally, she said new technologies may replace some parts of the slit lamp exam. She envisioned an increase in non-mydriatic fundus photog- raphy and the potential for digital, remote-controlled slit lamp examinations. New norm #4: Surgical schedules and protocols will change. Dr. Yeu said there will be more preoperative testing and a shift to the ASC vs. the hospital for surgical care. She said bilateral immediately sequential cataract surgery will increase as well, and there will be fewer in-person post- op appointments for routine procedures. New norm #5: The way we socialize and learn will indefinitely change. Dr. Yeu comedically described how the "Zoom mullet" will become more frequent, where people are business-ready up top but have a "party on the bottom" where a computer camera, in theory, does not see. "Where we meet our friends, where we have our play dates, where we have our meetings are all going to be at that same bar called Zoom or Skype, and certainly this is something we will likely In addition to your own case videos, Dr. Shah advised learning from the work of others by reading the litera- ture, watching case videos of experts, and sharing informa- tion about best practices and resources with your colleagues. There are also ways to practice at home. He said there are a number of devices and implants available for training purposes and model eyes, like SimulEYE (InsEYEt). "Be creative with the resources we do have at our disposal," he said. Eventually, Dr. Shah contin- ued, the crisis will end and we will get off the bench. "Reduced access and delayed care, however, may mean that the average case complexity goes up," he noted, especially early on. "Be ready. Be safe. Be sane. Stay healthy, and stay sharp. Remember, these pearls apply whether there is a pandemic or not, and we can use this opportunity to develop ourselves and be that much better when this crisis is over." Elizabeth Yeu, MD, Nor- folk, Virginia, made predictions about what the "new normal" could look like. "Certainly, not any one of us has a crystal ball to look into the future, but I'd like to share some facts and thoughts," she said, adding that "what we do know is that this viral pandem- ic will wax and wane for at least the next 12 to 24 months, so there is going to be a lon- gevity to this." Dr. Yeu briefly discussed herd immunity and the chal- lenges there are with the potential for a vaccine. "New norm #1 will be that change will be constant," she said, envisioning swings in the economy, unemployment, and the supply chain. New norm #2: Office dis- tancing, she continued, is here to stay. continued from page 16

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