When I first started out in practice, one of my senior partners sat down with me and said that to be a good retinal specialist, or a good physician for that matter, one needed to keep in mind the three "A's" of clinical practice: "Affability," "Availability," and "Ability." As a young physician* I appreciated the advice, but thought it might be an oversimplification of what I looked at as a very complex process of becoming a "good doctor." Over the years, I have come to realize that, as with many things, he aptly summarized the situation.

Even as the demands of practicing good "retinal medicine" are taking more of our time on a technical and practice management level, it behooves us not to forget the importance of behaving in an affable and humane fashion to our patients. We should be able to put our patients at ease as much as possible, carefully explaining the nature of their condition and the treatment options available while mitigating some of their concerns.

As retina specialists, unlike most of our colleagues in the ophthalmic community, we deal frequently with true emergencies, where time is of the essence. An article in this issue by ThucAnh T. Ho, MD, and Mathew W. MacCumber, MD, PhD, outlines the state-of-the-art in treating retinal emergencies. Obviously, our availability to manage these urgent situations is critical, either personally or through on-call rotations within our practices. Perhaps of equal importance, however, is our availability to answer our patients' questions and make them understand that we truly are working with them to improve their condition.

Finally, but certainly not of least importance, is true medical "ability." As David W. Parke II, MD, so clearly states in his guest editorial in this issue, the retina community, as well as our patients, is facing the threat of increases in the optometric scope of practice. These changes would license individuals with a fraction of retinal specialists' technical ability and medical knowledge to provide expanded retinal care for patients with sight-threatening disease. In gereral, of all the subspecialties in ophthalmology, retinal specialists spend more time training prior to entering clinical practice, and they demonstrate the highest level of attendance at CME courses and training sessions. Mere technical ability alone, however, is not sufficient given the increasing number of options available for treatment of retinal disease. The experience that comes from clinical practice and the interactions with our colleagues in our offices and at meetings enhance our ability to deliver the highest standard of care.

SOUND ADVICE SURVIVES THE TEST OF TIME

Just recently, I was struck by the fact that I have been in practice for nearly 20 years. Over that time, much has changed in our field. I expect that those changes will continue to increase as we move forward in the new millennium, not only in scope, but also in the speed with which they occur. In spite of this, I realize that simple, sound advice often does not chance. Perhaps it would be worthwhile for all of us to take a step back and think how we would be graded as retinal physicians. Would we all get "straight A's"?