What’s Your Favorite Sense?

This week in JAMA Ophthalmology, I came across an article that tried to value different senses. It was a small study, and there may be some bias as the authors themselves were part of an eye health department; however, it came to what I feel was the predictable conclusion: sight was the most valued sense.

The study surveyed 250 participants in the UK. The group comprised mostly of women (56.4%), and the average age was 50 years old, but included people 22 years and older. The vast majority of the study group did not have any family history of vision impairment. They included the following 8 senses in their questioning: sight, hearing, touch, smell, taste, balance, temperature, and pain. How would you rank these in order of most to least favorite? For me, the top choice is simple… My rankings would be as follows: Sight, Balance, Hearing, Taste, Touch, Smell, Pain, Temperature.

The study also looked at Time Tradeoff. Participants were essentially asked: How many years of perfect health would you give up in order to maintain your sight (or these other senses)? This could also be rephrased as: How many years of perfect health would you prefer compared to 10 years of life with complete vision loss (or other sense)? The results were quite astounding!

On average, people chose 4.6 years of perfect health compared to 10 years of complete vision loss. The second most valued sense was hearing as people chose 6.8 years of perfect health compared to 10 years of complete hearing loss. Even more interesting, 15% of people chose death over living 10 years with complete vision loss (compared to just 6% choosing death over complete hearing loss). While it’s important to keep in mind that this is just one small study that may not reflect the general population, the findings here seem to be reinforced by a couple other studies out there.

So what does this all mean? To me, this reinforces the value that my field of Ophthalmology brings to people. We value our vision and the health of our eyes so much that we would give up a lot to preserve our sight. From a personal standpoint, I’m grateful to be in a field that helps make a significant difference. Nobody really understands what we do (either as Ophthalmologists or Oculoplastics experts) until they need us and by then, vision could already be damaged.

From business and healthcare policy standpoint, I see a significant disconnect. First of all, it seems a little ridiculous to me that eye health is not universally covered. Vision care, from eye glasses to cataracts to other complex surgeries, should be a basic covered service because it has such a profound impact on people’s lives. The US system right now has just a patchwork of insurance options to cover eye health with many gaps in care. Imperfect vision not only affects one’s quality of life, but there is also an economic impact with loss of productivity

Secondly, all physician specialties have generally seen a cut in their reimbursements, but as policymakers, we should ask ourselves, what does the public value, and how should limited resources be distributed? As physicians in this economically tightening environment, we have to demonstrate objectively our value to the population. It is no longer enough simply to have patients say they like us.

Although I’m biased, I think it’s clear what the public values. People are willing to give up nearly 5 years of their life over a 10-year period to have good vision. That’s pretty remarkable.