Article Date: 9/1/2001

Say What?
Listening to a patient's chief complaint can keep you out of hot water.
By Jack Runniger, O.D.

"This is a 'must read' story that will really touch your heart," a physician friend e-mailed me.

A young family lived in a house next to a vacant lot. One day a construction crew turned up to start building a house on it. The young family's 6-year-old daughter started hanging out with the workers. The construction crew -- gems in the rough -- adopted her as a project mascot. They let her join them for lunch breaks, and gave her little jobs to make her feel important.

At the end of the week, they presented her with a pay envelope containing a dollar. The girl excitedly took the dollar home to her mom, who suggested they go to the bank and open a savings account.

"Where did you get the dollar?" asked the teller at the bank.

"I've been working with some men building a house all week," she proudly replied.

"Will you be working on the house again this week?" he asked.

"I will if the lumber yard brings us the %&#? wood," she replied.



The opposite

Obviously, the 6-year-old girl listened too well. On the other hand, I had to learn the hard way in the early days of my practice that I often didn't listen to patients sufficiently well.

"I still remember a column you wrote years ago about listening to patients," an outstanding Florida optometrist recently told me. "It taught me a valuable lesson that has helped me in practice."

The column was about a Mr. Len Zopacity (not his real name), an 82-year-old man who came to me for examination when I was first in practice many moons ago.

The patient was developing cataracts, and the resultant crystalline lens swelling had caused a reduction in his hyperopia. By decreasing the plus power by about a diopter, I improved his distance visual acuity from 20/80 to 20/40.

Young and innocent as I was, I delighted in having helped Mr. Zopacity better his vision. I looked forward to the appreciation and thanks he was certain to shower upon me -- until a week following dispensing when I received a letter from him that read:

I can't read a bit better with these new glasses than I could with the old ones. You sold me a pair of glasses I didn't need! You are a dishonest crook who should be run out of practice.

What went wrong?

When I went back to his records and reread what I'd written as the chief complaint, it was there in black and white: "I can't see to read as well as I used to." But I hadn't really listened to him.

It's the same thing as if you went to your physician because you were suffering from diarrhea, and the doctor discovered you also had sinusitis. You'd agree with him that the sinusitis needed treating, but you'd be a mite unhappy with him if you discovered that he'd prescribed a medica- tion only to treat the sinusitis, and that he'd completely ignored your primary reason for seeking medical care.

Gone deaf

An elderly gentleman was driving down the highway, when he was stopped by a state patrolman.

"I wasn't speeding," he proclaimed.

"I know," said the trooper. "I just stopped you to tell you that your wife fell out of the back seat of your car 20 miles back."

"Thank God!" said the old gentleman. "I thought I'd gone deaf!"

No matter how busy you are, make sure that you don't go mentally deaf when you're listening to your patients. Ensure that you're aware of their primary reason for being in your chair.

That's the lesson I learned from Mr. Zopacity.


Optometric Management, Issue: September 2001