Dealing with Perfectionism and Reaching Underrepresented Patients with Ruth Williams, MD

At the 2025 New York State Ophthalmological Society Envision annual meeting, keynote speaker Ruth D. Williams, MD, former President of the American Academy of Ophthalmology and current vice-chair of the Glaucoma Research Foundation, spoke on the hidden costs of perfectionism among cataract surgeons, ophthalmologists, and medical clinicians at large. She sat down with HCPLive beforehand to discuss her thoughts on ophthalmology at large and how to better reach patients who are unable to receive care.

“My personal view is that when you’re in a community, your job is to take care of the patients in the community and in that footprint, and sometimes that requires a lot of creativity,” Williams told HCPLive. “Sometimes you don’t even know what your patients’ barriers are.”

Williams praised modern ophthalmology training programs, noting that today’s residents and fellows finish their studies with high competency. However, the ensuing decade is critical for refinement and mastery of skills. Peer support during this time is imperative to preventing isolation and encouraging further growth.

Additionally, Williams noted technological gains, both in education and in the operating room, as a driving force behind the expansion of ophthalmology in recent years. Improved intraocular lenses, surgical tools, and refined safety protocols all dramatically enhance surgical outcomes. These gains not only reflect individual clinician skill, but also industry’s contributions to the field and the broader ophthalmology community.

“We have really good data to back that up and we know what works,” Williams said. “I just think as a community, we’ve been refining over time what we’re providing to the public, and it’s really extraordinary what we can offer.”

Addressing access to care, Williams indicated persistent socioeconomic barriers that prevent patients from receiving timely treatment. Declining reimbursements and increasing overhead costs can result in the closure of clinics, while underrepresented groups cannot find the money or time to make an appointment. Williams advocates for a community-centered approach to healthcare delivery.

Previous studies have emphasized the importance of communication in reaching underrepresented populations as well. Research has suggested that a major cause of fewer healthcare visits, and therefore poorer outcomes, are a result of language barriers and communication breakdown.1

Williams also suggests that diversifying the workforce can indicate for these communities that a practice is committed to them. Such diversity also affords a given practice a variety of benefits.

“Another thing you can do is have your workforce reflect the communities, and that is a win-win,” Williams said. “We in our practice have hired a lot of people from under resourced communities, and [they’re] amazing. First of all, many of them are bilingual and that’s added value. The second thing is that it provides a great job with health insurance and benefits to people who don’t necessarily have easy access to these kinds of jobs. They’re super proud and they stay a long time.”

References

1. Vidal GA, Chalela P, Curry AN, et al. Advancing Inclusive Research (AIR) Site Alliance: Facilitating the inclusion of historically underrepresented people in oncology and ophthalmology clinical research. Contemp Clin Trials. 2024;137:107416. doi:10.1016/j.cct.2023.107416