As Dean McGee Eye Institute (DMEI) celebrates its 50th anniversary this December, R. Michael Siatkowski, MD, MBA, reflects on the institute’s most significant milestones and its expanding network of international partnerships. Siatkowski serves as chief executive officer of DMEI, and he also holds the titles of Edward L. Gaylord Professor and Chair, as well as David Ross Boyd Professor in the Department of Ophthalmology at the University of Oklahoma College of Medicine in Oklahoma City.

In this Q&A with the Eye Care Network, Siatkowski discusses the program’s journey, its global collaborations, and the trends redefining both education and patient care, while outlining the challenges and opportunities that lie ahead for clinical practice and medical research.

Note: Transcript edited lightly for clarity and length.

Looking back, what achievement or milestone are you most proud of in the institute’s history?

Siatkowski: Our most important asset is our people, and our most important stakeholders are our patients. Over the past 50 years, DMEI has become a truly indispensable component of public health in Oklahoma. We have built a superb team of doctors, scientists, educators, and staff, coupled with a superb infrastructure, that allows us to provide a broad scale and scope of medical and surgical care without which many Oklahomans would need to leave the state, or, even worse, would not receive needed care. We have trained over 300 talented residents and fellows to address the shortage of physicians in our state and our nation, and [we] have made significant scientific advances which will lead to new treatments and preventions of visual loss. None of this would have been possible without the unwavering efforts of many amazing people, and the trust and support of our fellow Oklahomans.

With nearly 250,000 patient visits annually and international training programs, how does DMEI balance serving local patients while extending its impact globally?

Siatkowski: As DMEI has matured and the world has become smaller, we have recognized the need to serve on a larger scale. Our international efforts are a logical extension of the good things we were already doing. They started with inviting ophthalmologists from other countries to visit DMEI and learn from our physicians and scientists.

Twenty-five years ago, Brad Farris, MD, took this to another level by developing relationships in China and later Eswatini. Twice-annual trips abroad allow our doctors not only to serve and treat patients internationally, but also to provide valuable education and introduce new technology to physicians in these locales, thus multiplying our effect.

Now under the direction of Jeremy Tan, MD, these efforts continue in earnest and have expanded to include working with Ukrainian physicians to help prepare them to address oculofacial injuries encountered in the ongoing war. Our efforts in this regard, while valuable to our international colleagues and their patients, are perhaps even more valuable to our faculty and residents who participate in this work.

What qualities do you look for in residents, and how do you ensure they are prepared to meet the future needs of ophthalmology?

Siatkowski: We are proud to attract some of the world’s best and brightest young minds to our program. Successful residents everywhere will have a strong record of hard work with many academic and service successes, but we also pay careful attention to less tangible factors. Humility and patience allow residents to work together more cohesively in a team, and compassion and emotional intelligence serve not only their patients but also their colleagues in training. Inquisitiveness and a growth mindset allow them to overcome obstacles and persevere in residency to become true life-long learners.

Which current research projects are you most excited about, and how might they transform patient care in the next decade?

Siatkowski: Advances in inherited ocular disease will allow us to make more precise diagnoses and develop new gene and gene product therapy for many conditions, particularly macular and more widespread retinal degenerations. The large-scale, big-data approach of omics will help us learn the composition and role of multiple biological systems and processes related to vision. Ultimately, this will result in development of new biomarkers and targeted, individualized therapy which [considers] a patient’s own specific genetic makeup and potential response vs [adverse] effects to various therapies.

We will also see new methods of drug delivery, as well as new surgical techniques and ways to address optical rehabilitation after cataract surgery. A large-data approach in epidemiology will also better inform us from a public and population health standpoint…to determine best use of finite resources in developing new models and systems of care.

What do you see as the biggest challenges and opportunities for DMEI in the coming years, both in clinical care and medical research?

Siatkowski: Ophthalmic care and research are both facing the challenges of insufficient people and declining fiscal support in the face of an increasing burden of disease. Addressing this will require new paradigms. Care models will need to be more efficient and reflect a team-based approach that includes nonphysicians, utilizes artificial intelligence, and incorporates more remote and self-monitoring of chronic disease. Research will be designed to be more translational, more quickly, with an increasing frequency of dialogue with clinicians.

Finally, much more thoughtful reimbursement and funding schemes for clinical care and research must be devised. Fortunately, ophthalmologists are very intelligent and creative people, and I’m optimistic that our profession will lead the way in creating the future.

R. Michael Siatkowski, MD, MBA
E: [email protected]
Siatkowski serves as chief executive officer of Dean McGee Eye Institute, and he also holds the titles of Edward L. Gaylord Professor and Chair, as well as David Ross Boyd Professor in the Department of Ophthalmology at the University of Oklahoma College of Medicine in Oklahoma City.