Putting patients at ease in the exam room

August 25, 2014

Growing up in rural Illinois, there was really only one culture that I had interacted with: the farming/small town USA culture. So, when I got accepted to optometry school and began interacting with more cultural diversity than I had ever been accustomed to, I soon found I was struggling to find common ground with some of my patients.

Growing up in rural Illinois, there was really only one culture that I had interacted with: the farming/small town USA culture. So, when I got accepted to optometry school and began interacting with more cultural diversity than I had ever been accustomed to, I soon found I was struggling to find common ground with some of my patients. Many were low income; some were recent immigrants; some were leery of doctors; some were leery of male doctors; and some just were scared to go to the doctor simply because they always got bad news about their health. It dawned on me that I needed to improve my communication skills with people of different nationalities, cultural backgrounds, ethnicities, beliefs, careers, etc.

Build patient loyalty

I realize that most doctors may read this and think, “Why worry about that stuff? We don’t necessarily need to know all of this background to take care of our patients’ eyes.” I, however, would argue differently. Most of the populations I serve have trust concerns with white-collar people such as myself for a variety of reasons, which always left this gap in our interaction and communication. It was frustrating for me to explain over and over why a patient needed to use these drops I was giving him, only to find out later he didn’t care enough about himself to take the drops-or worse yet, I had failed to clearly explain to him why he needed to be on the drops in the first place. 

Finding common ground

For example, my optometry school and clinic was a stone’s throw away from the Chicago White Sox stadium. I knew that all of our patients were White Sox fans, but when the White Sox and Cubs would play each other, I would proudly don my Cubs tie and flaunt it in front of the patients. This was not a way to voice that my team was better (although I would claim the Cubs are the best team in Major League Baseball, despite their history of lackluster performances), it was a way to gently rib the patients and have a few seconds of friendly banter. I jokingly told them, “If you are a White Sox fan, then I’m going to have to find a different doctor for you to see because I can’t be in the same room as a Sox fan.” Of course, I said this with a smile on my face and with a lighthearted voice, but I was amazed at the improvement in the patients’ attitudes and cooperation. It was funny because after my 10 seconds of gently poking fun of the patient’s hometown team, you could literally see the patient relax and lean back in his chair. It was amazing how much more cooperative the patients were, how their compliance improved, and how much more they returned for follow-up care-simply because I was having some fun with them while also performing the same high-quality eye exam I always had.  

Some other things I commonly say to patients are:

• “I know being dilated is not fun, Mrs. Jones. But when I was in school, we had to practice on each other before seeing patients, and I was dilated a minimum of five days a week for a year. So, I understand your feelings toward dilation today, but believe me, I had it way worse.”

• “How is my student doctor treating you today, Mrs. Jones? Because her grade depends entirely on how you tell me she is doing.” This is usually followed by a very nervous smile from my student clinicians.

 

The importance of relationship building

Being on faculty at the Southern College of Optometry in Memphis, I strive to teach my students about this concept of relationship building and finding common ground with their patients. When in the exam room, I know what I’m saying really isn’t that funny to the outsider and may be perceived as weird, but when you are the patient in the chair, it works. I have other little quirky things I say at pretty much every patient encounter, and I’m sure my students think I’m a little nuts. But I’ve learned to read people better over the past several years by having a little fun in the exam room. I firmly believe the patients enjoy and respect that more than the doctor who has one foot out the door and gives the patient fewer than 20 seconds of face time. 

10 simple ways to keep patients happy

Professional friendships

Trust can build better patient communication, better compliance with treatment and follow-up times, further your bottom line, help you develop meaningful relationships with your patients, and best of all, it’s good for your soul. How many doctors can you name off the top of your head who are burned out on optometry and caring for patients? I think the number is higher than we want to admit. I find if I can bring a little sunshine and humor with my attitude into those dark lanes on a daily basis, I can care for my patients much better.

Some may argue that optometry is a business and that time is money. I would argue that nowadays patients typically are not loyal to one doctor, but they are loyal to their friends. If we can develop our relationships with our patients to professional friendships where we can interact, talk, and laugh with our patients, we will build a strong bond of loyalty with them.

My dad once said, “Chris, you have to work to make a living, but it’s OK to have fun at the same time, as long as the work continues to get done.” It is possible to rediscover the fun in optometry and eye care no matter what your age. Take an interest in your patients, whether it be sports, local happenings, an inside joke, or whatever. The discussion topic isn’t as important as the patient seeing you take off your doctor persona for 10 seconds to show him you are a regular dude who really wants to take great care of his eyes.

Being a young punk optometrist, as I commonly refer to myself, I’m not naïve enough to think I know everything this early in my career. But chairside manner can make or break doctors, and I’m determined to help my patients take better care of themselves and make The Eye Center at SCO even more of a place where patients want to come to get good care. My dad always said, “Your job as an employee and a man is to always leave something better than when you started with it.” I may not always be able to make peoples’ vision perfectly crystal clear, but I can always let them know I care. I hope my patients leave my exam room with at least the thought, “That Dr. Borgman might be a little odd, but I can’t deny he is doing what he thinks is best for me.”ODT