ASCRS News
December 2023
by Jeff Pettey, MD
Clinical Vice Chair, Moran Eye Center, University of Utah, Salt Lake City, Utah
Much of how we approach our current practice of ophthalmology is based on what we have learned from our prior experiences. Along the way, we have struggles, complications, and many successes. All of these experiences help shape how we approach our next patient. This issue of EyeWorld focuses on “lessons learned,” and I have invited a great teacher and friend Jeff Pettey, MD, to share his perspectives on lessons learned from his career thus far and how this impacts his outlook on how he approaches the care of patients both domestically and abroad.
—Sumit “Sam” Garg, MD, Chief Medical Editor
As the legendary Alan Crandall, MD, David F. Chang, MD, and Susan MacDonald, MD, held a phaco masterclass for our Guatemalan partners, I set up a small MSICS table in the corner to shorten the growing line of surgery patients for the day. Still in the early months of my career, I repeated the mantras imprinted on me by mentors past. Slow is fast, quiet hands, and Alan’s favorite, “Don’t be nervous, I can fix anything you mess up.”
As the day progressed, a funny thing happened: One line formed for Alan and David, and a second, with the most advanced cataracts, for my MSICS table. Although the skill gap between these stalwarts and me was never in question, I couldn’t help but smile, knowing, at least for that day, the easy cases went to Alan and David.
Finding myself in the same room as these visionaries was humbling and exhilarating. Considering lessons learned in global ophthalmology, I’ve received far more than I’ve offered in return. From mentors like Bonnie Henderson, MD, and Dr. MacDonald, to Geoff Tabin, MD, and Sanduk Ruit, MD, it has been a rich classroom for humility, humanism, and eye health. While I wish I could claim some grand plan that led me to global ophthalmology, truth be told, it was as much serendipity as strategy—a culmination of opportunities and a willingness to take a less clear path.
Whether you’ve just matched into ophthalmology or you are wrapping up a career and seeking more impact, we need everyone in the room.
From international to global
Entering the domain of global eye health can seem daunting, often clouded with uncertainties. The lingering question is almost always, “How do I start?” However, the answer might be closer than we think. Over the years, we’ve witnessed a paradigm shift from purely international to global ophthalmology. The latter is inclusive of our local communities as part of the equation. The world of global eye health beckons, sometimes not across oceans but in your backyard.
Beyond competence: embracing cultural humility
The notion of cultural competence is lofty, hinting at an endpoint of understanding. But the truth is, understanding cultures is a journey, not a destination. In the realm of global eye health, the role of a surgeon transcends the confines of the operating room. As partner surgeons, we are invited into communities with their rich tapestries of beliefs, practices, and values. While our expertise in ophthalmology may be vast, it’s crucial to approach our partners, recognizing that we are guests in their world. When we approach our partners with an understanding that we have as much to learn as we offer, we find the synergies to magnify our impact together.
Teach a man to fish
The statistics are daunting: 20 million individuals blinded by cataracts. Given the confluence of an aging demographic and the scarcity of global eye surgeons, this figure is projected to more than double by 2050. As surgeons, our instinct might be to view this problem through a simplistic lens—after all, we have the tools to rectify cataract blindness. Yet the solution demands more than just our surgical interventions in distant lands.
Skills exchange is a powerful force multiplier. Our partners, deeply rooted in their communities, can uplift the quality of care for their patients year-round. By mutually exchanging techniques and knowledge, we empower them to optimize patient care well beyond our time together, improving the outcomes of all their future patients.
Even more impactful is partnering with or establishing local training programs. Cataract blindness perfectly overlays with regions with inadequate ophthalmologist-to-population ratios. Having a single ophthalmologist per million people is all too common, and the imbalance perpetuates the growth of blindness. Investing in local training and nurturing the next generation of surgeons amplifies your impact exponentially as every graduate becomes a force multiplier, radiating change across their careers.
Our role in global ophthalmology is about more than just being surgeons; it’s about being mentors, partners, and collaborators. Start in your own backyard, approach partnerships with humility, and leave a lasting impact on our partner communities. By sharing our skills, fostering training, and magnifying our impact, we can illuminate a brighter future for global eye health. I look forward to the day when I can pass the most difficult cases to one of the young eye surgeons just starting on their path to global ophthalmology.
ARTICLE SIDEBAR
Lessons learned
Throughout this issue, look for the “Lessons Learned” boxes with tips from EyeWorld Editorial Board members and contributing physicians on what they have done to “level up” in their practice.
Contact
Pettey: jeff.pettey@hsc.utah.edu
