5 Questions with Marco E.M.Bianchetti,MD

1.What has been the most rewarding aspect of serving as president of the SOG-SSO?
First, I must share that being president of the SOG-SSO was not a goal I set out to achieve for my ophthalmic career. Even now, I feel that this position is more of a burden than a reward. This does not mean that I do not want to do this activity. I do my best to keep our beautiful profession as interesting, independent, and self-responsible as possible.

We are exposed to many external pressures, particularly from politics, industry, and economics. Twenty years ago, we laughed about medicine in the communist countries that struggled with diminishing financial resources and tried to economize as much as possible through standardized and automated procedures. We still remember well the eye factories of Svyatoslav N. Fyodorov, MD, where each doctor performed one specific task. Nowadays, in Western countries, medicine is moving in exactly the same direction. Innovations rarely come from the United States or Europe; more often they come from developing countries.

The economy and, to a great extent, the overregulation of medicine, hinder the development of our profession. Therefore, the most rewarding aspects of my time as president and as member of the council of the SOG-SSO are the decisions we have made to stop some of the regulating projects to maintain more freedom in how we treat our patients.

2.What do you hope to accomplish during your term?
An important issue for the near future is to keep Swiss ophthalmology out of managed-care systems. I believe that a patient must have free access to his or her ophthalmologist. It does not make sense for a patient to visit a general practitioner before going to an ophthalmologist. This makes the system more expensive. Another important issue for the upcoming months is the future of TarMed, the tariff structure through which all physicians throughout Switzerland are paid. General practitioners want to raise their incomes by reducing the payments to specialists such as ophthalmologists. Careful negotiation will be key.

3.What is unique about the outpatient eye clinic that you founded?
When we opened our doors in 1994, the Augentagesklinik Sursee was the first eye clinic in Switzerland based solely on outpatient surgery. We were warned that this model would not be successful in a rural region like Sursee. This was not the case. People were happy that they could be treated on an outpatient basis by their own ophthalmologist, rather than far from home at a hospital.

Since 1994, our clinic has grown to a network of 12 ophthalmologists in the central Swiss area. In addition to performing cataract procedures at our clinic, each physician practices a subspecialty. Also, we have a private-public partnership with Augenlaserzentrum Zentralschweiz in Lucerne in the field of refractive surgery. To the best of my knowledge, no other outpatient clinic in Europe functions this way.

4.What was your most memorable experience in surgery?
There are so many rewarding moments in our profession that I cannot identify one experience as the most memorable. It is always a beautiful moment when patients come back to the clinic the day after cataract surgery and are enthusiastic about their newly recovered sight. I think this is one of the great advantages of working in a more rural area. When people finally come to our practice, their cataract is advanced. The difference in their sight after surgery is striking to them.

5.What is something most people are surprised to learn about you?
Even though the Augentagesklinik Sursee, which I founded with three colleagues, has been a success, I do not view myself as, or want to be viewed as, a businessman. The purpose of the clinic is to create the environment for doctors and surgeons to provide our patients with the best possible service. From my perspective, it is a pity that economics is a driving force in the practice of medicine. The main question we should be concerned with is not how much a treatment will cost, but what the profit is in quality of life for our patients. Ophthalmology holds a strong position in this regard because it can offer patients a high return on quality of life.