5Q With Dante J. Pieramici, MD


What tactics have you used for managing high patient volume?

The most important tool for managing a high-volume clinic is an energetic, smart, and well-trained staff. Gone are the days when being a retina technician meant only checking VA and IOP and dilating the patient. Today, a proper retina technician needs to have intimate knowledge of retinal anatomy and pathology, as this will help in obtaining effective imaging data, allow efficient and accurate scribing in the electronic medical record, and permit participation in patient education. An effective scribe is priceless, and having one affords me additional time for examination of the patient and retinal images. Scribes also allow me additional face time to discuss the disease and treatment options with the patient and his or her family rather than inputting data. Today, the retina clinic is a real team sport.

Dr. Pieramici and his daughter Lily biking in Croatia.

How do you get the most bang for your buck at a retina conference?

My advice is to take it all in. Conferences tend to be centered around the didactic lectures, but much learning can be done outside the lecture hall. I would encourage taking time to meet and converse with colleagues during breaks and meals. A lot can be revealed in one-on-one or small group discussions. Don’t bypass the poster sessions, as many novel ideas and observations are first introduced to our community via posters. Spend some time walking through the commercial displays. These are great spaces to meet with medical and nonmedical colleagues to learn about new products, discuss recent study results, and get hands-on experience with new technologies. And don’t stay out too late! Getting good sleep and exercise at the meetings will make the days much more productive.

What is your impression of the latest generation of retina doctors? How are they different from your generation?

For the most part, young retina doctors today are very similar to the retina docs of my generation. They tend to be overachievers, hardworking, conscientious, and innovative. One of the things I value about our field is our culture of invention. Novel ideas, technologies, and treatments are welcomed and tested. Safe and effective therapies are refined and readily added to our armamentarium to benefit our patients. This spirit of constantly improving our profession is vibrant among the youngest members of our community. One difference in our younger colleagues is that they seem to desire and actively seek out a better work/life balance. I suspect that this attitude is healthy and particularly helpful given the high-volume clinics of today.

What surgical innovation in the pipeline are you looking forward to most?

I am most looking forward to viable retinal and retinal pigment epithelium cell transplantation. In the past few years there have been some very small, but very real, advances in this area. Patients who have asked about this technology have been told that it is just around the corner for the past 2 decades. We may actually be rounding that corner soon, and I anticipate phase 2 and phase 3 clinical trials of these technologies in the next few years.

What movie or television show is your guilty pleasure?

I have become a big fan of “Black Mirror,” a Netflix modern-day take on “The Twilight Zone.” Each episode explores the potential impact of many of the technologies being introduced to society today, such as artificial intelligence and augmented reality. These vignettes are great escapes for 60 minutes—but the storylines may linger in your mind for many months.

Dante J. Pieramici, MD
• Vitreoretinal Surgeon, California Retinal Consultants, Santa Barbara, California
• Financial disclosure: None


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About Retina Today

Retina Today is a publication that delivers the latest research and clinical developments from areas such as medical retina, retinal surgery, vitreous, diabetes, retinal imaging, posterior segment oncology and ocular trauma. Each issue provides insight from well-respected specialists on cutting-edge therapies and surgical techniques that are currently in use and on the horizon.