DO YOU “RECOMMEND” OR “PRESCRIBE”?

THERE’S A BIG DIFFERENCE; AND NOT KNOWING IT COULD BE HURTING YOUR PRACTICE

Peter Shaw-McMinn, O.D., Sun City, Calif.

WHEN COMMUNICATING A TREATMENT TO A PATIENT, A DOCTOR:

a) Hands the patient a prescription and tells him or her to fill it if the patient wants to.

b) Presents treatment options and tells the patient to choose from them.

c) Gives his or her recommendation on what to do.

d) Prescribes treatment.

HOW DID you answer? Do you give a prescription or a recommendation? Depending on how you use the words “prescribe” and “recommend,” they can seem similar. However, their concepts are quite different. Let’s take a look at their definitions:

“Recommend” means to advise or suggest, while “prescribe” is defined as a rule or a course of action to be followed.

Keeping these definitions in mind, here I discuss why you should use “prescribe” and how, specifically, to do it.

WHY “PRESCRIBE”?

You should use “prescribe” vs. “recommend” for one reason: “Prescribe” translates to expertise. When you use “recommend,” you’re telling the patient it is up to him or her to decide whether to follow the treatment(s) you’ve discussed. When you “prescribe,” however, you’re telling the patient that as the eye care and vision expert, you have the authority to tell him or her what to do.

Remember, the reason the patient chose you as his or her eye doctor in the first place is because he or she values your expertise and, therefore, wants to be absolved of the responsibility of trying to determine what is best for him or her, with the patient’s limited knowledge of vision and the eye.

At the exam’s conclusion, say, “I plan on maintaining your good vision for the rest of your life. You won’t have to worry about it — I will. With today’s technology, if you do what I prescribe, there is a good chance you will have good vision for the rest of your life!”

Patients are relieved to have a doctor who takes responsibility for providing services so important to everyday life.

In addition to “prescribing,” make sure you hand the patient off to your optician. When handing off to the optician, it is best if the optician is in the exam room while you are presenting the prescribed treatment to the patient. Doing so shows the patient the importance of your prescription, while also showing him or her that the staff is an extension of you. If having the optician present is not possible, a routing slip, exam summary or script restating the “prescribed” treatment will improve patient compliance.

HOW TO DO IT

To show the patient that he or she made the right decision in seeing you, show him or her that you’re taking into account all the factors of his or her history/lifestyle to determine need.

To accomplish this, examine the patient history/lifestyle survey. For example, does the patient have a history of AMD? Does he or she spend an inordinate amount of time using a computer or other digital devices, such as a cell phone?

Next, examine the patient to reinforce the possible need, and communicate it to him or her during the eye exam. At this point, the patient recognizes the need for treatment(s) and is waiting for your “prescription.”

Use the word “prescribe,” followed by the treatment and the specific benefit to the patient. The word “prescribe” and a description of the perk to the patient sends a message to him or her that compliance is required for what you said, while illustrating the importance of the “prescription.”

SOME EXAMPLES:

• “I am prescribing sunglasses for you with polarized lenses and UV protection to prevent blinding glare off surfaces and to help prevent cataracts, skin cancers and macular degeneration.”

• “I am prescribing computer lenses for you to relax the muscles inside your eyes and provide you comfort so you can work long hours headache-free.”

• “I am prescribing a blue-blocking tint to reduce your risk of macular degeneration since you are a smoker and have a family history of this condition.”

• “Because your vision is now reduced to 20/30, I am prescribing the best progressive lens available to give you the most normal vision available, focused up to 12 inches.”

A DOCTOR “PRESCRIBES”

It is your job as the doctor to give an order regarding what treatment is best for the patient. You can review options with the patient, but in the end, you order the specific treatment. Recommending a treatment leaves the decision-making to the patient. As optometrists, we live and breathe eye care 24 hours a day. Patients don’t spend much time thinking about eye care; much less keeping up with what new vision and eye care technologies can benefit them. Why leave the decision of what is best for vision to patients when they are paying an expert (you, the doctor)? So, the next time you see your patients, think about ordering a treatment plan rather than leaving it up to them to decide which is the best course of action. Remember, after all, it’s called a prescription pad, not a recommendation pad. OM

PETER SHAW-McMINN, O.D., is an assistant professor of clinical studies at the Southern California College of Optometry. He is the senior partner of Sun City Vision Center, a group practice including five optometrists. Dr. Shaw-McMinn is a consulting editor to several publications and co-author of the books “Eyecare Business: Marketing and Strategy,” “Diagnosis and Management of Computer-Related Vision Problems,” and “Eyecare Practice Tool Kit.” Dr. Shaw-McMinn has served as chairman of the AOA Practice Management Committee, the Association of Practice Management Educators, Vision West, Inc and serves on many advisory boards.