Pediatric Eye
Physicians and Surgeons has built a successful
practice specializing
in Kids.
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When Martin C. Wilson, MD, finished
his fellowship training at the Children’s Hospital
of Philadelphia (CHOP), he was asked to stay on as
faculty. While it was a huge honor to be a part of
such a prestigious hospital, Wilson had his own dreams
of starting a private practice. After eight years with
CHOP, those dreams became a reality.
“It’s a great hospital and I
had a great position, but I always wanted to have my
own practice,” says Wilson of Pediatric Eye
Physicians and Surgeons in Paoli, Pa. “Since opening
[in 2000], it’s been a lot of fun. There’s
definitely a fun side to being in private practice and
I’ve really enjoyed it.”
One of those enjoyable aspects for
Wilson was selecting the right equipment and putting
thought into the way the office was not only
decorated, but laid out. Wilson wanted to be sure he
tailored everything to kids. The waiting room has toys
to keep active kids occupied and the exam rooms are
kid-friendly and even complete with a child-sized exam
chair and other age-appropriate equipment. |
But in the end, a successful appointment
comes down to the physician and Wilson has mastered the
ability to keep kids engaged during an exam. He comes
prepared with toys in his pocket and an upbeat attitude with
each patient—no matter how many he may have seen that day.
Wilson knows that from the minute he walks in the door, his
young patient is already deciding whether he or she is
comfortable or not—and that time frame to win them over
can be short. That’s why Wilson directs his initial
attention to the child.
“It’s important to pay close
attention to the child and to talk to them directly,”
explains Wilson. “That’s something that kids appreciate.
There’s this limited opportunity to make a connection with
the child so I make sure they know I’m there for them. You
always have an opportunity to talk to the parent later, but
you want to make sure you win over their kid. Parents are
typically understanding of that fact. They’re okay with
you talking to the child as the patient, and explaining
things to them later.”
The ability to distract the child with a
toy or some other object that will hold their attention is
one of the keys to success, says Wilson. That’s why he
goes right into action the minute he enters an exam room.
“The reality is that the majority of what we do in the
office is not really painful or uncomfortable—so it doesn’t
have to be frightening,” he says. “If you can keep the
child distracted and keep them busy, then they don’t even
have the time to think about being scared. But if you stop
too long and talk to the parents, you may lose that window
of opportunity. As the child waits they start to get antsy
and look around at all the equipment and may start to get
scared.”
And even though he loved his job at CHOP,
Wilson also admits that keeping kids happy is easier in
private practice. “At a large and prestigious facility
like CHOP, patients may end up waiting longer and also tend
to see a range of professionals. The patient is visited by
the medical student, then the resident, then the fellow and
by the time you’re in the room, the child’s attention
span may be used up and they’re falling apart,” explains
Wilson. “That’s been one of the benefits of a private
practice. I’m able to limit the waiting time, which helps
make it a comfortable and a fun place.”
Wilson loves working with kids so much
that he finds each day in the office to bring new joys. But
that’s not to say it’s without its unique challenges.
One of the things that Wilson says is a special challenge to
working with kids is keeping simple procedures, simple.
Something that would be a quick fix on an adult can turn
into a larger scale procedure for a young child. “If you
have an adult patient with a stye you need to drain, it’s
a simple in-office procedure,” says Wilson. “But with a
child, as soon as you pull out a needle, you’ve lost the
child’s ability to stay calm. A lot of times things that
could have been done in the office for an adult have to be
done in an operating room and with anesthesia for a child.”
Another example, says Wilson, is when a
child comes in with a foreign body on their cornea. “For
an adult, you’d just ask them to hold still and you’d
take it off,” he says. “But working with a young patient
who has a foreign body on their cornea is when you’ll see
the biggest challenge to your skills of distracting. While
you may only need 15 seconds of cooperation, those 15
seconds may be impossible to achieve. You may try everything
possible but still wind up having to put them under
anesthesia and take it off in the operating room. That’s
tough knowing it’s a 15 second procedure turned into such
a big deal, but it’s just one of the challenges that comes
with working with kids.”
While Wilson specializes in kids, he does
see adult patients as well. Like general practices that
sometimes get the occasional young patient, Wilson has the
opposite scenario. “In most ophthalmology practices you
have an adult office that you try to make work for kids,”
he says. “We have a kids’ office that we try to make
work for adults. I do end up getting a lot of adult eye
muscle surgery cases since muscle surgery is a common
procedure for a pediatric surgeon. Other local
ophthalmologists refer their patients to me. It’s funny to
see the patients’ reactions when they come in, but most
end up liking it. I always tell the patient that I’m used
to seeing kids and I may treat them like a kid; But they
never seem to mind and in fact, most patients seem to feel
comfortable and at ease here.”
Wilson says he’s gotten so used to
seeing kids that he does find adults more challenging. Most
young patients only have one chief complaint but as adult
patients age, their list of health concerns often grow. “When
we get an 80-year-old patient in here who has a long list of
printed medication it’s a little overwhelming,” he says.
“Most kids are healthy with just a singular eye problem
like itching or pain. But we do have some cases where kids
have complex medical issues, as well.”
As someone who’s really built his
expertise working with kids, Wilson offers the following
advice to his fellow doctors who may see the occasional
young patient: “If it’s not something you’re used to,
it can be scary or intimidating, but try to look at it as a
fun opportunity. Working with kids can be a real joy. If you
try to look at it that way, having a young patient come in
may be the high point of your day!”
