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    How patient care resembles parenting

     

    I fit her with a pair of daily wear lenses with monovision correction. They did allow her to legally drive, but I was not optimistic.

    After seven trial pairs of contacts lenses and visits over six months, I put my foot down.

    One week later, she presented reporting losing a lens in her eye and inability to see distance with her lenses. Upon careful inspection, the lens was stuck in place and required proparacaine for removal. She was 20/30 at distance at near.

    I took a deep breath (so as not to scream, “I told you this would not work”) and told her that I was concerned that removing the lenses was so problematic.

    She responded, “Oh, I am better at it at home.”

    I asked where she was when she called this morning about the lens stuck in her eye. Of course, her response was, “At home.”

    I put on my “Dear child, I love you but I am going to kill you” face and informed her that we were done with that lens brand. I gently reminded her that monovision was not working due to her limited vision, and we needed to go with distance vision in thicker contact lenses with reading glasses to maximize the vision. We had given it a good try, but after this much time my magic bag of tricks was empty.

    She relented.

    Boom goes the dynamite.

    Much like when my child forgets his homework, I hope it sticks and she does not ask for monovision in six months when she returns for her general exam.

    Related: How to combat stress in your life

    Try it the patient’s way

    I have patients who may disagree with my diagnosis or treatment plan, and I make my case for why I am right.

    I think, “I am the doctor. I went to optometry school. You did not go to optometry school, and Google is not eye doctor school. I have been treating these problems for many years. I lecture on this topic. I have written books. I have lots of letters after my name. I have more letters after my name then you do in your whole name.”

    I do not say this, but I think it very loudly in all capital letters.

    I reiterate my point about why my treatment plan would be beneficial. But, some patients have to figure it out on their own.

    Provided their preferred plan of action does not put them in harm’s way, you may want to consider letting them.

    I have patients who do not want to take their glaucoma drops. I explain that without the drops, their pressure will go up.

    Patient A: “But I do not like to take them.”

    Patient B: “They sting.”

    Patient C: “They are expensive.”

    Admittedly, these are all valid complaints.

    Tracy Schroeder Swartz, OD, MS, FAAO
    Tracy Schroeder Swartz currently practices at Madison Eye Care Center in Madison, Alabama. She serves as Education Chair for the ...

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