VIDEO: Firm recommendations key to discussing glaucoma treatment options

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When I talk to my patients about treatment options, you know, there are a couple things that come to mind. One is that patients really are looking for a recommendation from you. So just telling a patient they have a bunch of options doesn't really help the patient that much.

So I try to think of what I would recommend for a family member or maybe even for myself and share that information with a patient and explain why the patients are often very concerned. It's important to know that they come with their own preconceived notions and that those are our headwinds when we offer things. So patients come in with a pre-baked notion that topical glaucoma therapy is probably the way to go, feels comfortable to them, it feels, gives them a sense of power 'cause they're putting the drops in, and you know, I really have to work hard on that kind of explaining why that might not be the best option, and explaining the other treatment options in as friendly a manner as possible.

Also touting the data, for example, with laser trabeculoplasty where really no rational person who's familiar with the data would choose a topical eye drop over laser trabeculoplasty, laser's clearly better in a multitude of ways. So, you know, I recognize the headwinds. I make a strong recommendation, giving them a choice between laser and drops. The patient will choose the drops every time and that's not best for patients.

So I make firm recommendations, explain my reasoning, and at other times, it may help to just explain to the patient, you know, "I know this may sound uncomfortable to you, but trust me, it's safer. It's what I do for myself or what I do for my family." Those are kind of the things we need to do more of. We need to take more time addressing these options. Maybe the patient won't go for it at the first visit. I feel like this is something where you earn their trust over time and so, you know, you do have to develop a relationship. And then once you have a strong relationship, they tend to be more and more comfortable relying on your recommendations.