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Cover Focus | July/August 2017

20 Questions: Martin Bechmann, MD

Getting to Know You

Currently, what book are you reading, what TV series are you binge-watching, what app do you use the most, and where do you get your daily news?

Book: I am reading Mrs. Hemingway by Naomi Wood, as I am a great fan of Mr. Hemingway—Ernest, that is.

TV series: Game of Thrones.

App: WhatsApp.

Daily news: A mix of radio; FAZ.NET, the news app of the Frankfurter Allgemeine Zeitung; and, on the weekend, the physical newspaper.

What is something in your life you would happily do again, and what is something you would never do again?

Happily do again: Playing guitar in a school band.

Never do again: Cross a glacier without appropriate protection. In 2012, I went on a glacier tour in the Alps. Quite close to us there was an accident in which two family members fell into a crevasse and one of them died. I never thought beforehand that the tour we were on was so dangerous.

What are three places at the top of your bucket list?

No. 1: Top of the Matterhorn in the Swiss Alps.

No. 2: Singapore.

No. 3: Australia.

If you had to donate half your income tomorrow, to whom would you give it?

To my sister-in-law, who is a social worker responsible for funding many projects to help underprivileged kids.

If there is one high-risk thing that you have not done but remain curious about, what is it?


Your Thoughts on Ophthalmology

What is the health care landscape like in your country?

The German health care system is bureaucratic, with many rules that are sometimes conflicting. In ophthalmology specifically, rules concerning intravitreal injections are confusing and are changing nearly every month. Another big issue is collaboration between doctors, especially if the doctors work as employees in the same practice. There are many, sometimes inconsistent, rules regarding this topic, and this can make practice development quite difficult.

How enthusiastic are you about the future of ophthalmology?

I am very enthusiastic because we have seen so many great innovations in the past 20 years, and there are even more to come.

What products in the pipeline excite you the most?

The combination of laser-assisted cataract surgery (LACS) and presbyopic IOLs. We witnessed the evolution of small incision lenticule extraction (SMILE) after femtosecond LASIK (femto-LASIK). Maybe LACS will enable us to develop new IOL models to address presbyopia even better than we now can.

What was your most memorable moment in surgery?

My first perfectly centered scleral-fixated IOL was my most memorable moment in a positive way, and my first dropped nucleus was the most memorable in a negative way.

What recent studies or technologies have influenced your surgical technique?

The ESCRS study of prophylaxis of postoperative endophthalmitis has had perhaps the greatest influence among recent studies.1,2 We have had only one case of endophthalmitis in more than 10,000 procedures after adopting the use of intracameral cefuroxime. Regarding technologies, in laser vision correction, the transition from femto-LASIK to the SMILE technique has been a significant advance.

What was the toughest decision you have had to make as an ophthalmologist?

The decision whether to pursue an academic career at a university or to start a private practice. Although I enjoyed working in a university hospital, I decided to enter private practice because I wanted to be independent and self-contained. To run my own enterprise was an exciting experience from the first moment. What I have learned above all is that there are so many chances that come along, and you just have to take them and never be afraid of failure.

How has ophthalmology changed since you started practicing?

The change in the field has been tremendous. The introduction of femtosecond laser technology has revolutionized anterior segment surgery, and the availability of intravitreal treatments and OCT have been great advances in the posterior segment.

What advice can you offer the new generation of ophthalmologists?

With all the new diagnostic devices available, never underestimate the value of the slit lamp. It is still the most important device to tell us about the eye. The slit-lamp examination gives us direct insight to both the pathology and the beauty of the eye.

If you could trade lives with a fellow ophthalmologist for 1 day, who would it be and why?

It would be my colleague and friend Siegfried Priglinger, MD, now in Linz, Austria. During our fellowship at the University Eye Hospital Munich, we both had the same goals; however, we chose different paths. His was academic and posterior segment, mine was private practice and anterior segment. I guess you could say that switching lives with him for 1 day would give me the opportunity to see what life would have been like if I had chosen academics.

If you were forced to limit your practice of ophthalmology to one procedure, what procedure would you choose and why?

It would be cataract surgery, which is still fascinating to me because of its beauty and its effectiveness.

Your Thoughts on Business

What differentiates your practice from those of your competitors?

Our practice is very patient-oriented. We try to be personal and to maintain the highest possible standards in both medicine and service.

How do you feel about private equity, and is there a place for it in ophthalmology?

In my opinion it is unstoppable, whether we like the idea or not.

How do you approach marketing your practice and specific procedures you offer?

Marketing is a crucial element of practice success today. We founded a marketing company ourselves to develop the Smile Eyes brand. This marketing platform is used by our own three clinics and also by other facilities in a franchise model.

How do you or your practice keep staff members happy?

By being friendly, honest, and fair to one another.

What is your end game?

I would like to work on a full-time basis until I reach age 60 and then reduce my workload gradually.

1. Seal DV, Barry P, Gettinby G, etal, for the ESCRS Endophthalmitis Study Group. ESCRS study of prophylaxis of postoperative endophthalmitis after cataract surgery: Case for a European multicenter study. J Cataract Refract Surg. 2006;32(3):396-406.

2. Barry P, Seal DV, Gettinby G, et al, for the ESCRS Endophthalmitis Study Group. ESCRS study of prophylaxis of postoperative endophthalmitis after cataract surgery: Preliminary report of principal results from a European multicenter study.J Cataract Refract Surg. 2006;32(3):407-410.