Article Date: 3/1/2005

Taking Cues From Your Patients
Want to really understand your patients and make sure they understand you? Answer these four questions to uncover their communication styles.
By Ann M. Hoscheit, O.D., Gastonia, N.C.

You're probably quite proficient at categorizing various ocular conditions -- severe dry eye vs. mild dry eye, emerging presbyopia vs. advanced presbyopia -- to prescribe the appropriate treatment. But can you decode your patients' communication styles to ensure their understanding?

Learning how patients prefer to receive information and communicating accordingly can ensure their compliance and also cement a long-term relationship.

Patients tell you how to talk to them. They tell you how much information they want and which delivery style works best. They also tell you when your approach is working and when it isn't. You just have to listen -- and watch -- for the cues. Ask yourself these four questions:

Watch for cues about a patient's communication preferences.


Does your patient "think out loud"? Or does she listen, nod and follow up with questions and concerns?

The patient who thinks out loud processes information verbally. She needs time to sit with you and talk through your diagnosis and treatment plan. The second patient wants time to digest the plan you've explained. She'll be happy to wait and think quietly for a few minutes while you finish your chart notes, before asking questions. Better yet, she'd like an opportunity to reach you later, after she's read the brochures you've given her and done some research on the Internet. She may send you an e-mail or call you with some carefully considered questions.

Both scenarios work well, and you'll find some patients process information both ways to some extent. By knowing your patient and taking the most appropriate path for that individual, you can ensure the information you're trying to get across hits the mark, and the patient feels comfortable and confident.

Does your patient "think out loud"? Or does she listen, nodding her head, and then follow up with questions and concerns?


You may think I'm referring to engineers here, and in a way, I am. Actually, half the population likes to receive detailed information. These patients usually want hard numbers, some history or prior experience to back up what you're telling them. For example, you might say, "Patients who are fit in multifocal contact lenses do extremely well; however, on average, they use their spectacle prescriptions 16% of the time." These patients also may want to hear why you chose multifocal lenses over other options, as well as what problems they may have with the lenses.

On the other hand, patients in the "big picture" group may be satisfied to hear, "With these multifocal contact lenses, you'll be able to see most things most of the time." For them, this is enough information. These patients prefer that you do the complex thinking and make a decision in their best interests.

Whether a patient is detail-oriented or prefers a general overview often is just personal preference. Another factor, however, is a patient's confidence in you. Someone who's been coming to you for years is more likely to trust your decision without needing to hear how you made it.


Often, a patient's emotions hamper decision-making. For example, when you're fitting a teenager with contact lenses and Mom is in the room, watch for her cues. Her daughter might ask, "Mom, can I get my contact lenses in a color?" Pay attention to Mom's reaction. She may be worried about the cost but reluctant to disappoint her daughter, risk an argument or appear "cheap" to you. Tuning in to her cues, and quickly, can save the day.

You might reply, "Yes, these contact lenses are available in colors, but I'd like to speak with your mother about whether this is the best option for you right now." Mom now has time to gather more information, determine if the lenses fit her budget and face her child with an answer from both of you.


Here's a patient you may recognize. You're fitting him with contact lenses, and he seems to think a weekly visit to your practice for weeks on end of "fine-tuning" will garner the same rewards as frequent flyer points. He's probably the same patient who arrives late for his appointments and is oblivious to the time he spends with you or your staff. These folks aren't rude or intending to test your patience. Quite simply, until you bring the process to a close, it will go on and on.

Another breed of patient expects closure at every visit. Often, this is the patient who arrives for his appointment exactly on time (or early) and deems you behind schedule if he's not ushered into your exam room immediately. These are the patients who need to know that fitting a specialty contact lens takes several visits or that a diagnosis of glaucoma is the beginning of a long-term relationship.

Regardless of patient type, it's important to establish how the patient's interactions with you and your staff will proceed. If you don't explain the process -- when the patient should return, how many visits will be needed and who can answer questions along the line -- you could end up with inconvenienced and annoyed patients, staff or both.


I realize this is a lot to think about every time you talk to patients. But your conscious efforts to learn your patients' preferred communication methods will soon become second nature. The payoff will be stronger bonds with your patients who appreciate your extra attention to their needs.

Dr. Hoscheit practices at Summit Eye Associates in Gastonia, N.C. She's a graduate of the University of Houston College of Optometry.



Optometric Management, Issue: March 2005