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Young Ophthalmologists
From Small-Town Doctor to World-Class Leader: An Interview With H. Dunbar Hoskins Jr., MD
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Twenty years ago, when he decided to take a pay cut and move from an internationally recognized glaucoma practice to a largely administrative role with the Academy, H. Dunbar Hoskins Jr., MD, wasn’t aware that he’d go on to lead the organization into the Internet age and through one of it’s most successful periods of expansion. Yet, despite the unknowns and the financial costs, he took a leap of faith — and now all of ophthalmology owes him a debt of gratitude for that.
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Dr. Hoskins' early career arc would be familiar to many young ophthalmologists. He attended college and finished his ophthalmology residency in his home state of Virginia. Upon completing a fellowship in San Francisco, he returned home to open a solo practice.

Dunbar H. Hoskins Jr., MD
Dr. Hoskins

A year later, however, he moved back to the Bay Area to join a successful group practice and became increasingly involved with the Academy. Once Dr. Hoskins took over as its executive vice president, he embarked on an unparalleled path — a 16-year tenure overseeing a period of exceptional growth for the world’s largest ophthalmology association.

Over the years he’s become known as not just a leader, but a mentor and role model for all of ophthalmology — a man whose wit and kindness complements his ability to motivate.

So it was to no one’s surprise — except perhaps his own — that members of the Academy’s YO Committee presented him with the Academy’s 2013 EnergEYES Award at the recent Annual Meeting in New Orleans, Nov. 16 to 19. This award was created to recognize ophthalmologists who have demonstrated exemplary leadership skills and displayed a high degree of energy to inspire YOs.

Dunbar Hoskins, MD, receives the 2013 EnergEYES Award in New Orleeans
Members of the YO Committee surprised Dr. Hoskins with the 2013 EnergEYES Award, during a ceremony in New Orleans.

Dr. Hoskins is “a legend in ophthalmology,” said YO Committee Chair Robert F. Melendez, MD, MBA. “His foresight about creating the ONE Network years ago was genius, and now his idea is helping residents and ophthalmologists access educational content across the globe.” Former deputy executive vice president David Noonan agreed: “The award is certainly deserving. He has spent a large portion of his adult career in medicine providing for improved opportunities for education across all of ophthalmology.”

In an interview with YO Info after receiving the award in New Orleans, Dr. Hoskins discussed his career — his toughest decisions as well as his own role models — and provided some useful pearls for each and every young ophthalmologist.

YO Info: What kind of career did you envision as a young man? Looking back, how does your career compare with that original vision?

Well, I always imagined I was going to be a small-town country doctor back in Richmond, Va. and I was almost there. After completing my glaucoma fellowship with Robert N. Shaffer, MD, at the University of California, San Francisco, I moved back to Richmond to start a solo practice.

But when I went to my first Annual Meeting and witnessed first-hand the people up on stage and the energy they had invested, I was fascinated and quite frankly became very interested in becoming more involved in the profession.

So, when Bob Shaffer invited me back to California to join his practice, it seemed like a perfect opportunity. Looking back, it was a big decision — moving from a small pond to a big pond. But at the time, I didn’t think of the situation in that fashion. I just really enjoyed working alongside Bob. Not only was he a well-respected physician, but also he was an internationally recognized lecturer and speaker. More importantly, he was a world-class mentor.

And, clearly, it changed the whole course of my career. Had I not followed through with my decision, I’m sure I would have ended up in Virginia, never become actively involved with the Academy and probably had quite a different life.

YO Info: Besides your role as Academy EVP, what other leadership positions have you served in your career and what lessons have they brought your way?

Another extremely important position in my career was my role has chairman of the board at St. Mary’s Medical Center in San Francisco.

This was a very valuable experience because it taught me how to listen. I didn’t know anything about hospital management at the time, and it turned out that the best way to learn was through listening — really listening to people, understanding problems and asking questions that were meaningful and focused on trying to tease out the reality of the situation.

YO Info: What was the most difficult decision you had to make in your career?

The hardest decision in my career was definitely whether or not to accept the offer to replace Bruce E. Spivey, MD, as Academy executive vice president. This was a real challenge for me — to basically leave a very solid career and move into something that was an unknown.

Hoskins’ Highlights at the Academy (1993–2009)
Academy membership grows by almost 40 percent.

Annual Meeting attendance increases by 25 percent.

Funding from the Foundation of the American Academy of Ophthalmology jumps from $280,000 to $2,500,000.

First Subspecialty Day.

First Mid-Year Forum and Congressional Advocacy Day.

American Academy of Ophthalmic Executives established.

Young Ophthalmologist and Senior Ophthalmologist Committees established.

Global Alliances Division established.

Public Trustees brought to the Academy Board of Trustees.

EyeSmart™ public education campaign launched.

First Academy website goes live — followed, 11 years later, by the Ophthalmic News & Education (ONE®) Network.

Prior to that role, I was a part of a successful glaucoma practice with global recognition. It was an interesting practice in that we saw complex cases, performed a lot of surgery and traveled around the world to meet wonderful people. So, it wasn’t easy to make that type of change and take a cut in income to manage the Academy.

And, although I’d already been involved in many other organizations and was obviously familiar with the Academy through prior roles as chair of the media committee and secretary of instruction, I didn’t really know that I myself could handle managing anything as big as the Academy.

But Bruce — another person who had a powerful influence on my life — really helped me realize my potential. Just watching him work and seeing his leadership style encouraged me. Most importantly, he expressed faith in my ability to take over the position, which made a huge difference.

YO Info: Many individuals have played important roles throughout your career. Is there one person in particular to whom you would have given the EnergEYES award if it existed when you were a young ophthalmologist?

Well, first of all, the award came as a total surprise. I was sitting in the audience and had assumed that someone else was receiving it! But it’s really meaningful. I think one of the things that we as physicians don’t realize as we go along in life is the impact that we have on the young people who are coming up behind us. And so being recognized for the influence that you have on younger people is just astounding because we don’t know it, we don’t observe it and we don’t think about it so much.

I could provide you with a long, long list of individuals worthy of the EnergEYES award, but I would’ve given it to Bob Shaffer. He was just a special person — anyone he touched felt better about themselves, and he was such a role model to so many young people at the residency program in San Francisco.

YO Info: During the course of your career, technology, especially that which relates to communication, has changed drastically. Do you feel that you were able to adapt well in your professional life?

The digital age has certainly transformed our society, and we must be engaged in it. You can’t avoid it. The real challenge is using technology effectively with a goal in mind and not letting it distract you too much.

Personally, I’ve always enjoyed the intellectual challenges associated with new technology. So, of course, technology really changed my life — and from very early on. I first got interested in computers in 1980 and bought an Apple II Plus. I designed a database program on that machine to manage the treatment of my glaucoma patients. I really enjoyed that challenge — it was such an education. A few years later, I started a small computer company. All of that background entered into the creation of the ONE® Network.

And as a group, it seems like ophthalmologists are balancing the use of technology reasonably well. But I am a bit worried. You can just look around at meetings and witness everyone doing what we used to call the “Blackberry prayer.”

I also think there’s a real risk that the high-touch side of the high-tech/high-touch dichotomy in medical care is disappearing or may disappear. Our interactions certainly have become more impersonal, and I honestly don’t know where this reality is going to lead us.

YO Info: Is there any advice that you’d like to impart on today’s young ophthalmologists — especially those interested in taking on future leadership roles?

Get involved. I had a friend of mine, a very accomplished ophthalmologist in his 50s, come to me recently and say, “I know exactly what’s going to happen in the next 30 minutes as soon as I see a patient’s medical chart.” He was tired and in need of some challenges. And that happens to all of us. It’s the burnout syndrome. And more and more young people are going to be victims of it simply because the environment is going to require them to see more patients in a shorter amount of time and deal with more bureaucracy and regulations.

So any outside interests that can engross YOs and renew that passion are extremely important. And the Academy is the perfect avenue for getting YOs involved in activities beyond just patients. Of course patient care is still very rewarding — the most rewarding thing you can do as a physician — but divergence is important and getting involved in other activities is critical.

Another piece of advice is to follow and engage in your passions. I heard Rob Melendez make a wonderful comment at the YO/SO Symposium, “So You Want to be a Leader in Ophthalmology,” in New Orleans. Someone asked him how he balances his life, and his answer was very fascinating: it isn’t so much about balance as it is engagement. You might not have all the time you need to spend in a particular realm of interest, but when you are there, make sure you are present both mentally and physically. And I thought that was a great piece of wisdom that everybody could use. Passion creates engagement and creates a joy of experience.

For more details on Dr. Hoskins’ career, check out EyeNet’s March 2009 feature as well as his piece in the June 2007 YO Info.

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About the author: Mike Mott is a contributing writer for YO Info and a former assistant editor for EyeNet Magazine.

 
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