RT Asks: Have you ever accidentally given a patient an over-optimistic prognosis? How did you handle the situation?

Yes, unfortunately. The patient had recovered good VA despite an oil fill after multiple surgeries for retinal detachment. Due to subsequent cataract progression, combined surgery was performed to remove the cataract and oil, but the patient's VA did not improve as anticipated. In retrospect, I was over-optimistic, deviating from the adage of “underpromise and overdeliver” that I usually adhere to. Yet the reality is that managing expectations can be tricky, and a misalignment between prognosis and outcome can occasionally occur. I handled this particular situation by choosing to spend chair time listening. I expressed that I shared his disappointment. I have found that sincerity and empathy can be more meaningful than scientific explanations; they are the foundation of the patient-doctor relationship.

—Allen Chiang, MD

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