February 19, 2017 | POSTED BY | Clinical Optometry, Clinical Pearls, Optometry School
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dsc_09871-1024x681I’m entering my last academic year of optometry school (3rd year at the University of Houston) and I thought to myself, what else do I have to learn? Well, a lot but two big things that came to mind was practice management and patient rapport building. We have a practice management class this year but not the latter, so I took it on myself to work on building up my communication skills and consciously be engaging with the patient. I thought that sharing my tips from what I’ve learned so far might be useful for someone, so here goes!

Before diving into my tips for patient interaction, it is important to understand the motivation. Why do we care about really getting to know the patient? Why not just grab their history, run our tests, and treat their eyes?

If you were like myself and 90% of optometry students, at your admission interview you said something along the lines of “I love working with people, getting to know them and helping them.” Sounds like a great thing to say for an interview right? Maybe at the time most of us actually believed this, but we may have forgotten it in our years of textbook studying and retinoscope slinging. I believe that really getting to know the patients and engaging them is pivotal in our practice to perform as better doctors, business-people, and just better human beings.

Why should we engage patients during our exams?

  1. Engaging a patient can be lucrative. Really getting to know a patient and having them enjoy their experience with you and your service allow us to make more sales. A happy patient tends to buy more and refer you to their family and friends.
  1. Engaging a patient allows for a better understanding of patient history and patient needs. A good patient history is key for diagnosis and treatment. Likewise, truly knowing what the patient want will allow us to cater to them what they really need and want. Engaging the patient is also critical for educating the patient on their diagnosis and treatment, making them more receptive of your recommendations, and is key for patient compliance.
  1. Engaging a patient can be fulfilling to your vocation as a social being. Breaking out of the monotony of “better one, or two?” and genuinely getting to know another person can give us new insight on the world and allow us to develop relationships

One of my inspirations come from Dale’s Carnegie’s “How to Win Friends & Influence People.” I took 3 points that Carnegie mentioned and reworked them to apply to patient encounters.

Clinic PatientHow can you engage patients during the exam?

  1. Find a shared topic of discussion. Being in Houston, I see patients of all shapes and sizes. It’s not often that I get a patient just like me, 24 year old Indian male from Canada who likes RnB music, is a great listener, and likes long walks on the beach… Finding something in common with a total stranger can be tough, which is why I start off the conversation in a generic way. After I introduce myself to the patient and we walk towards the exam room I ask, “how was the drive up here?” This is a great starter question as it is not too intrusive and is generic enough to keep the conversation going even if the answer was one-worded. I can usually follow up with questions such as where are you coming from? Was the traffic bad? (The answer is always a yes in Houston.) Is this close to work? Etc. All of these questions can have simple answers that you can feed off from to continue the conversation, which brings me to my next point.
  1. Let the patient do the talking. People love talking about themselves, so let them! The point of my first couple of questions is to get my patient talking. I might mention something about my commute or just throw in funny story to establish a tone of openness and discourse between the two or more of us. Our goal should be to set the tone of conversation and then rekindle the discussion throughout if needed. This leads me to my final point, which should be present throughout your entire interaction.
  1. Show interest. To truly engage a patient, you must be interested in doing so and the patient must know this as well. This is something I learned from a doctor I worked with previously who had a thriving practice. He had a way about him that showed his genuine interest to his patients. I remember observing him as he was doing his exams – he would be spinning the dials, typing on his computer, and chatting up the patient, until he would get to a point in the exam where the patient would be expressing their concerns. At this point, he would put the pen he always had in hand down on to the table quietly, but loud enough for you to know something had changed. He would turn in his chair to face his patient, lean forward towards them, and listen intently. Then he would always say, “listen,” pause, and say something like, “I want you to see the best that you can possibly see, and I am going to do EVERYTHING that I can do get your there Mrs. Smith, does that sound good?” The entire sequence of events would make even an observer want to respond with yes, believing everything he said. Maybe this routine was something he had been practicing for years, because it was very polished. But even though he did this with every patient, I know he meant it. This is something I have adopted with my exams, and I honestly do listen to what the patient says. I let them know that I am listening, and that I genuinely do want help them to best of my ability.

Now this didn’t happen overnight and I’m still working on it, but it has been something that has been making every patient interaction I have more meaningful. An attending taught me that the best way to improve a skill is commit to practicing and devoting one specific skill for a few weeks with every patient you meet. I now follow that advice to improve my skills whether it be peripheral 78D, gonioscopy, or engaging patients. Honing your patient communication skills will help you become a better clinician as you move from being an optometry student to a successful optometrist. I hope this was useful and please, try some of these tips out in your next patient encounters. Let me know how it goes – I’d love to know how these tips help others!