Clinical Scorecard: Managing the Growing Emergency-Care Demands in Ophthalmology: A Closer Look at Call Coverage

At a Glance

Key Highlights

• Feng et al. reported statistically significant upward trends from 2013 through 2024 in ophthalmology transfer requests, completed transfers, inpatient consultations, and emergency department consultations at US academic centers; figures differed across institutions.
• The author identifies factors contributing to fewer ophthalmologists accepting call, including compensation, equipment, medicolegal risk, hospital privileges, subspecialization, employer policies, and work-life balance concerns.
• Patients at hospitals without ophthalmology coverage may need transfer, sometimes many miles away. The author states that many transfers ultimately prove unnecessary and that delays when transfer is warranted may adversely affect ocular health.
• The author states that excessive workload on trainees harms education and well-being and may contribute to burnout.
• The AAO initiative brought emergency- and trauma-related educational materials together and introduced webinars and tools intended to facilitate taking call.

Guideline-Based Recommendations

Diagnosis

Management

• The author reports that AAO members can access emergency- and trauma-related resources, including quick-reference EyeWiki and the Wills Eye Manual, through the education app.
• The author reports that AAO webinars address call-related ethics, malpractice concerns, and management of particular emergency cases.
• The author reports that AAO tools support discussions with hospital administrators about compensation, response-time requirements, equipment, supplies, staff training, and operating-room access for emergent cases.

Monitoring & Follow-up

• The author states that Feng et al.'s findings establish a baseline against which progress can be assessed.

Risks

• The author states that transfers impose financial and practical burdens on patients and families and that many ultimately prove unnecessary.
• The author states that delays when transfer is warranted may adversely affect ocular health.
• The author states that excessive trainee workload harms education and well-being and may contribute to burnout.

Patient & Prescribing Data

Patients with eye concerns requiring urgent evaluation in emergency departments or inpatient settings, including patients at hospitals without ophthalmology coverage.

The article discusses emergency call coverage and transfer arrangements, not specific medications or prescribing regimens.

Clinical Best Practices

• The author describes AAO emergency- and trauma-related educational resources, webinars, and tools intended to facilitate taking call.
• The author describes tools for discussing call arrangements with hospital administrators, including compensation, response times, equipment, supplies, staff training, and emergent operating-room access.
• The author reports learning of local efforts in which physicians used some of the developed materials to improve ophthalmology call arrangements.

Related Resources & Content

• Reference 1: Feng et al.; full citation and URL not provided in the supplied text
• Reference 2: EyeNet, 2019 article; full citation and URL not provided in the supplied text
• Reference 3: Full citation and URL not provided in the supplied text