Regional towns are home to some of the top ophthalmologists in Australia and New Zealand, yet they don’t often get the recognition they deserve. In a new podcast series, Dr Sonia Moorthy will interview seven guests to gain real-world insights into the delivery of specialist eyecare outside the city lights.
When it comes to the regional ophthalmology workforce in Australia, the conversation is often focused on data, high-level analytics and jargon-filled programs that seek to identify and overcome this longstanding industry issue. But what about the stories behind the specialists delivering eyecare to these communities each day?
Anecdotes about what it means to be a regional ophthalmologist in Australia and New Zealand will be the focus of a new podcast by Queensland’s Dr Sonia Moorthy.
The first series, supported by Bausch + Lomb (B+L), will interview seven regional ophthalmologists from Australia and New Zealand, covering a range of topics including eyecare delivery challenges, timely and equitable access to eyecare, harnessing a sustainable workforce, gender equality through to the role of industry in region.
“The focus of this podcast is regional services with different perspectives. I want the guests to tell their story. I want to explore how they landed here. What are the things close to their heart? What has kept them going and the beauty of being in region? But also, what are the most challenging aspects?” she says.
“We want to deliver this message to up-and-coming ophthalmologists; but beyond that too, if we’re going to tackle the workforce issue, we’ve got to start at the grassroots level and adopt a collaborative approach.”
The guests
Regional eyecare is a personal passion for Moorthy. As a child in Malaysia, her family moved to multiple remote areas, taking her to the jungles of Bornea where her father managed oil palm and rubber plantations. Upon completing fellowships in paediatric ophthalmology and strabismus at the Singapore National Eye Centre and Moorfields Eye Hospital, London, she returned to Australia and landed in Far North Queensland in 2018. She practised publicly and privately in Cairns where she attended satellite clinics, providing eyecare to regional and remote communities in the Atherton Tablelands and up to Cape York. Today, she has a primary practice, EyeHub, on the Sunshine Coast and in April 2023 established a satellite clinic an hour away in Gympie.
She’s familiar with the multi-dimensional challenges of regional ophthalmology and, thus, has secured a line-up of regional ophthalmologists with complementary backgrounds, including:
- Dr Andrew Thompson, RANZCO censor-in-chief, ophthalmologist and medical retinal specialist, based in Tauranga in the Bay of Plenty region in New Zealand’s North Island
- Prof Angus Turner, ophthalmologist and Lions Outback Vision founder and director, based in Broome in Western Australia
- Dr Neil Sinclair, paediatric ophthalmologist and oculoplastic surgeon, based in Bunbury, Western Australia
- Dr Eline Whist, ophthalmologist, medical retina and uveitis specialist, based in Darwin, Northern Territory
- Dr Brent Skippen, ophthalmologist and oculoplastic surgeon, based in Wagga Wagga, New South Wales
- Dr Phoebe Moore, ophthalmologist medical retina and uveitis specialist, based in Tamworth, New South Wales
- Dr Andrew McAllister, ophthalmologist and vitreoretinal surgeon, based in Toowomba, Queensland.
On Thompson, Moorthy is excited to provide a New Zealand perspective as she chats to one of the key ophthalmologists in Bay of Plenty and the exemplary public and private eyecare he provides, while simultaneously training the future generation of young ophthalmologists
With Turner, Moorthy will explore his work with Lions Outback Vision that adopts a ‘hub and spoke’ model delivering outreach services to dispersed populations over Western Australia. Recently, he opened The Kimberley Hub in Broome offering a multi-disciplinary base for eyecare services to the Kimberley and Pilbara, with resident ophthalmologists and optometrists working together within a shared-care model.
“This is someone who is potentially harnessing the power of 10 ophthalmologists,” Moorthy says, noting she practised alongside Turner as an unaccredited registrar at The Royal Victorian Eye and Ear Hospital 15 years ago.
“It’s an example of how it really does take a village to make a change and he has certainly achieved that. I think it’s inspirational the ingenuity he has shown to reach this point. It’s an amazing model and worth highlighting.”
Moorthy also has a connection to Skippen who she went through ophthalmology training with. In the early stages of his career, Skippen was a junior doctor at St Vincent’s Hospital and went to Wagga for rural secondment on several occasions. He’s also worked for Médecins Sans Frontieres (MSF) in Armenia, and in regional areas like Goulburn (student) and Armidale, Wagga and Lismore (doctor). After completing his oculoplastic fellowship, he met his wife in Sydney, before deciding regional NSW was the best place to raise a family.
“His wife’s links to Wagga created that connection. It goes to show when selecting candidates for training positions, it’s true that if you’ve got someone with regional links they’re more likely to return to the regions,” Moorthy says.
“With Dr Skippen practising in a private group practice, and providing general oculoplastic services alongside training registrars in that part of NSW, he may offer a different lens on the issue. He is also the director of the Regional Medical Specialist Association.”
Moorthy is also excited to interview Moore, one of few female ophthalmologists in regional Australia. After undertaking further training at Bristol Eye Hospital in 2020, subspecialising in retinal diseases and uveitis, she returned to her Tamworth hometown in 2021 to work alongside her father, Dr David Moore at North West Eyes.
“She’s someone I consider ‘under the radar’ who needs to tell their story. She’s a high achiever and seems to have won every top prize you can think of,” Moorthy says.
“On top of her obvious tenacity and intellect, she demonstrates a high EQ. Being the proud mother of two young children, she is following her heart and gone back to Tamworth to do what feels right. She could have easily ended up in a prime teaching institute in Melbourne or Sydney and pursued an academic career alongside her clinical career, but that’s not what she’s chosen to do – and I want to hear why.”
Whist, another guest, is originally from Norway but moved to Australia to study medicine at the University of Newcastle in 1999. Today, in addition to being a part of Darwin Eye Surgeons, she is a staff specialist at the Royal Darwin Hospital, participating in outreach services to Katherine, Gove and remote communities.
“She also has experience with MSF and volunteered a lot before pursuing ophthalmology. She’s a gutsy character, very outdoorsy, and completed broad subspecialty including a fellowship with the Fred Hollows Foundation combined with the Professorial Fellowship in complex uveitis under Prof Peter McCluskey at Sydney Eye Hospital,” Moorthy says.
“Imagine the benefit she is providing to patients in the NT who would not have the opportunity to receive exceptional care from a specialist of this calibre had she not gone up there.”
Dispelling the regional ophthalmologist myth
An advantage of the podcast is the ability to have an earnest and honest conversation. Moorthy intends to go deep with her guests, addressing some misconceptions and challenges head on.
“The number one question is: what does it mean to be a regional ophthalmologist in Australia and New Zealand? I’d like that answered because there’s an impression in regional areas that we are disconnected and occupy our own universe, lacking skillsets and evidence-based knowledge compared to our colleagues in metropolitan areas. That’s a myth I’d like to dispel and the podcast guests will exemplify this,” she says.
“In the regions, you need to get comfortable with being uncomfortable. A lot of the time you’re practising solo, but need to also work hard to surround yourself with a network of specialists in related subspecialty fields like vitreoretinal, cornea and ocular oncology that you can call up should the occasion arise. You need to scale up – and do so broadly – and challenge yourself.”
In her own career, Moorthy has come up against gender inequality. Discrimination has often come from hospital administrators and older specialists, reflecting a generational gap, rather than patients – and matters have been made worse due to a lower-than-desired number of female ophthalmologists working in region, she says.
“Social inequality is a theme that’s continued and the more regional you get, the worse it is – and the worse the access to health care is,” she says.
As a visiting medical officer in the Queensland public health system in Cairns, Moorthy says it was a frustrating experience at times.
“Because you can see so many opportunities to do things better. If we could translate the things we do in our private rooms regionally into the public system, many of these challenges would start becoming less insurmountable. Since coming to Sunshine Coast, I’ve offered my services as a general and paediatric ophthalmologist to the public hospital but this hasn’t been taken up. This is beyond me, because I know the wait time for children to see an ophthalmologist is two years, and it’s the same for cataract surgery,” she says.
“That’s how the Gympie clinic emerged, and hopefully other regional satellite clinics in future. Is there a cost? Yes, of course, it’s taking time out of an already busy schedule and I’ve got young kids too, but it’s worth it when you see how appreciative the patients are. I came into medicine to make a difference; whilst I did not have this exact vision in mind, I am here now and it feels pretty good to be able to do that.”
Embracing the role of industry
When it comes to providing highly effective ophthalmology services in regional areas, Moorthy says it is important not to overlook the role of industry – a topic she will touch on in the podcast series.
During her early training, especially in the UK, she recalls being advised to tread cautiously with industry interaction to minimise biased clinical decisions.. However, during her RANZCO training, Moorthy believes she would have benefitted from exposure to industry, especially when it came to understanding the constant evolution of technology in ophthalmology.
In terms of regional surgical lists, Moorthy can recall many moments where industry representatives have been instrumental in ensuring the smooth and running of a complex cataract surgery list.
“Bausch + Lomb is an example of this. I was first supported by them during my first public list in Emerald Hospital. Being in Central Queensland miles away from everyone else, it is crucial all the ducks line up to minimise unwanted intra-operative surgical events and maximise list efficiency,” she says.
“In this instance, the staff had not done an ophthalmic list for some time so they were not familiar with the lenses and phaco machine – and something as simple as an incomplete prime can be absolutely disastrous if not recognised. I don’t know what we would have done without those representatives present to guide safe and complete set up, whilst trouble-shooting on their feet – it was extremely helpful and gave me the confidence I needed for a successful list.”
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