I read an interesting article about the use of collaborative goal setting with glaucoma patients. The authors discuss how an individualized assessment and collaborative goal setting empower patients to become more involved in their treatment. The result is drastic improvements in compliance with treatment, and therefore, enhanced therapeutic outcomes. It seems to me that the authors are restating a principle that has been the foundation of vision therapy since forever!
Any vision therapy program begins with an individualized assessment that explores a patient’s personal perspective on the vision problem and how it impacts daily life. This sets the stage for shared decision-making and setting realistic treatment goals. Once goals are discussed, treatment options can be viewed against these goals, while considering a patient’s values, lifestyle, and resources. When presenting treatment options and recommendations in this context, patient and doctor are both more prepared to work together to design an effective therapy program. Seeing progress toward goals will motivate patients to adhere to the therapy program.
The article describes a study in which ophthalmologists were videotaped while discussing treatment with patients newly diagnosed with glaucoma. By watching the videotapes, the investigators were able to measure the degree to which the doctors participated in individualized assessments and collaborative goal setting. The percentage of patient encounters where the doctor engaged the patient in this type of dialogue was astonishingly low! The authors acknowledge that optometrists were NOT observed and perhaps they would be more likely to involve patients in these discussions. I would like to think so!
But for me, this article is a bit of a wake-up call; a reminder to view patient care as a partnership. If you are not designing individualized therapy programs based on collaborative goal setting, you are losing an opportunity to maximize therapeutic outcomes. If you are doing this, take a little time to revisit how you are doing it and perhaps, how you could be doing it better. And finally, if you are a patient, ask yourself, is the doctor working WITH me to help me achieve MY goals?