5 Questions With James P. Gills, MD

What are some of the characteristics that distinguish St. Luke's Cataract & Laser Institute? Our most distinguishing characteristic is probably our large base of referral. Ninety-two percent of our patients are referred by people we have treated in the past. In contrast to some facilities of our size, we are not dependent on referrals from optometrists. We have well-known retina and cornea subspecialists, and our overall complications rate across the specialties is very low.

Please tell us about your participation in physical endurance competitions. Over the years, I've competed in six Double Iron competitions, the last of which when I was 60 years of age. When I was 56, I came in second place behind the first American. I've competed in many distance running and biking competitions and been nationally ranked in several categories at times. These activities have kept me in shape and at an optimal level to practice medicine. My daily fitness routine and the time I've dedicated to training for these competitions have had a positive impact on my practice, because they have enabled me to stay relaxed and focused despite a demanding procedural volume.

Do you think there will ever be the amount of innovation that was seen in the early days of cataract surgery? I think the innovations of today may be even greater than those of the past. For instance, I'm currently working on new ideas for intraocular drug delivery. The most difficult aspects of cataract surgery today are getting patients to take their drops, the subsequent effects of their noncompliance, and the chairtime required for discussing the dosing requirements. Additionally, ophthalmic solutions applied to the surface of the eye allow for the development of resistant organisms. Biocompatible inserts given during cataract surgery, however, are significantly less prone to resistance. They release their active ingredients over time, eliminating the need for continued administration on the part of the patient. In addition, the intraocular delivery of drugs would better inhibit VEGF and other subclinical reactions after surgery. These time-release implants could help tremendously with special-needs patients like diabetics. I think that the drug companies would be more supportive of these inserts if the government were to reimburse their use. Cataract surgery will have many more innovations in the coming years. I especially look forward to having the ability to modify the lenses after they have been placed in the eye.

What developments do you foresee on the horizon for ophthalmology? I think there will be two tiers in the field: government-funded procedures to address basic needs, and elective specialty procedures paid for by patients. More and more people today believe that they have a right to receive medical treatments, but no government or insurance system can provide for that. Medicine has simply become too sophisticated for either body to provide for the medical needs of each individual. Someone must be responsible for for the welfare of the patient; if there is total coverage by insurance or the government, the system will collapse. When patients become partially accountable, we see an overall improvement in the quality of medicine.

How and when did your passion for writing develop? In my family, there was a number of writers and painters, and my love for writing began in 1966 when I wrote a paper on the lineation of polysaccharides. I soon began writing on spiritual subjects and expressing my intimacy with God, hoping that my kids would read my compositions. Then my patients began reading them, and now I send over 50,000 books to prisons each month. I continue to write on topics like astigmatism and the safety of cataract surgery, but my primary interest now is the manner in which God heals.