Yari Mitchell has questions for Sumit Garg, MD: On integrating new tech and AI

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Hi, I'm Yari, and I have questions. And this is Dr. Sam Garg and he has answers. Let's see if they match. Hey, Sam, thanks for joining me today. How are you?
I'm doing great Yari, thank you.

Oh, excellent. So, I am really curious about innovation today. And I wanted to get your take on what have you integrated into your practice recently, that, you know, you're really excited about?

Yeah, I think it's a great question. You know, one thing I love about ophthalmology is things keep changing. What we were doing 10 years ago is not what we're doing today. I think most recently, what we've integrated is some new eyedrops. For dry eyes, specifically, like Miebo, new IOLs—So we have some early experience with the IC-8 lens and some of the newer Johnson & Johnson lenses that are coming out. There's one called the Odyssey that I'm really excited to try soon. We also, you know, are in the process of trying to incorporate Veracity, so I'm really excited about that and how that's going to optimize our surgical workflows.

Nice.

And then, you know, I think the day to day of being in the teaching institution, trying to make things relevant for our residents and our fellows, and keeping it interesting and relevant for them is something we try to do every day.

Yeah, it must be an interesting balance. Because you're trying to help them to get into a steady state in understanding how to work in a practice, and then you bring in new innovation. How do you balance bringing in a new innovation and giving them that exposure?

Yeah, I think some of it is by them observing us. Because, you know, my philosophy with residency, especially when it comes to surgical training, is I want them to become really adept, confident, safe cataract surgeons, old school way. Like, trying out the newest technologies may not be right when you're just learning. Especially if you don't have the sort of toolbox all filled out. But me and my partners, we're happy to try it. So, they get exposure watching us. And then as they progress through the year, then they start getting exposure to advanced technology lenses, presbyopia correcting lenses, femtosecond laser cataract surgery. And I think we're the only program in the nation with the LAL available to our residents at the VA, so they get exposure there as well.

That's nice.

But I love it. It's sort of the approach of, you know, have your child learn how to drive a manual and then let them go to the automatic later.

What's a manual?

Okay, we'll talk later. So, I'm curious as well, what's your take on AI, right? That's something that's popping up in innovation all over the place.

Absolutely.

Where do you think that's going to take your practice; how's it going to help you deliver care?

Yeah, I think it's a really important and interesting topic. I think it's probably already impacting my practice without me knowing about it, right? Between EHR and you know, when we type emails. The next few words are already there, right? So that's all AI.

Yeah.

But as we look at, you know, big data sets and being able to look at populations and trying to figure out risk management of patients, risk stratification of patients, what's the right lens for a patient, etc. I think all of that is going to continue to progress as we start to become… as we own the data a little bit more. We have the data, but we're not really looking at it that critically, and there's people who are. And it's really exciting that going forward, maybe we'll be able to tease out that one patient that would not have been the right candidate for a lens. Or maybe talk to a patient that may be a really great candidate for a particular lens technology, and they just didn't realize it, or we didn't realize it.

That's great. It'll be interesting to see in the next five to 10 years how it's really evolved. The access for care, decision making and the utilization of different therapies.

The other place is imaging.

I think imaging is going to be really important here and, you know, several of the players in the ophthalmic space are really doing a good job of providing us great images and retina detection for AMD, for diabetic retinopathy, corneal detection for keratoconus, for dry eye, etc. There are already things that are available. It's just how do we harness it and sort of work that into our daily workflow?

Yeah, so how do you think about — and I know this is probably a little bit early — but you talked about residents and that you want to have them be sort of, you know, strong with baseline cataract performance, or baseline care. How do you think about the integration of AI for them? Because that will change the landscape potentially. When would you consider introducing that?

I think early. I mean, I think the more exposure to this, the better. The more people working on it, the better. I think the bright young minds coming into ophthalmology are really going to catapult AI to the next level. I think they already do stuff that we don't know about. I'm sort of mid-career-ish in my ophthalmic career, and the way that some of our younger partners and residents and fellows approach things, how they organize things, like the apps they use to keep track of patients and their outcomes, it’s so much different than the way that I did it. And I really think there's a lot of opportunity.

That's very cool. Since you're in a teaching institution, you're offering a lot of advice to these individuals you're working with and training. What advice did you get in your career that has stuck with you?

My mentor, as you know, is Roger Steinert. And amongst other people, certainly. But he was always one to say, "Take care of the patient first. And if you do that well, everything else sort of falls into place." So, I try to always individualize my care to my patient, make sure that I'm taking their particular situation into account and not try to push any agenda for anything else. And so, that's served me well. I get really happy patients and I sleep well at night.

I love that. So now we're to the challenging part of this conversation.

The first part wasn't challenging?

No, that was easy. You covered that; you nailed it. So, last question actually: If you were an ice cream flavor, what would you be and why?
If I was an ice cream flavor, what flavor would I be and why? What flavor would I want to eat or what flavor would I… I'm just joking. So, I'm not a big ice cream guy. But I think I'd probably be Rocky Road. For obvious skin color reasons. But there's a little complexity to it.

Yeah?

It's very still. I think it's a solid. It’s a flavor that most people like. It's not for everyone. There's a little nuttiness in there, a little humor. And a little squishiness with the...

The marshmallow.

The Marshmallows. That's my belly. That's probably what I'd choose.

You heard it here. Well, I hope that you've had fun. I've had a great time. I think you did a great job. I think your answers matched the questions. Congratulations.
Excellent, thank you very much. This was a lot of fun.

That's great, no problem. And look, we'd love to know: What questions do you have? Because I'm Yari, I have questions, Dr. Garg has answers. Let's connect. Thanks.