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Disrupted But Undaunted: Richard L. Abbott’s Quest to Improve Eye Care Abroad and at Home
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Outside disruptions to surgery are never easy to plan for, but in the case of a 1989 surgery in China, Richard L. Abbott, MD, faced not just an unexpected disruption, but a historic one. On a trip with ORBIS to teach corneal transplants, he found himself in the midst of the riots in Tiananmen Square.

“I was two blocks from the square,” says Dr. Abbott. “The noise from the protesters was so deafening, I couldn’t hear my nurse during surgery. After work at the hospital, it was difficult for us to return back to our hotel, as the streets were closed, and there was a lot of confusion and lots of people everywhere.”

There was no immediate fear of danger, but at 2 a.m., Dr. Abbott got a knock on his hotel door and word that he had to leave China immediately. “I was told I had 20 minutes to pack up and leave for the airport.”

Despite his abrupt departure, that was not the last time the Academy’s 2011 president would visit China, nor was it his first. Beginning in 1982, he has had an extended engagement with colleagues and patients that has expanded from clinical care, performing surgery and teaching to his recent role in China’s implementation of evidence-based ophthalmic guidelines (the Academy’s Preferred Practice Patterns).

Dr. Abbott giving a lecture to ophthalmology students in Tianjin, China.
Dr. Abbott giving a lecture to ophthalmology students in Tianjin, China.

“I always had a strong interest in international education and exchange of ideas with colleagues who practice outside of the United States,” says Dr. Abbott. “Early on, there was a wide gap between medicine in the U.S. and countries in the developing world. But now, that gap is shrinking, due to ophthalmologists teaching in these countries, as well as physicians from other countries coming as students or fellows to the States and taking their learned skills and education back to their countries.”

Both in his work with China and, now, in his role as Academy president, Dr. Abbott is committed to helping ophthalmologists do what they do best. “One of my primary goals as Academy president is to better communicate with members and understand what they need and what the Academy can provide to help them improve the quality of care for their patients,” says Dr. Abbott. To this end, he has pledged to provide regular communications with members through the Academy Online Community.

“Yes, I will be blogging,” laughs Dr. Abbott. “Mostly what I want to achieve is to let our members know what the Academy does for them and hear their opinions and suggestions on how we could do it better. I believe that a lot of members don’t realize the broad scope and depth of everything that the Academy does.”

Dr. Abbott with Professor Zhao Kanxing, president of the Chinese Ophthalmological Society.
Dr. Abbott with Professor Zhao Kanxing,
president of the Chinese Ophthalmological
Society.

Similarly, his work in China is now focused on helping get the word out about the PPPs. “First, we need to let them know the guidelines even exist,” he said. “Next, they need to use them efficiently and economically. Finally, they need to maintain their use so the way they practice actually DOES change and they don’t revert back to their previous ways.”

With a country as large and diverse as China, this can be very difficult. “The way the medical system is set up in China, on the eastern seaboard, you have the large, more technically advanced medical centers,” says Dr. Abbott. “But as you travel west, the resources and quality of medical care decrease and become much more basic. In fact, in central and western China, in particular, there is a large incidence of cataract blindness and other basic medical needs that haven’t been met.”

On his next trip there in May, to a large medical center located between Beijing and Shanghai, Dr. Abbott will continue to teach and discuss implementing the PPP guidelines. His goal is to help the developed areas first and have those newly educated physicians, with the support of the Ministry of Health, use what they’ve learned to better educate the rest of the country.

And, with his new blog, he may share some of those experiences and the insights he gains with Academy members. “A lot of the health delivery and patient access problems I see overseas are similar, in many ways, to what we experience in the U.S.,” says Dr. Abbott. “The magnitude may be different, but patients are the same in how they respond to or view physicians, and physicians have the same desire to provide quality eye care. It seems that the rewards and frustrations are basically the same around the world.”

Dr. Abbott says he wants to hear from members what you want the Academy to do for you, so don’t be shy about commenting on posts. “The blogs and online community are a great way to start the dialogue,” says Dr. Abbott. “It allows me to communicate directly with the members. It will be an interesting experiment for me.”

In the meantime, here are a couple of pearls he has for young ophthalmologists.

Advice for residents and fellows: “After you have built the foundation of clinical knowledge and technical skills to care for patients through your training programs, you will need to improve your skills to effectively communicate with your patients and colleagues and function efficiently in a variety of clinical settings,” says Dr. Abbott. “Although the job market may sometimes appear tight or not ideal when you begin looking, there are actually many different types of practice opportunities available. We are extremely fortunate, as ophthalmologists, to practice in a profession that continues to innovate and find ways to improve patient outcomes for what we do. It’s a very rewarding specialty.”

Advice for YOs in their first few years practice: The key word is balance. “There are many balls to juggle once you leave your training,” says Dr. Abbott. “There are the challenges of clinical practice, the professional standards you need to maintain, the issue of ethics and professionalism, as well as the practical economic pressures we all face in running our office. And when you throw in family life, personal time and personal health, it can all become very overwhelming.

“Between seeing patients, traveling both nationally and overseas numerous times a year, and spending time with my wife, three children, and four grandchildren (soon to be five in April), balance can seem like an impossibility,” Dr. Abbott admits.

That’s why he encourages ophthalmologists to take full advantage of professional organizations like the Academy. “Whether you are just starting out, have been in practice for a few years, are volunteering overseas, or getting involved in voluntary clinical work or advocacy here in the states, the Academy is here to support and help you,” says Dr. Abbott.

“My job as president this year is to make sure you are aware of that support, figure out ways we can do it better, and hopefully, with the assistance of the Academy, allow you to maximize your personal and professional time and improve your clinical expertise and professional skills with your patients. I look forward to hearing your thoughts and ideas."

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About the author: Kimberly Day is a freelance health writer and medical editor and a frequent contributor to YO Info. She is the co-author of Hormone Revolution and ghost writer of Eat Papayas Naked. Additional reporting by Christi A. Foist, YO Info managing editor.

 
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