Article Date: 5/1/2004

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When You're Talking the Talk
Don't turn patients off by droning on. Here's how best to talk to them.
By Gary Gerber, O.D.

 Unquestionably, the way we talk -- or don't talk -- to our patients is by far the single most important factor impacting the level of success of our practices. Regardless of where you practice, your mode of practice, or your patient demographic make up, what you say to a patient and how you say it is at the core of your practice's eventual success or failure.

Say what?

How then can we hone this critical communication skill? We could start with something as simple as concluding a case presentation by asking a patient, "Do you have questions?" However, many patients might be embarrassed to say "Yes," feeling that if they do, you might question their capacity to interpret what you've just told them.

Additionally you can try, "Did I explain everything okay to you?" This helps shift some of the "blame" for them not understanding your explanation. Following are several other ways to phrase your closing comments with patients; however, I believe that you can have the most impact if you analyze your presentation to patients from the beginning, through the middle, to the end.


Lights, camera, action!

I've videotaped hundreds of hours of doctor-patient encounters. Both parties know the camera's on, but within seconds, they forget and loosen up. As a consultant, I've scrutinized these tapes to find ways for our clients to improve their case presentation skills. The interpretation of each encounter is different, but we can make generalizations.

Too much of a good thing?

Patients generally start to tune out our explanations when we get too technical or too long. Thirty to 40 seconds appears to be the limit of what patients are willing to listen to. Of course, exceptions always exist . . . . Also, we've found little correlation in this time frame with the seriousness of the condition being explained. For example, after about 30 seconds, patients enter "the zone" whether you're explaining glaucoma or hyperopia.

Get to the point

Patients tell us on surveys and the videotapes verify that they have a strong desire for us to address their chief complaint -- and not much else. While it's nice to tell a 29-year-old who has excellent ocular health all of the things he doesn't have wrong with him, don't forget to tell him why he gets headaches when he uses his computer.

Tell them what to do

Perhaps the largest omission we've seen repeatedly in analyzing our tapes is that doctors have a strong aversion toward telling patients what to do. They'll carefully, consistently and accurately lay out their clinical findings, yet they're routinely reticent to "close the case" by telling patients how they should proceed based on those findings.

Film your own videos and see if you find any of the common occurrences listed above -- namely, over-explaining and losing the patient's interest, not addressing the chief complaint or failure to bring your presentation to a credible close. If so, then tape yourself again -- this time without the patient -- and work on any of the shortcomings you find. More than any other pieces of practice-building technology or software, the words you speak have a huge impact on your practice's health. Recognize how profound this impact is and start taping and practicing today!

Dr. Gerber is the president of the Power Practice, a company specializing in making optometrists more profitable.  Learn more at or call Dr. Gerber at (800) 867-9303.


Optometric Management, Issue: May 2004