Article Date: 5/1/2007

Untitled Document

o.d. to o.d.

BY WALTER D. WEST, O.D., F.A.A.O.

Chief Optometric Editor

Does Your Prescribing Work?
We can be more effective in our recommendations when we communicate in terms that our patients understand.

Without a doubt, one of the most important responsibilities we have is the prescribing or recommending of professional services, medication, spectacles and contact lenses to our patients. I’m not sure that in many cases we do this recommending or prescribing in the best possible way.

The examination:
From patient to complaint Think about the way your patients’ examination visits go. The patient presents to your office and in the course of taking the history you and/ or your staff identify the patient’s “chief complaint.” Now, think about how many times you look at the patient’s record and, from the “chief complaint,” determine the course of diagnostic testing that’s appropriate.
In the minute you make your diagnosis, the patient is no longer the person who was having difficulty with his near vision, but rather an emerging presbyope. Or perhaps he is no longer the person who couldn’t wear his contact lenses for the whole day but rather, he is a person with dry eye.

From complaint to “doctor speak”
In each of these examples (and I could give you dozens more) we begin to see our patient as the diagnosis rather than a person who is experiencing difficulty due to the diagnosed condition. Because we now view our patient as the diagnosis, we begin to communicate in terms of her diagnosis rather than what she will experience as a result of our prescribed treatment.
The end result is that our language is more “doctor speak,” than “patient speak.” In many cases where we use doctor speak, the patient can’t or doesn’t make the connection between prescribed treatment and the problem they want solved.

Eliminate the disconnect by prescribing patient satisfaction
To eliminate this disconnect with the patient, I think it’s important to prescribe for the patient’s satisfaction “away from the chair.” So, instead of focusing your discussion on how you’re going to treat the patient’s presbyopia, focus on how you’re going to clear her near vision. And with the contact lens patient who can’t wear his lenses all day without irritation, communicate more about how you’re going to make his contact lenses more comfortable for longer periods of time.
Focusing on, and communicating relative to, what your patient is experiencing — in acknowledging her complaint as well as how their experience will change as a result of your recommendations — is very effectively delivered in the form of an “orienting statement.”
The technique of the orienting statement is very simply. It includes a review of what the patient is currently experiencing based on her “chief complaint” and a step-by-step account of the process through which you are going to guide the patient in an effort to lead her to the experience she desires.
In using these orienting statements, you and your staff are first creating patient expectation and then when you move the patient through the process as you described it to him or her, you are creating gratification that ultimately leads to patient satisfaction.

Prescribe away from the chair
Going forward, you can provide an enhanced patient experience by prescribing for what the patient needs away from the examination chair, rather than in it.



Optometric Management, Issue: May 2007