What's New With Ophthalmology? Q&A With Drs. Don Kikkawa and Robert Weinreb of the University of California San Diego's Shiley Eye Center
Don Kikkawa, MD, and Robert Weinreb, MD, work with the UC San Diego Department of Ophthalmology's Shiley Eye Center, an academic institution that also provides clinical care for eye disorders.
Dr. Kikkawa is a professor of ophthalmology and chair of the ophthalmology education committee at UCSD. Dr. Weinreb is a distinguished professor and chairman of the department of ophthalmology and director of the Shiley Eye Center.
Drs. Kikkawa and Weinreb weigh in on current issues in their industry, and how the Shiley Eye Center is adapting to the evolving healthcare environment.
Question: What are the top trends in ophthalmology currently?
Dr. Kikkawa: For chronic diseases such as macular degeneration and glaucoma, our therapies are directed at improving vision rather than just preventing further vision loss. Our evolving surgical techniques employ increasingly smaller incisions and more precise procedures that lead to faster recovery and more predictable results. In cataract surgery, we find increasing interest in premium intraocular lenses that allow for improved vision at both near and distance without the need for glasses or correction for astigmatism. Endoscopes in reconstructive and cosmetic surgery allow reduced operating times and more rapid healing.
Dr. Weinreb: Translational research is at the forefront of our efforts. This involves bringing bench research to clinical care, by developing newer medications, imaging, lasers, and stem cells, all of which our center is a leader.
Q: What issues are having the biggest impact on your specialty?
DK: Access to the highest quality eye care remains a growing concern. The ever-increasing aging population, limitations on insurance plans and the high incidence of uninsured all impact access. Combine these factors with declining reimbursements and the projected doctor shortage, we will likely see increasing wait times and surgical waiting lists.
RW: Conversion to electronic health records makes sense from a theoretical standpoint but practically there are issues with implementation, efficiency and the change in traditional doctor patient interactions. The patient may perceive that the doctor is paying more attention to the computer screen than him or her.
Q: How is Shiley Eye Center coping with these trends and issues?
RW: We have recruited nationally to find the highest quality physicians to increase our access. We are developing new and unique programs that are not found elsewhere, and creating centers of excellence to provide the best possible care. We have little control over insurance changes, but we can continue to offer the best comprehensive and specialized eye care for residents of our community, as well as our patients from across the US and internationally. With regards to electronic health records, we have a task force examining the issues of efficiency and maintaining the patient experience.
Q: How has your center changed or evolved in the last year or so?
DK: In June 2011, Dr. Weinreb was named Director of the Shiley Eye Center and Chairman of the UCSD Department of Ophthalmology. Dr. Weinreb has been at the forefront of leadership in all aspects of our specialty and we have been able to anticipate growing eye care needs and concerns. Our faculty continues to grow and as mentioned, we've recruited exceptional physicians to direct key areas of clinical care, research and to educate the leaders of tomorrow.
Q: Is there a specific procedure of subspecialty for which patient demand has grown substantially?
DK: All areas of our practice continue to experience growth over a loyal patient base. The aging baby boomers will continue to seek premier eye care services, including the areas of cataract, glaucoma, retinal degenerations, and cosmetic surgery. We are also experiencing growth in refractive surgery and pediatric eye care in our younger patients.
We continue to have high demand for our services and we have become more efficient by cutting overhead without compromising care of our patients.
Q: What are the most pressing industry challenges?
RW: The challenges for academic eye centers are to excel in patient care and research, as well as to train the next generation of eye care professionals and leaders of our specialty. We must accomplish this in an environment of declining reimbursement, increasing regulation and barriers to patient access.
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