BLOG: Dry eye pain points

ByDarrell E. White, MD

Dry eye is a painful disease. Everything about it hurts. Your patient’s eyes hurt. Your staff is in pain because of all of the preauthorization nonsense they have to put up with. You only have to look at their faces to know that the pharmaceutical rep visiting your office feels the pain coming from you and your staff as well as their upper management. The pain is real, and frankly it’s the nonmedical pain that makes it so bloody hard to want to be a DED doc.

Some years ago, I gave a keynote in which I attempted to define “concierge services” and then demonstrate what it meant to provide this kind of experience in a medical setting. In its basic form, a concierge anticipates a problem and solves it before a client is aware that it is even a possibility. In other words, concierge-level care means identifying a pain point and preventing it from causing any actual pain. This level of care and feeding can be applied both at the physician-patient interface and where practices interact with everyone else in health care.

Pain is felt differently, and has a different cause, for patients and practices. The pain point for a patient is price; the pain point for a practice is process.

I’ve made no secret of my distaste for the manner in which patients have been gouged by the pharma-insurance complex. What your patient cares about is price. What they are forced to pay for their medicine. That’s it. They don’t even get a chance to have a problem using their medicine if they perceive that they cannot afford it. The primary pain point for your patient is price. Want me to prescribe your latest, greatest medicine? Better fix this first.

For your practice, the pain point is process. Admit it, you really don’t care how much your patients actually pay for medicine. You just care that they do. What’s killing us is the avalanche of demands that are dumped on our staff by the aforementioned pharma-insurance complex as part of the process to determine just how much that patient actually has to pay. It’s as if we are being punished for having the audacity to prescribe care. When you are fixing the price issue, you’d better take care not to shift that pain to my staff and me.

Here’s an idea: Before you launch that flashy new program trying to stop the pain, think about who is feeling what kind of pain and why. It doesn’t do anyone any good if you lower price pain at the expense of increasing the process pain, or vice versa.

Disclosure: White reports he is a consultant to Allergan, Shire, Sun, Kala, Ocular Science, Rendia, TearLab, Eyevance and Omeros; is a speaker for Shire, Allergan, Omeros and Sun; and has an ownership interest in Ocular Science and Eyevance.