A day in the life
Let chaos commence
At this point, I must underline the peculiar character of some of our patients (of course not all, luckily!): loud, aggressive and unpunctual. Since our schedule is very tight (frequent pathologies, many patients, necessity to keep short waiting lists, long and frequent follow-ups), it is imperative to start the day in a rush, otherwise we will very quickly begin to accumulate a delay in appointments, and the patients will start complaining.
We know perfectly well that some patients will have met a traffic jam while others will have missed the bus, so we generally have a schedule of overbooking to compensate for late, ill or absent patients.
Usually a bulk of fluorescein cases, OCT patients, laser photocoagulation cases and routine fundi will stream through our clinic. During the morning we see at least 25 to 30 patients. We do, however, allocate specific days for PDT treatments (usually one day a week), or intraocular injections of anti-angiogenic agents or triamcinolone (twice a week).
Surgical procedures are usually performed twice a week, during which time I bounce in and out of theatre; going from one patient to the next, performing surgery and consultations.
Mornings in the clinic are generally very stressful and it is absolutely essential that the team and I are constantly focused and efficient yet calm. There is never enough time in the day and the last thing that I want to deal with is patients complaining because of the long waiting time. I often hear, 'Doctor, I had an appointment at 10 and it is now 10.30, when will it be my turn?' and 'I want to know exactly how long I must wait.' My patients rarely consider that each person I see is different and the time it takes to treat an extrafoveal small CNV is not the same as that required to perform a retinal panphotocoagulation.
During the morning, most of us do manage a very short coffee break but only one or two of us at a time, so as not to slow down the rate of patient flow.