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Lecture provides a call to action for ophthalmologists
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 Eric D. Donnenfeld |
The Charles D. Kelman Innovator’s Lecture at the American Society of Cataract and Refractive Surgery meeting is an annual opportunity to listen and learn from the greatest minds in ophthalmology. This year’s lecture, given by Richard L. Lindstrom, MD, was an inspiring tour de force by the ophthalmologist I consider the voice of our generation on the ophthalmologist’s role in education and innovation. Dr. Lindstrom provided a well-referenced documentation on the crisis of innovation that threatens the core of our commitment to the advancement of patient care. Ophthalmology specifically and medicine in general are at a crossroads in which the politics of mediocrity have overwhelmed reason and commitment to excellence.
The great majority of innovations in ophthalmology are thanks to the collaboration of industry and consultants. Charlie Kelman’s invention of phacoemulsification is a prime example. The U.S. health care system for decades has been the finest in the world in large part due to the teamwork of industry and physicians. All of these advances have directly benefited patients, and as Dr. Lindstrom points out, “innovation … often reduces cost.” The ophthalmic industry requires the clinical wisdom, spark of innovation, understanding of unmet needs and experience with patients that only consulting physicians can provide. Just as importantly, clinicians need industry. Taking an extraordinary idea from conception through prototypes, clinical development and the maze that is a U.S. Food and Drug Administration trial requires organizational skill, leadership, infrastructure and a level of risk that would discomfit most physicians. Of course, the relationship of industry and consultants creates conflicts of interest. However, as Dr. Lindstrom states, the management of conflicts of interest is a daily concern for all of us, and as long as we never lose sight of doing what is best for our patients, conflict management is never really challenging.
Innovation has become too difficult in the United States because the hurdles arbitrarily established by our government have become too high. Clinical trials in the United States are wastefully expensive and ridiculously time-consuming. As a direct result, innovation, the jobs associated with it and, most importantly, quality of patient care are leaving our country and moving abroad. As Dr. Lindstrom states, “It is time for we as a profession … to take an active role in defending our ability to innovate and educate our colleagues.”
Anyone who cares about advancing the art and science of medicine should read Dr. Lindstrom’s Innovator’s Lecture and be concerned. The issues raised should be discussed with our colleagues and patients and brought to the attention of our legislators. In my opinion, Dr. Lindstrom’s Innovator’s Lecture was profoundly more than an education. It was a call to action.