EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
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48 EWINTERNATIONAL July 2012 International outlook Go east, young ophthalmologist by Matt Young EyeWorld Contributing Editor While compensation takes a hit in the U.S., ophthalmology is full of opportunity in China Most physicians understand the delivery of healthcare to be a local undertaking. The treatment of patients is personal and by its very nature not exportable. Our influence as educators, however, is an important way in which we can shape the practice of medicine around the world. Ming Wang, M.D., views the global reputation of the U.S. healthcare system as a strength that has been overlooked. Our knowledge is ex- portable, and it is valuable as well. Dr. Wang describes his experience as an American physician in the Chinese eyecare market. He raises some inter- esting ideas as well as some unique possibilities. John Vukich, M.D., international editor M ore ophthalmologists are making less money in the U.S. That's a fact, according to the 2012 Medscape Oph- thalmologist Compensation Report. In the 2011 survey, 21% of ophthalmologists saw a decrease in their earnings compared to 2010. In this year's survey, 31% saw a decrease compared to last year. Compare that with the prospects of Ming Wang, M.D., who, having once suffered through China's Cultural Revolution, became an American ophthalmologist and eventually invested back into China as co-owner of Aier Eye Hospital Group, the nation's largest private eye hospital system. The group owns 40 hospitals in China and grows at the rate of one additional hospital per year. Last year alone, the group performed 80,000 LASIK procedures and 60,000 cataract procedures. Dr. Wang, also founding president of the Tennessee Chinese Chamber of Commerce, isn't resting on his laurels. He is keenly inter- ested in getting other American oph- thalmologists involved in China. Having experienced both the best and the worst of what China has to offer, Dr. Wang now sees that nation for what it is: an opportunity, especially for Americans and ophthalmologists. Forget that China has sur- passed Japan to become the world's second largest economy. Forget that the nation is the U.S.'s largest creditor or that it has its own Source: Image Source/Getty Images dynamic marketplace for better goods and services. Dr. Wang explained what should make China the go-to place for American business at a recent Chamber of Commerce event. He asked the audience, "What is your unique value proposition" in China? One person answered "money," but Dr. Wang explained that foreign investment is not as valuable as it was 20 years ago. Another person answered "inventiveness, creativity," but Dr. Wang explained that some- times inventing is not as important as perfecting (which Japan did for the automobile). Another answered "technology," to which Dr. Wang replied,"You can buy an excimer laser in China almost as easily as you can buy it here." "I stunned everyone in the chamber," Dr. Wang said. "The most important thing is that you are an American. You are perceived as knowing more, having better technology, and … bringing in this perceived quality/ reputation." Sec- ondly, eye- care is an excellent field to be a part of in China at this time. "For example, I just returned from [the] ASCRS [Annual Meeting]," Dr. Source: Ingo Jezierski/Photodisc/Getty Images Wang said. "I no- ticed there was a small delegation of Chinese ophthalmologists there— department heads mainly. Ninety- nine percent of doctors in China do not get to come to ASCRS. It is con- sidered to be expensive and far away. But ASCRS represents a level of thinking of world-class ophthal- mologists." He explained that Chinese oph- thalmologic thinking is behind the technology available. That leaves much room for American ophthal- mologists to arrive in China as elite clinicians and purveyors of knowl- edge. Education, therefore, is one important sector in which American ophthalmologists could excel in China, he said. "I think this new opportunity comes because China needs to improve its quality of healthcare delivery," Dr. Wang said. "Private healthcare is only 10% of China's market. Ten years ago, it did not exist. The main reason for this growth is that the government allows it because they see government hospitals as not able to meet the increasing demand of an increasingly well-to-do population." Reading the tea leaves Part of being successful in China has to do with reading the tea leaves, which largely involves examining government priorities. "Governance must justify the legitimacy of gov- erning" in China, Dr. Wang said. "Because officials are not elected, the number one criterion [of good gov- ernment] is stability. That is why China will do anything to keep the country stable. If you don't quickly improve quality of care, China