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The mission of Prevent Blindness Texas is to prevent blindness and preserve sight. We are leaders and change agents in the eye health space here to empower you!
Hey, it's your eye health experts, Prevent Blindness Texas, and welcome to Eyespiring, a conversation about all things vision and life. Doctor.
Heather Patrick:Hi, and welcome to this episode of Eyespiring. This morning, we have the pleasure of talking to Doctor Jacquelyn O'Banion.We're going to find out her story, why she does what she does, and what she hopes happens in the future for ophthalmology and global health care. We're going to start with getting to know her. She is part of the Department of Ophthalmology Associate Professor at Emory University School of Medicine and the Chief of Ophthalmology for Grady Memorial Hospital. She joined the Emory Eye Center in January 2016 and serves as an associate professor in the comprehensive service.
Heather Patrick:She brings a solid foundation in public health to enhance the leadership team and support Emory Eye Center's growing and expanding local and international programs in global ophthalmology. She received her MD from the University of Texas Health Science Center in San Antonio in 2009. Her residency in ophthalmology and a global eye care fellowship were completed at the University of Oklahoma. And she most recently completed a master's in public health at the world renowned London School of Hygiene and Tropical Medicine. So tell us something about you that isn't here that you want our listeners to know.
Dr. Jacquelyn O'Banion:Oh, goodness. I don't know. I think that this is... I'm kind of living my professional dream. Going into medicine was always about service and filling gaps in care for me.
Dr. Jacquelyn O'Banion:And training is a long road and has a lot of requirements. And I think, you know, it's just a, as I often talk to med students and residents, it's a lot of making little choices that keep leading you back to your why. I feel really, really lucky and fortunate to be living my why every day. I love what I do, and it's exactly what I'd hoped I'd be doing.
Heather Patrick:When did you know you wanted to be in ophthalmology? Because I think people that go into medicine, it's interesting. Think they either know very early on or it's something that they kind of decide later. And so what made you decide ophthalmology?
Dr. Jacquelyn O'Banion:I was late to ophthalmology. I was gonna do anything but ophthalmology. Really? On Yeah. The only physicians in my family are in my mom's side of the family, my grandfather and my aunt, and they are both ophthalmologists.
Dr. Jacquelyn O'Banion:So I was dead set against that. Was gonna do anything but that. I was not gonna follow in their footsteps. I wanted to do global health work. That was my reason.
Dr. Jacquelyn O'Banion:So I assumed throughout kind of college and med school that it meant I was gonna do emergency medicine or infectious disease. For a long time, I planned I was gonna do med peds, like a med peds fellowship and then do infectious disease. And then, you know, but I still went into my clinicals as a third year, just trying to figure out what did I like, what did I not like. I really liked surgery a lot. I liked the idea of fixing things.
Dr. Jacquelyn O'Banion:That's very much core to who I am. But I liked also the side of medicine where you had a lot of problem solving, figuring out what's going on and longitudinal, like talking with patients and knowing them over time. And so I did, in my med school, not everyone, so here at Emory, everybody does an ophthalmology week. That was not the case, that's not the case in most of the country and it was not the case where I went to school. I had to choose a surgical subspecialty to rotate in during my surgery rotation.
Dr. Jacquelyn O'Banion:And it was at the end of my third year and I decided I would do ophthalmology just so I knew what it was that my aunt and grandfather did. And lo and behold, there's a reason there's a genetic predisposition to it. It drew me in just because I got the whole spectrum of everything. You get to see a patient, get to know them over help to solve a problem, and then actually fix the problem. And that's what I really enjoyed.
Dr. Jacquelyn O'Banion:And just through keeping an open mind and knowing that I wanted to do global health work, I was already aware that there was some opportunity there within ophthalmology. And so it just kind of was something that fit the full picture of what I wanted in a career.
Heather Patrick:Yeah. So you have that rotation and it sets that little spark off. So what happened after that? Like, did you change course? I mean, what did that mean for your career at that moment?
Dr. Jacquelyn O'Banion:I don't know that I had a course yet other than knowing, again, that I wanted to do something in global health. And so from there, it was making little decisions. So when I was applying to residencies, I asked, you know, what opportunities do you have in global ophthalmology or global health? And and I kinda pushed people on it. So a lot of times they're like, oh, yeah.
Dr. Jacquelyn O'Banion:You can do that. But there's a big gap between you can do that, and this is how you do that. And so I was really cognizant in looking at that in residency programs. And I was fortunate that in the University of Oklahoma at the Dean McGee Eye Institute, they had an established program where the fourth year residents, every fourth year resident went to China on a rotation with faculty because they'd had a longstanding relationship there. And then by the time I came through, there was another opportunity too in Eswatini in Southern Africa.
Dr. Jacquelyn O'Banion:And so it was built in. And because it was built in, even though it wasn't till your fourth year, they had all the pieces there. So, you know, I voiced my interest and an alumni started taking me with him during the summers on a trip to Peru. And I used my vacation time and would go with him on these trips and learned a new surgical skill, but also just what it meant to be practicing in a low resource setting like that. And it was making, again, just little choices and finding those opportunities and kind of feeding that reason of why it was that I was going into medicine in the first place.
Dr. Jacquelyn O'Banion:Because it can be so hard during training to lose sight of that when there's so many tests and requirements and competencies, and you see everyone else moving on with their life from college and having real jobs, and you're still, you know, chugging away and, you know, hitting all those marks that you're meant to be. And so it was just kind of trying to keep that in mind and finding opportunity where I could.
Heather Patrick:So with that, holding onto your why, now where you are in your career, there are some questions later on, we'll talk about this, but since you hit on it, how do you help shape your medical students or the young doctors that you're working with? Because I do, the pressure is immense, right? And I think in any high level, visible, demanding position, working through the pressure is part of what you learn to do to be successful. But how do you help them focus in on that? Some people, it's inherent.
Heather Patrick:They can come back to their why, and they know how to do that. It's not easy. So how do you help them? What do you share with them so that they have that skill of when things are the hardest, I come back to my why?
Dr. Jacquelyn O'Banion:I think a lot of it is just sharing my story. You know, I'm I'm very open. It's just kind of who I am and in explaining to them, you know, why it is that I'm doing what I I do and asking them, you know, what is it that interests you? Why did you decide to go to med school? Was it just that you were on the top of your class and that's what you were expected to do?
Dr. Jacquelyn O'Banion:Or was there something more that was driving you in that direction? I also, part of I think sharing my story is that you don't have to see a clear path. So there was no field of global ophthalmology when I was going through training. There weren't fellowships yet. It was a lot of just knowing what it was that I wanted in medicine.
Dr. Jacquelyn O'Banion:And honestly, lot of people kind of thought I was crazy along the way. They're just like, what does that mean? What are you gonna do? How are you gonna make a living doing that? And I was like, I don't know.
Dr. Jacquelyn O'Banion:I don't know. I just know that this is what it is that I want to be. This is what I want my impact to be, and this is how I want to serve. And I'm gonna keep finding ways to do that. And so that's that's one of the things I try to stress with them is that you don't have to see...
Dr. Jacquelyn O'Banion:You don't have to pick a path that's already laid out. Just keep at the forefront of what is it that draws you into this. And I have a talk I give to some students and med students about, you know, I think this is a real key to prevent burnout because burnout is real in medicine. It's hard. It's a lot of emotion, a lot of mental energy, and a lot of physical energy of just up and down and walking around everywhere.
Dr. Jacquelyn O'Banion:You know, it takes a toll on you. And if you get sucked into all the hoops and achievements and numbers and all of those things without maintaining a little bit of what it was that drew you to medicine in the first place, you're going to burn out. And a lot of what I tell them is, you know, even though it's hard, especially in residency to find time to do those extra things, they're what refill you. So, you know, I ran a free clinic in Oklahoma when I was a resident there. It was once a month, I went to this church, I provided eye exams, gave glasses, and just seeing the gratitude from patients that didn't get care elsewhere, that's what kind of fed me and kept me going.
Dr. Jacquelyn O'Banion:And so while it can be a lot of extra effort upfront, it pays dividends in the end.
Heather Patrick:So you spent all this time training in medicine, and you get to a certain point in your career and you're like, Nope, I want a master's in public health too. So why both? What brings you to that intersection of medicine and public health?
Dr. Jacquelyn O'Banion:I had some really wonderful mentors in Oklahoma that really helped me kind of shape again, what it is that I was wanting and what I would need. And one of my mentors was like, okay. Well, let's make a fellowship so that you can gain these extra skills. And he connected me with various people in... That did global health work in in eye care.
Dr. Jacquelyn O'Banion:And I asked them, like, what are the skills that you think someone like me needs? And what are the things you wish you had known? And, kind of created this basket of things I needed to learn. And when I went back to my mentor, I said, okay, this is what it looks like. And we put together a clinical fellowship where I spent six months in different parts of the world and then also six months in Oklahoma working in underserved populations, but also just working to pay my my salary.
Dr. Jacquelyn O'Banion:And so we worked and we could do the clinical stuff. But then some of the softer things, which are the blindness prevention, program development, evaluation, all these things, that is what public health is. And one of the things he really stressed with me is he's like, you don't have to do this. It's taking on more debt. It's pro...
Dr. Jacquelyn O'Banion:It's postponing your career even further. Or you... But... And you can learn this over time like everyone else did. Or you can take one year, focus, learn all these skills, make all these connections, learn to think about medicine differently, and you're gonna start out ten years ahead.
Dr. Jacquelyn O'Banion:And he was exactly right. It it was a huge leap of faith. It was really kind of a a hard decision because you're just ready to start making money and not take more debt. Yep. But it it shaped me, and it shaped the kind of doctor that I am now and the way that I approach all of our work here.
Dr. Jacquelyn O'Banion:And I just feel very fortunate that I had someone to kind of help put what I was looking for into something a little more concrete and help me to find the avenues to get there.
Heather Patrick:Yeah. That's pretty amazing. So let's shift a little bit around advocacy, right? Because I think patient advocacy, understanding what your patients need, advocating for them is important to you. So at what point did you realize that going beyond treating individual patients to really looking at how do we change the systems, where did that happen for you, and why do you think it happened?
Heather Patrick:Do you think it was a combination of now you've seen it from different perspectives and you know that in order to really see the change you want for your individual patients, it's at a much higher level. We have to impact at a much higher level. So just talk about that kind of where did that happen for you in your career?
Dr. Jacquelyn O'Banion:Yeah, I think all physicians see it. See it on an individual level with the patients that sit that are sitting in the chair across from us. But you see it different. I see it now differently after having done the master's in public health. And what I often tell people is that I spent years learning how to take care of that one patient sitting across from me, doing everything I can for that one person.
Dr. Jacquelyn O'Banion:But what the the Miles per hour taught me was to look at medicine through a different lens and more of a population lens. And what makes sense for that one person doesn't necessarily make sense for the whole. And your impact can be so magnified if you are looking at the population rather than the individual. And it's also hard to really fully understand what that individual is dealing with and really bridge that when you don't understand everything that comes behind that person. If you're not understanding, you know, what led them to the point that they are in right now, you aren't going to be able to have the full impact on their care.
Dr. Jacquelyn O'Banion:So I think having someone that is coming in with glaucoma and they're having a hard time getting their drops in, and instead of focusing, I mean, neither is wrong or right, right? I mean, it all has to happen. Like working with that one patient, understanding what are your challenges and why can't you get this in? But also taking that public health point of view and understanding that, you know, they might be working three jobs, none of which has health insurance, and they're having to pay out of pocket for these medications, and they're trying to make it last longer, or they just can't get to the pharmacy to get the refill because they are working three jobs. You know, and under, it's learning to see beyond that one patient.
Dr. Jacquelyn O'Banion:And I really think that my time in London looking at health systems, what makes a health system, what breaks a health system, What leads to all of these little decisions at the patient level is what really helps, is what shaped my point of view. And then also having worked in a lot of different culture and country settings show... Has taught me that we're all facing the same problems. We have different modes of addressing it, but it's all the same problem. And so I think those two things, just having worked abroad in different situations, but also having that background in public health really kind of has shaped my ability to advocate for the patients in the profession and healthcare in general.
Heather Patrick:So as you've looked at vision, both very locally, nationally, and then globally, what lessons can we take from a global setting and put them into practice here, that we're missing the opportunity because maybe we think because we're here in The US, there's maybe nothing to be learned, but I don't believe it. I think there's a lot to be learned. So what are we missing that we... What opportunities are we missing to help change the picture for ourselves here as it relates to vision?
Dr. Jacquelyn O'Banion:I personally feel like the biggest place where we can change is in collaboration. One of the things that I think... One of my biggest lessons that I've taken from international work that I try to bring to the work here in The US is that idea of collaboration. So Vision 2020 was an international initiative of the International Agency for the Prevention of Blindness and the World Health Organization to work collaboratively to have national eye care plans. The idea being that the individual entities, nonprofits, the the NGOs, the standalone kind of organizations that fall under kind of IAPB and then the government systems that fall under WHO needed to work in cohesion with each other to have a national plan.
Dr. Jacquelyn O'Banion:That everyone can't be addressing different issues at all kind of needed to come together to have one idea of what each of the stakeholders are doing and how they feed into the bigger national agenda or plan. And there's been immense success, right, from vision 2020. And now, I mean, there's different iterations and different focuses from what that was, but the same concept is continuing to be applied. And I feel like that's what we're missing a lot of in The US, is everything is very disjointed. You know, all of the health systems are individual health systems.
Dr. Jacquelyn O'Banion:What happens in my health system is different than what happens in another health system, but the patient goes between both of those things, and we don't know what the other one's doing. And so I think what I often am preaching and working on with a lot of our partners is there's more than enough work for all of us. And the only way that we can make an impact or an... A dent in the the challenge is by working together. And it's also just, again, from a public health or business standpoint, it makes good business sense.
Dr. Jacquelyn O'Banion:It's it's... There... There's only so many people, so many resources, And so we need to use them efficiently and effectively rather than duplicating things all over the place. That also just creates more confusion for the patients. And so I think for me, that has been my biggest lesson.
Dr. Jacquelyn O'Banion:And what I really am working hard to do here is create more connected systems within the reality of what The US health system is. But there are ways that we can be better and do better and connect better for our patients amongst all of the health systems.
Heather Patrick:So do you think globally they're forced to collaborate more? Do you think that's why it works there? Or why do you think there's more success around collaboration than there is here? Is it... Because here, there's just so...
Heather Patrick:There is so much opportunity for different organizations to kind of jump in. Why do you think why do you think that is?
Dr. Jacquelyn O'Banion:That's a really good question. I think it's... I... You know, it's it's hard. I feel a little weird saying it, but, I mean, I think that it was because it was a little bit forced.
Dr. Jacquelyn O'Banion:Right? You know what mean? The the two entities that dictate a lot of policy Mhmm. And therefore where dollars go Mhmm. Mandated that this needed to happen in order for the dollars to keep flowing.
Dr. Jacquelyn O'Banion:And and so when everyone understands the the impetus, the reason to... That it's required, then they're gonna follow through with it. And it's not perfect, obviously. And it didn't work everywhere and it has to continuously evolve because that's what any program has to do. But I think that in this situation, that top down approach really worked.
Dr. Jacquelyn O'Banion:Yeah.
Heather Patrick:So when you think about the health disparities that you see, what does that look like when you're in the clinic? Do you, as it relates to vision, what does that look like when it comes together for you? A majority of the patients, they don't know about eye health and vision, and so it's too far gone, or they didn't have the opportunity resource wise. So what do you see in your clinic as it relates to kind of the challenges and barriers and disparities?
Dr. Jacquelyn O'Banion:I would say the kind of breaking it almost into two big buckets would be the first one is that first appointment, getting in. So the biggest bear... Or disparities and barriers I see is a lack of awareness. So patients just don't know that they need to see an eye doctor. They see well enough, they're able to get by, it's not a big issue.
Dr. Jacquelyn O'Banion:It's expensive, they don't know where to go. And it just is, there's not a real big impetus or push to to get that that foot in the door, that that first appointment. Right. And often when that happens is that, you know, things have been going on for a long time, and it's too late, like you said. So I I remember one woman I had not too long ago.
Dr. Jacquelyn O'Banion:She came in. She was so excited. She had the appointment with us. She'd gotten there, you know, gone through all those hoops. And she had assumed that her vision had gone bad because of cataracts.
Dr. Jacquelyn O'Banion:But when I looked, you know, she really didn't have much of a cataract, but she had end stage glaucoma. And having that conversation with her and saying, you know, she had had so much hope and excitement coming in and having to have that conversation and say, I'm really sorry, this isn't cataracts, this is glaucoma. This is something that's been going on for a really long time. Then their questions become why? You know, like, why didn't I know this sooner?
Dr. Jacquelyn O'Banion:Have to... A lot of this, you wouldn't have. You know, glaucoma is silent. It's a silent blinder. It doesn't cause pain.
Dr. Jacquelyn O'Banion:It doesn't cause any issues. So unless you have any, unless there is routine care happening or screening, you never would've known. So this isn't your fault. This is just kind of the system we live in and the reality we live in. Right.
Dr. Jacquelyn O'Banion:And so I find that that first access point to find things before they become blinding is one of the biggest disparities, the biggest barriers, because there's just not enough providers, there's not enough accessible providers, meaning that take the right kind of insurance or don't take insurance or, you know, like, how do you get to that first person? Then the other side of it is the chronic things. So, you know, my glaucoma patients, my diabetic patients, that... Especially diabetic patients that are coming in every month for an injection in their eye. And that's a day off work every month that they probably don't get.
Dr. Jacquelyn O'Banion:You know, a lot of our patients don't get sick leave or paid leave, you know, so they're having to miss work to make it to an eye appointment. And so understanding what their challenges are to getting there again month after month, even with our glaucoma patients, coming three, you know, three times a year is still a lot to go see one doctor. It's hard enough for me to go see my own doctors, and I have paid time off. So it's working with those individuals and understanding what their challenges are and their barriers are to getting there, maybe it's childcare and they can only come during the school hours because their kid is at school and they need to get out of there before they have to go pick up their child. And I feel like those, the chronic illnesses where they're having to come back repeatedly is another place where we really see the disparities and the inequities, because it can be very easy to write it off in saying that the patient is noncompliant.
Dr. Jacquelyn O'Banion:But in reality, they want to be. They really, really want to be compliant, and they want to be saving their vision, but they face so many little challenges and and decisions that they have to make to be able to get there that it is another... It's just a huge insurmountable hill sometimes.
Heather Patrick:Yeah.
Dr. Jacquelyn O'Banion:There we go.
Heather Patrick:So let's go back to the first bucket. How do we change that? How do we make it more accessible? Or how do we, this is where I feel like a group like Prevent Blindness has really the opportunity to make a significant change with helping the public understand why vision is so important as part of their overall health. Why do you think people still view vision as kind of a luxury or an optional care to their overall healthcare?
Heather Patrick:And how do we change that? How do we change this point, this first access point? And how do we help people understand how important vision is as part of their overall health?
Dr. Jacquelyn O'Banion:You know, I think there's a couple, I don't know, themes there. One is just education, right? So just educating people that there are eye diseases that can cause you to go blind that you will never know about until it's too late. So the importance of regular routine care and providing general screenings. And I think this is kind of where that other theme or piece comes in is that it's really difficult to argue about vision being a part of general health when the system views it as separate.
Dr. Jacquelyn O'Banion:You have vision insurance, you have medical insurance. That is sending the message that they are two separate things. Yep. And often medical is required, and vision is something you have to opt into. So it's, again, telling you that it's elective.
Dr. Jacquelyn O'Banion:Yep. You know, I think even within the the insured cla... Like, population, you have the distinction of, you know, glasses are sometimes covered, sometimes not, contacts might not, you know, LASIK is considered elective and not covered when you would be blind without it. So the structure of the insurance system sends that message. And it creates further barriers to someone accessing care.
Dr. Jacquelyn O'Banion:Because not only, I mean, maybe they finally found a way to get medical insurance, but it's not gonna cover their glasses or the vision portion of eye health. And so I think the more that we can inter twine those and integrate that, I mean, of course, from a systems and insurance coverage standpoint, but also, you know, when there's health fairs and they're checking for diabetes and blood pressure, HIV, the general fairs that you see that occur, ensuring that vision is a part of that so that the general public is seeing that vision is a part of health. If you can't see, you're not gonna be able to drop your insulin. You're not gonna be able to take the correct pills every day. You're not gonna be able to maintain your job to maintain that insurance.
Dr. Jacquelyn O'Banion:It touches so many aspects of our ability to care for ourselves and maintain our health. And I think just continuing to show it and integrate it and be there when they're doing diabetes fairs.
Heather Patrick:So let's shift a little bit about to your patients. So you see all different types of patients. How do you build trust with your patients? How do you specifically build trust with your patients? And then how do you help again, kind of your students, peers take that approach because I do think there's just across the board, right?
Heather Patrick:There are some doctors that do it really well. And I would imagine that the data says that their patients probably adhere more just because of that trust and relationship. So how do you build that? What does that look like for you?
Dr. Jacquelyn O'Banion:I think a lot of kind of what I was saying before, it's just a lot of openness. I go into each of my patients' rooms and just introduce myself. How are you? How is your morning going? Just kind of creating some rapport and getting to know who they are.
Dr. Jacquelyn O'Banion:And especially when we start talking about their vision, like, tell me how you're experiencing your vision. Because I can tell someone that they're scoring fine on our testing, but they are feeling that there is a change in their vision and they're struggling in different situations. So tell me about it. Where... When is it that you're struggling?
Dr. Jacquelyn O'Banion:What... How are you struggling? And really, you know, understanding their perspective on things, often talking about, what do you do for a living? Because a lot of our vision demands are different depending on how we're spending our day. If we're spending our day at a computer or we're...
Dr. Jacquelyn O'Banion:I had a patient just recently, she's a cook at the cafeteria at one of the colleges down the street. And she was telling me that she's fine most of the time, but when she's looking up at the tickets on the line, it's blurry and doubled and she struggles to see what she's supposed to be making off of the food ticket, which that's never gonna come through in an exam unless you're having that conversation and kind of saying, tell me, what is it? And I think that just being willing to listen and really get to the bottom of what it is that they're experiencing. No one wants to come to the doctor just upfront. They're not there unless there's an issue.
Dr. Jacquelyn O'Banion:So, you know, trying to get through on that point. Yeah. Yeah. I'll also say, know, I mean, I'm at Grady Hospital in Atlanta, and the large majority of our patients are black or African American. And as a white female, like, that's something I have to acknowledge Mhmm.
Dr. Jacquelyn O'Banion:And address and overcome to build that rapport. And oftentimes, can sense that someone is hesitant to... Maybe they don't believe what you're saying, or they're not thrilled about starting a medicine or doing a specific procedure or something like that. And I try to just address it head on and just say, it feels like you're unsure about this. You're having some sec...
Dr. Jacquelyn O'Banion:You're questioning this. Tell me what it is that worries you or that's concerning you. And I had a patient who told me her grandfather was in this Tuskegee trials. And she was like, I have a natural distrust. And I was like, there, as you should, that makes complete sense.
Dr. Jacquelyn O'Banion:So let's talk through this. And, you know, we did her cataract surgery and she was fantastic and she was thrilled. But a lot of it is just recognizing what patients are coming in the door with and not glossing over it, not ignoring it, but acknowledging it and doing what you can to build that bridge and address it.
Heather Patrick:So where's the balance? Because that takes time. Right? I mean, that's part of the challenge you're up against. You only have so much time with your patients, but in order to truly, I think, make the impact and be the best you can be, it's relationships.
Heather Patrick:You create relationships, right? Because it's the external information that helps you put the puzzle pieces together to really then put them on the best path. Where's... Two questions. Where's that time balance?
Heather Patrick:And also where's kind of the emotional balance for you too? Because I do think the best doctors are connected to their patients, but I also would imagine it's a little bit harder on the emotional component side right, to that burnout because you are vested in them as people, right? And so talk a little bit about that.
Dr. Jacquelyn O'Banion:So first, the time. It's part of the challenge in the way that American healthcare is right now. There's not a lot of time. I will say it doesn't take a lot. It's not spending an hour and going overboard.
Dr. Jacquelyn O'Banion:It's just coming in with a smile and a good energy and just not trying to rush through the appointment. It's, you know, just acknowledging them as a person. And there's gonna be days that, you know, it makes you run behind. And I tell my next patient, I'm so sorry, like I'm running behind, I appreciate you waiting. I've had some patients that just really needed a lot of time today.
Dr. Jacquelyn O'Banion:And I think a lot of times patients appreciate that. There's always some that don't, but that's just reality. And then the truth is that it ends up often balancing each other. Like I might have one patient that takes a long time, but then I have my next three are real quick follow ups that, I've already spent that time with them. And so it's that rapport is already there.
Dr. Jacquelyn O'Banion:And so it ends up kind of balancing it out. I laughed a bit about the emotional energy or time. So I am an introvert. Like, I do not... My husband is a very big extrovert.
Dr. Jacquelyn O'Banion:He thrives and gains energy from being around people, and I am not at all. And I expend a lot of energy in my day with patients. I think it's finding ways to recharge that and refill that. Sometimes it's even just like taking a walk down the hall to get a cup of coffee, just to give myself a few minutes before having to kind of go back in and be full of energy and attention. Someone told me this to find little bits of time somewhere.
Dr. Jacquelyn O'Banion:And I often, before I come in in the morning and then before I leave in the evening, sit in my car for like five minutes and might listen to my book, play a game on my phone, but I just sit there. But I just need those five minutes. And especially, as a working mom, because I go home and two children immediately need all of my attention and time as well. So finding little bits of time to kind of recharge, because it can be hard. That's not something that comes natural to me.
Dr. Jacquelyn O'Banion:It's something that I have to work on of make decisions to be more outgoing and talkative with people. I find it so much easier with my patients than I do in public groups, but it doesn't mean it's not draining because it is. So it's just finding little ways to give myself a break.
Heather Patrick:Yeah, I am also an introvert. I have had to, same thing, especially as I've grown in my career and certainly in this role as CEO, have had to really learn how to maintain that energy. And unlike you, it is a skill, I've gotten much better at it, but I've also learned to be very strategic about certain times where I can just unwind or when I've been on a trip, I call it peopling. Had to peeple a lot. And I mean, I will come home and literally won't go anywhere or talk to anyone for twenty four hours, depending on how much people and I had to do.
Heather Patrick:But I do think it also comes, it's interesting because so much of who you are is really wanting to learn about other people to help them get to where they want to be. And I think for me too, that's a big driver. It's always been a big driver of how do I help? How do I make it better? And so it's interesting that the careers we have require daily interaction.
Dr. Jacquelyn O'Banion:Yes.
Heather Patrick:But that you really do learn. It's relationships, right? We talk about all the time here. Is a relationship business, but really all of it is. It really is about building those relationships.
Heather Patrick:What do you wish the healthcare system could be when you think about it? What's your wish for the healthcare system? And then we're going to wrap up on the future of the healthcare system. But what do you wish it could be?
Dr. Jacquelyn O'Banion:I mean, my unrealistic wish. I wish that health care wasn't so business driven. I think that that's just... It's hard. Right?
Dr. Jacquelyn O'Banion:And one of the first lessons that I learned when I was in London was how medicine and healthcare is not a public service. Because it was going through all of... I remember going through all of the criteria for public service and like a public good, and that you had to have equal knowledge. Well, there's not equal knowledge because the physician and the patient have different knowledge base. Yeah.
Dr. Jacquelyn O'Banion:You know, and it, you know, it's a difference than I... Just for whatever reason, I remember their example being light posts, you know, that having a light post is a public good. And the reasons that medicine can't be a light post, you know, and I understand why it can't. But I think that there are ways that we can bridge that better. Especially if we look at it as a public good in the sense that having a healthy population benefits everybody.
Dr. Jacquelyn O'Banion:If you have people that are healthy, they're working. They're going to school. They are contributing to the economy and the the population and the community. When your population is unhealthy, they lack those things. They can't work.
Dr. Jacquelyn O'Banion:They can't contribute. Then they rely more on public services. And so if there was... I just wish that there was more of a bridge between the business of medicine and the public good of health. And that we could find a way to view health as that.
Heather Patrick:A great way to put it. This is a really great visual. It's a great way to put it. When I think about, I mean, I've been doing nonprofit healthcare for almost twenty five years. One of the things that really, I think, still drives me in this particular part of it around vision is that we can still actually change the outcome.
Heather Patrick:Really is within the purview that we could significantly alter the path. But the challenge, and this is my wish that I wish healthcare would shift, it truly is we still not have embraced the prevention side of it. Concept of, Team wise, we talk about this all the time. You're going to spend the time, you're going to spend the money one way or the other. Either you do it upfront and you plan or you react to it.
Heather Patrick:And usually on the reaction side, it costs you more in both. And so why can't we get to that place where we're going to spend the money, let's spend it up here so that we can plan and actually be more successful down the line than react. And for me, what does it take to get there? At least on the vision side, because there is so much prevention that we can do truly to change the outcomes. We're gonna get to a certain point in the next ten, fifteen, twenty years where we're gonna be like every other disease state basically now.
Heather Patrick:It's an epidemic. And now it's gonna cost us so much more money to fix the issue. So how do we do that? How do we change that now?
Dr. Jacquelyn O'Banion:I think it's, I mean, it's such a good and big question. I struggle personally in the work that I do in that I think education and screening are absolutely necessary for the prevention. You're not gonna prevent anything until you can identify that there's disease. So we need to get out there and be screening and educating the general population. I say to that rather than patients because patients assume they made it to a health care center.
Dr. Jacquelyn O'Banion:But we just need to to educate the general population of the need... Like, what could happen if they aren't getting, you know, these exams or screenings or preventative services. When I struggle with in my personal work is the gap. Like, I have a really large fear of spending a lot of money and resources in screening and identifying when we don't have a path to treatment. Because in my...
Dr. Jacquelyn O'Banion:I feel that that's just unethical. You are identifying a disease in someone and you are telling them you are going to go blind from this if you don't take care of it, but you're not. I don't wanna say providing because I don't know that, I mean, that's where I think people get so hung up is like, why do I have to provide this? It's not even that, it's showing an avenue for them to take care of it. And when they can't access somebody to help them with the treatment side of it, what are we doing?
Dr. Jacquelyn O'Banion:And so I think I a 100% agree that we need to focus on this early part. Yeah. But I just worry about that second step. Yep. Because those are both needed to prevent us getting to that last stage where they're coming in with blindness.
Heather Patrick:That gets kind of back to one of our conversations other than this about care coordination, right? And that need for care coordination. Coordination. Because I agree with you, and that's also our approach in screening. One of the reasons we kind of hit this plateau on screening numbers is because we can keep screening all day long.
Heather Patrick:We can increase and increase and increase that. But to your point, if there's no path forward or the path is so hard for them to take, we've really done an injustice. And so I think that's part of it. When we think about what model would have to be in place to really help that rate, to really hone in on education screening, to your point, it's that middle piece we've got to figure out. And I do think that is the key.
Heather Patrick:I think that is the key. My last question for you is, what you think your patients have taught you that medical school, public health would have never taught you?
Dr. Jacquelyn O'Banion:I think what I learned over and over again is that one patient is one patient. You know? What one person struggles with isn't the same as another person, but I can learn from each of them to take on to that third patient. And it's learning that they're each individuals. Everyone is an individual facing their own challenges and their own preconceived notions and beliefs and daily challenges and obstacles.
Dr. Jacquelyn O'Banion:And while we can make things easier for that individual from a systems standpoint and a public health standpoint, we still have to understand each of the individuals.
Heather Patrick:Thank you so much for sharing your time with us, your expertise, your insight. It has been amazing And you truly are. Thank you for being the doctor you are. Thank you. It really is.
Dr. Jacquelyn O'Banion:Thank you. Was fun.
Heather Patrick:Good. All right, with that, we will close and we will say, you can follow us, Prevent Blindness Georgia, Prevent Blindness Texas, jump in, be a part of our movement, help us build those models so that we can help more people get where they need to be and save their vision, improve their vision. So we always end the podcast with, tell us what your vision is. Thanks and have a great day.