This fall, Geoffrey G. Emerson, MD, PhD, FASRS, will begin a 1-year term as president of the American Society of Retina Specialists (ASRS). Dr. Emerson practices with Retina Consultants of Minnesota in Minneapolis, and is associate professor at the University of Minnesota. He has received many awards during his distinguished career, including the ASRS Senior Honor and the American Academy of Ophthalmology’s Secretariat Award. In our conversation, which has been edited for length and clarity, Dr. Emerson reflected on his long involvement with ASRS and discussed challenges and opportunities facing the Society and its members today.

Retinal Physician: As you prepare to take the helm as ASRS President at the 2025 meeting, what are your primary goals or priorities for your term?

Dr. Emerson: ASRS is the biggest retina society for US doctors, and it’s among the most inclusive of all retina societies. That’s our strength. Often, the dominant voices in our societies are academics or from big groups, so as president, I want to welcome and encourage participation from groups that aren't necessarily as well represented in ASRS as they could be—solo practitioners, retina doctors from small groups, and even international retina specialists. I want to make sure they also get the attention they deserve at the meetings and on our committees.

RP: What do you see as the biggest challenges facing retina specialists today, and how can ASRS help its members navigate them?

Dr. Emerson: There is a workforce shortage coming. It seems like we have more and more patients, and as doctors we are busier than ever, with less time in our schedules. I would like to see us train more retina specialists and for ASRS to continue doing what it can to help retina doctors have long, healthy careers.

RP: Artificial intelligence, home diagnostics, and surgical robotics are all evolving quickly—how do you see ASRS supporting members as these technologies reshape clinical practice?

Dr. Emerson: Technologies like these really do improve patient care. Over the 20 years of my career, I've seen new technologies like OCT, digital photography as opposed to film photography, and electronic health records. I think in all cases, these technologies boosted patient care.

The one problem is these new technologies you’ve mentioned don’t really address our workforce shortage or improve the cost of health care. Those are the technologies that we are missing. Technologies that focus on improving the burden of care, along with the cost of care, would be welcome.

How can ASRS help? We are a national organization, so we can introduce new technologies at a meeting, talk about them, and teach them. We can also monitor for adverse events and other problems. Not every new technology makes it. That's how ASRS can help.

RP: Advocacy and reimbursement continue to be top concerns. What is ASRS’s strategy for maintaining physician autonomy and protecting access to sight-saving care?

Dr. Emerson: Advocacy is important, and I enjoy it. Here are a few things that are on ASRS’s advocacy radar for the upcoming year:

• Research funding, including funding for the National Institutes of Health;
• Copays for patients are a barrier to care. We administer all these expensive treatments, and for a patient whose insurance covers 80% and then they must submit the other 20% as a copay, that can really add up—especially if it's a monthly injection. In the past, the Good Days copay assistance program was well funded by industry sponsors, but that support has dried up this year. As a result, many of our patients are now feeling the financial strain;
• Access to operating rooms is becoming more limited, and many of our physicians are struggling to secure OR time—especially for urgent cases like retinal detachments. We believe this is partly due to reimbursement pressures, where facilities may not be adequately compensated for complex, time-consuming cases. As a result, some ambulatory surgery centers are turning us away. We don’t have a solution yet, but we’re actively working on it; and
• Finally, a recent concern is a report from the Office of Inspector General for CMS recommending audits focused on retina specialists’ use of the -25 modifier. While we believe retina doctors are using the modifier appropriately, audits can be costly and stressful—and we expect they may be coming.

RP: Retina is a highly subspecialized field. How is ASRS working to support fellows-in-training and early career retina specialists in a competitive environment?

Dr. Emerson: This needs to be our priority because we’re facing a workforce shortage, and these younger doctors are our future. At ASRS, we already have 2 sections dedicated to supporting them: one for fellows in training and another for early career retina specialists. Both offer webinars and tailored programming that appeals to these subgroups.

It’s also critical to bring fellows and early career physicians onto ASRS committees and make them part of the leadership team. First, we need their fresh ideas. Second, we’re cultivating the next generation of leaders. But we’ll only keep younger doctors engaged if ASRS remains relevant and exciting to them—and what’s exciting to me might not be exciting to a younger doctor. Giving young doctors a voice in decision-making and putting them on the podium more often are good ways to make that happen.

RP: Looking back at your own involvement with ASRS, how has the society shaped your career?

Dr. Emerson: ASRS has been a fun and enriching part of my professional life. I got involved as a fellow and never looked back—I was the fellow representative to the board of directors and then joined my first committee, the Federal Affairs Committee. From there, I became chair of that committee, chaired a few others, and eventually moved into leadership. That’s actually a pretty typical way to become a leader in ASRS: start on a committee, become a chair, and then join the board.

I liked Federal Affairs; another committee that stands out to me is the Sustainability Committee. It’s a small group focused on reducing medical waste and emissions in retina practice. We’re looking at ways to minimize the use of potent greenhouse gases during retinal detachment repair and to cut down on foam packaging from temperature-sensitive medications. It’s a newer committee, but one that’s very meaningful to me.

Being involved with ASRS has been fun for me because I like to learn, and I also like the social aspect. Retina is so specialized that only our colleagues truly understand what we do, and that shared experience creates strong friendships and a supportive environment. Mentorship is another key part of the society. Some of it is formal, but much of it happens organically, just by meeting people at meetings and asking for advice. I’ve learned a lot that way—by talking to someone who’s done it before instead of reinventing the wheel. RP