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Believe it or not, the question of “what do the patients want?” has only recently been posed to our healthcare system. For many decades, medicine has always placed the physician who “knows best” at the centre of the healthcare model. However, there has recently been a paradigm shift to a more patient-centred approach to providing care. The scientific research supports this shift. Both patients and clinicians are more satisfied and more involved in the care process. Medical care is of higher quality and safety.1 Costs are ultimately decreased. Considering this and in collaboration with the Ophthalmology Department in Westmead Hospital, our research team explored the patient’s journey and perspectives in glaucoma care.
The priorities of most patients are quite similar when trying to access specialist medical care. Broadly speaking people want the highest quality care and a sense of continuity with their provider. Patients would like lower costs and waiting times too. Our research at two glaucoma clinics based out of greater Sydney, replicated these findings.2 We had undertaken a choice experiment (asking people to choose the most preferred glaucoma service between two hypotheticals services). Patients who participated overall preferred and were more willing to pay for a senior specialist clinician, continuity of care, low waiting times and low cost.
It is not very clear whether patients can pick the care that best matches their expectations. The system of modern-day medical care is complex and knowing what the best care is, or which service provider best matches patient’s expectations is difficult. Our second study interviewed glaucoma patients had found this exact result.3 Glaucoma patient are somewhat limited in their understanding and education of the healthcare system. Many patients relied on their primary care refer to guide them and trusted and accepted the service that is ultimately provided. There is seemingly limited choice that is provided to patients.
As a health profession, we have the responsibility of ensuring that care is patient-centred with patient input. Health providers and managers need to design services that meets the needs of their patient cohorts using the latest evidence. Providers need to be patient advocates in every aspect of medical care.
As patients, proactivity will always lead to a more superior result in the care that is provided. If you are unfamiliar with the health system and unsure what options are available for your care (public vs. private, utilising private health insurance, different types of eye specialist) always seek out the primary care providers who have a greater understanding and grasp on the system. These providers are much more easily accessible then sub-specialist colleagues and would gladly discuss and advocate on your behalf.
1 Australian Commission on Safety and Quality in Healthcare (ACSQHC). Patient centred care: Improving quality and safety through partnership with patients and consumers. 2011.
2 Lu TC, Angell B, Dunn H et al. Determining patient preferences in a glaucoma service: A discrete choice experiment. Clinical & Experimental Ophthalmology 2019; 47: 1146-1155.
3 Lu TC, Semsarian CR, White A et al. Journey to glaucoma care – trusting but uncertain and uninformed: a qualitative study. Clinical and Experimental Optometry 2020; 103: 484-489.
