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Young Ophthalmologists
One to One: David W. Parke II, MD

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Dr. David ParkeWhile my father was also an ophthalmologist and certainly had a major impact on my career, it wasn’t preordained that I’d follow in his footsteps. He encouraged me to widen my horizons. But after attending Stanford University and moving on to Baylor College of Medicine, I fell in love with ophthalmology myself.

I found it to be incredibly intellectually stimulating. As a very detail-oriented person, I liked dealing with such an intrinsically beautiful, complex organ that is so critical to our patients’ lives. I think that’s why ophthalmology is such a happy profession. We affect our patients’ everyday lives in a profound way.

After my fellowships at Baylor and the Medical College of Wisconsin (both in retina), I returned to Baylor to join the faculty, where I became the director of the residency program. It was very exciting to me to return to my medical school and have an opportunity to impact the way a major institution runs its educational programs.

At that time, the chair of the department was (and still is) Dan Jones, MD. For a young, totally inexperienced junior faculty person, he was a perfect chair. He gave me responsibility and an always-evolving balance between necessary authority and sideline coaching. Lessons learned have been particularly helpful to me in my current positions as the chair of the Ophthalmology department at the University of Oklahoma and the president and CEO of the Dean McGee Eye Institute.

While I’ve never been in private practice in the truest sense of the word, McGee is a hybrid structure. It’s a private, non-profit ophthalmology institution with a large practice component affiliated with a university, so it shares elements of both a large group practice and of a traditional university department. However, there’s much more independence regarding major decision-making. I believe it’s a wonderful structure.

In my position at Oklahoma, I’m able to function as a department chair, such as training and mentoring residents. Yet I have the honor and responsibility to lead more than 300 staff and more than 40 MDs and Ph.Ds. I need to make decisions as varied as managed care contracting and who cuts the grass. Best of all, I’m proud to be part of a highly respected institution that provides much of the ophthalmic care for all patients in the greater Oklahoma City area—regardless of ability to pay.

While I would have enjoyed the challenges of running a private practice, I would have missed the daily interchange with students and residents. Plus, academic medical centers have a profound responsibility to the community, and I share that sense of responsibility. And, after all, when you are in the clinic or operating room, you have the same commitment to your patients, regardless of who’s paying you.

I’ve been fortunate to have four particularly outstanding role models thus far in my life. The first is my father. He was in private practice until he retired from active practice. He then retrained in low vision and now serves pro bono at Yale, providing care and teaching residents. He taught me the effect an individual physician can have on a patient. Some of the things we as ophthalmologists may think are of lesser importance, such as listening to a patient and communicating effectively, are really the greatest gifts you can offer.

I mentioned Dr. Jones earlier. He is the most critical, algorithmic, logical thinker I’ve ever met in ophthalmology. He taught me how to focus on key issues in any complex decision.

Another influential role model was Tom Aaberg, MD. He was my fellowship director at Medical College of Wisconsin and subsequently the chair at Emory. He is the best teacher in the operating room that I’ve ever encountered. He is a warm, caring physician in the truest sense.

My most recent role model is not an ophthalmologist. In fact, Jim Tolbert is not a doctor at all. He’s a philanthropist and civic leader here in Oklahoma City. He taught me the broader context in which to make organizational and business decisions. He also showed me how a physician can — and should — bring value to a city by becoming a community leader with a broad portfolio of interests.

I’ve discovered how important it is for physicians to become involved in their community as civic leaders, not just as physicians. Every doctor should have a role model in this capacity, and I’ve been incredibly lucky to have such a fantastic one.

As young physicians leave training, they will face many new career decisions. Here is some of the advice I give our residents and fellows as they step out into the world. It’s not particularly sage or revolutionary, but I’ve come to think it has some value.

  1. When looking at job opportunities, it is very natural to focus on the money, especially in your first years when you are in debt. While the dollars are important, it is more important to look at the non-financial aspects.

    For example, how is the practice positioned and viewed within the community? With what core values do the physicians approach patient care? If these aspects of the practice are not good, you’ll likely end up leaving. If they are good, then you will be comfortable, proud to work there and you’ll likely stay. Remember … you can always work out the numbers; you can’t work out the culture.
  2. Contrary to what many people would have you believe, physicians are not dumb business people. You must understand the business of medicine as well as the science of medicine to effectively apply your skills to the greatest number of people.
  3. You owe where you are right now to a lot of people who shared with you their time, resources, training and expertise. Not just your teachers, but the Academy and other organizations. You now have the same obligation to give back in a way that enhances the profession of ophthalmology.

In the decades ahead, all of medicine is going to have significant challenges. Our culture and society must make some important value judgments on how health care and the provision of health care is valued in relation to other goods and services. Having made that determination, we must play an active role in how it is structured, what resources are supplied and how we can accomplish this to bring the greatest value to the most people.

This is a challenge for everyone in medicine, not just ophthalmologists. We must all get actively involved in this debate or decisions will be made for us rather than by us.

This is not a local, regional or even national issue. Rather, it’s a global concern. You can help accomplish this goal by acting as citizens and civic leaders as well as physicians. You owe it to yourself to become actively engaged — but in a fashion and at a level that you enjoy. This could include philanthropic work, the political process, community economic development, clinical research, indigent health care programs or healthcare economics. The key is looking through the huge spectrum of opportunities to find the one thing that you are passionate about. It doesn’t work without passion.

When it’s all said and done, it’s about putting your community, patients and profession before your individual practice. If you keep your patients’ and community’s interests at the fore, you will consistently make wise decisions. And if you serve your profession, you will ultimately serve yourself.

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About the author: David W. Parke II, MD, is the president of the American Academy of Ophthalmology. He is the chairman of the Department of Ophthalmology at the University of Oklahoma in Oklahoma City. Dr. Parke is also the president and CEO of the Dean McGee Eye Institute in Oklahoma City, Okla.