David L Ryan / Globe Staff

Who

Dr. John Loewenstein

What

Loewenstein, vice chairman for education in ophthalmology at Harvard Medical School and associate chief of ophthalmology for clinical affairs at Massachusetts Eye and Ear Infirmary, has recently developed a computer program to help teach medical students how to perform cataract surgery.

Q. Cataract surgery has gotten substantially safer during the course of your career.

A. No operation will ever have zero percent risk, but cataract surgery has like 97 percent success rates. Patients are tending to have surgery [while they have] better vision than when I was a resident. It's a good thing for the patients, [but] it puts more stress on the health care system because there's very high expectations by the patients. They expect to be seeing darn near 20-20 within a week after surgery.

Q. So, there's less room for error by trainees than there used to be?

A. The expectations are very, very high, not only in terms of the quality of care in the technical sense, but in building relationships to the physicians, access to the physician, teaching of patients by physicians.

Q. And less time for doctors to train them?

A. Because we're reimbursed generally less than we have been, you're expected to see more patients to keep your income or to keep the hospital bottom line looking good. A lot of physicians love to teach, and they used to be able to take half a day or day and donate their time for teaching. [But] even our full-time faculty now have pressures that reduce their teaching time.

Q. Proposed congressional budget cuts, you say, would also put more pressure on medical students.