Article Date: 3/1/2004

Can You Satisfy Both Sides?
Every patient has two sides. Try to help the side that you don't see.

Every patient has two sides: the side you see in the office and the side that exists the other 99.9% of the time. The side that exists outside of your office is the side that takes the prescriptions and recommendations that you give and puts them to use in the real world. Or it changes or ignores instructions. This side might easily be your harshest critic -- by ultimately deciding to leave your practice -- even though the "office side" smiles, nods and rarely complains.

Step outside

Recent research has begun to create a model of the patient who exists outside of your office. In terms of contact lens wearers, patients don't always complain about contact lens discomfort to their eyecare practitioner (ECP). Patients often associate a certain amount of discomfort with contact lens wear. In addition, some may fear that their ECP will take away their lenses, so they accept a little pain as the price of seeing without eye glasses.

Yet millions of patients stop wearing contact lenses each year when the discomfort becomes too unbearable. Yes, the wrong lens materials, the wrong lens solution, poor hygiene, non-compliance with wear schedules, dry eye, allergy, etc. can all cause discomfort. However, if the outside patient doesn't contact the ECP at the first signs of discomfort, or if the optometrist isn't aware of clinical and lifestyle issues that affect comfort, then that patient may become one of the millions who drop out.

The unseen glaucoma patient

Other research notes that patients who have glaucoma are frequently concerned with quality of life issues that are associated with vision loss (See "Practice Pulse" on page 10). They fear the loss of their job, insurance and independence. They're concerned with their ability to participate in sports, hobbies and other pastimes.

Patients claim that the clinical world pays little attention to these quality of life issues. I would speculate that patients who have other vision debilitating diseases have similar attitudes.

Helping patients see the way

You may tell the patient inside your office that a particular glaucoma therapy will manage their IOP. You may recommend a specific contact lens or lens solution to another patient. These measures, while clinically correct, are just one aspect of patient management. When you address how treatments will impact your patients' lifestyle, you'll gain a tremendous opportunity for improved care and patient retention.


Optometric Management, Issue: March 2004