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ASSESS YOUR ROTE PHRASES

IT’S GREAT TO HAVE PHRASES AND SYSTEMS IN PLACE, IF THEY MAKE SENSE

GARY GERBER, O.D.

I PLAY THE keyboards in a rock band. Recently, I’ve been playing with Joe Lynn Turner (Deep Purple, Rainbow). Some songs are highly technical and, therefore, require more practice than others. What fascinates me about practicing a lot is “muscle memory:” Without thinking; my fingers “remember” what to do.

We’ve all experienced this phenomenon, whether tying our shoes or squirting toothpaste. No thought is involved in these actions because we’ve done them so often.

IN PRACTICE

Think about what you say to a patient as you pull down the near-point card to begin your near refraction. Whether you say, “What is the smallest line of letters you can read?” or, “Which lines look blacker, up and down or sideways?” doesn’t matter. What does matter is that your brain acknowledges the pulling down of the card, which prompts you to ask one or more rote questions.

Another example: We’ve all been in that awkward situation of asking a patient, “Can you read those letters?” as we place the phoropter in front of him or her, and the patient replies, “What letters?” because the phoropter is binocularly occluded.

For a less direct example, think about how you answer the question, “So, doc, what exactly is astigmatism?” I’d guess that 1/3 of you say, “It means your eye is shaped like a football instead of a basketball;” another third say, “Your eye is shaped like the back of a spoon,” and the remainder say, “You have an egg-shaped eye.” A verbal stimulus kicked in a nearly autonomic verbal response that was almost subconsciously delivered.

ITS IMPACT

While you can joke with patients about the inadvertent binocularly occluded phoropter by saying, “Good, I wanted to see whether you were paying attention,” there are probably hundreds of rote phrases, systems and processes that you and your staff execute every day that may not really apply to the patient. The consequences are an immediate patient perception that you’re not treating them as individuals, but are functioning on auto-pilot. (See “Some Common Rote Phrases to Be Aware of,” below.) OM

DR. GERBER is the president of the Power Practice, a company specializing in making optometrists more profitable. Learn more at www.powerpractice.com, or call Dr. Gerber at (888) 356-4447.