How would you feel if I told you that the luxury perfume you spritzed on your wrist contains sperm whale excrement? You might think you are being tricked, or that you should have been made aware of this fact prior to your investment. The truth is that a critical ingredient in some fragrances, such as those by Jimmy Choo and Yves Saint Laurent, is ambergris, which forms in the intestines of sperm whales. Upon excretion—scientists are unsure from which orifice—ambergris has a foul smell. Over many subsequent years of floating in the ocean, however, the scent develops into a pleasant musk. Now, after learning the entire process of developing ambergris, it may seem more luxurious and less appalling.
Medicine has always had a communication problem. The patient-doctor relationship suffers because neither side truly understands the intricacies of the challenges faced by both parties. An aging population means fewer doctors (as they retire) yet more patients. Patients may perceive lengthy wait times and appointment delays as problems their doctor can control. However, the physician is likely packing their clinic so that patients are not waiting for the next available appointment, which could be months away. This leads to shorter visits and a valid perception that the doctor is rushed.
In an ideal world, physicians would spend more time getting to know their patients, and patients would understand the reasons why the doctor cannot meet all expectations. Time spent to get to truly know the patient cuts into the time available to explain the disease and treatment plan. When the health care system is overloaded, physicians have no choice but to focus on the disease, losing sight of how that may be detrimental to the patient experience. Unfortunately, communication between parties is lacking, and we lack the time to communicate about why we are not communicating.
In general, we rarely fully comprehend the inner workings of the things we interact with. Sometimes we are better off without that knowledge; other times, it is helpful. Do we need to know that we are spritzing ourselves with whale excrement? Maybe not. But I do think that distinguishing some of the complexities that patients and physicians face could help. In this issue of GT, contributors outline strategies for more effective communication and initiatives to incorporate patient feedback into glaucoma care in hopes of fostering more open dialogue on both sides.
