I thought it might be interesting to do a series of profiles on top glaucoma specialists around the world. I was inspired to start this because of my recent visit with Dr. Robert Ritch. He is certainly one of the top glaucoma specialists in the world from a variety of points of view. He is highly respected by his peers and he has been voted "Best Doctor" many times by his patients.
In this article I'll share my views on the qualities that I think make Dr. Ritch such an outstanding physician. I would also love to hear from others with glaucoma who have found a great physician and would like to tell us about this glaucoma specialist. Please leave your comments below or email me directly (at fiteyes.com).
Like many of us past 40 years of age, I've seen plenty of doctors in my lifetime! It doesn't hurt that I have a background in motorcycle racing, inline skating, windsurfing and other extreme sports. I've been to many types of physicians. I have also worked in a doctor's office and I have some close friendships with medical doctors. And now, with glaucoma, I'm seeing doctors more than ever. Even with all these experiences, Dr. Ritch stands out as a truly extraordinary physician. Here are some of his qualities I appreciate the most:
- Dr. Ritch communicates very well. He answers most of my questions - and I have a lot of questions! In contrast, think about how difficult it often is to get answer to our questions from our doctors. I believe it is a common experience to go for a visit with several questions in mind and come away from the visit without answers. And often the only option available is to wait several months until the next visit and go prepared with a written list hoping to be able to corner the doctor long enough to get satisfactory answers. What makes Dr. Ritch stand out is that he will reply to questions via email. I don't have to wait until the next visit to get a response. In fact, there are probably periods of time where I have asked Dr. Ritch new questions every single day -- and he has actually replied to me! Granted, his replies are often only a single sentence (or even just a few words), but he cares enough to reply with helpful information whenever he can. I've even gotten replies from him while he was in the middle of traveling half way around the world (that's how I got the picture of him in Myanmar, for example). The fact that he puts up with all my questions qualifies Dr. Ritch as an exceptionally caring and interested physician. But, as busy as he is, he even goes so far as to respond to select questions from the general public on a glaucoma support group.
- The fact that Dr. Ritch uses email and the Internet makes him very accessible to his patients (and even the general public, as I mentioned above). I wish every one of my physicians used email and would communicate with me via email. In my opinion, having this channel of communication open with my doctor changes everything. My father-in-law was looking for a physician in Miami, FL and he asked for my help. The first thing I did was write an introduction, look up the top physicians in Miami on the Internet and send them the introduction via email asking about their interest in having my father-in-law as a new patient. The physicians who did not respond to the email were eliminated from consideration because my father-in-law feels the same way I do about the value of email communication with one's physician.
- Dr. Ritch educates patients like me who ask probing questions. This is facilitated by the good communication, of course. But I appreciate the fact that Dr. Ritch doesn't dismiss my questions or comments when they are challenging in one way or another. I have had physicians get mad at me. One example that stands out in my mind is when I was sitting in an ophthalmic exam chair and the doctor was standing beside me. He has just checked my eye pressure and I asked him about using vitamin C to lower intraocular pressure. I also mentioned that I had read some studies on this subject that were supportive of the concept. The doctor got so upset that his face turned red. While making the point that I was an idiot to even consider the possibility of using vitamin C to lower my eye pressure, he was pounding on his thighs with his clenched fists. With his red face and clenched fists, I felt like he wanted to punch me. Obviously, that's an extreme example of a doctor who doesn't tolerate alternative points of view. However, I know I can ask challenging questions and I often express disagreement with my doctors. Many doctors don't take that well. I actually don't know for sure if I have ever made Dr. Ritch angry, but he has never responded with ego or negative emotion that I can sense. On the contrary, whenever he has additional information to provide he does his best to help educate me with solid information. My understanding of my health condition (glaucoma) has grown by leaps and bounds as a result of Dr. Ritch's willingness to help educate me via answering my questions and providing me with educational materials.
- Dr. Ritch tolerates my views when I disagree with him. For example, I disagree with some of the opinions expressed in a paper on weight lifting and intraocular pressure that Dr. Ritch helped author. I have had conversations with Dr. Ritch (as well as Dr. Vieira, the lead author) and they have both treated me with respect even though I'm probably a bit too opinionated about weight lifting and intraocular pressure.
- Dr. Ritch is a sincere patient advocate. He has surprised me a couple times by catching a small offhand remark in an email and then asking me about my situation. Mind you, this was not him responding to one of my questions -- this was Dr. Ritch noticing something and asking me about it or offering some helpful advice. Once this was related to my health insurance. I was quite surprised that he took so much interest in my personal health insurance problem. Don't misunderstand me - Dr. Ritch is far too busy to get deeply involved in my health insurance, but the fact that he cared enough to send me an email on the issue was very surprising and it underscores the fact that he is a strong patient advocate.
- Dr. Ritch wants to deliver the absolute best care and service to his patients. I assume most physicians feel this way, but some seem to care more than others. Dr. Ritch wants to make sure you leave his office feeling that you got the very best care, and in my opinion he succeeds.
- Dr. Ritch is very knowledgeable. He is widely regarded as one of the top experts in his field (glaucoma). I personally want a physician who is an expert and I'm willing to go out of my way to find such people. For example, I was a patient of Dr. Robert F. Cathcart III, one of the world's top experts on clinical uses of vitamin C, before he retired. I find it interesting that (in my experience) the physicians who are the top experts in their fields often happen to be the ones who will communicate more with their patients. My experience with run-of-the-mill doctors is that they build a fortress that prevents any patient from contacting them outside of a face-to-face appointment (except for emergencies). As a patient, having a very knowledgeable doctor who will also communicate with me is ideal.
- I like the fact that Dr. Ritch is research-oriented. He is current with all the latest knowledge in the field of glaucoma -- in fact, he and his team often help create that cutting edge knowledge.
- I also like the fact that Dr. Ritch is teaching-oriented. Dr. Ritch has trained 100 clinical and research fellows, many of whom occupy academic positions worldwide. Knowing that my doctor is teaching other glaucoma specialists gives me confidence that he is on his toes. The last time I was in Dr. Ritch's office he quizzed a Fellow about details of the structure and metabolism of a particular glaucoma drug. Dr. Ritch knew the details and he wanted his Fellow to know the details. In contrast, I remember when I asked my local ophthalmologist a question about the biochemical pathways of prostaglandin metabolism (in the context of a question about the prostaglandin analogue glaucoma drugs). He admitted that he had forgotten the details of prostaglandin metabolism. I prefer to have a doctor who doesn't forget those details and teaching others is a great way to ensure that.
- Dr. Ritch is well-respected in his profession and he gives a lot back. He has worked and lectured extensively at the International level and has organized numerous symposia and conferences both in the United States and abroad. He is a member of the International Task Force of the American Telemedicine Association and the International Assistance Steering Committee of the American Academy of Ophthalmology, from which he has received the Senior Honor Award. He has organized meetings, established teaching programs and helped to modernize ophthalmology in Thailand, Malaysia, the Philippines, Laos, and Myanmar.
- Dr. Ritch is open minded. This is a very important quality for me. I'm open to a lot of alternatives in medicine. I like Ayurveda and Traditional Chinese Medicine. I like orthomolecular medicine, homeopathy, and several other systems. It continues to amaze me that Dr. Ritch is open minded enough to tolerate my comments about subjects that many members of the American Medical Association consider taboo. I really appreciate his tolerance and open mindedness.
Using my comments about non-mainstream medical systems as my segue, I'll mention one thing I would change about Dr. Ritch if I could -- and if the world was a perfect place!
- Dr. Ritch is a product of the western allopathic medical system. This competitive, macho-oriented system creates doctors who routinely push themselves through fatigue and lack of sleep, who have little concept of a healthy, balanced lifestyle, and who advance to the highest levels in the field only after proving they can endure a substantial amount of hardship. This system doesn't create caregivers who are in tune with the subtle aspects of health in the same way that someone trained in Ayurveda would be. In some ways, Dr. Ritch is the epitome of success in the western medical system. And he expects his Fellows to endure the traditional hardships associated with a very tough medical education, including sleep deprivation, financial burden and unbalanced lifestyle. These are some of the things Dr. Ritch had to go through to reach the level of success he has achieved, and he expects his students to endure the same. In a perfect world, I would create a version of Dr. Ritch who had all the real Dr. Ritch's good qualities and who was also an Ayurvedic Vaidya with the ability to read the most subtle aspects of one's health through pulse diagnosis. In my perfect world I would also create an ideal version of Dr. Ritch who lived a very balanced lifestyle and who didn't ever deprive himself of sleep or work 23 hours in a day - but then I probably wouldn't get any answers to my many emails! Ah, that perfect world is such a hard thing to achieve!
Now that I've written this, Dr. Ritch probably has the right to use me to illustrate some of the qualities that he likes and dislikes in patients. Unfortunately, I'm sure that I will illustrate many of the negative qualities that he prefers not to deal with in an ideal patient. Knowing that this is absolutely true, I can only feel even greater appreciation for the fact that Dr. Ritch continues to expend so much energy to help educate me about my health condition and to help me manage it the best it can be managed.
Here is Dr. Ritch's contact information. If you ask him nicely, I'm sure he'll give you his personal email address too.
Robert Ritch, MD
Professor of Clinical Ophthalmology
Chief, Glaucoma Service
The New York Eye and Ear Infirmary
310 East 14th Street
New York, NY 10003
Medical Director and
Chairman, Scientific Advisory Board
The Glaucoma Foundation