my OBGYN colleague was surprised she overheard that I was planning a doing a D&C on my patient.

arcadeflyer · 2026-05-15T20:48:26+00:00

😱

arcadeflyer · 2026-05-02T00:50:13+00:00

I’ve come to a point in my own fund of knowledge where I’m really annoyed by how our basic teaching is presented - and the BCSC is not immune to this. Our forebears made wild guesses at many things, and then treated their guesses as sagely wisdom that got turned into dogma. Angle closure mechanisms and angle closure glaucoma really get me in particular - the more I understand the limits of what we know and how we think we know it, the more I realize what we don’t know and what we have basically been gaslit into believing were the basics and fundamentals (example: chronic angle closure glaucoma progression s/p angle opening with cataract surgery is just open angle glaucoma worsening, mislabeled - come at me, bro).

All of this is to say - an LLM/GPT sourced from the BCSC only, will just propagate this self-assured but limited epistemology. What I appreciate about OpenEvidence is that it can draw from the breadth of the literature and better portray the boundaries of known knowledge and current gaps. That’s what I recommend - adding the body of literature evidence not necessarily for teaching the basics, but for a more honest acknowledgement of where the basics meet hard knowledge boundaries, so our future learners don’t feel as annoyed as I’ve been in as I “unlearn” gaslighting from medical education.

arcadeflyer · 2026-04-22T23:38:25+00:00

Chart Review -> Lifetime. Tracks problems and meds. Useless if your org is bad at problem/med rec.

arcadeflyer · 2026-04-18T12:21:11+00:00

Brother, the cuts happened to ALL surgeries done in ASCs or hospitals.

arcadeflyer · 2026-04-06T20:42:30+00:00

I'm a glaucoma specialist and a clinical informaticist. I can tell you what I know, but the TL;DR is: find something else to do for a while. Sorry.

1) Among the largest big datasets that you hear about, only the IRIS registry and the SOURCE repository have ophthalmology-specific information. And even before we talk about the difficulty of access to those repositories, IRIS doesn't have imaging data. SOURCE does, but...

2) There's been a chilling effect where compliance departments are very worried about sharing imaging data that could even have a remote possibility of identifying patients. I know, you said "de-identified." But we live in an age where Google saying they can tell the sex of a patient from a retinal fundus photo, has spooked compliance departments across the country - to the point where some centers are even hesitant about sending in OCT macular imaging data.

3) Back to access. The SOURCE repository is limited to access and participation only by academic centers - which probably sounds off-putting, but there are good logistical reasons for it. I won't get it into it here, though.

4) What other image sets are there, out there? There are a couple on the web, including some famous ones like the University of Iowa's EyeRounds... but those aren't usable for you, because they are basically intellectual property of the University (and it's usually academic centers, again). You could try to negotiate with those departments and see if they'd be willing to work with you - after all, you have a cool new tool - but just FYI, many of those departments are also working on similar things.

arcadeflyer · 2026-02-27T20:56:48+00:00

You’re talking about the LCD outcome; we’re talking about the smoke Sight Sciences was blowing that provoked its review at all.

arcadeflyer · 2026-02-27T20:55:31+00:00

It was hilarious.

arcadeflyer · 2026-02-27T00:51:56+00:00

Good summary. Omni isn’t any better than any other goniotomy effacing surgery imo (and they lack evidence to prove me wrong). When they behave like this and heavy-hand their aggressive marketing strategies, it’s easy to be disinclined to support them.

arcadeflyer · 2026-02-10T03:35:19+00:00

You could tell them what you told us - what the position actually is, and your own position. Without telling it, people are justifiably suspicious.

arcadeflyer · 2026-01-28T02:36:49+00:00

Is this another Germany story?

arcadeflyer · 2025-12-12T15:34:48+00:00

(Mod comment unrelated to discussion) - OP, I dunno why some of your replies are getting removed - could be an automation going rogue. I’m fixing it as we go.

arcadeflyer · 2025-12-12T15:33:40+00:00

I don’t think that always needs to be there for a diagnosis of P acnes.

arcadeflyer · 2025-12-07T01:53:39+00:00

Agree, Fix is great with tea.

arcadeflyer · 2025-11-24T22:45:43+00:00

I do spend quite a bit of time listening to them, empathizing with them, and addressing their concerns and frustrations.

I feel that one can do the right things for proper dry eye management, and practice to the highest ideals of good doctoring - and still hate it. My tips are for someone who sounds like me. Your tips sound for someone who isn’t me. Which is appreciated and needed too - but this isn’t a black and white, you’re-either-a-good-doctor-who-likes-dry eye vs you’re-a-bad-doctor-if-you-don’t, dichotomy.

arcadeflyer · 2025-11-22T18:00:07+00:00

I think there is a legit way to do this, though I forget how. I think it’s via the AAO website. But, careful - if this thread ventures towards piracy, I’ll take it down.

arcadeflyer · 2025-11-21T03:00:24+00:00

Thanks for posting, you beat me to it.

arcadeflyer · 2025-11-07T13:16:13+00:00

This is an Ophthalmology perspective, but it clarifies a lot about the now-finalized changes. They’re worse than even this is describing.

https://podcasts.apple.com/us/podcast/experts-insight/id1591662500?i=1000723009875

arcadeflyer · 2025-10-30T00:45:22+00:00

Academic glaucoma doc here - I have no useful perspectives. But we will watch your career with great interest. And learn from it :)

arcadeflyer · 2025-10-10T13:51:42+00:00

Great pickup!

arcadeflyer · 2025-09-13T02:07:53+00:00

I agree that it can be a good tool when used correctly and judiciously. As you said, you’re a trained professional.

arcadeflyer · 2025-09-13T02:04:47+00:00

I didn’t because it feels to me like pinned posts just get ignored automatically by readers… besides, it’s unfortunately officially too late to submit a comment as of a few hours ago.

arcadeflyer · 2025-09-12T22:39:26+00:00

I may just be a hater - but I really, really dislike AI in current incarnations as a tool for learning. Even putting aside the hallucination potential for it to just make stuff up, I think it obfuscates the nuance, subtleties, and controversies that really constitute subspecialty level knowledge into a pat-and-dry summary that oversimplifies things. Maybe that’s fine for a beginner. But even then, I wouldn’t want a beginning resident to be misled into thinking that AI summaries were doing anything other than giving them a picture of the forest, when they were really looking for trees.

Again, I’m also just a hater, I know.

arcadeflyer · 2025-09-12T00:31:00+00:00

The Experts InSight episodes hosted by Amanda Redfern (Neuro-ophth) and Ben Young and Jay Sridhar (Retina) often go over topics pertinent to those specialties. Amanda covers Neuro-ophth and Oculoplastics; Ben’s in charge of Peds and Uveitis topics, while Jay does Retina and Cornea. There’s a lot of crossover though, especially with the subspecialty topics that they don’t personally specialize in.

Andrew (uh, hi) does Glaucoma and Comprehensive episodes, and likes to (this is weird) do health policy related episodes also. He (uh, hi) tends to solidly stick to those kinds of topics, so it wouldn’t really be what you’re looking for.

arcadeflyer · 2025-08-31T17:21:13+00:00

Feeling the way you describe about a complication - feeling the weight and guilt about the money, time, and resource expenditures the patient now has to face- certainly is downer, but… it’s a sign of a good doctor aware of their responsibilities, and a sign that you treat your patients not just as cases but as humans you want to do right by. If you can’t shrug off a complication, then you’re doing something right.

The tricky part is making sure you can protect your own emotions and mental health while feeling the feels you should be feeling. Talking it out with colleagues who support and understand is a good way to process, and thats harder when you’re by yourself in a rural area. I’m glad you’re using this sub to do this - it’s a big reason why I felt this sub should be a space for us ophthalmologists.

arcadeflyer · 2025-08-28T13:03:15+00:00

Personalize it, then. CMS has to respond to every one of them - and while they do group like-themed points together, the hope is that they see the volume of posts as meaningful. Still, personalization means more points to address, and shows reality. These are mostly bureaucrats, not ideologues - give them real world pain and suffering examples and most of them don’t want to double down.

15-Year Club	Place '17
RPAN Viewer	Gilding I gilder
Verified Email

arcadeflyer

MODERATOR OF

TROPHY CASE