Ophthalmology

Expectations 20 years ago were that America would by now be dominated by gigantic practices. It was believed that these super-practices would be formed largely through the merger of small practices into behemoths with 20 or more providers in multi-subspecialty, multi-location groups — groups with all the “O’s” under one roof.

The reality, of course, has fallen profoundly short of this. Most practices are still modest with three or fewer providers. I believe that a momentum toward the development of super-group practices will resume in the near term for a number of reasons.

Aloha from the Waikiki Yacht Club. Aurelia pulled into the dock here in Honolulu at 6:30 p.m. local time last night, after a 22-and-a-half-day passage from San Diego. This was 8 days faster than the last voyage 15 years ago owing to quite unusual weather patterns, more global climate change mythology at work, no doubt. It will take a few days to clean Aurelia up and get her packed for shipping back to San Diego; a few more months for me to put this adventure into perspective. I’ll be back ...

Aloha from Aurelia at 22 degrees, 0 minutes north, and 152 degrees, 35 minutes west at 12 Noon PST, on Saturday, May 26. Based on current conditions, Aurelia should be pulling up to the dock in Honolulu late Monday or early Tuesday. The major challenge left will be transiting the Kaiwi Channel which runs between Molokai and  Oahu. Gale force winds are predicted for the next 48 to 72 hours, and the narrow gap between islands concentrates both the wind and wave patterns. Hope your weekend is ...

Aloha from Aurelia at 22 degrees, 30 minutes north, and 150 degrees, 6 minutes west, at 9 a.m. Pacific Standard Time on Friday, May 25, Day 19 of the voyage. We are 440 miles from Honolulu. Somebody has to open a kite store around here. It’s been blowing 25-plus knots for the past four days. Aurelia is blasting along with just one-quarter of her usual sail area and getting an additional boost in speed in every wave we surf down. A boat designed to do five knots is now hitting ove...

Aloha from Aurelia at 22 degrees, 41 minutes north, and 147 degrees, 42 minutes west, at 9 a.m. Pacific Standard Time, on Thursday, May 24. This is Day 18 of the voyage. I woke up abruptly on the cabin floor just after midnight, when we fell off one of the waves from the recent storm. A brilliant sunrise directly behind us as we plow ahead to Hawaii. Two flying fish on the deck this morning, and yesterday afternoon, a beautiful white tern, with a long, split swallow-tail circled the boat for sev...

Aloha from Aurelia at 10 a.m., Wednesday, May 23, at 23 degrees (fades out), 145 degrees, 39 west. Sorry for the hiatus yesterday. Because of a high-pressure gradient, local winds and waves built to a level  (fades out) ... or since. This weather pattern is expected to linger until Sunday or Monday, so this blog site may stutter a bit over the next few days. We’ve exhausted the last of the ice fresh veggies and fruit, so it’s on to canned food and peanut butter and jelly sandwic...

OSN was informed by Brynn Campbell at Commanders’ Weather that John Pinto is currently encountering 30-knot ENE trade winds and high seas which have made it impossible for Mr. Pinto to update his blog today – and possibly for several days.  Pinto is more than halfway along in his solo journey from San Diego to Honolulu about the 24-foot Aurelia. He will send his next post – and OSN will publish it – as soon as he is able.  

Aloha from Aurelia, at 24 degrees, 20 minutes north, and 141 degrees, 4 minutes west, at 9:00 a.m. Pacific Standard Time on Monday, May 21. After a week of exceptional 100-plus nautical mile days, the last 24 hours have gone a little bit slower, at about 85 miles. Our weather routing service predicted light and fluky winds about now, and they were right. The good news is that with each passing mile, the winds get better, more consistent, and somewhat stronger. As the crow flies, we now have 945 ...