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Objective This article determines the prevalence of physician parents among ophthalmology residency applications.

Purpose Incarcerated patients represent a uniquely vulnerable population in the outpatient ophthalmology setting, and the reliability of follow-up in this group is undetermined. Methods This was a retrospective, observational chart review of consecutive incarcerated patients evaluated at the ophthalmology clinic of a single academic medical center between July 2012 and September 2016. For each encounter the following were recorded: patient age, gender, incarcerated status at the time of encounter (a subset of patients had encounters before/after incarceration), interventions performed, follow-up interval requested, urgency of follow-up, and actual time to subsequent follow-up. Primary outcome measures were no-show rate and timeliness, which was defined as follow-up within 1.5× the requested period. Results There were 489 patients included during the study period, representing a total of 2,014 clinical encounters. Of the 489 patients, 189 (38.7%) were seen once. Of the remaining 300 patients with more than one encounter, 184 (61.3%) ultimately did not return and only 24 (8%) were always on time for every encounter. Of 1,747 encounters with specific follow-up requested, 1,072 were considered timely (61.3%). Factors significantly associated with subsequent loss to follow-up include whether a procedure was performed (p

Purpose There are no uniform standards to inform patients to what extent trainees are involved in their care. This may lead to inequities in sharing the potential risks associated with receiving care in an academic setting. This study was designed to determine patients' level of knowledge of the medical education system, their preferences regarding who provides treatment, and how strongly they would react if they found certain members of the care team were involved without their consent. Design This study is a prospective, nonrandomized, and observational survey of a convenience sample. Methods Consecutive patients referred for a cataract surgery evaluation to the Veteran's Affairs Ophthalmology Department in Lexington, KY between 2015 and 2017 were recruited. Results Ninety-six of 113 eligible patients (response rate 85%) completed the survey. About 33, 69, 33, and 49% of respondents recognized an intern, resident, fellow, and attending as a doctor, respectively. Three quarters (76.1%) felt it was important to be asked permission in advance of a resident assisting or performing surgery, and 21% indicated they would go elsewhere if they found that a resident would assist in, or perform their surgery. About 21, 21, and 58% of respondents would be upset or very upset if a resident was in the operating room, assisted in, or performed surgery without their permission, respectively. Conclusion This survey demonstrates an overall willingness of this specific, largely confined patient population to receive supervised care from training physicians provided they are fully informed and educated on the role of those involved in their care.

Abstract Objective The main objective of the article is to determine the relative direct financial cost and benefit of an advanced practice provider (APP), optometrist, and faculty ophthalmologist compared with an ophthalmology resident. Design Single center cost–benefit financial analysis. Methods The direct total expenses, including mean salary and benefits; the cost/week, based upon calculated hours worked; and net revenue, based upon technical collections subtracted from total expenses were collected for all APPs, optometrists, faculty ophthalmologists, and ophthalmology residents at the University of Kentucky for the 2016 to 2017 academic year. Optometry and ophthalmology faculty collections were adjusted for clinical full-time equivalents. Results Total annual mean salary and benefits for 242 APPs, 4 optometrists, 17 faculty ophthalmologists, and 9 ophthalmology residents were $126,797, $117,021, $338,233, and $71,210, respectively. Assuming a 50-hour-work week, the calculated hourly costs were $48.77, $45.01, $130.09, and $27.39, respectively. Ophthalmology residents do not directly generate work relative value units or collections. On this basis, the net annual revenues were −$62,729, $122,757, $566,119, and −$71,210, respectively. Conclusions Ophthalmology residents are relatively inexpensive compared with potential substitute health care providers, although they are unable to generate direct revenue. Indirect costs and benefits are likely substantial, but currently incalculable. More candid analyses of the role and financial impact of trainees in health care are needed.

Abstract Purpose To estimate the cost of the match process for all ophthalmology applicants and the departmental costs at the University of Kentucky during the 2017 to 2018 match cycle. Design Financial analysis. Methods Using the available national match statistics for the 2017 to 2018 ophthalmology residency match and the mean of all residency interview costs available in the literature, the estimated mean and total match costs were calculated for all applicants, including application fees and interviews. Program costs were estimated based on direct interview costs, lost productivity, and fixed costs. Results Of 625 applicants, 475 matched into an ophthalmology residency position in 2017 to 2018. The mean estimated cost was US$6,613 for matched applicants, and all applicants spent US$4,646,950 on the match in aggregate. Our department spent an estimated US$179,327 over four interview days with 12 faculty volunteers, or an average of US$3,736 per each of 48 interviewed applicants. Conclusions and Relevance Matching into an ophthalmology residency position is expensive not only for the applicant but also the program. Reforms to the process would likely be beneficial to both parties.