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Calvin Roberts, MD, CEO of Lighthouse Guild, joins host Firas Rahhal, MD, to talk about the guild’s work to inspire visually impaired people to achieve their goals.
Dr. Roberts has more than 36 years under his belt in ophthalmology, ranging from academia and private practice to industry. He shares the positive and the negative of transitioning from a private practice on Park Avenue in New York to being the CMO of Bausch + Lomb. And he talks about the importance of autonomy and security when considering the leap to industry, along with the impact on those around you.
We’ll also learn how Dr. Roberts is weaving his previous experiences into the work he’s doing for Lighthouse Guild, and how the organization strives to reduce the burdens of vision loss for its clients. Click “play” to listen.
Firas Rahhal: Hello again, everyone. Welcome to the Retina OIS podcast again this is Firas Rahhal Partner at Retina Vitreous Associates in Los Angeles and Partner at ExSight Ventures in New York. And I am more than delighted to have an old friend of mine his guest today an old friend and teacher and mentor of mine.
Cal Roberts: How old, How old? You’re talking about old. What do you mean by old, Firas.
Firas Rahhal: Well, so let me clarify old meaning in the duration of the friendship, certainly not in the biology of either the guest or the host.
Cal Roberts: Okay.
Firas Rahhal: The duration of the relationship dates back to, well, I guess about 1990s I think when I started the residency at Cornell, and I’ll get right to it. Dr. Cal Roberts, who is our guest was a faculty member at Cornell at that time, and was for many years before and thereafter. Cal is a good friend and as I said, a mentor and after being at Cornell for some time, he ended up going into private practice in Manhattan private practice of general ophthalmology, cataract and refractive surgery. And then he went on to become Senior Vice President and Chief Medical Officer of eyecare at Bausch + Lomb and after those three or four careers, is now CEO of the lighthouse guild in New York City, which is part of the reason we’re here today. We’re going to talk about that. But I want to hear about a lot of the previous stuff to whatever, Cal, Dr. Roberts feels comfortable to talk about and Cal, I believe you still are clinical professor of ophthalmology at Weill Cornell Medical Center. Is that right?
Cal Roberts: I do. And I still teach this course on medical ethics, or where we talk about some of the interesting dilemmas that ophthalmologists face. And how does a young doctor figure out how to tackle them. So still good fun, I still look forward to doing it all the time.
Firas Rahhal: So Cal as a as a good friend of yours. I’ve watched you shift in these different career moves. And I know they’ve all been fascinating for you. But the one that gives me as a clinician, the greatest pause and the greatest interest to hear about is that transition you made from private practice of ophthalmology in Manhattan. At the very you know, pinnacle of practicing ophthalmology. I know your practice, I know what you were doing. I know how great you were at it. And you were in the prime of an excellent career as a gifted cataract surgeon, you then decided at some point to move into industry and for our viewers who are clinicians like myself, who might be considering an opportunity in industry. Tell me about that decision. What were the challenges in that decision? What drove you? And what kind of anxieties or apprehensions Did you have before and after leaving the practice of medicine which you spent an entire lifetime getting to?
Cal Roberts: So, it’s a great topic, and it’s the question that people ask me all the time. How do I know whether I would like to go into the pharmaceutical or biotech industry? And the answer is that you have to kind of figure out who you are. So there’s a couple points to it. What I love about my jobs, are the relationships that I have with colleagues, the opportunities to mentor others and to be mentored. One of the things about medicine is that the way you practice it, it can either be a team sport, or it can be a individual sport. So that if you are a doctor in private practice, this is a very much an individual sport. You are working mostly by yourself. And the beauty of working by yourself is the absolute autonomy that you have this ability to make decisions unilaterally. So when I was a doctor in a premium cataract practice on Park Avenue, I must have made 100 decisions every single day. You need surgery, you don’t need surgery, you should have a premium. Well, you should have a torque you should have multi-focal. You should come back in two months you should take this medicine you should do that I make these decisions all day long. When you go into industry, you rarely make a decision on your own. Everything then becomes a team in sport, with Team decisions. And so for some people, this can be frustrating, because you know what should happen. But what happens is that if you make a unilateral decision, the number of people that it’s going to impact might be significant. And they’re not going to like the fact that you’ve made a decision that impacted them, particularly without discussing it with them, and having them be a part of it. And so that if you’re going to embrace our role in pharmaceuticals, or biotech, one of the first things you have to decide is, how do I feel about losing that autonomy that I have in practice, that ability to make on the spot decisions all the time using what I know, and the situation to do what’s best for my patients, you’re giving that up, that’s going to be gone. Secondly, security. One of the things I know for sure, is that if you are a good doctor, in private practice, you can probably continue to do this job, for the full length of your career, for as long as you want to do it, you can probably continue to do it. And you don’t have to ever worry about the fact that you might lose your job. Now, when you go into industry, it’s just the opposite. Okay, because you know what happens, if this doesn’t work out, you’re going to get fired. And you’re going to be without a job. Okay. And while you may be the world’s greatest, practicing retina surgeon, turns out, you know, what, you might not be the greatest medical director of a pharmaceutical company. And what happens if your turns out, they just turn out, you’re no good at. But the more complicated is what happens if you are good at it, and you’re really successful. And you’re at the top of your game. But then the company gets sold. And you’re out of a job, for no fault of your own. And again, you rather work. And these things happen all the time. So consequently, what I find that most clinicians want to do, is they want to stick their toe in and see how it feels. Knowing that if it doesn’t work, like you always go back to my practice. So they’re happy to try the high wire act. As long as there’s a net. Sometimes that works. But more often, if you’re going to go and get one of the bigger jobs in industry, they’re going to require that you do this full time and that you give up your practice. And you say to yourself, Well, I really want to do this. But give up my practice, give up the practice that I spent all these years, busting my chops in order to be successful and get a following and now walk away with no promise that this is going to work out. So this really takes a leap of faith. And it really takes a feeling that this is a unique opportunity. So this is what I had at Bausch and Lomb. I was very fortunate that I was hired by Brent Saunders, who’s the CEO and Fred Hasson, who was the chairman of the board and they had a vision for where they wanted to bring Bausch + Lomb and what they needed was a clinician who could get out front and tell the story of where this company was going to colleagues, to other ophthalmologists. When I took this job, my friends looked at me like, this is the most puzzling thing I’ve ever heard of. Then as you said, you would walk away from a very successful Brigham cataract practice on Park Avenue in New York to go work at Bausch + Lomb with no security. People thought maybe I was sick. So, maybe he has like, Parkinson’s, or something, and he can’t operate anymore. And consequently, that’s why he’s doing it or something like that. I mean, we do which, which was not the case. No, no, my health was great. So I did it. Because I saw an opportunity that other people don’t see. Which is, which is what you do. In the investment world, you look around, and you try to see opportunities that other people don’t see. And that’s the key to to a successful career, whether it’s in medicine, or in R&D, or investing. So I would encourage people to do this. And what the hard fact, and this is a fact that I tell people, which is, which is kind of hard, is that? This is not the retirement job. And so people say, well, when I’m ready to retire, maybe I’ll go into industry. Okay, Earth to doctor. No one wants you when you’re 70 years old. Matter of fact, truth of the matter is, no one probably wants you when you’re 60 years old. So when I was hired by Bausch and Lomb, I was 55. And so I was, you know, at the peak of my surgical career. And so the question is, well, are you willing to walk away at that age, if I was, if I was smarter, I would have gone earlier. Because if I had gone earlier, if I had gone when I was 45, rather than 55, the number of opportunities that could have come available to me, or that much more. And so there’s this trade off. There’s this tradeoff between what you know, and who you know, and so that some of the medical jobs in industry are based on what you know. And so your ability to know mostly, to be able to work on clinical development, to be able to run a clinical trial, to understand how medicines work. So that’s kind of like one type of job. The other type of job is who you know, the relationships that you have, within the family community. We’re really fortunate, as ophthalmologists that the community is relatively small. And so that we can know many of our colleagues. And so sometimes you get hired, because of the fact that you are well regarded and well known within the community. And therefore, you can use your network for the benefit of the company that you’re being hired by. Well, in general, that tends to happen as you’ve been in practice for a longer period of time. And so that, and so the people who get hired for who they know, tend to be the people have been practiced for longer. The people who are hired for what they know, tend to be hired at a younger age.
Firas Rahhal: I never put it in that context, did you when you made this transition? Were you wanting to or fight considering ways to dip your toe as you alluded to and realize that wasn’t realistic or did you plan prospectively along the way that you were going full steam ahead? If and when
Cal Roberts: Yes. I was so I was the lead. I wanted to go in and really do this. I saw an opportunity that maybe even you know, my friends, Brent Saunders and Fred Hasson didn’t see the opportunity to take the company and tell the story. And I knew that I had to do it full time, so I didn’t get my time. The other is that there’s one more factor that I left that which I really want to talk about. And the other is the impact your decision has on others. So I mean, my decision to leave clinical practice, and to go into industry impacted a lot of people, starting with the people who worked in my practice, who all of a sudden, I wasn’t going to be there anymore. And so all these people will work with me for many years. Now, all of a sudden, the guy call Roberts isn’t there. The other people that impacts is your family, and particularly my wife, Andrea. So she and I had been married for 30 years, at the time that I gave up clinical practice. And she married a doctor who went to work in the morning, and came home at night for dinner. And all of a sudden, I take this job that often I am out of town 20 nights a month. And she’s home by herself. Or home. And if I was a little bit younger, with her kids were still home, she would have been had to be home with her kids. And so the impact on her, in many ways was greater than the impact it was on me. Her life had to change. Because I wasn’t there. I wasn’t there like I was before. And so I think that is part of the decision making, I think people have to think about is to how a decision to change your career is going to impact others.
Firas Rahhal: I can almost hear my wife calling you to find me one of those jobs that keeps me away 20-30 days, maybe you’ll get a secret call from her. That’s very cool of you to share that personal aspect of it. And that’s honestly, when young professionals are making decisions like this. These are the hugest parts of it really. And the toughest parts of it. And I’m glad you shared that in your in your mid 50s at the time. So still a challenging part of it is balancing all these changes into an already preexisting lifestyle. And, obviously it worked out for you. And you, you you’ve then subsequently gone on to do the Lighthouse now. So one after the other. But they’ve all been for a good period of time you did Bausch + Lomb for 10 years. Right? Yep. And you were in clinical practice for over 20 years.
Cal Roberts: Yeah, I was full time at Cornell for 16. I was in private practice for another 10. So 16 in the cloud, in academics, 10 years of private practice 10 years at Bausch + Lomb.
Firas Rahhal: Can you tell us a little bit since we’re on to it now, the history of the Lighthouse (Guild)? It’s many decades, if not 100 years, and I know fairly little about that history. Can you share with us some of the history that’s led to them to the current situation?
Cal Roberts: Yeah, so the Lighthouse was founded in 1915. And so you do the math, 116 year old organization. And for most of its history, when it was an organization that was providing services to people who were blind or severely visually impaired. Now, what we have come to learn is that there is a huge population of people who are not completely blind, but who are moderately visually impaired. So Firas, if I was going to ask you a question, I’m going to put you on the spot.
Firas Rahhal: Okay.
Cal Roberts: All right. What percentage of people who are legally blind, so that’s 2200 or worse? Visual field 30 degrees or less? What pretty centage of the people who are legally blind, became legally blind after the age of 21.
Firas Rahhal: After the age of 21, I’m gonna guess 65 to 70%.
Cal Roberts: Which is what I would have said before, it turns out that it’s more than 95%. All right, so and the reason why I choose 21 is because 21. By 21, most people have completed at least most of their formal education. And so that we’re saying that 95% of the people who are legally blind did so after the age of 21, what that means is that they grew up, they grew up as a sighted person, and then had to reinvent themselves now as a visually impaired person. And so that these are people who know where the keyboard is, who know where the cell phone is. And so that with great technology, you can take some of these people, and try to bring them back to the lives that they had when they were sighted. And so that’s what excites me, this ability to help people to discover ways that they can have independence, navigation. Knowledge, in ways that that you and I never thought was possible. When I came to Lighthouse Guild, I had no idea about some of this technology that was available. And the more I learned about this, I become a walking show and tell, I just show people all this great technology and show them all this great stuff that’s available never goes Wow, never knew this stuff was available. So consequently, what I do, when I speak to retina surgeons, is I show them great stuff. And I say they’re gonna send me your patients. And don’t send me just your patients who are blind, I’m happy to see your patients who are blind, send me your patients who are 20/50, 20/60, 20/70, who have a small central scotoma, that’s keeping them from being able to read send them to me, I’m going to show them stuff that they never believed was possible. Because I can’t tell you how many people I see very successful people. All they know about is a magnifying glass, they walk around with a magnifying glass hanging around their neck have no idea, the technology that’s potentially available to help them really lead greater productive lives. And so what we’re trying to do at Lighthouse Guild is take this venerable institution, this 115 year old institution, and turn it into a tech company, a company that brings together the great minds that are working on great technology. And we act like the connecting rods, we bring them all together, the entrepreneurs and the end of scientists, and the academics and the physicians, and of course, the users, we bring them all together to advance this technology. So that’s what gets me excited. This is similar to what we did a Bausch and Lomb, which is to just raise the level of innovation. And now we’re doing the same thing, an area that is discovered. And so that’s what makes it so exciting.
Firas Rahhal: Dr. Calvin Roberts, my friend, my teacher, one of my great mentors, from the early days of my ophthalmology career, and a great ophthalmologist and now a leader at the Lighthouse. Thank you for coming on. Through all these careers that you’ve had, it seems that you’re excited at a high level by all of them, and we know you’re succeeding at all of them. And thank you for coming
Cal Roberts: Oh Firas. This is my pleasure. Thank you so much for having me.