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Today's Practice | Nov/Dec 2012

5 Questions With Millicent Grim, MD, MBChB, DTM&H, MMed(Ophth)

1. How have your professional experiences in Africa, Europe, and the Middle East informed your approach to practicing ophthalmology?

My goal as an ophthalmologist is to improve patients’ overall visual function and comfort. Learning the medical practice and regulatory differences in various marketplaces necessitates finding solutions for my patients that will work within each individual market, in the presence as well as the absence of health insurance. The regulatory framework keeps evolving (and tightening here lately).

Self-promotion and marketing was not something I was familiar with initially. I had to get used to the concept of advertising my services and skills in the medical marketplace of the Middle East, first in Muscat, Oman, where I was employed for 6 years, and then at my own practice, the Gulf Eye Center in the United Arab Emirates, for the past 10 years. The ethics and return on investment of medical marketing can be challenging due to the diversity of this largely expatriate medical market.

2. What motivated you to get a diploma in tropical medicine and hygiene, and how has this diploma made a difference in your career?

At the time I was completing this diploma, I had not yet decided which discipline I would specialize in, and I wanted to broaden my knowledge base. This diploma affords me an understanding of the vast scope of tropical diseases relative to all the branches and disciplines of medicine.

3. What have you learned from your work with surgical outreach programs?

The Bureau for the Prevention of Blindness in South Africa does an outstanding job of making basic eye care available to disadvantaged communities. Since its establishment in 1944, the bureau has organized multi-annual eye care tours to designated rural areas. The bureau also trains local medical and nursing practitioners in basic eye care screening.

The cataract surgeries performed during these tours help patients regain independence and mobility, allowing them to resume daily life activities. I always endeavored to perform cataract surgery on all or most of the eligible patients to maximize the tour’s outlay and time. In the early years, my colleagues and I learned to achieve good outcomes and clear corneas in the absence of medical luxuries such as ophthalmic viscosurgical devices, phaco machines, and IOLs. In recent years, better surgical techniques have made procedures safer and enhanced visual outcomes.

4. What factors have influenced your outlook on your life inside and outside of ophthalmology?

I continue to learn to distinguish the forest from the trees in life as well as in eye care. The exquisitely detailed design and function of our visual system fascinates me, and I believe it is representative of the vast and detailed creation of the universe. Trauma care and rehabilitation work taught me how the eye and vision are fragile and robust, and this holds true for all of human nature.

I have gained patience from working with children, and this has served as a useful skill for dealing with demanding patients in the private sector who have choices and are free to return or seek care elsewhere. I endeavor to effectively solve clinical problems and not linger or prolong the treatment process unnecessarily (costs are real), yet I refuse to take shortcuts if there is a risk of relapse with unsupervised care. With close to 200 different nationalities and languages represented in Dubai, my colleagues and I cater to widely diverse cultural realities, and we strive to make informed consent meaningful. Team members and friends become an extended family and a support system while we remain guests in the country.

5. Who are your role models?

In my personal life, I have numerous role models. My professional role models include Anthony Murray, MD; Gideon Du Plessis, MD; Paul Roux, MD; Hans-Reinhard Koch, MD; and Stephen Updegraff, MD.