Fostering the “Gift of Sight”Adapting the Aravind model of high-quality, high-volume, low-cost surgery in rural ChinaVision In Practice: A Humanitarian Commercial Enterprise
China Blindness Data✤ Total number of blind people: 6.6 million (2011 estimate)✤ Total number of visually impaired people: 13 million (2011 estimate)✤ National blindness prevalence: 0.5% (2006 estimate)✤ Leading causes of blindness: cataract, diabetic retinopathy, corneal disease, glaucoma✤ Cataract surgical rate: 800 (2010 estimate)
Vision in Practice: Our Mission Vision in Practice strivesto eliminate needless blindness in China (and beyond) by providing doctors and support staff with the clinical and surgical training, business skills, resources and networks they need to build, operate and expandhigh-quality, high-volume and ﬁnancially sustainable eye care practices in any community regardless of patients’ ability to pay.
Cataract surgery training at AravindSince 2008, organized training in India of 50+ Chinese surgeons in ECCE, SICS, phaco
What awaits thesesurgeons upon theirreturn to China?✤ Limited access to surgical opportunities, despite training✤ Temptation to “moonlight” outside on nights, weekends✤ Continuing low salaries due to “monopoly” of senior surgeons✤ Collapsing morale, temptation to abandon medical practice for industry jobs
An Aravind-Inspired Workplace✤ Demand generation: Intense ✤ Cost recovery: Premium focus on rural screening camps subsidizes low-cost surgeries✤ Capacity building: Training, ✤ Reimbursement: Multiple retraining and recruitment to sources of revenue capture meet newly generated demand ✤ Nothing is “free”: Standard✤ Safety is paramount: Low rate Surgery provided at “no cost to of complications best assured the patient”, but optional by staff empowerment, high upgrades help drive revenue skills and accountability ✤ Patient counseling: Even the✤ Services with dignity: Treat poor can make intelligent, patients as if they were kin informed decisions
Prototype: Tancheng Xinyimin HospitalFounded in 2009 by local Tancheng County ophthalmologist Dr Tian Zuolong
Dr Tian ZuolongInspired by Aravind in Dr Ramakrishnan’s 2005 lecture at COOC ShanghaiTrained in SICS by Dr Hao Xiaojun following Hao’s 2-year fellowship at AravindFounded Xinyimin Hospital in 2009, determined to embrace the Aravind modelWithout screening and using only SICS, has restored sight in 1,000+ walk-in patientsIn 2011, joined with Vision in Practice to redeploy Xinyimin as demonstration hospital
Dr Hao XiaojunFirst read about Aravind in Chinese edition of Ophthalmology World Report in 2003In 2004, selected as ﬁrst Chinese trainee as Dr Venkataswamy demanded a China strategyIn 2006, became the ﬁrst international doctor to undertake a 2-year fellowship at AravindSince 2008 has experimented with “screen-to-surgery” model in Hangzhou and GuiyangCo-founded Vision in Practice in 2009, serving as Medical DirectorCo-leading ViP’s overhaul of China’s top residency program at Fudan University/EENT
Dr May KhademFaculty ophthalmologist at Northwestern University, and veteran anti-blindness activistDecades of experience as cataract surgeon and surgical trainer in many countriesDeployed to China in 2010 with a personal mission to tackle barriers to quality eye careJoined Vision in Practice in 2011 as Director of ProgramsLeading ViP’s overhaul of China’s top residency program at Fudan University/EENT
Jeffrey ParkerVeteran journalist and media executive based in China since 1990Founding editor of China and India editions of Ophthalmology World ReportIn 2007, bridged Chinese and Indian ophthalmologists with surgical training exchangeFounded Vision in Practice in 2009 to foster better venues of practice for Aravind traineesAs ViP’s Executive Director, strives to match resources with opportunity and acute need
All together now: Screening as a joyous team effort
Outreach in the open airDespite only one day’s notice, 86 villagers turn out for county’s ﬁrst free screening
Logistical challengesof poor, rural patients✤ 88 years old, with operable cataract in both eyes✤ Lives alone with no phone, doesn’t know her own address✤ Hobbled to screening on feet that were bound in her youth✤ Keen for free screening, walked 1 hour from another village
Camp Metrics✤ Screened villagers range from infants to nonagenarians✤ Screening differs widely: many ailments, wide demographics✤ Nearly 1 in 3 presents with serious cataracts, most with at least one operable eye✤ Many have no means to travel to hospital or district town
Vision in Practice Objectives✤ Provide access to high-quality, hands-on surgical training that remains virtually unavailable in China✤ Provide management consulting/coaching to cultivate a dynamic, efﬁcient workplace marked by teamwork, smart division of labor✤ Provide empowerment training to nurses, technicians, marketing, logistics, ﬁnance and other non-physician staff to optimize efﬁciency✤ Comprehensive community outreach training to accelerate demand✤ Facilitate access to insurance reimbursement, grants, investment, loans and other ﬁnancing to achieve sustainability/proﬁtability
Vision in Practice priming the pump: Quality ﬂows to all, regardless of ability to pay
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