The Patient Customer
Mark Packer
There was a cartoon in The New Yorker magazine many years ago now in which one socially erudite martini-wielding fashion plate said to another, “I don’t have time for instant gratification.” In the world of Refractive Surgery, the concept of the “Wow Factor” reflects the attitude lampooned in this satire. LASIK, in fact, has offered immediate relief for the vast majority of optically challenged individuals willing and able to undertake the surgical path, and 95% say they would do it again (http://www.usaeyes.org/lasik/library/lasik-success-rate.htm).
Refractive lens surgery (cataract or lens removal with implantation of a multifocal or accommodative intraocular lens for the correction of presbyopia) does not offer the same instantaneous results because time is required for adaptation to the new visual imagery. Nevertheless, 95% of people who have multifocal implants achieve the same level of satisfaction one year after surgery as people who had LASIK (Table 19, http://www.tecnismultifocal.com/package-insert.pdf).
The individual with cataracts who sees the opportunity to achieve freedom from bifocals in the context of a medically necessary procedure represents a unique hybrid in the world of medicine: a patient, by dint of having a diagnosis, and a customer, by opting for an elective procedure not covered by any type of health insurance. Who are they? (Nair BR. “Patient, client or customer? http://www.mja.com.au/public/issues/xmas98/nair/nair.html).
Because patience is required for neural adaptation to multifocal lens implants (1), the phrase “patient customer” epitomizes this new role. Also, because patience is a virtue we develop in the second half of life (2), patience is appropriate to the practice of presbyopia correction. Finally, because personal payment for a valued service carries with it all the force of the conventional customs of commerce, these individuals truly embody the identity of customers, with all the rights and responsibilities pertaining thereto.
References
1. Pepin SM. Neuroadaptation of presbyopia-correcting intraocular lenses. Curr Opin Ophthalmol. 2008 Jan;19(1):10-2.
2. Arrien A. The Second Half of Life: Opening the Eight Gates of Wisdom. Sounds True, Incorporated; illustrated edition (September 1, 2007). Pages 80, 83, 141.