From engaging in overseas eyecare missions to domestic efforts for the needy, ophthalmologists are embracing volunteer work in ways that provide satisfaction on both a personal and professional level.

“We sometimes forget the impact of what we do on our patients and their quality of life,” notes Cathleen M. McCabe, MD, chief medical officer of Eye Health America and medical director of The Eye Associates in Bradenton, FL. “Providing charitable care shows us what happens when patients don’t have access and, out of desperation, find a way of getting care. Once they receive care, it’s life-changing for them in that they can regain function. Oftentimes their family member who had to care for them can regain some independence in their life again as well.”

Dr. McCabe has been involved in international surgery missions and local efforts, providing free or reduced cataract surgery for the uninsured or underinsured through her practice’s ASC.

“That I have a skill and ability to vastly impact somebody else’s life is refreshing,” she says. “You always get back a little more than you gave up.”

A founding partner of Eye Surgeons of Indiana, Kevin Waltz, MD, gave up his U.S. practice at the end of 2016 to focus on his work in Central America. Dr. Waltz is president of Ophthalmic Research Consultants, which provides contract research advice, service, and product development in Central America and the U.S. He’s chairperson of the Central American Eye Cliníca board of directors, which helps members improve eye care in the developing world.

Once a month, Dr. Waltz flies to Central America to help eye clinics—representing dozens of local, U.S., and international ophthalmologists—provide eye care. He and his colleagues go from village to village, taking referrals from local priests of those who don’t have access to nor can afford eye care. Most patients present with potentially lethal cataract problems.

Typically, the charitable cases Dr. McCabe and her colleagues see are patients who are legally blind, unable to drive or work, in part-time jobs without health benefits, homeless, or have mental health issues, and their vision is impacting the health and safety of themselves or their families.

Eric Purdy, MD, of Vision Care Ophthalmology in Fort Wayne, IN, has conducted 65 international humanitarian eyecare missions. In the U.S., he works in a region with a large Amish population.

“These patients do not believe in government-based or private insurance, but they often have community-based co-ops that assist with medical expenses,” he says. “We offer them Medicaid- or Medicare-equivalent discounts for surgery fees. Our local hospitals and ASCs offer similar discounts. The Amish typically will not accept charity, but they eagerly seek discounted fees.”

Key Considerations

Those who engage in charitable work must consider several factors, from equipment cost and time investments to setting boundaries.

“Doing it on your own the first time is intimidating; you don’t understand the rules or your options,” says Dr. Waltz. “It’s better to do it with an experienced organization, such as SEE International or Voluntary Optometric Services for Humanity, to see if you like it.”

According to Dr. McCabe, surgeons in her practice decide for themselves if they want to be involved in charitable work, and certified registered nurse anesthetists also are asked if they are willing to provide their care free of charge. She and her colleagues work through local and national groups, such as EyeCare America, the American Society of Cataract and Refractive Surgery Foundation, and Lighthouse for the Blind, to help identify potential patients and obtain financial backing.

“The most difficult part is understanding if the financial need is really there,” says Dr. McCabe. “Sometimes, we’ll work it out with the family if there’s any financial ability to pay, even over time, and if not, we’ll write it off.”

Patients from another country may not demonstrate a financial need, but have issues producing the necessary paperwork for charitable care.

The Cost of Volunteering

Volunteer work is both consumables- and technology-intensive. Financial help can be found from a variety of sources, such as Alcon, Johnson & Johnson, and Bausch + Lomb, says Dr. Waltz.

Time is one of the biggest costs of volunteering—the cost of missing work and having to continue to pay office expenses while engaged in the effort. Another consideration is equipment. It’s not practical to transport equipment back and forth from one’s practice to sites overseas, notes Dr. Waltz. He befriends local doctors to keep and use the equipment.

“You’ve got to struggle to get it there the first time, and then it’s quite valuable when it’s there,” he adds.

Charitable care also carries an emotional cost. One must know how much is “too much,” financially and emotionally.

“We’ll let ophthalmologists in their 30s make one trip a year,” says Dr. Waltz. “In your 30s, you’re building your practice, raising your family, and taking care of patients. In your 40s, you can go more often. In your 50s, we let people go as much as they want.

“I did one trip a year for 10 years, and now I go a lot because I have friends there, productive things to do, and I can afford to do it,” he says.

Like Dr. Waltz, Dr. McCabe is driven to continue her charitable work by a personal conviction to give back to the community.

“I think this applies to all ASCs in that we survive because of community support,” she says. “It’s important for us to be an integral part in the overall health and well-being of the community.”

Reaping the Benefits

Dr. Waltz notes his offshore volunteer work has made him a better surgeon. He derives his greatest sense of satisfaction on the flight home.

“It’s exhausting,” says Dr. Waltz, “but there are any number of strangers who are going to have a better life because of what I’ve done. The ultimate goal is for the U.S. surgeon to go and support the local doctor, so they can in turn help their patients more. It’s very gratifying.”

Dr. Waltz, who plans to resume his U.S. practice, notes that his charitable work has had a positive effect on his patient care stateside: “When I get a surgical problem in the U.S. that’s difficult, it’s less threatening because I’ve been through it elsewhere.”

While Dr. McCabe understands that providing charitable care is good optics that may attract paying patients to a practice, that’s not the biggest reward.

“For me, it’s more about helping the individual than making a big show of it,” she says.

Dr. McCabe says while colleagues may be reticent to get involved in charitable work because “once the spigot’s turned on, it’ll be like a waterfall you can’t turn off,” doctors can control that situation by analyzing their capacity and comfort zone for a volume that will not negatively impact their practice, partners, or themselves. This year may be a difficult one to initiate charitable care, as many practices and ASCs are getting past the financial challenges brought on by the pandemic, such as staffing shortages.

“It’s a difficult year to take on more with no compensation,” Dr. McCabe notes. “However, last year helped to highlight that what it really comes down to is the need to act on the behalf of each other as a community, and how important it is to think of each other and the health and safety of those around us.” ■