contact lens practice pearls

Presenting Your Treatment Plan

BY THOMAS G. QUINN, OD, MS, FAAO

It is our job to recommend the best advice to patients to pursue a treatment plan that meets their needs. Unfortunately, it's estimated that only 50 percent of patients suffering from chronic diseases in developed countries follow treatment recommendations. Here are some strategies to improve effectiveness.

Understand Your Role

In today's healthcare environment, the doctor serves less as an authoritative parent figure and more as a knowledgeable coach. This is particularly true when caring for younger, healthier, well-educated patients who want control in their health care. To influence patients' decisionmaking, it's essential to develop trust.

Trust is largely earned on an emotional level. Think of your favorite aunt or uncle. Undoubtedly they asked questions and listened to your answers. They responded in language you understood. In short, they shared their attention and respect.

Embedded in a relationship of trust is mutual respect. The great thing about respect is you earn it when you share it. Show your respect by actively listening to patient concerns. Why are they here today? What feelings of concern are they expressing?

Listening provides insight into understanding a problem from the patient perspective. How concerned is he about late day discomfort with contact lens wear? Sometimes the concern may not be as great as it should be. Knowing this helps you approach the problem properly.

Presenting Your Case

Focus all your attention on the patient and state your understanding of the need. Use the patient's own words, such as "I know you're experiencing discomfort with lens wear, especially later in the day."

Pause to give patients a chance to agree or disagree. Some may play down the symptom, others may add concerns such as "and my vision gets filmy." This will clarify the issues and ensure you're on the same page.

Explain it simply. "Your contact lenses are coated. This has caused the underside of your upper eyelid to become irritated from blinking over the dirty surface."

Then say, "I recommend…" Don't use phrases such as, "You could do this…" It dilutes the strength of the recommendation and undermines the respect and trust you've worked so hard to develop with the patient.

Describe features that provide benefits that meet patient needs. For example: "I recommend that we refit you with a daily disposable lens. You wear a lens for a day, then throw it away. This allows you to place a fresh new lens on the eye each day (feature). It prevents your eyelid from getting irritated (benefit), allowing you to wear lenses comfortably and with clear vision (meeting the needs).

Give patients the opportunity to respond to your recommendation. You can prompt them by asking, "How do you feel this new plan will work for you?"

They may express concerns, some of which may be based on misconceptions, giving you an opportunity to clarify ("These lenses cost only 31 cents more per day, and you won't need to buy lens solution, which offers convenience as well as cost savings.").

Despite your efforts, some patients won't want to follow your recommendations. Be willing to compromise. For example, in the case of a patient who habitually wears a two-week replacement lens for two months, refitting him with a one-month lens instead of a daily disposable may be an acceptable compromise.

Everyone's Happy

A mutually agreed upon and easily understood treatment plan that delivers patient satisfaction promotes patient loyalty and professional satisfaction. Everybody wins! CLS

To obtain references for this article, please visit http://www.clspectrum.com/references.asp and click on document #156.

Dr. Quinn is in group practice in Athens, Ohio. He is a diplomate of the Cornea and Contact Lens Section of the American Academy of Optometry, an advisor to the GP Lens Institute and an area manager for Vision Source.