One of the best, and perhaps most important experiences I’ve had was getting into a “lifestyle” rehabilitation program at Hackensack University last year. It was a 12 week makeover during which I went to their gym three times a week and gradually increased my endurance, as well as pledged to re-invent myself nutritionally. No great secrets – just the determination to put the kibosh on red meat, fried food, sugars, alcohol, sodas, and increase exercise and intake of water (though a medicinal glass of red wine is still in the mix). Shedding 35 pounds and other baggage has made a big difference, but I want to share an additional perspective that has me thinking a bit differently about how we treat our patients.
I’ve never been a medication person. Blessed with generally good health, I’ve never had the experience of taking medication on a regular basis until a year ago. Prior to the rehabilitation program I mentioned above, my physician at the time started me on a cocktail of meds targeting my blood chemistry (the usual BP/cholesterol/blood thinner stuff). I experienced some side effects which weren’t desirable, so I asked him what we could do to reduce the dosage or change the balance. He wasn’t interested in having a reasoned discussion, so I left in favor of another physician with whom there was (and is) a much greater sense of mutual respect and collaboration. Undertaking lifestyle changes to reduce dosages and wean off medications with appropriate monitoring is a delectable way to enjoy the true meaning of doctor/patient co-labor, or working together.
It reminded me of some other paradigms in health care, and in eyecare in particular, that are ripe for disruptive holistic approaches. Take for example glaucoma therapy and, to be specific so-called “normal tension glaucoma”. The current treatment approach is to prescribe topical medication to drive down the intra-ocular pressure as low as possible. But that doesn’t really make much sense to the patient because the pressure is not the problem in the first place. And there’s really no good long-term evidence that this approach works any better than lifestyle changes that might be neuro-protective. It’s just that with a chronic condition of this nature, that’s all we really “know” how to do. But what if a patient pledges to undertake lifestyle changes that reduced stress and are known to be neuro-protective in other conditions?
When there is good doctor-patient collaboration, compliance is likely to increase as the patient engages more fully in the journey of self-discovery and healing. How many examples can you think of in vision therapy and rehabilitation that fit this model?