Mentorship from Afar: Dr. Fletcher Models Multidisciplinary CollaborationAccess to mentorship in low vision rehabilitation isn't always readily available. Mentorship from afar can make a lifelong impact on a clinician's practice despite a lack of proximity. In this episode of Low Vision Beyond the Clinic, host Erika Andersen Ko sits down with retinal disease ophthalmologist Dr. Donald Fletcher to talk about what nearly 40 years and 35,000 low vision patients have taught him about multidisciplinary vision rehabilitation, clinical humility, and asking thoughtful questions. Dr. Fletcher calls himself "a salesperson for the team": using his physician credibility to elevate the work of occupational therapists, orientation and mobility specialists, physical therapists, vision rehabilitation counselors, and even Buddy the security guard at the front desk. His humility extends to challenging his own clinical assumptions, including once incorrectly believing that patients with age-related macular degeneration didn't have mobility problems; a belief overturned through conversations with orientation and mobility specialists at the Smith-Kettlewell Low Vision Rehab Study Group. Dr. Fletcher's advice to any clinician who wants to grow: ask thoughtful questions, and make friends with a researcher. A conversation for low vision practitioners, vision rehabilitation therapists, occupational therapists, orientation and mobility specialists, ophthalmologists, optometrists, and anyone interested in multidisciplinary approaches to age-related macular degeneration and vision loss. Topics explored in this episode:TIMESTAMPS TOPICS 00:05 "If I make it into heaven, it's because I push the team approach" 01:05 Welcome and host introduction 01:35 Thank you to CAER for the relaunch microgrant 02:14 A 2006 Envision moment: the ruler, the Likert scale, and an unknowing mentor from afar 04:32 40 years, 35,000 patients, and the friend who first suggested the team approach 07:30 "My role is to be a salesperson for the team" 08:38 Buddy the security guard and why first contact matters 10:26 An assumption Dr. Fletcher was wrong about: AMD and mobility 12:18 Trekking poles, AMD, and meeting clients where they are 14:11 Origins of the Smith-Kettlewell Low Vision Rehab Study Group 16:12 "What have you learned this past year?"—the democratizing opener 17:52 Priya Parker, gatherings, and designing for the outcome 19:17 Spicy discussions, bridging clinicians and researchers 21:12 "Make friends with a researcher"—and Art Jampolsky on asking the right questions 24:58 A pitch for "So What" groups at the Envision Conference 25:42 Erika's reflections: servant leadership and what's ahead this season Thanks to Dr. Donald Fletcher for being on the show! Dr. Fletcher is an acclaimed ophthalmologist and longtime advocate for team-based low vision care, currently practicing at Envision in Wichita, Kansas. He co-founded and continues to lead the Low Vision Rehab Study Group at the Smith-Kettlewell Eye Research Institute, where clinicians and researchers gather each February to share difficult cases, fresh ideas, and the occasional spicy debate. After nearly 40 years and more than 35,000 patients, he remains curious, humble, and impactful. Thank you to CAER: A big thank you to CAER, the Colorado chapter of the Association for Education and Rehabilitation of the Blind and Visually Impaired, for the microgrant that supported the relaunch of this podcast. A small grant with a meaningful message: asking questions about how we grow as practitioners is inherently valuable. References and resources mentioned in this episode:Envision (Wichita, Kansas) One of Dr. Fletcher’s clinical homes and an example of the team-based low vision rehabilitation model discussed throughout the episode. The Envision Conference The annual interdisciplinary low vision conference, where Erika is co-facilitating a “So What” small-group discussion with Dr. Fletcher on central field loss. The 2026 conference includes a dedicated small-group track with CE, plus virtual gatherings continuing post-conference. Smith-Kettlewell Eye Research Institute Home of the Low Vision Rehab Study Group Dr. Fletcher co-founded with Drs. Ron Cole and August Colenbrander roughly 20 years ago. The Art of Gathering Parker, P. (2018). The Art of Gathering: How We Meet and Why It Matters. Riverhead Books. Referenced for its approach to designing meaningful, intentional gatherings—starting with the outcome you want and working backward. The EFFECT Study Rubin, G. S., Crossland, M. D., et al. (2023). Eccentric Viewing Training for Age-Related Macular Disease: Results of a Randomized Controlled Trial. Ophthalmology Science, 4(2), 100422. The trial that sparked the “spicy discussions” at the study group and helped catalyze Erika’s evolving approach to central field loss—covered in the prior pilot episode interviewing Dr. Michael Crossland. Note: Several people referenced in conversation—Stan (Dan) Wineapple, Drs. Ron Cole and August Colenbrander, Dr. Walter Wittich, and Smith-Kettlewell founder Art Jampolsky (“the key to good research is asking the right questions”)—are part of Dr. Fletcher’s personal and professional history rather than linked resources. Connect with the podcast:Have a story of clinical growth—a piece of research or an insight that helped you pivot in your practice? Erika would love to hear it. Reach her through the contact form at lowvisionbeyondtheclinic.com. If this episode was useful, share it with a colleague, send Erika a note, or write a review.
