Article Date: 6/1/2013

Execute Meaningful Handoffs
vision care

Execute Meaningful Handoffs

How to seamlessly transfer the patient’s care to your staff


In our profession, now more than ever, we wear two hats: optical and medical eyecare practitioners. Both areas have constantly increased in complexity. There are more options for spectacles as well as for contact lenses, and increased scope of practice treating glaucoma and other medical conditions require more return tests and visits. Add the fact that reimbursements are declining, and it is essential that we utilize our support staff to see more patients and remain profitable. Delegation is critical, which requires personal handoffs.

Here, I discuss two of the most common handoff scenarios and how to seamlessly transfer care to staff.

Handing off to assistants

One handoff is to an assistant for scheduling future medical and contact lens exams or referring to other healthcare practices.

A good example in my office would be a patient who needs cataract surgery. After discussing the diagnosis, I explain to the patient that we will schedule her appointment for a consultation. Using our intraoffice communication system, I signal for an assistant. Once the assistant is in the room, I say, “Mrs. Smith, we talked about your change in vision due to a beginning cataract, which is natural and normal but does affect your vision and your safety when driving. I recommend a consultation with Dr. Jones, and I’d like my assistant, Krista, to set up an appointment.” This reaffirms the information for the patient and allows the assistant to understand the patient’s status.


Having your assistants and opticians sit in your chair and use the same computer you’ve used during the examination helps elevate the patient’s perception of the staff member during a handoff.

Another example of an assistant handoff is a contact lens patient who would benefit from a contact lens refit. After finishing the refraction and medical testing, an assistant is similarly called to set up the appropriate appointments.

Actions speak louder than words, and this is also true with handoffs. Ask your assistant to sit in your chair, and use the same computer that you’ve been using during the examination. This transfer of power helps elevate the patient’s perception of the staff member, as I have put the assistant in the “driver’s seat.” This shows the patient that I trust the assistant to take care of him/her.

Another way to establish patient trust is to create a personal connection. For instance, if a patient tells me during the exam that he/she is scheduled to run in a half marathon next month and I know my assistant is an avid runner, I mention this during the introduction. Every staff member is part of my office “family,” and this helps patients to feel like they are part of this family as well. (However, try not to dwell on “small talk,” as it’s important to complete these handoffs and move to the next patient.)

While maintaining eye contact, shake the patient’s hand, make any final connections to the patient’s hobbies (for example: “Good luck with your half marathon”), and allow the assistant to finish by scheduling the patient’s appointment. This handoff allows you to feel comfortable moving on to another patient, and the patient also feels comfortable with the assistant, which is just as important.

Handing off to opticians

Oftentimes, an optician handoff would follow the assistant handoff, and I consider handoffs to opticians the root of optometry. Although many O.D.s don’t want to think of themselves as salesmen, optical sales drive a majority of our revenue in most practices, making this handoff particularly important.

Set the stage for this handoff during the examination. For example, with a presbyopic patient after the refraction, I present a handout that details his/her options. Then, I explain, “Mr. Smith, I recommend progressive lenses, which allow you to have excellent distance vision as well as intermediate and reading vision. Progressive lens technology now is better than ever.” I also go on to recommend progressive sunglasses, as well as anti-glare on the lenses and often a third pair of indoor progressives or single-vision readers. The patient then can mull the optical options during the medical eye examination, which I perform after the refraction.

When the exam is complete, an optician enters the room. Introduce the patient to the optician, and, as with the previous example, make any possible personal connections. As before, the doctor moves to a neighboring chair. Have the optician sit and view the final refraction in the EHR system along with the patient. (The handoff is more relaxed if the doctor sits in an adjacent chair rather than stands.)

Review each and every spectacle prescription, often relating the need for each prescription based on personal lifestyle. For example, “Bobbi, this is Elizabeth, our optical expert, who will help you with frames and lenses. Bobbi is preparing for a trip to Disneyland, so I recommend polarized prescription progressive sunglasses. We’re also updating her everyday progressives in addition to a first pair of indoor progressives for work. All three pairs should have anti-glare treatment.”

Having transferred trust and authority to the optician, you are now ready for your next patient. Opticians linger a little longer in the privacy of the exam room to review insurance and lens details before entering the eyewear gallery. There, the optician can refer to the doctor’s recommendations during frame and lens selection: “Let’s start with the progressive sunglasses that Dr. Azevedo recommended.”

A careful process

Handoffs allow for successful delegation and transfer of care to staff, allowing you to move to the next patient with confidence. It can be a challenge, but when you slow down and communicate as a team, everyone wins. OM


Dr. Azevedo practices at A to Z Eyecare in Arcata, Calif. E-mail him at, or send comments to optomet

Optometric Management, Volume: 48 , Issue: June 2013, page(s): 72