You'd have to have your head deeply planted in the sand for the past decade to avoid the attention given to the issue of "What Patients Want." The reality is clear that the contract of providing medical care is no longer doctor-centered but today includes the patient in some level of partnership.

As a trend like this evolves, you can track its progress by where it's discussed in print. No more confined to practice-management gurus, WPW has achieved the status of full scientific inquiry, as evident in the number of peer-reviewed articles on the topic. This month, ophthalmology joins in.

Researchers at Duke report a rare study in this month's Archives, rare in that unlike most such studies, which have focused on patients in a primary-care setting, theirs asked ophthalmology patients what they want from their doctors.
The authors acknowledge that their focus groups revealed few surprises, though the study is interesting reading nonetheless. They suggest the dramatic rise in the number of elective refractive surgeries and the increasing competition in the eye-care market are two key drivers in the trend toward better, patient-focused quality care. Among the calls for better communication, empathy, more and clearer information, the subjects listed honesty as their top desire in interacting with their eye doctor.

That's an especially useful bit of information in light of the recent developments in the refractive surgery market. Headlines in the consumer media are once again focusing on LASIK, thanks to the FDA's recent approval of a second wavefront system.

As New York City ophthalmologist Barrie Soloway says, for him, wavefront "has put the 'wow' back" in LASIK. That's great news, and LASIK needs it. Procedures are down in a struggling economy. LASIK fees, which had leveled off and even risen in recent years, fell by 4.6 percent in the most recent survey by MarketScope. Wavefront will certainly help remedy that. It is surely generating new interest.

Let's hope that What Patients Want is not forgotten in a rush to bring this technology to bear on a down market. Patients need to know very clearly that, as of today, no wavefront system can promise any specific patient any specific benefit. As in every other area of ophthalmology, what patients want most is an honest assessment of their condition and an honest appraisal of how the measures their doctors prescribe will alter their chances for improvement.