Hosts:

John Kitchens, MD

Scott Krzywonos

Guest:

Rishi P. Singh, MD

Chair, Department of Ophthalmology, Harvard Medical School

Chair, Department of Ophthalmology, Mass General Brigham

Show Summary:

In this episode, John and Scott break down two major developments affecting retina practices nationwide before welcoming one of the field’s most influential leaders. The discussion opens with the newly announced CMS GLOBE Model, a Medicare Part B demonstration project designed to lower drug prices through most-favored-nation pricing, and what it could mean for buy-and-bill retina practices. They then turn to the FDA’s expanded label for EYLEA HD, which now includes retinal vein occlusion and allows monthly dosing for certain patients.

In the second half, the hosts are joined by Rishi P. Singh, MD, newly appointed Chair of Ophthalmology at Harvard Medical School. Rishi reflects on stepping into leadership at one of the most storied institutions in medicine, his path from retina specialist to hospital CEO and back to academia, and how academic centers must adapt amid policy shifts, private equity pressure, and rapid technological change.

Topics Covered:

1. The CMS GLOBE Model and most-favored-nation drug pricing
2. Potential administrative and financial impact on practices in affected regions
3. The FDA’s expanded EYLEA HD label for RVO and monthly dosing
4. How label flexibility may change first-line treatment decisions
5. Insurance lag and real-world adoption challenges after label changes
6. Leadership transition at Mass Eye and Ear and Mass General Brigham
7. Balancing clinical care, research, and training in academic medicine
8. The role of academic centers in advocacy, innovation, and policy influence
9. Physician recruitment, culture, and servant leadership
10. Private equity’s role in modern ophthalmology
11. Industry collaboration, integrity, and long-term impact on patient care
12. The future of ophthalmology drug access under Part B and Part D reform

Key Quotes:

1. “The biggest issue for any of us is if buy-and-bill medicine disappears from our practices.” — Rishi P. Singh, MD
2. “We’ve been too focused on reactionary medicine and not enough on prevention.” — Rishi P. Singh, MD
3. “Anything that substantially disrupts drug pricing is going to have downstream consequences for practices.” — John Kitchens, MD

Credits:

Production & Marketing: Laura Brown

Business Operations: Liz Hogan

Listen and Subscribe:

🎧 RetinUp.com | Available on Apple Podcasts, Spotify, and YouTube