Harvey Uy, MD is the new president of the Philippine Academy of Ophthalmology. He is also heading the phenomenal startup Pacific Eye and Laser Institute. Dr. Uy is the rare individual who is able to excel in clinical practice, research, entrepreneurship, and family life. After specializing in ophthalmology, he went for further training in retinal diseases and ocular immunology in the United States. Here is our interview:
What is exciting you in your field right now?
The convergence of several technologies: digital and ophthalmic technologies are coming together to give doctors a level of precision and efficiency unimaginable just a few years ago. For the patients, even the elderly, it is now possible to have cataract surgery and come out with a vision as good as a young person’s vision. In our field, technology is constantly moving and improving at rapid speed, and this includes the increasing level of safety for the patient. It’s like landing a plane: before as a doctor you have to land the plane yourself; now most steps are on auto pilot.
So will there still be a need for doctors? People have been saying technology is moving forward at such rapid speed, doctors will one day become peripheral in the lives of people, and doctors will only be there for the most complicated end-of-life procedures.
Yes, you still need doctors to explain, to comfort, to put the analysis together: but doctors will have to be more adept in using advancing technologies.
How is Philippine medical education? Are our medical students ready for these advancing technologies?
We have a long way to go in terms of technologies. We need to have basic research in order to produce our own technologies. I am more concerned about producing our own research than versatility in using machines.
Our medical education system is structured for teaching, like the Philippine General Hospital has very good teaching capabilities. Research is largely being done at the National Institute of Health (NIH), not fully at the university level yet. I am not familiar with the NIH, but I have no doubt they have good people there doing good work.
US medical education has strong emphasis on basic sciences. That’s needed if you want to move things forward. The Philippines is very practical-experience driven, like drawing blood, checking the blood pressure, giving medicine. We need more time learning about the diseases. If our students spend 24 hours drawing blood and injecting medicine, they will not become better doctors the next day. We need more studying rather than experiencing medicine. Nobody in our batch in the University went to internal medicine in the Philippines, as many became intimidated and were used as slave labor, rather than becoming excited by the field of internal medicine.
Your startup Pacific Eye has diplomas and certificates of all your doctors from United States training institutions on the wall of the waiting room: does this help? Are they necessary?
When patients go to an eye center or health facility, they immediately look for signs of quality: they look at the place, the staff, and eventually they look at the wallpaper. It helps: these diplomas and certificates show that our doctors have been exposed to the latest technologies being developed in the world; although of course being trained or exposed to the latest technologies in the US doesn’t mean you will become a better doctor than the one only exposed to local training. It is only an indicator of a certain level of exposure.
How different is the US practice of medicine to the Philippines? Is there any treatment a patient can get in the US for say glaucoma that a patient will not be able to get here in the Philippines?
No: if you are talking about accepted techniques, there is nothing you can get in the United States that you cannot get here. The advantage of the United States is they are leading in research. The next generation of treatments will come from them and other countries with a strong research culture, like Japan and Germany. The next generation treatments will not come from us. We will be buying from them.
In the US the approach to the patient is more systematic. A patient has to go through a whole systemic review. This is probably due to their lawsuit culture. It can make it a lot more expensive because they practice defensive medicine, but as a plus, they look at a patient holistically. The Philippines is more problem centered.
You are one of the first movers in stem cell treatment. How is this different from the stem cell treatment in the country that has created so much controversy?
The controversy is usually for treatments that claim to make people look and feel younger. In our case, we use stem cells for incurable eye diseases, using this in the context of scientific studies, so we do not market or advertise this. To objectively measure results will take time as we still have to scientifically establish the benefits of such treatments.
Is the Philippine government helping?
Government regulations help weed out groups that are just trying to make money by making this a fad, claiming this as a kind of miracle drug. The role of government is important. But we need resources, the way the Japanese government gave their doctors 200 million US dollars. To develop stem cell technology for eye diseases, one percent of 200 million US dollars from our government will go a long way. In many of our studies, patients fund them themselves. This is the reason why it is taking us a lot of time to get enough number of patients to do a good study.
If you were given a million US dollars, would you be able to do the research? Is the infrastructure there for people to do the legwork? For manufacturing to happen?
You can do a lot with a million US dollars: you can start building the infrastructure for research. You can help also develop the culture of sharing among the leading Philippine training institutions.
We are trying to develop low-cost treatments to solve glaucoma. We work with the University of Colorado. We do quality research. We have a lot of patients. This gives indigent patients an opportunity for quality eye care. Our move forward will be much more rapid if we are able to have the money and get more people involved. I think Sunfu Solutions’ concern for manufacturing capability, for building that capability, will partly be solved, or taken care of, if we have the research production. It will be the start.
Dr. Stephen Foster, my mentor in Boston, taught me how to take care of patients, but more importantly, he instilled in me the desire to do research. I used to think research is just for geeks.
But aren’t you a geek?
Well yes, but I previously did not see the benefits of research. Research is a way of multiplying your time and multiplying your ways of helping the world.
There are those who say what we need is basic medical equipment, the non-brands that are good but do not have catchy or established names. What do you think? People like Dr. Reynaldo Joson think our resources are getting sucked up by these big machines produced by giant multinational brands.
There is validity in that point. The flip side is those who can afford the highest possible medical care may just go elsewhere, and Thailand and Singapore have been very successful with medical tourism. Technology is definitely important. We are not very successful so far as the reputation of the Philippines as a safe and good place to visit is not good. Patients will only spend maybe 1/3 of what they would spend in the US if they come here, but if patients do not have relatives staying here, they may not want to come here because of our image problem in the world. We are successful in getting balikbayans, Filipinos who work overseas, they still want their health care to be here in the Philippines. But we need to gain the confidence of people who are not from here, people who do not have relatives here; people who will just come here because they know they can get quality care without breaking the bank. Sunfu’s concern for capacity building will be complemented by our ability to have the resources to go into research, and we need money for that.
I think manufacturing is very achievable. What we need are the ideas. We have to have basic research first, more than anything. India is probably the same as us in terms of capacity, except they have one billion people as their home market, so for generic drugs and low-technology products, like intraocular lenses, they are becoming leaders in the field of production, or leaders in, Sunfu’s favorite word, manufacturing. It is only a matter of time that they will move up. We also have to get going.
What can patients expect from your leadership of your professional society?
Our theme is to strengthen ethics, and to further information sharing with different medical doctors and societies that are in different fields of specialization. We want to drive up the quality of care. It doesn’t mean it is not already good now, but there is always room for improvement.
How has your transition been to entrepreneurship? Building this eye center must have been quite a learning experience.
It is exciting. You come to work and see people you hired: you are responsible for their training and development. I have had no frustrations. We are on our way. We just need to slowly build it up. In starting a business, one learns to appreciate friendships: that you get by with a lot of help from friends, like your group, Sunfu Solutions. You need a lot of talent, knowledge, resources to build up a place, for an eye clinic to become an eye center, to make it good and efficient and viable, and eventually for the eye center to become an institution.
I managed to have a new perspective and respect for entrepreneurs: in what they have to go through, the obstacles they have to hurdle. Entrepreneurship also made me appreciate the need for well-trained people.
How long have you been practicing? What have you learned about people in those years?
I have been practicing medicine for 15 years. I have learned that each human being is different: each human being has a unique way of viewing the world, has his or her own unique concerns, and his or her own value system.
Pacific Eye is doing very well. Congratulations.
Thank you, but we are just in our first year, so we started from a base of zero. There is nowhere to go but up. Let us see how we do next year compared to this year.
Please share with us a few book titles that you tell your friends and relatives to read.
The Case for Christ: A Journalist’s Investigation of the Evidence for Jesus by Lee Strobel. This will strengthen your faith if you are Catholic.
Kill as Few Patients as Possible: And 56 Essays on How to be the World’s Best Doctor by Oscar London, MD. This book is a humorous take on what can be a stressful life of a medical doctor. It gives the important message that the doctor should not take himself too seriously.
Management Lessons from the Mayo Clinic by Leonard Berry and Kent Seltman. We are trying to instill what I have learned from this book in our own set-up: from selection of employees to training to their empowerment. We give our staff only one guiding principle: the needs of the patients come first.