DR. ROBERT LEHMANN
Focus Through the Generations (FTTG) offers insight from four different generations of the nation's top ophthalmologists. Hear from the experts themselves on their varying life experiences in the industry.
Dr. Lehmann's experience includes pioneering success in breakthrough eye treatment and care. He is the first surgeon to offer small incision cataract surgery, No Stitch, No Patch, No Shot cataract removal, and refractive surgery in the Nacogdoches/Lufkin area, and the first surgeon to implant the ReSTOR® intraocular lens in the United States.
hear from DR. ROBERT LEHMANN
Our host, Polly Neely had the pleasure of sitting down with Dr. Robert Lehmann for an exclusive discussion regarding his life and industry experiences. Get to know Dr. Lehmann a little deeper in this episode of “Focus Through the Generations”.
Polly Neely: Hello, thank you so much for joining us today, for Focus Through the Generations. We've a very unique time right now where we have four generations of actively practicing ophthalmologists. What a wonderful time and how much fun we're having, getting to interview all of them. I want to give a shout out to Bruder for helping us support this series, and we're so grateful that they are, and thank you Bruder and your Bruder mask, lots of people love it. So today I have with me, Dr. Robert Lehmann from Nacogdoches, Texas. How are you Dr. Lehmann?
Dr. Robert Lehmann: I'm fine Polly, good to see you again.
Polly Neely: You too. I'm going to give you just a moment to introduce yourself, not that everybody doesn't know who you are because they do, but I'm going to give you a moment to introduce yourself and just tell us a little bit about you.
Dr. Robert Lehmann: Sure, well I'm what they call a "damn yankee", down here because I grew up in Wisconsin. I went to medical college in Wisconsin, came down to Houston for my specialty training internship, Baylor College of Medicine, affiliated hospitals, in '73 to 1977, where I finished my practice. I settled in East Texas, deep East Texas a place called Nacogdoches. In fact, we're the oldest town in Texas, and it's been a blessing to practice here for 40 plus years.
Polly Neely: How did you find Nacogdoches, Texas to go to?
Dr. Robert Lehmann: Nacogdoches, Texas, it barely on the map in fact, but if you look at the old Texas maps, you'll find it there before most major cities. It was the prettiest town along the way, driving from Houston back up North to Wisconsin.
Polly Neely: Wow, I know the first time I went there, I was like, okay what airport do I go to? And then I found the airport and then I'm like, oh good lord now I got to drive forever to get there so, but its worth it.
Dr. Robert Lehmann: Actually, even back then, it was known for good healthcare, timber industry and chickens, raising chickens, so those were the three industries in the area.
Polly Neely: Well, I've enjoyed it, every time I've come down there it is a great place to live. One of the girls here just asked if you had any real estate down there for sale.
Dr. Robert Lehmann: We have some real estate, but not for sale
Polly Neely: Yeah, I know you do. Well, I want to get started today and ask you some questions and a really fun one is what is it like having your daughter as your partner now in your practice? We had the pleasure of interviewing Dr. Anna Lehmann earlier and I'm not going to tell you what she said, we're going to hear what you have to say.
Dr. Robert Lehmann: Well, one of the greatest blessings of my life has been having our daughter Anna Lehmann join this practice. I always envied those doctors that had that opportunity to have a son or daughter practice with them, and now I am one, and she's just been remarkable. We did fear we would lose her to plastic surgery or hand surgery or some other form of microsurgery because she's so detail oriented and so good at everything she does.
Polly Neely: Yeah, she said something similar, but let me ask you a question, how is it business wise sharing that responsibility with Anna?
Dr. Robert Lehmann: Well, business wise, it has been a pleasure because Anna and our other two associate surgeons, are just very easy to work with and very competent, very skilled. So, initially I was concerned, my patients, as you mentioned Polly, you've been to Nacogdoches as a consultant a couple of times, and you can't go to a garage, go grocery station or any store without patients saying, oh, hey, how are you? You know, you did my LASIK or you did my cataract surgery, and I was concerned that patients wouldn't want to let go of the old man. It has been no trouble at all, and in fact, I might be getting a little bit jealous.
Polly Neely: Because they've watched Anna grow up, so they're excited for her, like you are, yeah, she was so pleased to be where she is, and I can see you two working well together because you have a lot of the same dynamics of practice and detail. So, and she did mention hands, so I know that was a concern too when she said that. I'm like, "Oh, I bet your dad was sweating."
Dr. Robert Lehmann: You know it's been a lot of fun for her to come home and us to be, Kathy and I be with our grandson, her son Roth who's now 15 months, I believe, and Anna will tell me about her day and share a patient or two and I'll tell her about patients that we've had, that I've had that day, and it's really a great, great ability to share patient information like that.
Polly Neely: I love that, I love it because we're talking to some dads and sons and a little more combative than daughters and sons I think when you go into practice together. So, maybe you, you were lucky to have your daughter go into practice with you
Dr. Robert Lehmann: Very, very well.
Polly Neely: Let me ask you while we're on that case, tell me about your most interesting Bruder case.
Dr. Robert Lehmann: Amazingly, we were at lunch today and a patient, an octogenarian came up and said, "Dr. Lehmann, I tried to see you today, and now I see you're out of the office." And she had a great big chalazion on her left upper lid. And so, I told her about a Bruder mask, she could pick it up at my office at a drug store, and I told her, I have one for Kathy, I give it to her every morning, and she loves it for her dry eye. And if you will use this, according to my instructions, she will probably have that lesion go away and won't have to even come see us right now.
Polly Neely: Look at you, talking yourself out of patients, but more importantly is that you bring it to Kathy every morning, I'm sure with coffee.
Dr. Robert Lehmann: No, tea.
Polly Neely: Tea, okay. Now that's my kind of doctor right there.
Dr. Robert Lehmann: As a matter of fact, Polly I borrowed her cup this morning.
Polly Neely: I know that's her cup because I recognize that signature. Absolutely. Oh, wow, let me ask you a question in hindsight what would you have done differently in your career if anything?
Dr. Robert Lehmann: Whew, that one blindsides me, I really don't know. I can't answer it very quickly because my career has done what I had hoped it would do. I've had the ability to be involved with research, devices, pharmaceuticals, and yet been in a community where I have been very close to the community, to the patients and where I still feel very appreciated. You know, I did have a practice in the metroplex for a number of years and there's a difference between big city folks and our east Texas folks in terms of just how much they really appreciate a physician still today.
Polly Neely: I love that I think that was one of the things I wanted to ask you about too, is practicing. I know you had practiced in the city as well and practicing in the city and that particular patient, you've sort of grown into your patients and they've grown up with you. So, it's a little different, I think than being in a city atmosphere where there's lots of competition there, you might see your patient once or you might see them every five years or maybe they don't remember your name, but where you are is totally the opposite of that. You've got that base that really good base.
Dr. Robert Lehmann: Well, we've always had the right ethic about patient care, but I will say this, if you don't have that ethic about your patient care, you're not going to be very busy in East Texas because, you know, patients, they are, it's a close-knit community and, patients talk, and you want that talk to be welcoming and to be positive.
Polly Neely: And I don't think social media affects your patient clientele I think it's more word of mouth. Am I correct?
Dr. Robert Lehmann: Oh, social media is what again, yeah no, I'm not that old, and I guess we're involved in social media, but the reality is that I have had some very nice things said out there by patients that are more involved in social media than I am and it's always great to hear, but I kind of like the patient coming up at the restaurant or the grocery store and saying, you know, you may not remember me, but you did this or that, and I'm so pleased, and it might've been 20 years ago, 30 years ago.
Polly Neely: I'd love to go back to those days. I'd like to know, who's saying what about me, so I'd like to go back to those days where they come up and either tell me I'm really horrible, or I'm really great.
Dr. Robert Lehmann: Rather than read it on the internet
Polly Neely: Or have somebody call me and say they saw it, So, yeah, I know how that is. Have you personally had any eye surgeries then, Dr. Lehmann?
Dr. Robert Lehmann: I have had no eye surgeries done, I did have COVID back in August and I had a little right Lower quadrant pain, and it went away. Well about six weeks ago, I at age 73, had an appendectomy, and the surgeon happened to be a very competent fellow, I had it right here in Nacogdoches, and he said, "You know what went on in August with COVID was just a mild case of appendicitis." And he said, "Once you get that you're going to be seeing me in the OR eventually." and sure enough, I did. But no, I'm sure I've got nuclear sclerosis, I am old enough to have had that for five years or 10, and I'm still 2020 and no surgery yet.
Polly Neely: That's so awesome, that's so awesome, you guys are lucky with that. Tell me about one of your, out of your career, one of the most interesting cases you've ever had that brings to mind right away.
Dr. Robert Lehmann: Well, I tell you what pops into my mind with that question, is a lady who was so blind, and she had no family that called upon her very often, and she actually put pads on her knees so she could kneel around through the house and not have to worry about bumping into something and falling down. It was a sad, sad case, she had bilateral mature cataract and it was finally a neighbor or somebody that called from the church and brought her into the office. She was probably late to mid 70s, no insurance, never signed up for Medicaid, nothing, and just in a very sad state. Well back then we were doing Gift of Sight anyway. Were we not doing, Gift of Sight, we would have done hers regardless. And we did her cataract surgery and the lady had great vision and it completely changed her life, and ours.
Polly Neely: I know, see that's, the stories are great that I'm hearing about things like that, and I love these stories because I think these are the stories that go untold.
Dr. Robert Lehmann: Yeah, most people in our office were in tears that day.
Polly Neely: Yeah, I love these stories, thank you for sharing that, that means a lot. What do you think from COVID that you've experienced with your practice through COVID, is there anything that you would take from that that you learned during that time that you're going to put into practice on an ongoing basis this year?
Dr. Robert Lehmann: Well, of course telemedicine might be an obvious answer to that, I'm not the guy. I really think the one thing that COVID has led to and I think everybody would agree with this, is a decline in medical care. You know, people that have healthcare needs are putting them off and some of them are afraid to go out and see the doctor, and some of them are in situations where the doctor isn't going to see them anyway or they do it via zoom and zoom is better than nothing, but, having been in practice here since 1977, I would lose my mind if I couldn't touch a patient, if I couldn't lay hands on a patient. I enjoy patients come in and the little sweet 80-year-old has gotten all dressed to come to see her doctor.
And you want to be able to give them a pat on the knee and say, you really look nice today and look them in the eye. Not just because of COVID but because of EMR and computers I also think medicine has lost something. You can go to the doctor now and often he will be, or she will be looking at their computer or their laptop and they'll be typing their history and your information in if they don't believe in scribes, which I have scribes, I will not touch the computer. But I think having to look at a paper chart for so many years, and to know at a glance or a few glances, what my patient is there for, the whole history of that patient. Now to look at a computer and to see one part of data, when was the surgery, what was the surgery, what did their OCT look like? You know, you've got to go from page, to page, to page, and I think you're taking a greater time for the patient interaction with much less actual direct patient interaction. And I think we've lost something.
Polly Neely: I agree, I date back to paper charts and I remember lining those charts to look for the doctor and here's the section on test... You know here's your testing, here's your surgery here's your history, and I had to do was look, and you have everything you needed right there. And now I go in the rooms and I'm like, show me this, and it's click, click, click, show me this, it's click, click, click, and by the time of like click through six screens, I forgotten what the first click was, so it didn't really matter. So, I agree. You know but we met back in the days of Ivy, remember?
Dr. Robert Lehmann: I do, I think we may have had the first Texas installation of Ivy. You absolutely did. And it was a DOS system, show you what I don't know about computers, what I do know is it was very stable, very stable environment for those days.
Polly Neely: It was, that's how I started out doing that so it's funny, DOS, haven't heard that word in a long time. I'm going to finish by asking, well there's one more question I want to ask you though. This is going to be a fun question. If you could pick anyone dead or alive to have lunch with and pick their brain, who would it be?
Dr. Robert Lehmann: Well, I hate to get sentimental because it would just be a visit, but it would be Dr. Beauchamp from Dallas, pediatric ophthalmologist, who taught ethics. And I don't know that I talk much about ophthalmology, but he did my grandson Charlie's muscle surgery, and for strabismus, obviously, and I saw him about 10 days to two weeks before he died of cancer. Had no idea that he was ill. And it'd just been one of those situations where I would love to have given him a hug and said goodbye. So that may not be the kind of answer you've heard or expected, but that would be one person that I got to, I missed saying goodbye to.
Polly Neely: That's a great answer, I mean, it makes us thing about every day and always make sure you say those words you want to say. That's right. If you get a chance again. Well, here's my final question and I hate ending this with you because I love talking to you. How have you seen technology and ophthalmology transition in your career and where do you see it going in the next 10 to 15 years?
Dr. Robert Lehmann: What a blessing I've had with this career because as a senior resident, we got to go down to Cali, Colombia and help the residents there at Hospital Universitario del Valle, and we were doing intracap cataract surgery, and in a soft, cataract in a 50-year-old you might do phaco and then fit them with a contact lens, and that was state-of-the-art. The evolution from there to posterior chamber implants to then doing extracap surgery, coming back to phacoemulsification, no shot, no stitch, no patch which I've been doing now for 20 plus years, since the, I forget his name, the doctor in New York said, "You know, you can just do this with tetracaine." And I thought, "No, you can't." But I tried and he was right, we could. Refractive surgery, RK, ALK, LASIK, PRK, all the advances,
I did a corneal transplant in East Texas having been trained at Baylor, David Peyton, I pretty well knew how to do that. That was in 1977, I wouldn't dream of doing DSEK right now which has become much, I think, safer and better, but I don't do enough of those kinds of things to be comfortable, so we have corneal specialists that do that. But the evolution of lens implant technology from anterior chamber rigid lenses in UGH Syndrome, to routine use the poster chamber lenses, and single-piece aspheric lenses, and presbyopic correcting lenses. And I think that, you know I feel like Don Quixote on a windmill sometimes because we've been involved in most of the studies as principal investigators for the presbyopia correcting lenses, and the reality is until we have a true accommodating implant we'll still be on that quest. Although now with trifocal lenses, I think we can certainly satisfy more patients more readily. But we're still looking for that 100% and it's still avoiding us right now. So, the technology that I have been able to be a part of in these 40 plus years has been again, another great, great blessing and opportunity.
Polly Neely: And you've taken advantage of all those and done them well. So, I appreciate you so much and for you as the person that I know you are, as well as your career and what it's gone to and now your legacy with Anna, so I love all of that. So, I want to thank you so much for being with us today and your stories and sharing your life with us and thank you.
Dr. Robert Lehmann: Well, thank you for the invitation, come see us Polly.
Focus Through the Generations is supported by Bruder Healthcare Company.
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