Leading in ‘Everyday Ethics’ and Health Equity

Published in Wilmer - Summer 2022

As an expert in medical ethics, health equity, and school-based delivery of vision and health care services, pediatric ophthalmologist Megan Collins, M.D., M.P.H., has made a name for herself as a leader to watch.

Thanks to the generosity of Baltimore ophthalmologist Allan Jensen, M.D., a former chief resident at Wilmer and associate professor emeritus, and his wife, Claire, Collins is adding a new title to her expansive list of credentials: the inaugural Allan and Claire Jensen Professor of Ophthalmology.

Wilmer Director Peter J. McDonnell, M.D., introduced Collins to the Jensens soon after she joined the faculty in 2014, knowing of their mutual interest in medical ethics. Over the ensuing years, they have become good friends and share interests in history, books and music.

“I can’t imagine two individuals who are more committed to professionalism and the doctor-patient relationship,” Collins says. “The fact that they value my work in ethics and ophthalmology, and to be recognized as the inaugural holder of that professorship — it’s left me speechless.”

In 2014, Collins established a longitudinal teaching curriculum in ethics and professionalism for Wilmer residents, taught in partnership with faculty members from the Johns Hopkins Berman Institute of Bioethics, where she has a joint appointment. The topics covered include shared decision-making, informed consent, managing racial bias and discrimination against patients or physicians, physician burnout, and the ethics of grateful patient philanthropy

“We have designed a case-based approach that incorporates the issues our residents face in the course of their training,” Collins says. “We provide them both the foundation and framework to help navigate ethical issues that may arise in everyday practice.”

Collins is exploring additional ethics collaborations with Wilmer faculty members in new areas such as artificial intelligence, in particular investigating the role of technology in building decision-making algorithms. She also is looking at ethical considerations in building models of school-based care, including how to build partnerships with parents and educators about vision and eye health. The professorship will enable her to expand on these and other projects in health equity and community engagement.

“What’s always been important for me in my care of patients is the sanctity of the relationship between a doctor and a patient … and caring for patients as a whole,” Collins says. “I’m not just thinking about their eyes in isolation, but thinking about that child, that parent, their relationship with you, their understanding of their condition and how you can partner together to ensure a child gets the care that they need to have the best outcomes.”

Over the past seven years, Collins has helped lead Vision for Baltimore, the largest citywide, school-based vision program in the country. The program, a collaboration among Johns Hopkins, Baltimore City Public Schools, the Baltimore City Health Department and others, provides vision screenings, eye exams and glasses to schoolchildren in grades pre-K–8. The program has screened more than 64,000 students, administered 11,000 eye exams and supplied glasses for more than 9,500 students.

Students who received eyeglasses through the program scored higher on reading and math tests, according to a September 2021 study Collins co-authored in JAMA Ophthalmology. The study, which analyzed the performance of 2,304 students in grades 3–7 enrolled in the program, showed striking improvements for girls, special education students and those who had been among the lowest performing. The project emanated from the earlier Baltimore Reading and Eye Disease Study led by Collins and other Wilmer faculty members, which showed that less than two-thirds of second- and third-grade students studied reported wearing glasses as prescribed, and 66 percent needed replacement glasses — identifying a strong need for intervention.

Additionally, Collins co-founded and codirects the Johns Hopkins Consortium for School-Based Health Solutions, which works to develop successful, scalable, school-based health solutions to address barriers to health and wellness in underserved populations. During the height of the COVID-19 pandemic, Collins and others, through the eSchool+ Initiative, created online modules to help school district leaders and teachers support students during school closures and advise them on safe practices for reopening.

Collins has a strong commitment to mentorship and teaching. She is director of the Wilmer Pediatric Ophthalmology fellowship program and has supervised the training of over a dozen fellows during her tenure at Wilmer. Additionally, she supervises students from across Johns Hopkins’ schools of medicine, public health, nursing and education, and the Berman Institute. “I am profoundly grateful to my mother, a retired teacher and school administrator, who instilled in me an appreciation for education and the power of teaching and mentoring,” says Collins.

“We are grateful to the Jensens for enabling Megan to continue her vital work improving vision for Baltimore’s schoolchildren, and bolstering professionalism and ethics for our trainees,” says Landon King, M.D., executive vice dean for the Johns Hopkins University School of Medicine. “She has continued to lead in pursuit of multiple emerging concerns, and she brings creative approaches to managing and solving tough problems.”

“I feel so fortunate to work at Wilmer,” adds Collins. “I’m constantly challenged and inspired by the work that I get to do and the people I get to work with.”