The rendering of most goods and services today focuses on connecting the consumer to the product in the simplest, most efficient manner possible. In many industries, the purchasing process has been streamlined to eliminate obstacles that could delay or inhibit a sale—often by eliminating the so-called middleman. Beyond providing increased accessibility to goods or services, cutting out the middleman enables a company to take greater control over its narrative and allows the consumer to take greater control over his or her experience. This is the philosophy behind the direct-to-consumer model that many existing companies have adopted and many new startups are being built upon.

Although a natural fit for many goods and services, the direct-to-consumer model has also been pervading other other more surprising industries at an accelerating rate. Goods that sellers and consumers long thought required a physical point of contact—from mattresses to engagement rings—are no longer being provided under that assumption. Startups revolutionizing the delivery of services such as alcohol recovery and fertility testing are finding success outside the traditional delivery model by enabling the consumer to access their services wherever and whenever best for them.

Health care, as well, has been affected by the rise in direct-to-consumer offerings, as seen with the uptake in health and wellness monitors and home-based diagnostic tests. But despite this trend and its true potential for the future, health care delivery as a whole is far from streamlined or direct. From start to finish, obstacles line the patient’s experience, from the initial “purchasing” decision to the receipt of the “product” and beyond. Health care providers know this, because we have just as many hurdles to clear. Prior authorizations alone add layers of unreasonable complexities and demands that impede the delivery of care on a daily basis.

As in many other industries, change is needed to streamline the system and to minimize the many hurdles between the consumer (ie, the patient) and the product (ie, health care). On a smaller scare, in ophthalmology and glaucoma specifically, innovations are placing greater control in patients’ hands. The rise of telemedicine services, home-based diagnostics, and drug delivery devices are eliminating obstacles for patients and improving accessibility to care. As you will see in this issue of Glaucoma Today, medical glaucoma care has long been fraught with barriers, but new solutions hold promise for helping patients and their providers to navigate them.

Although such progress is a step in the right direction, it will be difficult to truly revamp the delivery of glaucoma care until change is seen on a larger scale. Slight modifications to the health care system that minimize the role of the middleman and position the delivery of care so that it becomes more direct to the consumer could truly be a win for patients and providers alike.

In his book America’s Bitter Pill, an in-depth look at the US health care system, lawyer, journalist, and cardiology patient Steven Brill writes, “When it comes to our health, we don’t care about cost-benefit analyses; we care only about maximizing the benefit.”1 As health care providers, we are acutely aware of how to maximize benefits for our patients; what we truly need is a systems-wide effort to minimize the collateral damage inflicted in the process.

1. Brill S. America’s Bitter Pill. Random House Publishing Group; 2015.