• President's Statement

    Green Shoots on the Horizon

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    Tamara R. Fountain, MD

    By Tamara R. Fountain, MD, 2021 Academy President

    Listening to a podcast on last year’s wildfires, I learned about a resilient (and patient) species of fir tree that can’t survive without fire. The pyrophile seed cone lies dormant, sometimes for years, until the intense heat of a destructive fire melts its resin shell, liberating seeds that germinate in the charred soil below. Green shoots soon dot the smoldering landscape, a reassuring sign that out of destruction there can be renewal.

    As ophthalmologists, we had high hopes for “the Year of the Eye,” but, like a wildfire, events of 2020 destroyed the normal fabric of our personal and professional lives. The Academy was one of the first medical societies to experience pandemic disruption when the San Francisco Bay Area issued the nation’s first stay-at-home order in mid-March. Within days (and thanks to years of earthquake disaster planning), the nearly 200 Academy-headquarters staff transitioned seamlessly to executing Academy business from home.

    It was hardly, however, business as usual. Pandemic hot spots on both coasts were consuming available resources and threatening full-scale collapse of regional health systems. After the Academy’s recommendation to temporarily sus­pend all but urgent eye care, our members were in need of information and guidance. And they needed it quickly.

    The Academy website landing page was retooled as a one-stop, everything-you-need-to-know COVID portal—the science of the virus, the pathophysiology of the disease, the playbook for financial survival and practice preservation. As initial lockdown restrictions lifted midyear, AAOE and the Academy’s D.C. office shifted into overdrive to guide members through the practice management and regulatory gauntlet of rebooting clinical practice. As 2020 drew to a close, “where all of ophthalmology meets” migrated online with the first-ever virtual Academy annual meeting—a jam-packed three-day weekend with a mix of live and on-demand presentations providing over 700 hours of CME.

    2020 will be a grim year for the history books. From the highest office in the land to local PTA presidents, it tested all leaders—our 2020 Academy President Anne Coleman being no exception. A renowned clinician-scientist whose public health background provided the perfect skill set for this unprecedented year, she steered us with equanimity through the health crisis of a pandemic, the challenge of racial health disparities laid bare, and the disruption of all normal Acad­emy governance and rhythms. She, along with CEO David Parke and COO Lawrence Mendenhall, conducted a master class in transparent and reassuring crisis management. It was a privilege to serve by their sides this past year, and I will be a better leader for the bar they’ve set.

    As a new year dawns, we are encour­aged by unprecedented progress on the vaccination front but we are far from being out of the COVID woods. The fires of the pandemic are still burn­ing as our nation faces fiscal headwinds not seen since the end of the last World War. Federal bills coming due for COVID-19 will further strain physician reimbursement, threat­en patient access, and, perhaps, further erode traditional barriers to mid-level scope expansion across the entire house of medicine. We in ophthalmology have our work cut out for us. As we roll up our sleeves, let’s remember that with every crisis comes opportunity. 2021 gives us the chance not only to rebuild and restore the profession but also to rethink and retool the ways we treat patients and attend to our own professional devel­opment and practice management needs.

    As we reimagine ophthalmology, whether that be adapting residency training to an e-learning environment, narrowing racial gaps in eye care, enhancing telehealth technology, or re-thinking entire office workflows, all while protecting fair physician payment, our efforts are informed by a singular mission —the service and well-being of our patients. This is the profession’s raison d’être and the motivation for everything we do.

    There are challenging days ahead. There are also reasons for optimism and hope. What an honor and privilege it is to preside over the Academy as ophthalmology looks for the bright green shoots on the horizon.