I love questions. Questions start conversations and can lead to deeper, more meaningful connections with our patients. A question gives us such an incredible opportunity to engage with patients and translates to more empathetic conversations. When patients are able to ask questions, they feel heard, and a true doctor patient relationship is formed. In other words, questions can change an encounter from transactional to relational and build loyalty and trust. Engaged, educated patients are empowered patients who are more likely to better care for themselves. As such, we must be prepared to answer their questions.

Here, I’ll walk through the top five patient questions in my practice and the tools I use for making a meaningful connection with patients.

DO I (OR DOES MY CHILD) NEED GLASSES?

We write glasses prescriptions every day and can become a bit numb to the process, if not careful. Remember that although we may have written prescriptions a million times, it can be very disconcerting for patients to hear, for the first time, that they need glasses. This can be especially true of patients sliding into their 40s who are reminded, yet again, of the joys of getting older. Let’s not gloss over the patients’ feelings.

People tend to believe their own conclusions, for example, “I need glasses; I’m old,” over someone else’s, in this example, the doctor’s, whose conclusion might be “glasses would help me to more easily accomplish my daily tasks.” Let’s help patients come to that conclusion by tying our solutions to the pain points uncovered during the exam. We should use phrases to prescribe the solution to their problem — with confidence.

CAN I WEAR CONTACT LENSES?

This question makes me cringe. I want my patients to know what all of their options are, whether it’s glasses, contact lenses or refractive surgery. I am the expert and, if patients have to ask me whether they are candidates for contact lenses, I feel like I’ve lost some of my credibility as the expert.

To correct this, let’s implement several questions within our patient appointments. For example: “Are you interested in wearing a contact lens?” Another question to ask: “What do you want to achieve with contact lenses?” This sets us up for a successful contact lens fit (especially multifocal contact lens wearers). Knowing their goals, their visual demands and their motivation are essential to prescribing contact lenses. Let’s not wait on them to ask this question.

However, many patients do think they aren’t good candidates. So, when this question is asked, we can educate the patient that with all of the technology available today — single use lenses, GPs, scleral lenses — almost every patient can wear a contact lens.

IS THIS MEDICATION COVERED BY MY INSURANCE?

Our patients expect us to know the answer to this question. Never mind that the patient’s therapeutic benefits are a contract with the patient and their third-party insurer. The onus is still on us to help our patients through this process, so they can obtain the medication we prescribe and they can afford. Patients blame us if anything in that process go awry.

Let’s properly set expectations when we prescribe medications. We should walk the patient through how the medication works, how often they need to use it, possible side effects, when to expect relief, what is going to happen at the pharmacy and to utilize our practices as a resource. People get nervous when they don’t know what’s normal and what’s not. We should identify one or two people in our practices to be in charge of coupon cards, prior authorizations and answering prescription medication call backs. The last thing we want is for patients to not get their needed medications.

DO I NEED SURGERY?

Most commonly, this question comes along with a diagnosis of cataracts. Other referrals to a surgeon could be for a blepharoplasty, retina or glaucoma surgery.

I answer this question by saying cataracts are ready for surgery when the patient can no longer accomplish what they enjoy doing every day because of blurry vision, glare or feeling unsafe to drive. There is no magic number, although insurance company’s dictate when they will reimburse for the procedure. I also like to discuss with patients the added benefits of combined cataract surgery procedures if they have glaucoma: Some minimally invasive glaucoma surgery, also known as MIGS, are done with cataract surgery. The combined procedure can limit the risks involved in two separate procedures, while providing better control of the patient’s glaucoma.

With premium IOL options available, cataract patients can also be less dependent on their need for glasses, should they desire. We walk through all of the scenarios, so patients are much more prepared to ask quality questions when they do have a surgical consult. Information heard more than once allows for better understanding. Patients only get to have cataract surgery once, so it’s very important we answer this question correctly.

Relatedly, in terms of ocular surgery in general, let’s challenge ourselves to just make surgical referrals to surgeons. What I mean by this is that many times, referrals that wind up with an ophthalmologist could have been handled by an O.D. who offers specialized care. A great example is a patient diagnosed with glaucoma or as a glaucoma suspect. Instead of automatically sending this patient to an M.D. when we are no longer comfortable managing the patient, we should consider referring him to another O.D. who has made this a specialized part of her practice. We have so many experts in our own profession, let’s lean in to those relationships before immediately punting the patient to an M.D.

HOW OFTEN DO I NEED TO BE SEEN?

I love this question. It gives me an opportunity to reinforce any diagnoses uncovered during the exam, to educate on the importance of an annual eye exam and to ask whether there is anyone else in the family who needs a comprehensive exam.

One of the biggest myths I like dispelling is that just because you see well, your eyes are healthy. Our patients don’t know what they don’t know. We should walk them through everything we look for during the exam and congratulate them on taking the time to take care of themselves.

And, let’s not forget kiddos! Parents sometimes are shocked to hear that children need to be seen at six months, 3-years-old and before school starts. We, as a profession, are starting to make great strides in educating the public about the importance of annual comprehensive eye exams. Let’s reinforce the importance of eye care visits and teach the value of what we have to offer.

The Mehrabian Rule of Personal Communication

PRACTICE LISTENING

When listening, 55% comes from body language, 38% from tonality and 7% from the actual words. (See “The Mehrabian Rule of Personal Communication,” above.) Our schooling and studying teaches us the “what” of answering patient questions. We should practice “how” we answer.

• Practice active listening techniques, such as good eye contact and repeating the patient’s question back to make sure we got it right or paraphrased it in our own words.
• Ensure efficiencies in our clinics so that we have true face-to-face time to listen to our patients. This doesn’t mean we have to spend a lot of extra time; it does mean being intentional with our time spent. We should delegate where we can, and utilize a scribe so that we are not wasting precious face time entering data. Five minutes of face time with a doctor is much more powerful to a patient than 30 minutes spent with a doctor who is task-gathering and data entering.
• Start to catalog the top five questions we get asked, and then role play with our teams how to best answer them. Our teams are most likely getting the same questions. When everyone is using the same language, and has similar answers, it makes the patient experience very cohesive.
• Study our audiences. Different personality types need information delivered in different ways. In our clinic, we use the DISC profile of personality types — dominant, inspiring, cautious and supportive — to improve communications. The refraction is where this becomes readily apparent. A patient who exhibits dominant behavior, for example, jumping ahead before we can even get the instructions out, isn’t likely to want long explanations. A patient who exhibits cautious behavior, for example, one who waffles between “one or two” and asks multiple times to see it again, is more likely to need lots of information before making a decision, as he doesn’t want to make a mistake. Knowing this about our patients — and, quite frankly, ourselves — allows us to communicate effectively. We do this in hopes that our patients leave our practices feeling like we just “get” them.

FINAL ADVICE

One parting piece of advice about questions in general: When patients or team members ask us questions, let’s pause for a moment and consider: “Is this the real question, or is it a surface question?” Answering a question with an open-ended question can allow us to get to the root of what the patient/team member is really seeking. When we get this right, we are not just putting a Band-Aid on the surface problem for it to again crop up later. Deeper questions lead to deeper connections. As humans, isn’t that what we are truly seeking? OM

DR. MCGEE is owner of Precision Vision of Edmond, in Edmond, Oklah. She is president of Oklahoma Association of Optometric Physicians. She serves as a consultant for Allergan, EyeEco, EyeVance, Cynosure, Compulink, Lumenis, Optovue and Takeda. Email her at selinam@yahoo.com.