Ethical Global Outreach in Residency Training

Acknowledging how self-interest, altruism, and global health experiences intersect.

Grace Sun, MD, and Alina Husain, BS

Glaucoma Today

During my (G.S.) 10 years of serving as the program director of the ophthalmology residency at Weill Cornell Medicine, I interviewed hundreds of applicants who were interested in global ophthalmology. When asked to describe their interest in global health training, applicants often replied with some variant of the same response: to help those in need and to provide care to underserved populations. When I, in turn, described our international opportunities, I always sensed their surprise, and occasionally their disappointment, at my response: “Your experience may be largely nonsurgical.” In the residency interview setting, I was not able to delve into the complexities surrounding global health experiences. I wanted to share my experience as a Peace Corps volunteer in Nicaragua, where I, too, set out with idealistic (and rather naïve) intentions to “save the world.” I wished I could explain that, although we engage in global health experiences with altruistic intentions, we often stand to gain more from these experiences than do the communities that host us. Given the growing interest in global ophthalmology during residency training,1 it is important to reflect on how best to engage in global health experiences and serve host communities. GLOBAL OPHTHALMOLOGY ROTATIONS In July 2013, the Accreditation Council for Graduate Medical Education began to allow up to 1 month of international rotations to be applied to residency training.2 Since then, a growing number of US ophthalmology residency programs have been adopting global health curricula. At least half of ophthalmology residency programs offer or support resident international experiences,3-5 but the global health curricula offered differs substantially by program. Not all programs have mandatory requirements that residents must meet before practicing abroad, even though many faculty believe additional training outside of the standard ophthalmology curriculum is necessary to practice in an international setting. The lengths of international experiences vary from weeks to months, with the most commonly reported duration being 1 week or less.3 Given residents’ limited preparation for—and the short duration of—global health experiences, it is important to understand the motivations for these experiences from the perspective of residency programs and learners. By offering global health opportunities, US ophthalmology residency programs aim to provide residents with international experiences, deliver humanitarian aid, and engage in medical diplomacy.3,6 Through these rotations, residents gain increased exposure to ophthalmology and other health care systems; broadened clinical, surgical, and research experience; and exposure to other cultures.

In Consideration of House Calls and OD-to-OD Referrals

Eyetube

This month on The MOD Pod, Cecelia Koetting, OD, FAAO, Dipl ABO, invites Damaris Raymondi, OD, FAAO, and Jason Besecker, OD, MS, to discuss their recent articles in Modern Optometry. Have a listen as Dr. Raymondi shares extra details about the patient experience that opened her eyes to the transformative effect that offering at-home visits can have on a patient's life. Dr. Besecker then explains why being receptive to OD-to-OD referrals enables clinicians to do what they do best—whether that be specialize in scleral lenses or dry eye or provide full scope care—while serving the best interests of their patients and establishing important relationships with colleagues in their communities. 

Expand Your Opportunities for Profitability

Consider adding these technologies to your practice and reap the rewards.

Christopher Lopez, OD

Modern Optometry

Running a successful optometry practice goes beyond providing quality eye care services. In order to thrive in today’s competitive health care landscape, optometrists must adopt strategic approaches that maximize their profit streams. Optimizing profitability requires both the owner and staff to embrace cutting-edge technologies and expand the scope of services offered. The good news is that optometry practices can increase revenue and achieve sustainable growth. This article explores how using advanced technology and treatment options can lead to improved business and patient outcomes. Note: specific technologies and treatment options are mentioned here because they are those with which I am most familiar. (See Additional Options for a rundown of other technologies and treatments that may boost your practice’s profitability.) Additional Options Below are second-tier technologies and treatment options that can increase practice revenue and growth. ANTERIOR SEGMENT IMAGING CPT code 92285 (External ocular photography with interpretation and report for documentation of medical progress). Although reimbursement is not great at approximately $20, this can be made up for in volume with the sheer number of billable diagnoses. DILATION AND IRRIGATION CPT codes 68801 (Dilation of nasolacrimal punctum, with or without irrigation), 68810 (Probing of nasolacrimal punctum, with or without irrigation), and 68840 (Probing of lacrimal canaliculi, with or without irrigation).