Ophthalmologists need to identify, utilize their potential power

Once ophthalmologists organize politically and within the culture, they will be able to help the most people.

ByMatteo Piovella, MD

Matteo Piovella

Let’s take a snapshot of the importance of ophthalmology today. Ophthalmologists manage the visual outcome of the population, which is a significant social responsibility. We know that more than 92% of the connection a person makes with the real world is done with the eyes, emphasizing the importance of ophthalmology.

The technological and intellectual growth that has occurred over the past 25 years in ocular surgery gives the ophthalmologist the ability to help the majority of the population. Ophthalmic surgery is just one segment of surgery that has increased dramatically with technological advances. This is something easy to see: Cataract surgery is being performed on more people than any other surgery in history. In Italy, we perform half a million surgeries a year; in the United States, there are 3 million ophthalmic surgeries per year.

These numbers give us a wonderful world of data and experience. We have experienced and recorded the complications that happen in every 1 million cases. This is something that is not possible in any other type of surgical specialty, just because of the sheer volume. This is one of our strengths. Now that the technology and techniques are well known everywhere, there are no longer the significant differences between the leading surgeons and general surgeons of 20 years ago, when the majority of surgeons were on the outside looking in. And today there is the new dream of managing refractive error.

Untapped potential

But I want to encourage my colleagues to take a minute to think about this professional reality and how our impact is different in the political and social arena. I submit that for the ophthalmologist to make his or her full impact on the larger population, it requires more than just knowledge about ophthalmology. My opinion is that we have a lot of untapped potential.

We are doing a remarkable job, but to get to that fully realized potential of helping the larger population, we need to start building something new, right now. The world is changing every year, and being a physician is based on more than just capability and ethics.

In my family, my father and mother were physicians, and they experienced the concept that people liked doctors. The doctor was an important reference not only for illness, but also for life.

We need to recapture and cultivate that image and act as leaders who serve the interests of our patients. I fully realize that this concept is related to the past, and I am not saying we should work like older generations who considered ophthalmology a nice pastime. The world and our profession has changed. We need to change our focus to also be business-minded, with a political mind, to protect the safety and needs of the population where eyesight is concerned. There is no other profession entrusted with this responsibility. We are the soldiers in this case.

The only other people who are working on this do it for commercial reasons. In Europe, we have problems in which the practice of ophthalmology is attacked by other parties that are completely commercial, such as opticians, for example. In most of Europe, our relationship with optometrists is not the same as in the United Kingdom and United States. Optometrists are something that is necessary in the United Kingdom because they have over 60 years of experience and are incorporated in the profession. And in the United Kingdom, there are only 700 ophthalmologists. In other European countries, we have thousands of ophthalmologists who have better backgrounds compared with opticians.

I use this example about this situation only, while trying not to be controversial and remain positive. What we really have is a fantastic opportunity. We have an opportunity to give the best services and the best quality in our profession. To provide that, it is necessary that an organization of leading people decide to work together toward this goal. The personality, capability and the goodwill of the ophthalmic profession are there. We are not alone. We are people who are serving the population, but we must have the opportunity to do that.

Perspective shift needed

We need to change our mindset. It is not enough to be the leading surgeon in phaco techniques or the best in the world for refractive surgery. What we need is an instrument to support this reality. We need an instrument that will connect us with the politicians and that will push the government to try to oblige us. Right now, Europe seems like a basket with hundreds of different opinions and goals, instead of considering ophthalmologists as one community.

So how do we achieve our common goal? The world is complicated. To be practical, I feel it is important for each country to participate in one society, only one per country, that can collect the requests that will support this idea. When you are in a council, you are many states, and we can end up with 10 representatives for each nation. But the first step is to have one council for each nation and only one representative for each nation in Europe. This is nothing new. This can follow what has happened in other countries, such as the United States. Not completely like the United States, but we have enough to learn about organization, partnership and how to be part of a project. This editorial space can be used to talk and to push and to be confident for the ophthalmologist. It is time for a change in Europe, and the time to start that change is right now.

We need to understand and accept that every day we ophthalmologists become less significant, and this is a tragedy. Not for us, but for the population. We need to be powerful to protect the population. If we are not powerful, the level of health care for the entire population goes down. It is an opportunity for a new relationship in the new century.

I have learned these things from my practical experience in my position as secretary-treasurer of the Italian Society of Ophthalmology since 1998. I understand how important it is to work with one another toward common goals.

For Your Information:

Matteo Piovella, MD, can be reached at Centro Microchirugia Ambulatoriale, Via Donizetti 24, 20052 Monza, Italy; +39-039-389498; fax: +39-039-230-0964; e-mail: piovella@piovella.com.