reflections
THE HUMAN SIDE OF OPTOMETRY
Listen Up!
Patients may not necessarily hear exactly what you say.
BY TOM LINER, O.D.

About 8 years ago, one of my associates performed a comprehensive exam on Amy Stone, one of our repeat patients. He found nothing out of the ordinary but told Amy, who was about 45 years old, that we'd also need to do a routine dilation as part of her exam.

Instead of having her dilated retinal exam performed that day, Amy preferred to reschedule it for another time.

Several weeks later, Amy was nervous about the exam and returned to the office to ask why the dilation was important. I was the only doctor in the office that day, and my receptionist asked her to wait in one of our exam rooms until I had time to speak to her.

Explaining the reasons

"I understand you have some questions about having the dilation," I said after introducing myself. Amy asked why having the test was so important.

I explained the usual reasons, which, like you, I've listed countless times for my patients. I told her that the procedure allows us to perform a thorough exam of the eyeball's inside cavity. We'd look for retinal tears, holes, detachments, tumors and so forth. I said that the exam also lets us discover many eye diseases that don't present symptoms. Without a dilation, we typically wouldn't be able to see them.

After I'd explained the reasons, I asked if she had any questions. Amy had just one.

"So I need to have a dilated rectal examination?" she asked.

I couldn't help my sudden outburst of laughter. "No, I won't be giving you a dilated rectal examination; that procedure is outside my specialty," I said. "I'll be giving you a dilated retinal examination."

Amy started to laugh. Needless to say, she was greatly relieved and her nervousness subsided. Because I could tell that she had a sense of humor, I let her know that her comment ranked as one of the funniest remarks I'd ever heard from a patient.

Three truths

The humor of Amy's comment notwithstanding, at least three important truths lie behind this episode.

• First, Amy's misunderstanding reinforced the importance of clear communication with patients. Patients don't always understand our instructions, and embarrassment may sometimes prevent them from asking what we mean. I try to use straightforward language and repeat explanations or instructions until the patient understands what I've said.
• Second, this experience reminded me that although we may consider what we do in our offices each day as routine, for some patients our procedures can provoke fear, nervousness and discomfort. I try to stay mindful of this.
• Finally, clarification can help build up your patient base. I had to wonder how many of Amy's friends and family heard about the eye doctor who wanted to do a dilated rectal exam. That's not a way to gain referrals.

And keep in mind that, occasionally, a patient might even think that seeing an eye doctor is a pain in the butt! 

DO YOU HAVE A MEMORABLE EXPERIENCE YOU'D LIKE TO SHARE? DISCUSS YOUR STORY WITH KAREN RODEMICH, SENIOR ASSOCIATE EDITOR OF OPTOMETRIC MANAGEMENT AT (215) 643-8135 OR RODEMICHKF@BOUCHER1.COM.