Article Date: 9/1/2013

Create a Diverse Practice

Create a Diverse Practice

Make your practice one that attracts all patients.


As eyecare professionals, we communicate with a diverse group of patients every day. So, it’s important for us to constantly be prepared to examine and adapt our current strategies to provide a better eyecare experience. (See “Diversity in Health Professions,” page 36.)

My practice, Clayton Eye Center, has been in the same Atlanta location for 35 years. However, we’ve undergone a transformation through the past decade in the diversity of both the patients we serve and staff we employ. As Atlanta’s demographic landscape continued (and continues) to shift, we began to attract more patients from various ethnic backgrounds, encountering language and cultural barriers.

Two out of three ethnic minorities agree the “best eyecare practices” include staff from a mix of races and ethnicities.

40% of Americans believe that an eyecare professional who is the same race or ethnicity will understand them better.

Source: Transitions Optical, Inc. 2013 Multicultural Survey

More than 8 out of 10 Hispanics and African Americans agree that a company that makes sincere efforts to be a part of their communities deserves their loyalty.

Source: Yankelovich MONITOR Multicultural Study 2010

Two out of three Americans believe it is a sign of respect for their own, or others’, culture when an eyecare professional shares eye health education in another language.

Source: Transitions Optical, Inc. 2013 Multicultural Survey

I worried that, as an English-speaking optometrist, my messages were not clear to patients who speak English as a second language, or not at all. Therefore, I knew that we needed to make changes to provide quality care. While these changes didn’t happen overnight, my staff now playfully refers to Clayton Eye Center as the “United Nations of eyecare practices.”

My practice has patients who speak many different languages. While some of this change has been a result of natural shifts in the population, much has been earned as a result of referrals and word-of-mouth communication.

For example, we’ve developed a healthy reputation with the large population of Korean-Americans in Atlanta. Our practice is roughly a 40-minute drive from the Korean section of Atlanta, and many other optometric practices are closer to this area than Clayton Eye Center. Still, our population of Korean-American patients continues to grow, because we have people on our staff who speak their language and understand their culture.

Here, I share the steps my practice has taken to meet the needs of our diverse patient base.

1. We hired staff who speak multiple languages.

My staff members represent all the subgroups we serve, as our staff overall speaks seven languages. This way, whether I’m conducting an exam or patients are choosing eyewear, someone is always available to clearly communicate with our patients.

For you to thrive in this environment as we have, it’s vital to take the time to determine who your patients are and who is living in your area to build a diverse practice. Conduct an informal survey to determine the languages spoken by a good portion of your patients.

Once you’ve done this, ask potential staff members what languages they speak during interviews or include a question in their job application. In addition, ask a few questions about their understanding of different cultures, as this familiarity can be just as important as knowing how to speak their language.

2. We educate staff on cultural diversity.

I recommend having ongoing staff training and discussions about various cultures of the communities around us. This is especially important for staff members who don’t speak the particular language and are not familiar with the culture as there are times they will have to interact with these patients.


The staff at Clayton Eye Center in Atlanta, including the technicians and optical department, playfully refer to themselves as the “United Nations of eyecare practices.”

3. We utilized bilingual materials.

Even English-speaking patients appreciate the availability of materials in another language — whether it’s for themselves or other family members. These tools should be made available in all areas of the office — from the reception room, to the exam room, to the dispensary.

One of the pieces my staff and I have found helpful in recent years is the What to Expect: Diagnosis Guide from Transitions Optical, which I helped develop a couple years ago. The guide includes side-by-side English and Spanish explanations of common conditions and diseases. We have placed the guide in each of our 14 examination rooms and use it as a supplement when diagnosing a patient.

For example, when I’m talking about diabetes, I point to pictures and different stages of diabetic retinopathy, and my Spanish patients read about the disease in both English and Spanish. Individual guides on specific diseases can also be photocopied and sent home with patients as educational brochures.

Handing patients a brochure in the language they feel most comfortable communicating is a simple way to help ensure they have the information they need to take care of their eyes (or their family’s eyes) between appointments.

Be sure to have an interpreter in the exam room as well when a patient does not speak English well. This helps to avoid confusion and further increase patient understanding, compliance to your directions and satisfaction.

Diversity in Health Professions

Zack Tertel, assistant editor

Workforce diversity in health professions increases access to care for underserved populations and leads to improved public health, according to “The Rationale for Diversity in the Health Professions: A Review of the Evidence,” a study conducted by the U.S. Department of Health and Human Services (

The study showed that, as similar race, ethnicity and language lead to better communication, these factors positively impact patient-practitioner relationships and the likelihood the patients will receive and accept appropriate care.

Specifically, the study found that patients from underrepresented minority groups, including African Americans, Mexican Americans, Native Americans and mainland Puerto Ricans, tend to receive better interpersonal care from practitioners of their own race or ethnicity. In addition, non-English speaking patients who see a practitioner who speaks their language experience better interpersonal care, have greater medical comprehension and are more likely to keep their follow-up appointments.

A diverse practice

Building a multilingual, multi-culturally diverse staff is not only helpful from a business perspective but also very enriching from a personal perspective. Making the efforts listed above will lead to a multitude of benefits for you and your staff. OM

For more information, visit

images Dr. Smick is a lecturer in the U.S. and abroad and currently serves as chairman of continuing education for the International Vision Expo meetings. He is a member of Transitions Optical’s Diversity Advisory Board, is a fellow of the American Academy of Optometry, and is also past president of the Georgia Optometric Association, the Georgia State Board of Examiners in Optometry and the Southern Council of Optometrists. He is a former recipient of the “Optometrist of the Year” award for the state of Georgia. E-mail Dr. Smick at claytoneye@aol. com, or send comments to optomet

Optometric Management, Volume: 48 , Issue: September 2013, page(s): 34 - 36