Bascom Palmer takes top honors in Ophthalmology Times Best Programs Survey

After a seven-year hiatus, Ophthalmology Times resumed its Best Programs Survey this fall. While a few new names popped up on the list, Bascom Palmer Eye Institute at the University of Miami Miller School of Medicine, Miami, remained at the top of the Best Overall Program category, followed again by the Wilmer Eye Institute at the Johns Hopkins University School of Medicine, Baltimore.

Number three in the overall list has a new name with Dean McGee Eye Institute at the University of Oklahoma, Oklahoma City-the first time that institute has appeared in the top category since the survey’s inception 20 years ago.

Completing the Best Overall category were the University of Iowa at fourth; Duke University Eye Center at fifth; Wills Eye Hospital/Thomas Jefferson University at sixth; Massachusetts Eye & Ear Infirmary/Harvard University at seventh; W.K. Kellogg Eye Center/University of Michigan at eighth; Moran Eye Center/University of Utah at ninth; Stein & Doheny Eye Institute/University of California Los Angeles at 10th; Casey Eye Institute/University of Oregon at 11th, and the Cole Eye Institute/Cleveland Clinic at 12th.

Bascom Palmer Eye Institute also came in at the top of the Best Clinical Care and Best Residency Program categories. It came in second in Best Research Programs, edged out by the Wilmer Eye Institute.

The Best Clinical Care category included Dean McGee Eye Institute in second place; Iowa in third; Wilmer Eye Institute in fourth; and Wills in fifth. Best Residency Programs-after Bascom Palmer Eye Institute-were Dean McGee in second; University of Iowa in third; Wills in fourth, and Wilmer Eye Institute in fifth.

The Best Research Programs included Bascom Palmer Eye Institute in second, Massachusetts Eye & Ear in third, Duke in fourth, and Dean McGee in fifth.

Ophthalmology Times conducted the survey through Survey Gizmo. Of 235 chairmen and residency program directors invited to participate nationally, 73 did, for a 31% response rate.

In interviews with Ophthalmology Times, the chairmen at Bascom Palmer Eye Institute and Dean McGee Eye Institute both expressed appreciation for the accolades, with both being quick to give credit to their entire staff and community at large for what their institutes have been able to accomplish.

Welcome surprise

Bascom Palmer Eye Institute Chairman Eduardo C. Alfonso, MD, called the news a welcome surprise.

He said one element that helps the institute succeed is a commitment to always putting the patient first.

“We ask ourselves all the time how we would want to be treated,” Dr. Alfonso said. “Everyone who works at Bascom Palmer is asked to think about how we can provide better care, from the patient experience to the outcomes of the care from a clinical standpoint, to thinking outside the box.

“If we don’t have a current way to diagnose or treat this condition, how can we ask that question in the research arena to be able to provide this patient the best care possible? That culture is extremely important,” he said.

However, Dr. Alfonso said that having a good philosophy is only successful if you can operationalize it.

“One of the advantages we have is that we have been doing this for a long time here,” he said. “We have put together policies, procedures, and processes that are looked upon every day to make sure that what we want to do gets done.”

Dr. Alfonso also noted that many of the 1,300 people who work at Bascom Palmer Eye Institute view it as a lifetime-career commitment, which enhances quality as well as consistency in all facets of the operation.

New name in survey

Dean McGee Eye Institute Chairman Gregory L. Skuta, MD, said he was honored by the peer recognition that these rankings reflect.

Dr. Skuta said much has happened since 2010 that may have helped his institution attract more notice.

A 78,000-square-foot pavilion (now named the David W. Parke II, MD, Pavilion) was dedicated in September 2011 and the original 70,000-square-foot pavilion (now named the Thomas E. Acers, MD, Pavilion for the institute’s founding president) was renovated to provide for expanded patient care, education, and research programs.

Under the leadership of residency program director Michael Siatkowski, MD, the institute enhanced its educational experiences and academic productivity; it developed a microsurgical education center; and it created a robust Visiting Professor Program, which exposes residents, fellows, and faculty to leaders in the field, Dr. Skuta noted.

He also said that leadership and service are woven into Dean McGee’s organizational fabric. For example, four past or current members of the faculty have served as president of the American Academy of Ophthalmology from 2007 to 2017, including Dr. Skuta in 2014 and Cynthia A. Bradford, MD, currently.

Dr. Parke, who now serves as chief executive officer of the academy, was president in 2008; C.P. “Pat” Wilkinson, MD, served as president in 2007.

“We are very proud of those contributions and service to our field,” Dr. Skuta said.

Elements of success

Both chairmen were asked what they believe is essential to success in healthcare today.

Among other factors, Dr. Alfonso cited a willingness to embrace change, particularly regarding technology.

For example, Bascom Palmer Eye Institute replaces certain surgical equipment annually, instead of following the recommended three-year depreciation schedule.

“Technology is changing very quickly and we want to be able to embrace that,” he said. 

Having the money to acquire the latest upgrades requires a long-term financial plan and a solid donor network, he said.

“We have a significant number of philanthropic supporters who see the vision we have and who are committed to improving patient care, so they invest their resources with us so we can be partners in providing change,” he said.

Dr. Skuta cited faculty recruitment as another essential element for success today.

“We have been fortunate over the years to attract outstanding and very productive faculty who have expanded the breadth and depth of our clinical and surgical services (ocular oncology is one example),” he said. “They offer cutting-edge techniques and are personally contributing to clinical and surgical advances and scientific discovery.”

Of the Dean McGee ophthalmologists recruited before 2013, 100% have been listed among the Best Doctors in America, Castle Connolly Top Doctors, or both, he said, adding that such recognition often takes at least five to 10 years to achieve, if ever.

Resident education

Both programs ranked at the top of the residency education category. Dr. Alfonso attributed his program’s success in this arena at least in part to the long-standing belief that education is the single most important activity done at Bascom Palmer Eye Institute-an attitude that started with founder Edward Norton, MD.

“That legacy has been continued by every member of the residency program. Every faculty member, including the current director of the residency, Steven Gedde, MD, is committed to the program,” Dr. Alfonso said. “Steven is a unique leader who has brought together a team that provides a superb educational experience to our residents.”

Dr. Skuta said Dean McGee’s commitment to educating the next generation of ophthalmologists also goes back to the program’s debut, in 1975 under Dr. Acers’ leadership.

“His devotion to resident education has been further augmented by the exceptional leadership of Dr. Michael Siatkowski, who is a national and international leader in ophthalmic education,” he said. “Along with our faculty, he has elevated an already outstanding residency experience to even higher standards of excellence.”

He said that some of the outstanding features of Dean McGee’s residency program include robust clinical and surgical volumes, a broad variety of pathology, international opportunities, a well-equipped microsurgical laboratory and associated surgical curriculum, meaningful interactions with basic scientists, engagement in advocacy and state and national organizational activities, and high expectations and standards.

Research

While Wilmer Eye Institute ranked tops in the research category this year, Bascom Palmer Eye Institute was second and Dean McGee Eye Institute was fifth.

Dr. Alfonso said that one of the keys to his institute’s research program is the clinical component.

“The very large number of patients that we see gives us a unique opportunity to conduct very important clinical research,” he said.

The institute conducts a significant amount of laboratory research too, he added. It has 18 research faculty who work only in the laboratory, and another 71 clinicians who also do research, Dr. Alfonso said.

Dr. Skuta noted that Dean McGee’s research activities have been elevated over the past 20 years by the leadership of Robert E. “Gene” Anderson, MD, PhD, director of vision research.

“He and his colleagues have engaged in transformative vision research in our department and across the medical campus,” Dr. Skuta said.

Humanitarian service

Both chairmen also stressed the importance of community service to their institutional missions.

Dr. Alfonso said that Bascom Palmer Eye Institute personnel are quick to respond during the acute phase of crises, being among the first medical responders in New Orleans after Hurricane Katrina, for example. The institute also sent its “vision van” to Japan to help after the earthquake and subsequent tsunami. Institute members also provided care in Haiti after its 2010 earthquake, work that continues today.

“We are now working with our colleagues in Puerto Rico to provide them with resources so they can continue eye care on the island and to help patients who are being sent out of the island here to Miami,” he said.

In the chronic phase of community service, he said the institute offers free community clinics throughout south Florida, and participates in numerous national and international programs as well.

“We ask all staff members to participate in at least some form of community service,” Dr. Alfonso said.

At Dean McGee, Dr. Skuta noted that Bradley Farris, MD, has helped establish international partnerships so that all third-year residents travel to serve in China or Swaziland.

“That has been a very meaningful experience to help them gain a better understanding of what is happening in the international arena and we hope it inspires them to continue international service throughout their careers,” he said.

Looking to the future

Neither program seems interested in resting on the laurels of its current achievements, however.

For Bascom Palmer Eye Institute, Dr. Alfonso sees continued evolution in the strategic areas that will make vision care even better. He said these include identifying better preventive measures as well as pioneering treatments in the areas of gene therapy and stem cell or regenerative medicine therapy.

“In terms of diagnostics, we want to be at the front line of using digital technology to expand our ability to offer diagnosis and treatment in the virtual realm,” he said.

“We have grown in our physical environment, we have offices in Plantation, Palm Beach, Naples, and soon to open in Abu Dhabi, but those are physical locations,” Dr. Alfonso said. “We are really looking to expand eyecare in the virtual space, which we expect will be more cost effective and allow us to bring better outcomes to more people.”

Dr. Skuta said he sees Dean McGee’s future including the continuing process of recruiting outstanding clinical and research faculty, as well as expanding its residency program to a full complement of 15 (five in each year).

“We are also planning renovations in one of our pavilions to further expand our clinical capabilities and will continue to seek methods and philanthropic dollars to support our people and our many programs,” he said. “Having celebrated our 40th anniversary just a couple of years ago in 2015, we are grateful for the early leaders who built upon an extraordinary vision for the Dean McGee Eye Institute’s future. We continue to be committed to advancing that vision for the next 40 years and beyond.”