April 11, 2022

Episode 22: Dr. Geoff C Tabin, MD MA

A discussion on

“Quality over Quantity: Compassionate Capitalism”

The Himalayan Cataract Project - Cure Blindness

Dr. Geoff C Tabin, MD MA

The first episode of season 2 premieres the much-awaited conversation with Dr. Geoff Tabin, MD who is the Fairweather Foundation Professor of Ophthalmology at Stanford University. Featured in the well-acclaimed book “Second Suns”, we walk through his journey partnering with the incredible Dr. Sanduk Ruit in founding the ‘Himalayan Cataract Project - Cure Blindness’.

Dr. Tabin did his undergraduate education from Yale University and went on to obtain a MA in Philosophy from Oxford University on the prestigious Marshall Scholarship. After completing medical school from Harvard University, he went on to train in ophthalmology at Brown. Following residency, Dr. Tabin completed a corneal surgery fellowship at Melbourne, Australia. It is our great pleasure that we learn from him his thoughts on global ophthalmology and how eyecare equity can be achieved on a global scale.

Key discussion points:

  • Gravitating towards Ophthalmology

    • Passion for rock-climbing

    • Interest in public health - equity in global health

    • Lure to curing blindness in Nepal where practice of lens implant was absent

  • Meeting with Dr. Sanduk Ruit

    • Connection through fellowship in Australia

      • Mentor: Dr. Hugh R Taylor

    • Dr. Fred Hollows: Training local systems

    • Dr. Ruit’s focus in Nepal: Human resource utilization and reducing cost in Kathmandu, Nepal

      • Compassionate Capitalism

  • The Journey

    • Dr. Tabin’s partnership with Dr. Ruit

      • Focusing on the academic side and hoping to arrange western fellowships

    • Starting a full residency and now full subspecialty fellowship in Nepal

  • What led to the success in Nepal?

    • Partnership and teamwork: creating a system where everyone thrives with high volume surgery

    • A combination of passion and care for fellow humans ingrained in the culture

    • Picking the best students out of the crop of medical graduates

    • Financial renumeration: ophthalmology became the most attractive field

    • Focus on quality led to quantity

  • Low-cost cataract surgery: Sustainability

    • Low cost lens factory in Nepal

      • Issue with manufacturing and distribution/marketing to meet the growing masses

    • Surgery kit: $11 for all reusables

    • Green impact

      • Dr. David Chang’s article on comparing waste between different institutes and countries (link in reference page)

    • Initiative at Stanford

  • Core principles to achieving sustainable care

    • Focus on quality

      • Replicating the same quality in the US to the poorest regions of the world

    • The dilemma of increased quality in developing nations

    • Dr. Norval Christy and moving towards the sustainability model of global ophthalmology

  • Attracting and retain global ophthalmology talents

    • Financial incentives to work locally in countries

      • Prospect can be grim in certain countries such as Sudan

      • In several African countries: ophthalmologists are on government salaries and other specialties such as pediatrics and medicine are more sought after.

  • Starting global ophthalmology training early in career

    • Focus on passions and letting them lead you to the essence and spirit of a true physician

    • Negotiating time over money

    • First global ophthalmology fellowship program in 2008 at the University of Utah

      • Idea of making this a major portion of your career

    • Stanford’s focus on global eyecare development

    • World is a very small place and we are actually more and more connected

  • “We still have a long way to rest. Don’t ration the passion!”- Dr. Tabin ‘Second Suns’

  • Future of global ophthalmology

    • Hope to see Africa going the same direction as Nepal, Bhutan, India in overcoming needless blindness

    • Seeing some really good ophthalmologists in Cambodia, Myanmar, etc.

    • The cost of treating people with needless blindness through cataracts and/or those with refractive error is $14 billion

      • Funding and attention to health disparities around the globe is within our reach but needs to be supported by the right people

Episode-based Resources:

Resources — Open Globe Talk with Rizul (openglobetk.com)

 
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Episode 23: Dr. Bala Ambati, MD PhD MBA

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Episode 21: Dr. Peter Macintosh, MD