To the Editor.
—I am a retired ophthalmologist as well as an occasional patient. I found Dr Paton's1 recent essay appalling. No soft words, such as sympathy, kindness, or professional ethics, occur. Even the word patients hardly appeared except as the necessary component of other concepts, such as efficiency, high-volume surgeons, money, flow patterns, and replication of centers. Dr Paton is partially right—21st century ophthalmology is already here but in an early and unpleasant form. A startling insight is that the Big Brother of 1984 is us."High-volume surgeons" and other high-volume ophthalmologists will find more time to increase their productiveness when Dr Paton's suggestion is adopted that 250 residents be trained each year instead of the present 500.Dr Paton is duly regretful, but he is sternly willing to lay it on the line. Those ophthalmologists who do not seize the moment ("find a satisfactory provision system") may
Goodside V. Ophthalmology in the 21st Century. Arch Ophthalmol. 1987;105(2):167. doi:10.1001/archopht.1987.01060020021006
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