Hovanesian interviews Mazzo on ophthalmology’s future in coronavirus pandemic era
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In this video, OSN Cataract Surgery Section Editor John A. Hovanesian, MD, FACS, interviews Jim Mazzo, president of the ophthalmic devices strategic business unit for Zeiss, about what changes will take place in the ophthalmic industry and physician practices with the coronavirus pandemic. What follows is a lightly edited transcription of the interview.
John A. Hovanesian, MD, FACS: Hi, I’m John Hovanesian, and we’re having today a conversation by remote video with Jim Mazzo, who is going to talk with me about the future of eye care, as we see ourselves emerge from the COVID epidemic. Jim Mazzo, thanks for joining me today.
Jim Mazzo: John, thank you very much. You’ve never looked better, John.
Hovanesian: And I very much like the beard. Jim, you’ve had just about as much experience as anybody in eye care, and by that I don’t mean you’re old. I mean that you’ve done it all. Jim is global president for Carl Zeiss Meditec’s strategic business unit for ophthalmic devices, and that includes the diagnostics we’re all familiar with, as well as all of their surgical ophthalmology business and refractive lasers. Jim started his career with 22 years at Allergan, where he rose to leading the North American and European business, and then he spent 11 years as, originally, the founding chairman and the president of AMO, including its transition to Abbott. He’s served small companies as well in leadership. He worked for AcuFocus as their CEO before heading to Zeiss, where he is now, and where he is soon to retire. Congratulations on your retirement from Zeiss, but I understand this is not your retirement.
Mazzo: No, and well again John, thanks very much. It’s an honor to talk to a good friend and somebody I really admire in our industry. You know, this is actually just a retirement from Zeiss. This is my 40th year in the industry. I absolutely love, as you know, what I do. I’m very fortunate. The industry’s been great to me. You, as practitioners, have been someone I’ve always admired what you do every day. So, all I’m going to be doing is transitioning away from Zeiss. I’m going to stay on until the end of September, help assist Euan [Thomson, PhD], and work with Ludwin [Monz, CEO of Carl Zeiss Meditec] and the team. And then I’ll continue to work with the companies that I have like Neurotech and Avellino, and add a couple of others. Stay involved in the associations, on the board of ASCRS. So, for anybody that was hoping they would see less of me, are going to be vastly disappointed because they’ll see my ugly mug still continuing in our industry.
Hovanesian: So Jim, you have set records at Zeiss, as you did with companies before in success. At Zeiss, you know, I think it’s fair to say that you reformed the company around the focus on customers, and that led to a whole new way of succeeding in selling. You have transitioned the business to one that is going to be more digital in the future. So, with your understanding of both the company side and the customer, the physician practice, look ahead for us and tell us if you can. To start with, what do you see in the future after we arise out of this epidemic?
Mazzo: Well, first off, let me just say thank you for saying that. I would tell you, as you know, I have been very lucky in recruiting a new team and adding to the team. So, the likes of the Andy Chang’s and the Angelo’s [Angelo Rago] and the Dirk’s [Dirk Müehlhoff] deserve all the credit. I just was able to bring them on board. So, thank you for that.
You know, I would say that I’m equating what’s going to happen in the practices is to what happened to the travel industry under the travesty of 9/11. And that, it just transformed how we travel. I think now, it’s going to transform on how you see patients, how we interact with doctors. I think it’s going to be much more information before you walk in. I don’t think the casual walk-in visit, the bring in mom and dad into the room, all that is going to happen. I think even ... the handing a pen to your patient to fill out their form is gone. And you know, sometimes I think, actually, when you transform, because of a catastrophe or of an issue, you actually make things better. So, I actually think your flow of your practices might be better because why should we be having people fill out things on a pen? Today the digital age is there. So, I would say that I actually think the flow of your patients will be different in your offices. I think you don’t need to see, and I’ll add one other comment. Prior to COVID, I said that one of the biggest issues we were facing is more patients, less doctors. I said that before COVID. And that was going to be traumatic for you and your practices and for our industry. So, it was going to happen anyway. You couldn’t see the same amount of people. You couldn’t have your office be as encumbered with non-productivity type of patients. So, this was going to happen; COVID is accelerating it, John.
Hovanesian: So, I think it’s a very interesting collision that you’re talking about between the demand and the supply of doctors, and the inefficiency of the way we used to deliver care. When I think back, and I’m old enough to remember life well before EHR systems. Electronic health records came around about 10 years ago, when my practice really fully embraced it, began using it for clinic visits. I think I can speak for most doctors in saying that they have not made us more efficient. They’ve created a lot of benefits. But they’ve not made us more efficient. As we look ahead toward becoming more digital, how do we find solutions that actually make us more efficient, that allow us to do more with less time?
Mazzo: Well, you’re being very humble because you’re one of the leaders in this area in what you’ve done at your practice as well as with your system [MDbackline]. So, you’re actually a visionary in what you’ve done prior to this, and I could easily go on record with that because you’ve been talking about that prior to the COVID. You know, again it goes back to my point. I think necessity is going to drive this. If the practices are not set up to be able to self-diagnose away from the office, they’re going to falter and fail. So, this is now, and from moving from a nice to have to a need to have.
I think these practices are going to have to educate themselves. You know, one of the most difficult things we have in lives as we get older is to break habits that got us to be where we are. You know, we’ve been successful, and we sit there and go, well why change? If I’ve been successful, why do I have to adapt? Well, I think success is now going to be because you better adapt. And if you don’t adapt to this digital workplace, I don’t care how you’ve gotten there, that’s going to change. Again, it is going to be a requirement. Not a nice to have anymore. It’s going to be a need to have. You’re going to also need to capture that data. I said something before this COVID exercise. I said he or she who owns the data will win. And so that predictive analysis that you can get from the data will make you a better physician. So, I think the stalwarts that say I’m sorry, I’m not adapting, will be on the beaches in the Bahamas because they will not be practicing.
Hovanesian: And that, you know you say that like it’s a bad thing.
Mazzo: Well, it all depends on how much money they have to go in the beach in the Bahamas. That’s the big question.
Hovanesian: Yeah. And we’re going to talk about that as well in a moment. So, it’s interesting when you talk about the data because previously the data, really the data that we collected, was, you know, the data that came from instrumentation, like OCTs and visual field machines, and you know, optical biometers. Are those machines going to become less important and others become more important in the future? Do you see the sales of those types of machines for companies like Zeiss changing in the future?
Mazzo: Well, let’s talk about the first question. It is incumbent upon us as industry now to ensure that the equipment you utilize has the data capabilities to start when the patient is diagnosed to treatment. You know, for you not to have that information right there, in your microscope, is really our problem, not yours. So when you diagnose a patient, that data should be easily transformed into your digital microscope, so that when you’re doing the surgery, it’s there looking through your oculars, or even now as you know, what we can do with the 3D screens. So, we have to do that.
Now, selfishly I will tell you, I think we at Zeiss have been doing that. We’re not great at it yet. But you know, with Veracity and with Forum, with EQ Workplace, we were starting to understand. And now, we’re going to have to be more aggressive in that. So, it is going to be critical for us as manufacturers to ensure that you have that data access. Because I will tell you if we don’t do it at Zeiss, somebody else is going to do it. And so, I know we’re putting a lot of effort to it before. We’re going to accentuate it. And you know Euan, who is coming over to take my place, actually has that digital background, so it’s a perfect handover to Euan, who understands how to do this.
Hovanesian: I want to talk a little bit about telemedicine and its role here. This is a tough one to figure out because we’re, now, because we can’t see routine patients in the office. Because of the shutdown, we’re trying to do our best with telemedicine. But we’re fairly focused on what we see with the microscope and what we see with the OCT. Do you see, and do companies like Zeiss, and others, see the future of doing remote monitoring of patients as important, and do you see, on the horizon, instruments that are going to capture an OCT or a retinal exam that a patient could own at home?
Mazzo: Most definitely. And you know, what I feel good about is, that I was saying this along with my team of Angelo Rago and Andy Chang and Erin Powers, we were saying this pre-COVID. So, it’s not like, “Oh, I’m jumpin’ on the bandwagon now ... .” We were saying this before. Again, goes back to what I said earlier: more patients, less doctors. It was going to happen no matter what. You cannot see every patient as they walk in. And in fact, it makes you more productive if you’re able to see Mrs. Jones via this remote. So at the end of the day at seven o’clock at night, when you’re done with your practice, you get on the computer and Mrs. Jones, you know the OCT comes up, you can send her a text and say listen, you don’t need to come in next month. Thanks, we’ll see you in a month. I mean, that’s productivity. Plus, as we’re getting older, we’re not as accessible. I mean you know ... Kelly’s [Mazzo] parents are still with us. So lucky. But they’re now in a nursing home. They don’t have the same access. I don’t want my father-in-law driving. So, why should they be driving to meet with you when you could’ve easily identified and told her, “Listen, you know Nancy, you’re lookin’ good. You don’t need to come in.” Or guess what? Maybe even better, “Nancy, we need you in now” versus she waited a month for her next visit. So, I think this is proactive measures to be able to manage patients accordingly, and I also will say something, too, which great for our health care system, it’s going to drive costs down. And we need to drive costs down across all health care because that’s a pandemic there, health care costs. We can’t afford to continue to operate the way we’ve been operating. So, this crisis is actually going to accelerate something that needed to be done.