 Welcome everyone and thanks for listening in to our second episode of chat with the chair podcast today We're joined by dr. Lisa shock it associate professor and interim chair of ophthalmology and visual sciences at the University of Maryland School of Medicine Thanks for being with us today. Dr. Shock it. Thanks for having me Why don't you start off by telling us a bit about yourself and what led you to pursue the field of ophthalmology? Well, since we're here on campus I will start off by saying that I was actually born in Baltimore at University of Maryland and then I went to Bryn Mawr school for high school moved on to Brown University Did my residency and medical school both at University of Pennsylvania and then I did a fellowship at Tufts of Thalmik consultants of Boston in vitro retinal disease and when you asked what led me to pursue ophthalmology I would say, you know everything in medicine is interesting, but nothing particularly, I guess really grabbed me and I was struggling a little bit to decide what I wanted to do But I thought in my life who is the person who loves their job more than anyone in the world? And that's my father. He is a retired retina surgeon And if you know at the height of his career if you ask like or thought about what his hobby was It was retina and everything was retina and ophthalmology and he invented things he He just found everything so exciting so he suggested to me to go over to the ophthalmology department at my medical school and I was very fortunate there's a Fabulous chairman there named Stuart Fine who actually also went to medical school here And he was a fabulous mentor and quickly got me engaged in research and in ophthalmology And just from there I became very interested and you're also a retinal Specialist as well. Yes, and then I ended up at University of Maryland where he was also the interim chair. Wow Yeah, that is funny. So what do you have a particular area of interest in at this moment? I do everything in retina, you know from macular holes, retinal detachment surgery Macular degeneration, retinal vascular disease I am particularly more interested in diabetes because it's such a prevalent disease in our city But I do take care of all round diseases and as the interim chair of ophthalmology for the department Tell us about your vision for the department and your leadership style and how you really see your team Making great impacts on the state of Maryland and the city of Baltimore and the whole community I think the unique thing about our department is that we are a cohesive unit We really work well together We you know, I have the great situation where when I'm seeing patients in our Redwood campus There's always a cornea specialist and a glaucoma specialist. And so we often see very complex referrals from other Institutions or other private practices and we are very able to work as a team And so I think we're able to provide the best quality Coordinated care in that way we can do combined surgeries or and we have great discussions on figuring out the best care for the patient I would like to be more and more engaged in the community and my specific interest is diabetic retinopathy and Specifically diabetic retinopathy in the Baltimore City community I will tell you that I was a little bit shocked when I moved to Baltimore because it was a little different than where I was training Which some of the pockets of Boston where I was training was very wealthy and here we see unfortunately very severe disease that we should never see it's all preventable and It breaks my heart. I would say at least twice a week. I will see a young typically African-American female who comes in Maybe complaining of floaters, you know And I look in their eyes and it's just horrible and I can tell them that they're gonna go completely blind within a year if they don't proceed with treatment and I can't always get them to adhere to treatment and that's my biggest struggle and The most important thing I think we need to try to change. Why is it that they are hesitant to the treatment? There's a long list of reasons Unfortunately, I think you know one major reason is like mistrust of providers and some like, you know hesitancy to trust me We are fortunate. We have this fabulous photographer who actually was the photographer at the department when my father was there, too so he Is a bit older African-American male who really Sometimes I will explain everything show the pictures Try to engage the patient and I can I just get this feeling that the patient's not gonna come back They're not they look at me a little funny and I know they're not they're not really like engaged So I go in the other room. I say Ricky you get this patient. You need to talk to them You need to explain the photos and explain what they need and then they come back and oftentimes he can get them to comply with treatment because He's African-American and they trust him more But I wish we could get more community health care workers more engagement of this population to to be able to Improve the care because this is all preventable vision loss What exciting research is being done right now in the field of ophthalmology? I'll first tell you the research on this topic and the research on this topic is interesting because we've tried to Improve these issues like we've tried to improve engagement, but it's been difficult But there was a very interesting study done in 2015 in Philadelphia Looking at older African-Americans and trying to engage them with care and engage them with just coming in and getting their baseline exams and They used a church Going out into the community and use community health care workers and really paired people To figure out what the barriers to care were and they really improved their dilated exams and Similarly, I will say that on November 5th the endocrinology department is doing a big community outreach at the new Shiloh Baptist Church and the ophthalmology department will be there Screening our patients in the community for diabetes What are some of the challenges you face as the leader now of the department of ophthalmology? I mean one challenge I face in general is this challenge that we're already talking about is non-adherence and you see that also in glaucoma and other diseases in our inner city population Because of barriers to care such as you know patients need to go to work or need to take care of family members and they can't always Come in for their appointments and therefore we're getting to patients way too late and The surgeries become very complex. So it's harder to restore vision when we're when everything is so far gone What advice would you offer to somebody who is interested in pursuing a career in ophthalmology? The first thing I would say is to find a great mentor I was very fortunate by finding a great mentor in Dr. Stewart Fine when I was in my Residency but in order to help with training steps It's always important to find a great mentor and then also find a place where you're comfortable working We are very fortunate here where Everyone in our department is a team player and we all like to work well together And that's a great opportunity for learning for further research So finding a great mentor and finding a place where you're interested I guess the third thing is find something obviously that you're passionate about because it's always easier to Pursue and work on things that you're most interested in Talk to us about the challenges you faced and you and your team during COVID and how you were able to overcome those challenges, especially, you know dealing with the eyes You're right there up close and personal in people's faces So how was it that you were able to still maintain your your patient volume and everything else with all these barriers? Ophthalmology is a little bit harder because we did try and we did do some Virtual visits and it was a little amusing also because like you would call a patient and Some of the older patients trying to put the camera up to their eye was was quite challenging But it you really can't get an appropriate exam for virtual. So that wasn't like a great option for us Our team did some great work specifically. Dr. Ronnie Levine did some great work with virtual rotations For the medical school and for residents who still wanted to rotate with us And she set up these fabulous wet labs that were virtual to teach students how to Suture and she became nationally renowned for her work The patient volumes went down for a little but we're you know We've we've learned like everyone in the country and in the world to deal with COVID But there was a little bit of a bump in the road for us for sure Talk to us about your relationship with referring physicians and how you ensure that they stay up to date on What's going on with their patient and how you nurture that relationship with other referring docs? Sure, I actually was originally in private practice in the community And so I came here with a lot of relationships with some great referring providers And you know, I'm often texting them emailing them calling them on the phone for updates Epic is pretty easy to like shoot off a letter to someone So I feel that we are all pretty good at at texting and emailing our community providers So the relationship works well Talk to us about the differentiators What makes the University of Maryland Department of Ophthalmology unique in their approach to patient care and also in their approach to research The approach to patient care is really the teamwork like we have a you know an ease of teamwork We're a small department. We're always, you know I recently had a complex post-operative issue that was really, you know a little bit mind-boggling and I very easily could call my colleague Dr. Saidi on a Saturday and just say hey, what do you think of this and He he actually was fascinated by the question and was excited to talk about the complex issues So that that's the the unique thing about our department is we all Are happy to talk to each other and happy to help each other out So we always have an expert at our fingertips And you also provide care 24-7 for any eye emergencies, correct? Yes, and we do get a lot of eye emergencies because of our relationship with shock trauma What are you most excited about in the future of the treatment for retinal disease? There are constant advances in our field, you know right now there are We've gone from larger gauge Instrumentation to much smaller incisions which allows for faster post-op recovery and more Delicate dissection of tissue. We have better visualization during our surgeries and then in the practice setting we use a lot of introvitral drugs to treat a host of diseases including diabetes and macular degeneration and It's unfortunate that currently a lot of those injections need to be monthly So the future holds that there are a lot of drugs in development that Will hopefully make it so that patients don't need to have their injections as frequently Do you also offer expert second opinions or guidance to referring providers? Helping to educate them on when to send a patient when to refer a patient to whether it's a retina specialist or Cornia expert glaucoma expert whomever Yes, we constantly get second opinions for all of our subspecialties and we're always available by phone or text Just to you know ask an opinion as to who the best provider I've I've done that on multiple occasions and we're you know so easily can grab each other from different locations So even you know, I got a cornea emergency the other day But knew where to grab our cornea specialist from the VA. So we're we're very easy to work with I believe So anything else you think those listening in should know about either the University of Maryland Department of Ophthalmology Your physicians or just the future of retina disease Just in summary, you know, we are a very cohesive Department that is happy to take care of any of the referrals from the community and We work well together and can provide very sub-specialized coordinated care Thanks again for stopping by for chat with a chair brought to you by University of Maryland faculty physicians, Inc For more information about today's guest or to listen to additional episodes visit Umfpi.org backslash podcast until next time