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The Art of Patient Communication

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Patients may not be able to judge the quality of their treatment, but they can and do judge how well they are treated. The role of ophthalmic medical personnel (OMP) is to assist the physician in effectively communicating all aspects of the encounter so that the patient leaves the office confident in the care that is received. While perfecting technical skills, don’t forget that communication matters. Too often it is ignored. It is often poor communication in the face of a bad outcome that initiates legal action by a patient.

I visited several ophthalmic practices this year. Some positive experiences. Many times, however, it was not. Allow me to elaborate.

Instilling lack of confidence — not to mention the HIPAA violation?
As I waited in the reception area to meet with the physician, I noticed that the new patient information sheet had been photocopied so many times it was no longer really legible and was copied at an angle. This was very frustrating to the patient.

An OMP entered the area and called out a patient’s name. After the patient identified herself, the OMP announced to this hard-of-hearing patient, “You’re here for a YAG laser capsulotomy in the right eye, right? I’m going to start dilating your eye.”

Patient: It’s my left eye.
OMP: No, the chart says it’s your right eye.
Patient: I know what eye I don’t see out of, and it is my left.
OMP: Huh? Well I guess we’re going to have to recheck that. But that will put us behind because I’m delayed in dilating your eye.

You should have seen the expression on the other patients’ faces. I’m not sure I didn’t look shocked too.

A science and an art
The concept of effective OMP and patient communication is a necessity—not an option. Because communication is a science and an art that can be learned, refined and mastered, there are many benefits for those who pay conscious attention to improving their technique. Effective communication is even more important with the time constraints placed on our patient schedule.

First encounter
The initial encounter sets the stage for what is hopefully a long relationship. The expression “You don’t get a second chance to make a first impression” is certainly true. Think about the way the OMP greets the patient. Is the patient called by his/her first name? While this is not a problem for me (and my last name is difficult to pronounce), most of our Medicare-age patients are accustomed to be referred to as Mr. or Mrs. Using this more formal greeting demonstrates respect for them.

The OMP should take a few moments to introduce him/herself. The patient may think you are the physician! When obtaining the chief complaint and HPI, etc, you’ll get a better response if you ask permission to obtain information from the patient. An appropriate way to do this is to state, “Doctor Smith has asked me to gather information from you to assist in the exam today.” Too often OMPs state, “I need to you tell me…” when of course the reality is that patients don’t have to tell OMPs anything. They are there to see the doctor. The OMP’s role is to begin the process of establishing a partnership between the practice and the patient

The Bayer Institute for Health Care communication stresses the importance of sincere empathy. When patients acknowledges that they have been heard and understood, and that they have had your full attention, they have a greater sense of confidence, which results in less anxiety.

Educating the patient
Ophthalmic terminology may be very familiar to us, but certainly not to our patients. OMPS must be sure that the patient feels comfortable enough to ask for further explanation if he/she doesn’t understand. Most patients have the same type of questions, whether they express them or not.

  • Why is this happening to me?
  • Can something be done about it?
  • Will it hurt?
  • How much will it cost?
  • Why is this test recommended?
  • When will I receive the results?
  • When should I be seen again?

Any video or printed materials provided to the patient should be followed by a question-and-answer period to assure patient understanding.

Interruptions at a minimum
Nothing is more frustrating to patients, OMPs and physicians than frequent interruptions. No matter how important, they break the pattern of communication with the patient sitting in front of you. Always think twice before interrupting. Never discuss another patient’s care in front of someone else.

Master the skills that keep you patients returning

  • Don’t omit the pleasantries.
  • Try not to appear to be in a hurry, even though you are.
  • Maintain eye contact.
  • Keep the conversation on track.
  • Listen without interrupting.
  • Every patient should leave the practice with something that has your name and phone number on it. A pencil, pen, newsletter or a welcome to the practice brochure are just a few examples.

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About the author: Sue Vicchrilli, COT, is the Coding Program Manager for the American Academy of Ophthalmic Executives.