viewpoint
Where Have All the
Billions Gone?
When it comes to eye care, arm your
patients with reliable information.
FROM
THE EXECUTIVE EDITOR, Jim Thomas
What's the most pressing problem in health care
today? According to Arthur Caplan, it's the scarcity of reliable information
that "consumers" need when choosing a doctor or understanding a
procedure. We don't know what we're getting for the billions of dollars that we
spend on healthcare each year, he says. "It's a scandal," he concluded
in a recent issue of Philadelphia Magazine.
We could easily dismiss his comments as those of
a headline-grabbing consumer activist, except that Arthur Caplan directs the
University of Pennsylvania's Center for Bioethics.
And we could argue over the use of the word
"consumer" instead of "patient." But the point remains:
Across the entire healthcare spectrum, no party, including doctors, communicates
to patients the value of healthcare services. Or, to put it another way, doctors
have an opportunity to improve the healthcare system by educating patients.
The challenges of education
As Sarah Marossy, O.D., notes in this month's
cover feature, "Contact Lenses vs. Surgery," beginning on page 34,
patient education presents several challenges in eye care. First, optometrists
must overcome a time trap. It would take more chair time than most practices
could afford to explain all the vision corrections options available, from
eyeglasses to contact lenses to surgery. (See Dr. Marossy's article for
solutions to this dilemma.) Using years of education and practice, the doctor
can narrow down the choices to those that are most appropriate for the patient.
In limiting the choices, the doctor may not
present every option available to his patient or explain why some modes of
vision correction are more appropriate than others for this particular patient.
This leads to another challenge: The doctor's professional recommendations don't
always meet the patient's expectations, which are often based on far less
clinically reliable sources, such as advertising, friends and family.
("Aunt Bertha says I should try LASIK, but my doctor never mentions
it.")
Cover the bases
Ideally, the patient leaves each office visit
understanding which modes of vision correction are appropriate and which are
not. The patient is ready to enthusiastically pursue (or continue) the
recommended course of treatment. In the eyes of the patient, both the doctor and
staff demonstrate their expertise and communicate the message that their
practice provides unsurpassed levels of care.
Anything less might result in a scandal.
Optometric Management, Issue: July 2004