contact lens care and compliance

What We Can Learn From the West Point Cadets, Part 1

BY SUSAN J. GROMACKI, OD, MS, FAAO

In my position, I am privileged to serve some of the most outstanding young individuals that the United States has to offer. Intelligent, physically fit, and polite to a T, the college students (cadets) of the United States Military Academy at West Point, N.Y. accept their physical, military, and academic rigors with maturity and integrity.

They also make excellent patients. Sure, there are incidents of noncompliant behavior in any group, but these cadets take seriously the West Point motto: Duty, Honor, Country. Using these principles as a backdrop, let's see how the cadets' way of life can serve as a model for the rest of our patients—and for us.

Duty

With few exceptions, the cadets keep their appointments. And despite their busy schedules, they comply well with their treatment regimens. What helps, for sure, is our built-in method for ensuring good compliance. If a cadet misses an appointment, our staff sends a letter not only to him, but also to his tactical officer (“TAC”). This is a big deal, as a TAC is a superior who likely has served 10 years as a military officer and has the power to influence a cadet's career. Of course, the students are taught from the first day of their basic training (“Beast Barracks”) to follow directions. Do you think that a change in culture within your practice would help your patients follow instructions?

Unlike their fellow members of Generation Y, the cadets make sure they have a legitimate reason before they question authority. But, still a member of that generation, they do appreciate knowing why we have made a medical decision for them. Your patients deserve the same courtesy.

But—as when dealing with cadets—there should be no patient “choices” when it comes to contact lens compliance. They deserve to hear what is best for the health of their eyes (e.g. rub lenses, replace lenses on schedule, etc.) and that's that.

Honor

The West Point Honor Code states that, “A cadet will not lie, cheat, steal, or tolerate those who do.” My cadet patients do not lie to me because they are prevented from doing so by the honor code. The code is an integral part of the cadets' four-year experience in part because one day, in the heat of battle, there will be no time for anything but the truth. This honesty also reflects the respect that they have for each other and for authority. What a benefit to those of us caring for them; in assessing patient compliance, I always know that I am getting a straight answer.

How does this translate to patients in other practices? It is important to provide a compassionate climate of authority and mutual respect within your practice. Offer your patients open lines of communication—beginning with an open body posture—so that they will feel comfortable telling you the truth. And you must give them honesty as well; I truly believe that most people will respect and appreciate a person who is being honest with them. CLS

Disclaimer: The opinions of the author expressed herein do not necessarily state or reflect those of the United States Government, the United States Army, or the Department of Defense.

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Dr. Gromacki is a Diplomate in the Cornea, Contact Lenses, and Refractive Technologies section of the American Academy of Optometry. She is chief research optometrist at Keller Community Hospital in West Point, New York.