OCT 25, 2010
The authors conducted this study to determine how cataract surgery patients feel about receiving postsurgical care from practitioners other than ophthalmologists, such as nurses and optometrists. There are certainly many ways to co-manage postoperative care, and this is an interesting review from the patients' perspective on one of them.
Subjects in the study were 194 cataract surgery patients at one hospital in the Netherlands who received their first-day visit and final visit from an ophthalmologist and 289 cataract surgery patients at the same hospital who received co-managed care consisting of a first-day review by a nurse by telephone and a final review by an optometrist. All subjects completed the Consumer Quality Index Cataract Questionnaire.
The authors found that patients in both groups rated the quality of care they received positively. Patients who received first-day care from a nurse said they preferred the care they received significantly more often than did those seen by an ophthalmologist. However, most patients said they preferred the final review by an ophthalmologist.
The authors offer a possible explanation for the discrepancy between patients' reported positive experience combined with a preference for final review by an ophthalmologist: Perhaps they did not experience enough benefit in return for not seeing an ophthalmologist during their visit to the hospital. In the case of patients who received first-day care by telephone from a nurse, not having to travel to the hospital may have outweighed not seeing an ophthalmologist.
The authors conclude that the study's results strengthen the case for implementing co-managed care to meet the current shortage of ophthalmologists. However, they recommend that such care provide added value for patients.
In the day of co-management, it is important to note what works well for patients and providers and where things can be improved. I would like to see more articles that examine how patients perceive and value care from physicians and other providers, as well as a study designed with private-practice, real-world patients following various co-managed pathways.