Dear Sir,
I would like to commend Dr. Honavar on his tactful and timely editorial detailing the departure from Oslerian bedside medicine in modern clinical medicine and ophthalmology.[1]
I agree that the implementation of electronic health record (EHR) systems, a limited emphasis on thorough clinical examination in super-specialized disciplines, and the ever-increasing role of advanced ophthalmic imaging have all served as distractions from humanistic “high-touch“ medicine.[2] Dr. William Osler's legacy and Sir Luke Fildes' “The Doctor“ illustration serve as compelling allegories of holistic care in a new age of ophthalmology around the world.
Drs. Das and Panda aptly describe the future of eye care as requiring a combination of traditional skill-based care and empathy in addition to the contemporary technologies of analytics.[3] This paradigm is relevant in the contexts of diagnostic accuracy, holistic and humanistic patient-centered care, and especially the medical training of competent and benevolent physician ophthalmologists.
I believe a fervent desire to maintain human-centered care persists among practicing and in-training ophthalmologists. Several surveys analyzing resident reflections on their education have revealed a significant desire for case presentation with demonstration as a primary learning methodology as opposed to didactic lessons and monologues.[4] Residents also consistently expressed interest in increased hands-on experience in the clinical setting utilizing physical diagnostic aids such as the 90D, 78D, gonioscopy, applanation tonometry, perimetry, and the indirect ophthalmoscope.[5] Human interaction and hands-on clinical evaluation are the crux of medical beneficence, and these findings are consistent with students' wishes to capitalize on this aspect of medical training.
As Dr. Hanover duteously points out, it is students, teachers, and practicing clinicians who will be responsible for dissecting out this balance between valuable advances in technology and traditional clinical excellence.
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Conflicts of interest
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References
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