Hillary Golden: Lessons in Glaucoma Patient Care [Replay]

In this episode, which originally posted in June 2025, my esteemed guest was Hillary Golden. 

Hillary is a keynote speaker and advisor on the topic of patient care in ophthalmology with a particular focus (no pun intended) on glaucoma. 

Doctors, practice administrators, and healthcare technicians will learn about the experience of a patient from diagnosis to ongoing treatment. Whether you are in eye care or not, this is an episode for you. 

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This episode is brought to you by Seasoned Advice HR, where I help eye care clinics to hire, retain, and manage better — helping you get Better Results Through People. Learn more at seasoned-advice.com. 

Contact me directly at mike@seasoned-advice.com 

Get my free HR and leadership downloads here: https://www.seasoned-advice.com/signup-for-free-downloads

Transcript

Welcome And Why This Matters

SPEAKER_01 0:01

Greetings and welcome to iCare Leadership Live. This is the podcast for iCare leaders who want to level up their leadership, create better cultures, and improve the financial results of their clinics. Now, let's join the show. All right, well, hello everybody. Hello to the LinkedIn world and uh to the podcast world. My name is Mike Lyons. Thanks for joining us. This is LinkedIn Live hosted by me and sponsored by Seasoned Advice, my HR consulting business, where I help healthcare businesses hire, retain employees better and minimize their HR risk. And you know, the point of these LinkedIn Live sessions is to have guests who are experts in healthcare or leadership or some combination of that, or just people I find fascinating. And today's uh guest is no exception. Uh today's guest is Hillary Golden. Hillary is a patient strategy consultant, keynote speaker, and advocate in the glaucoma world. So we're going to be talking about glaucoma patient experience today. Um and I'm super passionate about eye care. Um, I've spent a lot of time working in the eye care world, and I just think it's so fascinating. And I love interacting with folks like Hillary. She has a ton of knowledge and passion around this because she uh she didn't start out being passionate about this. So we're going to talk about her history a little bit of how she came to this. But I hope that you'll find it a good discussion. And even if you're not in the eye care world, I hope that it'll be a meaningful discussion. Maybe you're interested in healthcare in general, or maybe glaucoma is not your focus. But I think there will be some takeaways here that will be useful. And so with that, I would like to welcome Hillary. Thanks for being on the LinkedIn Live with me.

SPEAKER_00 2:01

Thanks for having me, Mike. I'm really excited to be here today. And uh I think we're gonna have a great discussion and look forward to sharing some information and um and having a nice back and forth with you.

SPEAKER_01 2:12

Yeah, yeah. And and just as a little, a little additional plug. So, yeah, you're you've done some keynote speaking in the eye care world. And so you are you're a passionate advocate for all this stuff. So maybe let's start with a very, you know, briefly, like, how did you come to this point in your life to be uh passionate about eye care and glaucoma specifically?

A Sty Leads To Diagnosis

SPEAKER_00 2:35

Yeah, it definitely um I didn't run to it, it ran to me. So I've been in uh medical sales for over 25 years. I've sold everything from uh software to hardware to imaging, CAT scans, everything in between. I've also been involved in computer guided surgical navigation training, so training doctors on that. And then in July of 2020, I went to the eye doctor for a sty and I went to see an optometrist. And I thought, you know, kept putting hot compresses, nothing was working. And I thought, well, I need to go get this checked out. So I go to the doctor and they said, Well, do you want to do a full eye exam? And at the time it was during COVID, so everything was shut down. So I actually had time to sit there and get a full eye exam. And I said, Sure, why not? You know? And uh, so they dilated my eyes, and the first thing she did was look inside my eye, and she said, I don't like the look of your nerve. And I said, Well, look, lady, I'm here about this sty. And like, that's my main concern. So, you know, we'll just deal with this nerve stuff like later. She's like, I'm more concerned about your optic nerve than your sty, and we need to address this now. And so her the change in her voice just told me, like, okay, this is not just something minor, this is a big deal. Um, she said we need to do some more tests, so we did some more tests. Um, she had me come back, she made me promise her that I would come back. And when she said that multiple times, promise me, promise me. That's when I knew, like, okay, but so but I didn't know enough to be too scared. I just thought, you know, she's overreacting. Whatever this is, she's overreacting. And so I um came back, we did some more tests, and she said, you know, I need you to go see a glaucoma specialist. And knowing what I know now and seeing my test results from then, I I mean, I don't know how she kept as cool as she did because she just, you know, we need you to go here. I need you to promise me that you're gonna go to the glaucoma specialist. And so I went to the glaucoma specialist and she confirmed that I had glaucoma and it was severe. I had lost almost 40% of my side at diagnosis, which is super scary. Um, and that's why I say knowing what I know now and seeing my tests, it was a big deal. And she wasn't overreacting. And I did need to get to a glaucoma specialist as soon as possible and get it addressed. So it was uh urgent and I'm glad it happened. And and you know, I'm glad I had that sty that day because if I wouldn't have had the sty, I might still be undiagnosed.

SPEAKER_01 5:21

And so those were on it, was unrelated, huh?

SPEAKER_00 5:24

Totally unrelated.

Normal Tension Glaucoma Explained

SPEAKER_00 5:25

And, you know, that's usually so I have a weird kind of glaucoma. I mean, I'll call it weird because it's uh I have normal tension glaucoma, which means, you know, most of the time what I thought I knew about glaucoma was that, you know, you had to have high eye pressure and you had to be like in your 70s. And, you know, so I was like, how could I have glaucoma? Like my pressure, they told me my pressure was, you know, normal. And then I'm not, you know, 70. So how do I have it? And you know, knowing what I know now, um, you don't have to be in your 70s, you can get it at any age. And also you can have a lower eye pressure that's considered normal and still have damage. So so that's why I wasn't diagnosed till it got really bad because my pressures were normal. So there was no red flag that came up for the doctors to go, oh, we need to look further into this. So most people with normal tension, they don't get diagnosed till there's a lot further along as far as the damage and progression.

SPEAKER_01 6:24

So, you know, I come from the retina world, so I know a lot about some of the signs and and symptoms that people come into retina with. Um, but it sounds like you, I mean, you didn't realize that you had this vision loss.

SPEAKER_00 6:37

No, so your brain is uh an amazing organ in your body. And as you're losing sight, your brain does something called interpolation, and interpolation is kind of filling in the gaps. I told you I used to sell CT scanners. Well, when you sell CT scanners, CTs take slices, right? So it's digital slices and then it puts those slices together. Well, there's tiny little spaces in between those slices, and it doesn't necessarily know what's in that space, but it fills in that data using the information from the adjacent slices. So you're kind of interpolating that data is called interpolated. And so when I was diagnosed, I was like, oh, my brain's interpolating the data. The doctor was like, wait, what? And I was like, Yeah. And um, I mean, although they knew that word, they didn't have a patient telling them that, but I was thinking of my 3D days and going, yeah, because the day I'm getting pieces, so it's actually filling in the information that it's missing. And so because it's doing that, most people with glaucoma don't have any symptoms at all. If you have narrow angle glaucoma, that's a little bit different, and that can actually cause pain, really bad headaches, and um, your pressure would be going up really, really high. Sometimes people's pressure goes in the 60s, so it's called a narrow angle attack. That has that has symptoms, but for the most part, most types of glaucoma do not have those same symptoms. So it is the reason why, you know, they say go get an eye exam, because if you've lost a tiny bit of sight, you don't notice it. Even though I've lost a ton of sight, yeah, I don't really notice it because it's it's by my nose and my brain is filling in that data. So it's it's kind of hard for people to understand how you lose sight because I used to think, you know, you either are blind or you're are you're sighted. And now that there's lots of variations across there, it's not just one or the other.

SPEAKER_01 8:37

I I am definitely gonna make sure I get my eyes schedule here. I and I didn't expect that to become uh an outcome of

The Brain Hides Vision Loss

SPEAKER_01 8:45

our conversation today, but that you know, for those listening, that's a great thing to do, right? To it sounds like make sure you get your eye exam because you just never know.

SPEAKER_00 8:56

Yes. And I was getting one regularly, and it just shows you that, you know, um no matter what, even if you think your eyes were okay, there's so many eye diseases. Like you talked about, there's so many retinal diseases, you know, just with glaucoma is um is more of a group of diseases, but uh it it damages your optic nerve. And with retina, they're doing a lot of research. They're doing a lot of research with glaucoma as well. And there are gonna be some new treatments coming out for genetic diseases in retina. And with glaucoma, they're trying to restore sight, but it is um, it is hard once you've lost sight and glaucoma to it's gone as of right now. And I always say as of right now because the research is ongoing and there's trials being done right now to transplant retinal ganglion cells into the optic nerve to try to regrow that area that's you know lost sight. And, you know, one day we might be able to do it. For now, for now, we've lost it, it's gone. But, you know, I have hope. I have hope for the future. And and that's kind of earlier we talked about, you know, why did I get in this space? Like what why am I passionate about this? I mean, I came from you know the dental world and and dental sales and then moved into ophthalmology because uh, you know, with my diagnosis, I started selling glaucoma devices and got and went into glaucoma surgeries and was training doctors on how to do the surgery for glaucoma um with the devices. And I saw that there's a big gap. And the gap was between the doctor and the patient and these companies that are creating these devices. So there's you know, three pieces to the puzzle, a lot more than that, but three main pieces. And then there's all these gaps in between. You know, we talked about that interpolation. So how do I how do I interpolate these three pieces and make them connect that are not connected right now? And there's some connection,

Trust And Why Patients Quit Drops

SPEAKER_00 10:50

but you know, doctors are limited on their time based on their reimbursement and based on their schedules, there's not enough glaucoma specialists, there's not enough ophthalmologists, and so they're having to see so many patients a day because they're just overloaded, and then that cuts down on the time that they get to spend with a patient. We're always talking about compliance in eye care, especially with glaucoma, because you're using these drops most of the time. And when you're talking about that, doctors are saying, you know, my patients aren't compliant, but a lot of times I always say, I always push them a little bit further and say, Well, do your patients trust you? And I'm not saying that to try to challenge them or or question them in any way. I'm saying, do your patients trust you? Because do you spend enough time with them for them to trust you? And it's again, it's not their fault. It is the it's the system. And when you get diagnosed with something like glaucoma, and you know, they they say, okay, use these drops or you're gonna go blind. Okay. I don't I don't know that that really works.

SPEAKER_01 11:56

Yeah.

SPEAKER_00 12:08

Use these drops so you can see your son graduate from college. Like there's so much more than threats that you can use to paint the picture.

SPEAKER_01 12:17

I I I'm a big fan of what you're talking about right now. And and that's you know, that's what motivates people, I think, is the outcome. What is the outcome that I'm gonna get here? Is it just okay, you're not gonna have this symptom anymore? No, it's I'm going to have a richer experience. You know, I was at a um my son had an orthodontic visit the other day, and the doctor was just masterful in painting a picture of actually literally showing on a video this is what your son's jaw looks like, and this is why this problem is an issue, and this is how we can solve it, and these are some of the things that could be outcomes later if we don't address it, and just took the time to educate and inform. You know, for me, I have never been to an orthodontist. This was all new to me. I probably could have used the same treatment my son's about to get, but uh, it was so wonderful the way it was expressed to me. And just I was like, yes, where do I where can I give my money right now?

SPEAKER_00 13:17

Yeah, where do I sign?

SPEAKER_01 13:18

Yeah. It's very motive.

SPEAKER_00 13:22

So yes, and I think that when you can paint that picture and you can paint a positive picture, not just, you know, and they didn't just tell you like, if you don't do this, your son's gonna, you know, have this, um, have TMJ pain the rest of his life, you know, all these things that are that could be possible, right? But they told you, like, you and you know because you could have potentially had that same surgery, and you're like, oh, wow, it could have changed part of your life, right? Because it could have been maybe better in a in a in a way and and helped you with some jaw pain or or whatever it is. And those are the kind of things that I think really make the difference. And ideally, if it was an ideal world, we would have a you know, patient educator, patient advocate in every ophthalmology office that could explain, take the time and explain these things. Like that's not the reality of today. Hopefully, down the road, that's where healthcare is going, or at least ophthalmology, because people are walking out and you know, like you said, there's there's no symptoms for glaucoma. So most of the time, and you're telling me to use this drop that's gonna give me symptoms, so it's gonna make my eyes red, irritated, burning, and itchy. That's what most drops can do. And then there's other side effects as well, but those are just a few, right? So I'm telling you to go home and use this drop, and it's gonna actually make your eyes red and hurt. And and the doctor doesn't necessarily tell you this. So you go home. The first time I had a drop, I went home and started using it. My eyes got red, itchy. So I just stopped using them.

SPEAKER_01 14:57

Yeah.

SPEAKER_00 15:05

And you know, I've had eye infections in the past where they give you drops, your eyes feel better. And these were making my eyes feel worse. So I was like, why would I use a drop that makes my eyes feel worse? So then I go to my appointment the next time. Have you been using your drops? No, I think you gave me the wrong drops. What? So, and here I am. I've been in healthcare, like I know what it is to be a patient, but yet I thought they gave me the wrong drops. And they said, Well, no, that's you know, the side effects. And it's like, whoa, okay. So now you're telling me that I have a disease with no symptoms, and I have to use a drop that's gonna give me symptoms, and then that's gonna save my eyesight down the road. But in the meantime, my eyes are just gonna be red all the time, and you know, so you so these are it sounds like these they're little things, yeah, but over time this compounds, and then you have to get on multiple drops, so then your eyes are even more irritated, and the drops have something called BAK in them, which is kind of like a bleach, and it's to keep the bacteria from forming in the drops, but it also damages your cornea. So then people have cornea issues. So you're you know, you're fixing one thing and hurting another, which happens a lot of times with medications and drugs, right? I mean, every drug has a side effect, but so all of this has to be balanced. And if the patient doesn't understand this, that's when you run into the noncompliance. So it's not just that patients are non-compliant because they forget or there's apathy or they just don't see the point. It's because these drops are hurting their eyes. And there's ways you can work around that. They make preservative free drops that are easier on your eyes. You could potentially get a surgery and you could potentially get off a drops altogether, or maybe, you know, cut your drops in half. And instead of being on three drops, you're only on one. Um, so there's options, right? But people don't understand this. Some people just stop going altogether to the doctor and um they're just resigned to the fact that I'm gonna go blind. And the bottom line is with glaucoma, if it's found, once it's found and it's being treated, the chance of going blind is very, very, very minimal. There's things that can be done.

SPEAKER_01 17:23

Yeah. You know, I um it makes me think about a a uh retina doctor that I know of who always wanted to get to know the patient. And what are you telling me about your life? Tell me about your family. What do you like to do in your in your free time? And I think it it was a calculated move. I mean, obviously, this is a nice doctor, they want to get to know their patient, but it serves a purpose because it empowers that physician to be able to say, I know you're passionate about woodworking. This is gonna help you, you know, preserve your vision, preserve your ability to do the thing that you love to do. And I know you mentioned that you have grandkids, and just kind of what you were saying is help to provide that motivation for the patient to want to continue treatment, which it may not be fun. No one wants us to go sit and have an OCT and go have an FA or whatever, they don't, or and then get an injection in your eyeball, right? Those aren't necessarily fun things, but but there's a reason why we do that.

SPEAKER_00 18:28

Absolutely. And I think, you know, the doctors that take the time and talk to the patients, and you know, it's it's all about relationships and that just is building trust, right? So I I mentioned trust earlier, and that's why I think it's so important because if a doctor doesn't tell you there's going to be possible side effects, if they don't tell you what all of your options are, then you the trust it's like trust erodes slowly, then all the all at once. Okay. So the doctor's running late, like all these little things, you know, they don't they don't acknowledge you in the office. The person, the tech that brings you back doesn't say your name. They don't say, you know, who they are, they don't tell you what they're gonna be doing. These are little things that I notice that not all patients are gonna notice, but I think it's so important to take the patient back, acknowledge the patient. Hi, Hillary. Today we're gonna be doing a visual field test on you. Are you familiar with that? Even if I've been there a hundred times, just are you familiar with that? Do you understand what we're gonna do? Yes, get all of that and gain agreement before you're doing the procedure, you know, and coming from a back a background in sales, it's like you always gain agreement before you move to the next step. So if you started out and there's like a miscommunication and you keep going, that's gonna stay in that person's mind. That that misunderstanding that they never got over is still gonna stay in there.

SPEAKER_01 19:52

Yeah.

SPEAKER_00 19:52

You've got to address it when it comes up. Otherwise, it's it's stuck, right? You're stuck. So let's move forward and keep gaining agreement. Yes, I understand we're gonna do a visual field. Then sit down. You've done this before. Do you need me to explain what we're gonna do today? You're gonna press this little button, like all those things, like, and it's a fine art because you need to do it in a way where you're not condescending, right? And you're not be placating the patient, but you're giving them space to say, hey, you know, I've done this before, I'm really comfortable. I know what we're gonna be doing. I'm still nervous about it, but I appreciate you explaining it to me. And that's as simple as it has to be. And you can make such a difference. And that's where that, you know, trust piece is like if if you're handled well and you feel like, you know, they held your hand as you walked back, not literally, but figuratively, yeah, they're taking care of you, they're watching out for you. Then you finish your test. I'm gonna walk you into a treatment room now, or I'm gonna walk you back into the waiting room, and then we're gonna come get you in a few minutes. Like all of those little steps make such a big impression on a patient. And it all, it all makes a difference with compliance. And I mean, I know there may be doctors that fight me on that, but I'm gonna tell you it makes a huge difference because you trust the staff, you trust the text, you trust the front desk, you trust the doctor. You're gonna be more compliant with your meds. You just are, it's the reality.

SPEAKER_01 21:22

So, yeah, I I um in my background, we would train our technicians and our front at front desk staff on a five-step service process. And everything you said is exactly what we would teach. And it actually applies to leadership as well. And so, you know, greeting the patient, being responsive to their emotional state, right? So, are they worried? Are they stressed? How can we address that? Yeah, explaining this is a big one, right? So, just what you said I'm gonna give you these drops, they're gonna cause this, this, and this symptom, but it's you're gonna get a certain benefit from that. So, taking the time to explain, ask. Asking questions, um, and then explaining what's going to come next so people know what to expect. And leaders can do this too. So I'm as an HR person, I'm always interested in the leadership aspect. But as a leader, we can do those same things with our staff. So giving and giving the employees an experience. And believe me, we want to have compliant, not only do we want to have compliant patients, but we want to have compliant employees. Yes. And so the things you're talking about work with employees as well. So explaining, giving reasons, and building trust is huge. I love that you talked about that with patients

Small Staff Behaviors That Build Trust

SPEAKER_01 22:35

because you know, nothing is more sensitive, like, hey, lean back and I'm gonna do something with your eyeball right now. Like that is a vulnerable moment, right?

SPEAKER_00 22:43

It is, it is, and it makes such a difference, like you said, just those little things in explaining. I had uh an experience with a tech one time, and you know, because I said it's it's a fine line, it's a balance, right? So I went in for an appointment and I had this. The tech was assigned to me, and she just kind of would mumble, and then whenever she would explain things to me, she would, it was just very, you know, okay. So what we're gonna do, and I just felt very, you know, I felt it was like very patronizing, and I felt like I'm not hard of hearing, I'm not, you know, like uh um you can talk to me like a like I'm a person. And I felt like she was kind of like talking down to me, and it just made me feel really uncomfortable. So I went in another time and I get the same tack, and the same thing happened, and and every time I would go, I would start crying because uh the eyes are losing sight is very sensitive subject, and yeah, you know, it's very emotional. And here I am trying to taking all my strength to go in there. It was when I was, you know, in the first couple of years of being diagnosed, which I was still figuring everything out, and now I'm almost five years diagnosed and I'm in a different place. But at the time I was still, you know, it was very raw and trying to figure everything out. And um, and every time I would go, I would just be crying and crying. And I told the uh so the third time I went and I got the tech, I'm like, okay, evidently she's assigned to me, uh, some kind of way, you know. I don't, I don't know if they did that or not, but it seemed like that. And so I said, I can't just do this anymore. And when the doctor and the um scribe came in, I said, I this girl that brought me back is very sweet, and but I'm sure she means well, but that there's something in our personalities that's not working, and I need to get a different person, and um, you know, again, it was just it's just me, right? Yeah, she may do that with everybody, and everybody else is fine, and maybe it's just not didn't work for me, but for me, I had to say that I was uncomfortable, and it's it's part of what brought me to be more of an advocate about my health care, is because of situations like that where I just thought, I just have to do this, I just have to tolerate this, and and that's just what I'm resigned to. And I think that's what a lot of patients feel like when they go in, like you just have to get whatever comes at you. And so I told the doctor and the scribe, I said, Look, I just I think I need a different person. Can you just uh in the notes or whatever you need to do? I don't know, but just put a different person, and nothing against her. I don't think she means like it's coming across, but there's something about it, it's not working for me. The next time I had a different person and I had a totally different experience, and I didn't cry that whole visit. And you know, so that makes it like little things like that make a huge difference, and then it also told me when you feel uncomfortable, like say something, you know? It wasn't, and again, I wasn't it's not like I was going online and giving a bad review and saying, if you get Sally as your tech, you're gonna cry when you leave. Like that's not what I that was not what my intention. That's not what I wanted to do. I just wanted to say, hey, can we do this maybe a little differently? Because I'm finding that when I come here, I'm leaving in tears every time and it's just ruining my day. And I don't feel like I'm getting as good of an appointment because I was I was so emotional and I needed to get questions answered. So I needed to be available intellectually as well as emotionally, and I felt like I can't do that if I'm getting thrown off in the beginning of the appointment.

SPEAKER_01 26:34

And this just that highlights the importance of hiring people with good emotional intelligence, right? And so being able to recognize the patient and where that patient is at. Maybe they do need a slower, you know, speech, maybe they need like a more of a focused communication style, or or maybe maybe they're they need some information delivered in a different way, or maybe they need, but you have to be able to recognize that, you know, oh my gosh, whatever I'm doing, this person is going in a bad direction. How can I turn that around? And so with something that's a high trust service like ophthalmology, you gotta have good emotional intelligence in your staff. And and um, and the other thing is, you know, you're you gave a gift to to that practice because they get to give feedback, hopefully, to that person of like, hey, you know what, not everyone likes that, or you know, how can we tweak your style, right? And and and that's a learning point for that person. And so hopefully that person was able to learn from that experience. But, you know, you highlighted that for me, like probably most patients, they probably 99% would not have done that, right? They would have figured to stop showing up or go to a different doctor or whatever, just to avoid that conversation.

SPEAKER_00 27:51

Yeah, and I think that's why, you know, you realize you have to stand up for yourself. Like I talk to patients all the time, and they're scared to get a second opinion because they don't want to hurt their doctor's feelings. And I get it. But when I told my doctor, I said, Oh, I need to go see this other doctor because there was something that he was doing that was different. And I said, I want to just go there and get it, get another opinion. And he's like, Oh, that guy's great, go there. Those are the kind of doctors that you want because they don't have all this ego in the way where they're you know threatened by you going to get a second or third or fourth opinion. It's like the guys that are in the gals. I mean, I have a female glaucoma specialist now that's amazing. And, you know, when they are open to you getting other feedback and getting another opinion, and just because with glaucoma, there's no like there's no, there's a set a certain amount of an of an algorithm where, you know, okay, you put them on drops, they'll get SLT, which is a laser that you can try to drop your uh pressure that way, and then they'll their surgery. But as far as like how you do those steps and which surgery you pick, it's it could be it's totally different. It is just like crazy how many people have different opinions. So if you go to five different glaucoma specialists, you could get five different opinions on what surgery you should have. So it can be very overwhelming. That's a lot of information. And so I do think you can run into analysis paralysis when you get too many opinions and you're just kind of stuck because you're so confused. So you have to have some education up front in order to make that decision. But you have to get the information and the doctors that are open to it and that are open to the feedback, that's where you can really make changes because I'm sorry, no matter how many people you have coming into your office, there's always gonna be someone who has a bad experience, no matter what. No matter if you have a perfect staff and you have perfect everything. And not that anything's ever perfect, but there's always gonna be places where you can get better. And that's why I think, you know, with speaking, I, you know, go to a speaking class every week and we give speeches and we get feedback and they say, This is what you did really well. This is where I think you could make some changes, and this is what I challenge you on. You know, so we get good, we get the bad, and then we get the what could you, where could you push yourself? Like, I see this in you. Like you're, I don't think you see it. And that's where you can take that into an office setting and do that with your employees. And you know, most offices do, but since there's a lot of turnover right now, it's really hard to get text, you know. So I think you're getting what you get, and sometimes you don't have uh as many options, so you've got to learn how to do this feedback better because if you're limited on your options, then you gotta make the ones you have better. And the only way to do that is through feedback, and

Speaking Up And Getting Second Opinions

SPEAKER_00 30:55

it's not easy, it's not easy to give feedback. It wasn't easy for me to even say, Hey, can I get a different tech next time? Because yeah, we're our situation's not working.

SPEAKER_01 31:04

You know, and what I have found is is if that trust is there, you know, you build a foundation of trust. And so maybe that doctor had built a certain trust level with you, and that that then you knew that, okay, if I say something about this, then this physician is going to take care of it, right? And so so there was a, or maybe you just powered through it, but hopefully there was a trust level that they had that where you're like, okay, I know that I feel safe with this doctor. They're going to respect my choice and my feedback, and they're gonna help find put someone else on on my whatever account next time.

SPEAKER_00 31:42

Yeah, because it's scary because you don't know how your feedback's gonna be taken. And sometimes, you know, I think that's what all that's what most patients are afraid of is that you know they give this feedback and there's pushback, and then they're I want to get a second opinion. Oh, well, go get a second opinion, but you know, once you leave here, don't ever come here again. Yeah.

SPEAKER_01 32:05

This show is sponsored by Seasoned Advice HR Services, where I help eye care businesses to make more money and save more money by hiring better, retaining better, and reducing your HR risk. If you would like an HR assessment or ongoing HR support, please reach out to me at seasoned-advice.com. You know, my wife was at a uh she had a primary care doctor uh for a while, and the staff was really kind of surly and like questioning her and and and she left that practice, but but like you talked about the little things that send a message about your practice, whether it's the front desk or the people answering the phone, the doctor, or the tech. You receive messages. Is this a safe place for me to voice my concerns? Is this a safe place for me to get treatment or whatever? And everything needs to be sending this message safe, safe. And if it's not, then you risk, you know, you're gonna have a leaky bucket of patients, right? Leaking out of your practice and going elsewhere. And like that's a total judo move that you mentioned of like, oh, you want to go see someone else. I love that. I mean, what a great that communicates trust. And like, I care about you, Hillary, because you know what? It doesn't matter if you see me, if you see Sally, if you see Dr. Smith, like I want you to be taken care of. And boom, that is a that's a trust builder right there.

SPEAKER_00 33:35

Absolutely. And it just shows, like you said, they are caring about you as a person in your eyes, and they want the best for you. And if that other doctor has something that no one else is doing and that that can potentially help you, I'm I'm on board with it. And um, so those are the things like not only does that build trust, but then you're you feel like seen and heard. And I think as a patient, that's that's what we all want is you know, we all want that in life, but especially as a patient, you want to feel um seen and heard. And I felt like, you know, okay, he sees me, he hears me, he knows that I'm not just gonna sit here. I'm not the kind of patient that just sits here and goes, okay, use this, do this, and you know, come back and come back in six weeks and we'll check your eyes again and then do this, do this, come back. Like, I'm not that patient and I'm gonna ask questions. I would go in with my phone. And in my notes app, every day I would like be driving and like, oh, wait, I need to ask this, or I would, you know, I'd be driving and I'd be talking into my phone, make a note of blah, blah, blah, blah, blah. Ask this question next time you're in the office. And so I'd go in and have all these questions. And I got to the point where I'd say, you know, they want to put the drop in your eye, the numbing drop in, so they can take your pressure when you first sit in the chair. And I would say, Nope, we're not doing that yet. We're answering these questions. And um, it was like I wanted to answer my questions, you know. And then once I knew they would answer my questions, then I would let them put the drop in, trust my pressure, do the rest of the exam. And then I would open my phone and ask my questions. But it was like I had to uh what I needed more was those questions answered. I needed the questions answered more than I needed the rest of the exam. And so that was what was more important to me. And that's why I led with the questions because I said, just please let me do this first. And again, it takes time to become that advocate for yourself. But I realized, like, after going, because you go a lot, right? I go a lot because mine is severe. Some glock patients go twice a year, um, some go three or four times a year. I go more often than that. So I was going a lot, and it's like when you go a lot, you observe things. And I'm I'm a big observer and I'm very curious. So I'm always trying to figure things out, or how could this be better, or how could this be easier, or you know, how can I be calmer in my appointment? Like all these things are going through my head the whole time I'm sitting there. I'm not just sitting there waiting for my appointment. I'm thinking, oh, that guy has a walker, and where's he gonna sit? And can I help him sit more easily, or can I move? Am I in a position where it's a better seat? Like all these things are going through my head. So when you're you're having all that and you have to figure out what do I need ultimately as a patient, as a person, you know, in everyday life. But when we're talking about the patient side, what do I need? And like you've got to bring that to the forefront. And yes, I know you need my pressure. Yes, I know this, but I need this more than I need you to know the pressure.

SPEAKER_01 36:41

Yeah. So now, so this is making me, I don't know that we've touched

From Sales To Patient Advocate

SPEAKER_01 36:45

on that moment. So you had your diagnosis and it sounded like you you stayed in sales, but more on the ophthalmology side. But tell me about that transition into advocacy and consulting, and you know, because it sounds like you have a lot of passion and you're sitting there in the office and you're like, oh, I could improve this or this could be better, right? And so you have a lot of value to add. How did you kind of make that leap from I'm gonna stop doing the sales thing and I and I want to start adding value in a new way and then and talk about that a little bit?

SPEAKER_00 37:17

Yeah. So I after I was diagnosed, I had been in in, I was training on the computer guided surgical navigation. And then I um I started like researching glaucoma. When I'm researching glaucoma, like a job comes up. Oh, a job selling a glaucoma device. Like, oh, that would be right in my wheelhouse. And again, this is when I was like, this is in early days of being diagnosed, so I'm like still wrestling with all this internally, trying to figure out, you know, people keep this diagnosis quiet, people don't talk about it. And so I was, you know, still in that space of like, I don't know how I'm gonna address this or talk about this or whatever. And once I started, um, went into training with a with the first company that I worked for, and I'm sitting in a training class and got the job selling a device, sitting in a training class with, you know, about 50 other people, and there's doctors that are coming up and talking to us. And the doctors are saying, like, here's a visual field, what would you do for this person? And I'm looking at these visual fields, and it's like visual field after visual field after visual field, and all of them just have like these little gray spots, and I'm thinking, mine is like black. This whole quadrant is black. Like, what are why are they showing these? And I had never seen anyone else's, I had only seen mine, so I didn't know what it was supposed to look like. So sitting in that room, I realized, like, oh wow, you know, then they'd show one and they'd say, Oh, this is more, this is a moderate to severe person. And I'm thinking, well, what am I? You know? And we took a break. The last doctor that presented, everybody's walking back into the room. The last doctor that presented sitting at a table. And I walk over to him and I said, I said, Hi, I know you just presented. I said, and most of the people had gone. So it's just like me and him. And I said, This is my visual field. Like, what do you think of that? You know, what do you think of this? And he was like, What? And I could just see in his eyes that all of a sudden he starts saying, You need to have a trab, which is if you know anything about glaucoma, it's like the most severe surgery you could have. Um because of normal tension, it's hard to draw pressures low enough. It's easier to go from high. The percentage of you know, dropping that, you can drop it pretty good. But when you're low and you just have to drop, you know, three points, it's harder to get that lower drop than it is to get that higher drop. Yeah, so he um starts telling me all this, and then my head is just like all I start hearing is Charlie Brown talk. Like I'm not hearing anything else he's saying. Yeah. And I said, after he finishes talking, I'm like, okay, thanks for the information. And I walk away, I walk into the room, and all of a sudden, like my eyes well up. So I walk straight to the bathroom and just start crying because I didn't know that my eyes were severe. Um so once I realized that it kind of took that for me to realize it. And once I realized that, I just said, There's a reason that I have this, there's a reason, you know, that God gave me this. And I have all these years of medical experience. I have this comprehension of reading these studies and being able to extrapolate information for patients really easily. This it comes easily to me. I can't just have this for myself. I have to be able to share this. And that's when I realized like this isn't about the glaucoma, this is bigger than that. This is a calling. And I feel like I've been called to, you know, be that I talked earlier about those three pieces to be that like that interpolation between the patient, the doctor, and these companies, because I think with the background that I have and the experience that I have, it really like combines these in a way that is really hard to find somewhere else. And so what I've found is in speaking and telling my story and sharing that, you know, with companies and doing consulting and explaining to reps uh what I really love to do that I haven't done yet is to go into these new rep trainings. So I explained about that training that I was in. We had like five doctors come talk to us. We didn't have any patients, patients where the story is. The doctor's the solution, right? And the and they're talking about that, but everybody, but there's like a huge piece missing. Where's the patient in that? Where is the patient? All these companies say they're patient focused, but then they're not bringing patients in to talk. And so I'm all about bringing patients in, talking to patients, hearing patients' stories, because that's where the value is. You know, it's what's gonna change people, what's gonna motivate people, it's the story. And so when you bring someone in to talk to your sales force and you say, This is a patient and this is who you're helping, I'm happy to be the face of glaucoma for that. It's not something that I've ever wanted, but since I'm here, I'm gonna use it the best I can. And that's when I kind of everything changed for me that day. And I said, I can't just be uh in the in the passenger seat of this car anymore. I have to get out, have to get in the driver's seat. I don't know where I'm going that day. I didn't know where I was going. I didn't know what I was gonna do, but I knew I couldn't stay in the passenger seat. I knew I had to change.

SPEAKER_01 42:51

Wow. It sounds like a real, I don't know, lightning bolt moment for you. And it's cleared like you have so much passion around that that anyone, and you talked about, you know, the three stakeholder groups, right? You know, you could be of such benefit to the patient world, the provider world, the treatment world. And I and I think even like educating employees as well, practices could definitely leverage the knowledge and experience that you've had to help employees understand like, hey, we have a sacred responsibility here. This is why we're doing what we're doing. I mean, what a powerful purpose to help someone through this journey. And it gives you more empathy, I think. So, one thing I want to say for those listening here, while just while I can take a break to mention, if you have a question for Hillary or a comment, we would love for you to drop that into the LinkedIn comments on the um on the live page. We will see those and we can respond to them. So if you have something for Hillary or a question, or if you just want To say hi. Um, tell us how how great we're looking on camera today. We'd love to hear that too. Thank you for that. And so, yeah, I love I love the work that you're doing. Let's see here. You you have a lot of knowledge about the treatments that that are being done and some of the up-and-coming treatments.

New Treatments And Patient Voices

SPEAKER_01 44:20

It sounds like you spent a lot of time educating yourself about that, attending conferences and learning about that. Are there any, I don't know, what's what's fascinating that's coming up about glaucoma treatment for you right now that you want to share?

SPEAKER_00 44:35

Yeah, there's so much coming in the pipeline, which is which is really exciting because, you know, there needs to be just constant research. And I love uh I love researchers because they're doing like this work and these, you know, boring little cubicles at their bench and you know, looking in the microscope and trying to find things that are gonna, you know, potentially save people's sight or restore sight. And that to me is just, you know, they don't get enough thanks. But there's so many things in the pipeline. There's um some new goggles that are coming out that help patients um like me that have normal tension that you know you wear at night when you sleep, and it uses negative pressure to lower eye pressure. And then um at night, when you lay down and you're in a supine position, your eye pressure goes up. Just everybody, even if you don't have glaucoma, like that happens because your um, you know, your blood pressure is changing, the the way your blood flows through your body because you're in that laying down position. And so when you're up, the pressure in your eyes is lower just because you're sitting up or standing. And so when you're um laying down and at night, you get these, you can get these pressure spikes in your eyes. So wearing these goggles overnight, it's kind of like wearing a CPAP machine, but um, but for your eyes, and so you're protecting your eyes and keeping your eyes at that pressure level that the doctor wants without those spikes. So that's something that's interesting because it's not, you know, a drug or a drop. It's something that's like neuroprotective. So we're protect trying to protect the optic nerve by using those and also lowering pressure in a way that you know doesn't add another drop on to the regimen, which can you know decrease compliance and all that. So that's exciting. There's there's lots of new drugs coming out too. There's there's an endothelial blocker that's that's coming out that in the past, endothelium blockers have been used for other diseases and it's a systemic drug. Number one, they're really expensive. Number two, they are um, they've got a lot of side effects, and this is something that's injected directly into the eye for glaucoma, which could be an incredible breakthrough. So there's all this new research, and you know, like you mentioned, this a lot of this is is talked about at um at meetings. And um I try to go to a lot of the conferences, the medical congresses, and the meetings. And you know, what what I what I really am trying to do as well is is get these meetings to have patient speakers because you know there's all these doctors that speak, but there's not a lot of patients that speak. And um, maybe they'll have one patient, maybe, and it'll you'll be in a little room somewhere. But you know, even if you had patients speaking, like keynote speakers at these at these events, even though doctors are seeing patients every day, you're still not hearing the full story. You know, you're you're hearing bits and pieces and and they get it, but it's like there's so much more to these people than just you know, these these like five-minute, 10-minute appointments that you see the patients at. So that's one of the things I'm trying to really champion is for these conferences to have patients come speak because again, that's where the value lies, is in the story. And you know, even if it's not me, it's like I don't care. If you don't want me, that's fine. But I want a patient up there, you know? I want a patient. I want to hear from a patient, and I think it makes such a such an impact. And um, you know, the doctors bring huge value. And I think there's some conferences that'll have doctors speak with patients, and I'm gonna do that this summer with the glaucoma foundation. Um, they have a think tank meeting. So I'm gonna be at that, and we're gonna have a doctor's gonna speak, and then I'm gonna speak right after the doctor. So it's kind of giving both perspectives the patient and the doctor perspective, which I think is uh something that is unique and needs to really be on a broader scale.

SPEAKER_01 48:31

Awesome.

How To Reach Hillary And Closing

SPEAKER_01 48:32

We're I've I've really enjoyed this conversation. You've you've shared so much knowledge and passion on this subject. Um, and so I appreciate you joining me. Um, I've learned a lot. I glaucoma wasn't something I knew much about, and so I feel like I I have gotten to walk in your shoes a little bit, and it sounds like that's really a lot of what you are trying to do. And so, hey, it worked here for me. I have a better understanding, and um I I want to ask, you know, how can people get in touch with you if they would like to work with you and learn more about what you do?

SPEAKER_00 49:09

Yeah, so I have a website, it's just my I founded a company called Glaucoma Coach. Um, my website is glaucoma coach.com, so pretty easy. And then I am um on LinkedIn as my name, Hilary A. Golden, and I am on Instagram as glaucoma underscore coach. And um, and those are those are the main places that uh people can find me. And again, my my email is pretty easy too, Hillary at glaucoma coach.com. So I'm I'm pretty easy to reach. All of that is available also on my website for contact information. And um, yeah, I like you said, I'm passionate about this subject. I am you know fighting to make people more aware of glaucoma just so they get eye exams.

SPEAKER_01 49:57

Yeah.

SPEAKER_00 49:57

I just want you to get an eye exam. I don't care how you get it, just go get one. And um, you know, your kids, your wife, like everybody, uh make sure everybody gets an eye exam. And that's really the best thing you can do um for your eyes because like I said, there's so many different eye diseases, and some of them have symptoms, but you know, many of them don't. And um, or they do, but if you catch them early, then you could really stave off a lot of trouble down the road. I think it's really yeah.

SPEAKER_01 50:28

I'm I mean, I'm moved by that, and and I absolutely will schedule my eye exam in the near future. So I personally thank you for that. I'm so glad that we're connected. I cannot wait to share this uh with my network uh because I feel like this was a great discussion. And thank you so much for joining me and thanks to everybody who watched and participated or is listening. Um, if you have questions for Hillary, please follow her. Please check her out, please communicate with her. She's so passionate, and I think she could add a lot of value for your eye care practice and can't say enough good things about that. So thanks for joining. Um, my name is Mike. I am HR consultant who specialize in healthcare. So if you ever need any support with staff recruitment or retention, that's what I do. And so, yeah, this has been the uh this edition of LinkedIn Live with me. I love to have guests on who talk about healthcare and leadership and anything in that spectrum. And Hiller, you've been a wonderful guest for me today. So thanks for joining.

SPEAKER_00 51:33

Thank you, Mike. I really enjoyed it. It was really fun. Thanks for having me.

SPEAKER_01 51:37

Awesome. Thank you, and I hope everybody has a great rest of their day. Bye-bye.

SPEAKER_00 51:43

Bye-bye, thanks.

SPEAKER_01 51:46

Well, that brings this episode of iCare Leadership Live to a conclusion. If you enjoyed this episode, please subscribe to the show on your podcast app and share it with someone who would value the content. I promise to bring you more guests and content to help make you a better eye care clinical leader. I also invite you to subscribe to my HR newsletter for iCare leaders. You can find information about that at seasoned advice.com. Now go out there and lead with confidence.