Sophie J. Bakri, M.D. , is an ophthalmologist and the chair of Ophthalmology at Mayo Clinic in Minnesota. Dr. Bakri, who specializes in retinal surgery, joins our podcast to discuss her vision for the future of ophthalmology.
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Welcome to the Mayo Clinic Ophthalmology podcast, a weekly podcast on All things ophthalmology brought to you by Mayo Clinic. I'm your host, Doctor Andrea Tooley and I'm Doctor Eric Botham. We're here to bring you the latest and greatest in ophthalmology medicine and more. Doctor Sophie Bakri is the chair of the Department of Ophthalmology here at Mayo Clinic. She joins us today to talk about her vision for the future of ophthalmology. Doctor Sophie Bakri is the mcmillan Professor of Ophthalmology, a Vitra retinal surgeon and chair of the Department of Ophthalmology here at the Mayo Clinic. Doctor Bakri's research focuses on pharmacology for age related macular degeneration, diabetic retinopathy and venous occlusive disease. She is also a principal investigator on numerous multi center clinical trials on novel drugs for retinal disease. Doctor Bakri serves on the editorial board of the American Journal of Ophthalmology retina seminars, seminars in ophthalmology and OS L I Retina. She served on committees on the macular society Retinal Society and a AO and is a board member of the American Society of Retinal Specialists. She has won numerous awards, recognizing her work in ophthalmology and we are honored to sit down with her today. Well, thank you, Eric and thank you, Andrea and I am honored to participate in this podcast with you today. Welcome. We're so happy to have you here. It's an honor. It's a special treat as there have been so variety of changes in our department. And being here as a podcast is one of those changes that have been part of Andrew. You know, that journey a little bit better than me, even as the ideas for this and culminating um led to us being here today. Yes, exactly. I want to give you all the credit for starting this podcast. This was your idea. And as the chair of the department, I know it's something that you wanted to start. And Eric and I are really enjoying getting to start this podcast and so talk to us about why you wanted us to start a podcast. What this means to you, what you think this means for an academic department to have a podcast. Well, well, thank you so much. First of all, I'm honored that you're helping with this. Um not only helping but really, really running the show. Um Obviously, everything we do, um you know, is a team effort and our successes are due to the success of the team. So why podcast? Well, I think we have to really rethink the way that we consume information. I think our lives have all become extremely busy, but yet there's this word out there. Work, life balance, work life integration. And I think that for um most ophthalmologists listening, having a podcast is a great way to consume information. Yet also uh work out, um you know, maybe enjoy the commute to work a little bit more and so on so forth. And um we have an outstanding department. Uh we have tremendous faculty. Um and that's just ophthalmology. Of course, we have the mayo clinic and there are tremendous resources and we hope through this podcast to really um bring and share some of the learnings of the faculty in our department, but also within uh Mayo Clinic. Um because it's uh it's, it's just great. It's such an honor to be, you know, part of such an integrated healthcare facility. Yeah, I'm so excited selfishly to just get to sit down with some of the people, not only in our department, but at Mayo at large, especially being junior faculty, there's so many senior faculty in the department that you don't know all of the exciting things they're doing or maybe you want to pick their brain. So I'm selfishly very excited about that. And then even getting to connect with ophthalmology at large, connect with other people that we might bring as guests on the show. Um see what people want to hear about what people want to listen to while they're working out or on their commute. It's all very exciting. Yeah, I echo that Mayo is such a unique institution in my opinion, um that it, it really is anchored on relationships and teamwork. And I think the environment here is one of collaboration, connecting learning from each other and, and yoking efforts forward clinically in research in, in, in teaching. In my time here, I've celebrated all the opportunities we have to do that and just on a granular basis, even on our patient to care, moment to moment basis, how intentional the institution is to connect with each other, to support patient care um in that relate, I agree with you. It's exciting to think about episodes to, to have moments to connect with each other in our department and beyond, to learn from each other and share those moments uh in ways that are packable for wherever people are and whatever they're doing to hopefully be blessed in their clinical practice and care exactly that there's a lot of opportunity for innovation here. And I know that you have a lot of vision for innovation in the future of ophthalmology and being a chair and kind of getting to decide where health care is going, what, what we want to focus on and what we think the future is. What, what's your kind of overall um vision for ophthalmology? This is a big question but just thinking about innovation and where we can go. What do you see as a department chair? That is a very, very long winded question with a very long winded answer but I'll do my very best. So ophthalmology is a field that is just so ripe for innovation as you know, that there is so much coming out there. And as a department chair, what I want to do is I want to facilitate the transformation of our faculty's ideas into products that may help patients. And I think that mentorship is going to be key to this. I mean, we know over the years we all come up with, you know, certain ideas, you know, better ways to do things, better ways to build a mouse trap. But then what, you know, do the ideas die? Well, we don't want them to die. We actually want to benefit from all these ideas. And uh we are setting up a robust mentorship programs to help, you know, junior faculties such as yourself, come to us with ideas, you know, in a safe environment and uh coach you as to how to bring that idea to fruition. Now, we've had many, many successes in the department. Um You know, some of our senior faculty uh um have, have really um um have made great strides in research. Uh You know, one example, um you know, is a glaucoma drug uh that is now in clinical trials and that I think is something that we have to celebrate. Um you know, we have one of our more junior faculty as well learning from the senior faculty about his glaucoma drug and his mechanism. And now, you know, moving along that pathway to translation in retina, um we have um we have moved from perhaps one person initially working on stem cells to an entire team working on um uh on the full spectrum of stem cells from uh from how we're going to uh cultivate them to how we're going to implant them on the retina to, you know, creating surgeries. Um uh and, and best practices. And so I think we've really come a long way. But one of the hallmarks at Mayo Clinic is the team science approach. And I think that is, is something where we don't work in silos. We're encouraged to not only knock on doors but keep our doors open and be receptive. And when I think about the number of projects in our department, I mean, we have collaborations with radiology, we have collaborations with biomechanics, immunology, uh pulmonary um the Pulmonary Department. I mean, the list goes on, I'm struggling here to think because as I go through each faculty member, everybody has, you know, a collaboration. Uh you know, we have grants are ones that are being written in collaboration with other departments with multi P I CO P I um things and, and so really, you know, what, what we want is to have people think innovatively but also not hit a ceiling. So, so that's one of the things that I really want to do. You know, I think many of us along the way, have kind of stumbled on things by accident. We've made mistakes. You know, we've learned from our mistakes. Maybe we hit something the third time. But wouldn't it be better if we can coach and mentor the right way so that people can get on the path that they wanted to get on right from the beginning? Oh, I love that. One of the things I've been humbly um naive about but very excited to learn more about and certainly is I think is coming in a collaborative way, not just within a department, but across Mayo is a I artificial intelligence. We're learning more and more about big data and how that be processed. But just, you know, you're in a different seat than, than many of us as you see this collaborative work happen or this upswell of energy around the I share with us how special that is happening here at Mayo and might impact our department. So, one of the first things that I'm going to acknowledge is that Mayo Clinic as a whole has an initiative known as the Bold Forward 2030 initiative. And when an institution has an initiative labeled that way that immediately tells us that they are supportive of our initiatives and our goals with that. So that's the first thing and I think that's fantastic. Secondly, Mayo Clinic um already has a lot of A I capabilities um and continues to build capabilities and um and uh has collaborations with Google and inference and a lot of great things have come out of A I um in other departments. Now, ophthalmology is a very unique field because we can pretty much see everything we can see the retina, you know, we can see the optic nerve. And uh what we have uniquely at Mayo is a collection of images, a collection of data, but also correlates with patients um systemic information. And so, um uh to tell you how important this is as, you know, a department chair, uh typically uh appoints um uh faculty leaders for different areas. You know, for example, you know, Andrea is the vice uh one of the Vice Chairs for Education and Eric, you're the vice chair for Quality, but we have appointed a Vice chair for Artificial Intelligence and Digital Health, really outlining the importance of that as a trajectory that we want to go in. So, one of the first things is to look at how we make our data curable or really understandable. Uh by this, uh we are building an uh what we're calling an A I playbook. So that again, going back to mentorship. But when a faculty member comes and says, I want to study the relationship between X and Y, we have a way that we can guide that faculty member. So uh A I is definitely one thing. Um But how is A I going to help our patients? OK. So we have to think um we have to think about the future of ophthalmology. We have to think about the aging population really a stagnant uh number of ophthalmologists and how we're gonna serve a growing population. Now, the traditional way is that we see everybody face to face for every visit. And if you take glaucoma, for example, or diabetic retinopathy, you assess for progression as an ophthalmologist. But wouldn't it be great if we can have a machine assess for progression? And we bring the patient in when they need an intervention or when they need surgery. Ok. Aligning with that A I is how are we going to serve patients at home? And that's where digital health comes in and we will be partnering with companies externally as well as building our own products um to be able to monitor some of these conditions. Um Some of it involves hardware. Uh We've already, you know, created some hardware for uh for wide angle funders viewing, which is very exciting and you'll hear more about in the future. Um But uh think about um think about glaucoma monitoring, think about home fields, think about homo CTS. Um So really, it would be um not only nice to know when we need to see the patients and remember many of them come to Mayo clinic from rural areas, they come from really far away. Um And we have to think about healthcare disparities as well. People can't afford to come to uh to the physicians, uh they can't, some, some of them can't afford the trip. So how do we make it easier for patients? And I think that there's a tremendous role for digital health and a tremendous role for A I um in these areas. And the other, the other thing you may have heard is that A I in some areas can, can help and tell us things that a human being cannot. So looking at a nerve and to is it male or a female or what's the gender of the patient? For example, you know, it's really amazing the potential opportunities and what we can learn, especially with the retina and the object nerve. There's so many things, subtle subtleties there that clearly machines are picking up that we're not, that blows my mind. I think it's, it's fasting. We're sitting in a building here at the mayo clinic called the plumber building and the Mayo Brothers, the two doctors that really are put this place on the map a long quite a while ago, one of their first hires was doctor plumber and his, he had many transformational ripple effects. But part of his biggest impact in health care was the transformational idea that instead of carrying around a little packet, that was my chart and you took it home every day, your chart was owned by the institution and went to every patient visit with you and thus starting internal medical records. And that's what mayo is, you know, benefited patients through for so long. Um It's changed the way we, we think of information, patient information that lets us care for them in an individualized way, but also learn from information in a collective way. So as we sit here in the plumber building, which kind of got that going in the, in the within medicine. And you think about this is really a transformational thing in one sense. It puts health care back in the the convenience and accessibility of the patient. It allows the patient to go back to sort of contribute to their chart, even though they may be at home, monitoring their pressures or visual fields, allowing us to better care for them, improving their charts, but also improving the way that we collect data, analyze data and transform care in the future. So I just was sort of a neat perspective of where we've come from walking around with a little piece of paper to having a collected medical record and, and, and advance the way we study data through the rep study. That's what we call our, our studies here in the Rochester Epidemiology project. But also just how A I is gonna take that to a new level that um in one sense might be intimidating. But through leadership like yours in here at Mayo, to understand as you articulated, we want a I to be something that every new physician comes into or a new care provider comes into the mayo clinic and be able to interface not just with a patient, not just with a medical record, but with a mechanism of evaluating the medical record that takes all of our care to a new level. Yeah, you mentioned the word intimidating and I just really want to sort of comment on that. I think there are some physicians and ophthalmologists out there that feel that A I may replace them. And it's absolutely not true. I think that A I will assist us but also enhance us in enhance our ability to care for the patient up in new opportunities and new expansion of things that we really didn't know how to study or treat. So we don't know what we don't know. And I think A I is, is teaching us that and in some situations, it's given us a little bit of a wake up call about just how, how strong the capabilities are. So, you know, you're right, it's absolutely transformational and I hope that we can make uh new discoveries, new associations, new linkages and being able to link that entire patient chart, including, you know, for example, you know, the genetics. Um it's just gonna be incredible. So I I am really looking forward to it and it may be a capability that every faculty member will either come in with in the future or develop. At some point. I'd like to go back and you, you talked about new ideas that go from, um, from bench to bedside. And, um, there are so many different opportunities that, um, people come up with and, and some of them in places just sit as you talked about here. There's been a, a number of areas that I've seen in my short time, be on the, on the cusp of changing care everywhere, drug delivery included. But share with, share with us just a little bit of, of your perspective on a couple of those. And, and I say drug delivery in light of how important that is in a patient. Um How do we say not uh ease of ease of, of delivery but also in disease impacting way. What drug delivery is an example might do for patient care in the future? Yeah, absolutely. So, um you know, looking back at how research used to be people did research and, and myself included because I, you think this topic is really interesting and so you do the research, the topic is interesting and then you go back and you find that there's been some other related information and then you say, gosh, this is so interesting. I think we could really make something of it. And then you go to the venture's office and they say sorry, there is some prior art somewhere in some language and some literature. This is not gonna go anywhere and then you start to understand uh why it's important to consult with these professionals early on. So that by uh learning what's been done and learning the new directions that you could potentially take your research in or sometimes really small tweaks, you could actually create something that could get into the hands of patients or should I say could get into the eyes of patients. And I think that that's one of the things again about team science. Again, we used to work in silos um uh a long time ago and then SILOS became teams and now the teams have gotten bigger. Um You know, we get, we get counsel. And the goal really is that when you have an idea, how quickly can we get it into the eyes of patients? So I think that's really been a tremendous transformation over at least the past decade. And I think, um I think patients um have really benefited from that. Um in terms of, you know, drug delivery, there's a lot of exciting things coming out. Um One of the things I will say and, you know, I, I have a special interest in, in drug delivery, spent a long time poring over the literature. And I finally understood why there's so much literature on the topic, but it doesn't go anywhere. It just wasn't quite tweaked the right way. And so I think that with our, with our new team capabilities, um at Mayo, as I mentioned, we'll be able to hopefully mentor faculty to get the right direction, you know, the first time still within the realm of their interest, of course. Um But really, so we can move things along quicker. Drug delivery is, is a fascinating area. There's so many ways to deliver drugs to the eye and the beauty of the eye is it's accessible and we can deliver uh medication locally in a way that doesn't cause uh systemic side effects. So I think it's really been a very attractive targets for um in general um industry because you know, they understand that you can um you can deliver it easily, you can study it, you can image it. Um And so I think that the field has benefited as a whole uh from that, just as you said, industry, how do we tie all of this work into our partnerships with industry, our goals for helping reduce health disparities using big data, using A I and fostering innovation, creative research. How do we partner, how do we work with industry to make that happen? No, I think, I think the word partnership collaboration, I mean, you, you're exactly spot on. Um Andrea. Um again, in the past, there used to be uh the university setting and then there was the industry setting and now one cannot survive without the other. OK. When we um when we create ideas here at Mayo, um we know that the physicians and the scientists, we know what they're good at. They're good at doctoring, taking care of patients and creating the science. The training they haven't had is how you get that drug into the eyes of patients. And that's where our industry partners come in here because they can, um, they can license, uh, you know, one of our patterns and they can take that along and that allows the physician to go back to seeing patients. And then maybe thinking about the unmet need and thinking about what else we can do. You know, I have to say that internally, I get very frustrated when a patient asks me a question and I hear myself saying, you know, I think we've reached the limit of science or I'm sorry, I, I don't think there's anything we can do or, and they ask me why I say, you know, that's a poorly understood um condition. And I find myself now writing this stuff down saying, you know, I'm at mayo clinic, there's really no excuse, right? We have to find the answers to these questions and it's only by having physicians in the clinic that we're able to assess that unmet need and bring it back. So I think if you don't collaborate, I think that's a real problem. And I think there are certain stages at which you collaborate. And even within industry, there are small companies and there are big companies and they have to decide when they've reached the limit of their expertise and it's time for them to involve yet another partner. So I think skills of teamwork, collaboration, good communication are going to be really essential to moving anything that we do forward. So I just want to thank you for sharing with us. You are in such a unique position as you were shepherding so many of us along this journey, expanding new opportunities in care, but also in research and development. And uh it's a treat to be able to sit here and say we have a new opportunity in media relations. And so we thank you for your leadership to this point and are excited for the future of ophthalmology and the future of our department for our patience, both locally and beyond. Well, thank you, Eric and thank you Andrea and I look forward to working with you on this new endeavor and uh sharing uh what we've all learned along the way. Thank you so much. You can find all episodes of the Mayo clinic ophthalmology podcast on our website. Thank you for listening and we definitely look forward to sharing more next week.
