Optometric Management Tip # 565   -   Wednesday, January 09, 2013
Communicating with Patients: What is a Totalnee?

I learn so much by visiting offices of physicians. Usually it confirms what not to do. Today I happened to accompany someone to the office of an orthopedic specialist. We had to wait about 30 minutes, which actually is a rather short wait at an MD's office based on my experience. While waiting, I observed a technician escort a patient back to the exam area and it made me wonder if my staff might be guilty of what I felt was a problem. It could easily happen in any of our offices.

The technician was a female of about age 25. The patient was a male; around age 70. They were walking down a hallway which was really not wide enough for them to be side by side, so the technician was leading the way and she decided to start taking the case history, presumably to save time. The first problem was that she faced straight ahead as she walked, so it would be quite difficult for the patient to hear her clearly. It may not have helped that he was older. It also did not help that the patient could not walk as fast as the technician (it is an orthopedic office, after all). I heard the technician say: "So did you have a totalnee?" The patient said "I beg your pardon?" The tech responded without turning her head or making an effort to be any clearer: "Did you have a total knee or just a partial?" He said "I'm sorry, I don't understandů" I couldn't hear the rest but I'm sure they got it sorted out eventually.

How insensitive of that staff member. I'm sure the patient must have felt badly that he could not comply with her questions, but do we really expect him to know what a "totalnee" is? That is how it sounded, by the way. I am assuming that totalnee is ortho-slang for total knee replacement but if you leave off part of the term and don't speak clearly, few of us would follow it. I hoped my technicians do not say something to a patient like "Did you have your fields yet?" Say it fast enough and I'm quite sure most of my patients would have difficulty with the question. Some of our words are simply not in the patient's normal vocabulary. A caring staff member would take the time to ask the questions in a quiet environment, looking directly at the patient, using a clear tone of voice. One other idea: let's not ask technical questions that we could easily look up the answer to.

Food for thought
These are exactly the kinds of things I bring up at staff meetings. I believe we must constantly try to do better. Our staff needs to be continually reminded about how important it is to make the entire patient experience enjoyable. We must show patients that we care for them as people. We must not let the appointment schedule, the insurance paperwork, the medical record system, discounted fees or other frustrations of our jobs get in the way of our caring relationship. If you and your staff can do that on a regular basis, your practice will be wildly successful.

I recall a staff training retreat that was held by a local bank that wanted to teach excellence in customer service. They had role-play sessions where the tellers had to act as the bank customers. The bank wanted to make the younger tellers more sensitive to the older customers who often still come into the bank in person rather than using electronic and drive-up services. Each teller had to wear eyeglasses which had some Vaseline smeared on the lenses to simulate a customer with vision problems. They had to place cotton balls in their ears. They waited in line until it was there turn and they then had to carry out a transaction, such as write out a check and accept cash back. The bank president told me it was quite a good learning experience that really stayed with the employees.

Best wishes for continued success,

Neil B. Gailmard, OD, MBA, FAAO
Chief Optometric Editor, Optometric Management