Barriers to and Suggestions on Improving Utilization of Eye Care in High-Risk Individuals: Focus Group Results
Table 1
Examples of comments on most frequently identified barriers.
Barrier (% of total comments, = 351)
Example
Cost (24.0%)
“It’s about the finances. They wouldn’t let the doctor see me because I didn’t have the $20…They want all of the money before the doctor sees you, you know, so that knocks a lot of us in this community out of it.” (Focus group 1, participant 4)
Trust (15.5%)
“But I’m not gonna trust these doctors who are all about the money. They tell us we need glasses when we don’t…It’s not my care that they’re going after that day. It’s the number of patients they see that day to make their quota and be able to make the payroll. Trust is key.” (Focus group 3, participant 4)
“All the hospitals around here, nobody should be going blind. They need to start treating people b/c they want to and b/c they care, not so they can make money. I’ve seen animals get better treatment than some of us poor folks, and we don’t even go around biting people!” (Focus group 4, participant 5)
Communication (12.5%)
“I don’t want him to be talking to me about words that I don’t understand. Just tell me exactly what’s going on in a language I can understand…You know, explain it very well. Don’t try to go over my head and I don’t understand.” (Focus group 2, participant 2)
Distance/transportation (10.2%)
“And transportation to be able to get to the eye doctor also. A lot of people don’t have their own transportation, then you have to ask someone and pay for them to take you.” (Focus group 2, participant 2)
Doctor-patient relationship (8.7%)
“…they are not sincere. They don’t have any feelings for you…They’re not concerned about the person…I’m a whole person!” (Focus group 1, participant 6)
“…If you go to the grocery store and the cashier is rude, you don’t wanna go back to that store no more. Same thing with the doctor. Except you’ll probably go back to the store b/c you gotta eat. You don’t have to go to the doctor.” (Focus group 4, participant 5)
Lack of knowledge/education about eye care (6.1%)
“We hear about the heart, the lungs, kidneys, cancer, all of that, but we never hear about the eyes…we don’t know what we need to do to take care of our eyes. We don’t know enough about prevention in order to keep our eyes.” (Focus group 3, participant 4)
Insurance (5.8%)
“…And the first thing is “Do you have insurance?” And if you don’t have insurance, you might have an appointment, but they’re gonna turn you away.” (Focus group 3, participant 4)
“Look, the only time I’ve ever experienced staff that’s cranky and rude is when I didn’t have insurance…” (Focus group 4, participant 4)
Service at the doctor’s office (5.8%)
“They tell you to be there at some early time in the morning and you get there and you wait for hours! Our time is valuable too! Maybe I’m not an eye doctor but I have valuable things to do, like work to feed my family.” (Focus group 3, participant 3)
“An unfriendly doctor or unfriendly staff will keep me from going back every time.” (Focus group 4, participant 3)
Procrastination (5.0%)
“I think we have a tendency to put it off unless they have a problem directly with seeing. But just for an eye exam, I think we have a tendency to put it off.” (Focus group 2, participant 5)
Other (2.9%)
“There are some practices that don’t want new patients. So where do you start?” (Focus group 3, participant 4)
“That’s why someone who knows the person should go with them [to the eye doctor] b/c I don’t feel like they would receive the same treatment as someone who knows what’s going on…that’s one thing that really discourages me about doctors…I don’t think you should treat anybody different or put them down b/c of their economic status and things of that nature. But it happens.” (Focus group 2, participant 2)
Problems with vision devices (1.7%)
“Well I think the glasses damaged my eyes. I was not having any problems until I wore those glasses for about a week. Now I take them off and I can’t see nothing.” (Focus group 3, participant 6)
Race (1.3%)
“It’s not pointed out as a factor. But deep down, it’s still a little bit of tension there. It’s not supposed to be a factor.” (Focus group 2, participant 5)
Fear (0.7%)
“You know, I just have a fear… That’s why I’m debating whether I’m going back or not…” (Focus group 3, participant 5)
