Article Date: 6/1/2005

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If You Don't Know All the Answers ...

... then let your willingness to learn become a powerful tool in your office.

I don't know," are three very powerful words that can actually instill confidence in patients when they ask you a clinical question you don't know the answer to. When followed up with, "I will do some research and get back to you" or "I'll refer you to Dr. Jones who is a specialist in this area," patients will respect your honesty and candor for admitting the obvious — that we don't have all the answers. Rather than guessing or pretending to know the answers, which is readily obvious to a patient, it is better to acknowledge your limitations and do what's best for the patient. This seems straightforward. It's the way most of us handle these clinical encounters.

However, consider these questions from staff members.

"Dr. Allknowing, Flag Day falls on a Sunday this year and I was wondering if I'll be paid for that on the following Monday?"

Or perhaps, "Dr. Knowitall, why don't we give patients a credit towards their flat-top bifocals if they haven't adapted to their progressives?"

Don't fake it

If the answers to these questions aren't readily available, just as in dealing with patients, it would be best to not guess or fake an answer. For the first question, you might say, "Let's go look that one up in our office policy manual so I can explain it to you." For the second, if the policy was never well thought out or perhaps needs updating, then you should reply, "You know, we should revisit that policy during our next staff meeting and have a deeper discussion about why we do things that way."

Why is this so important? Because showing staff that you are fallible, human and quite capable of making mistakes allows them to do the same without fear of retaliation or retribution. Fostering an office culture of respect and trust often starts by showing subordinates (staff in this case) that the boss is indeed imperfect and doesn't have all the answers all the time . . . and is willing to learn them and adapt to change.

I continually hear from doctors, "Gary, because my staff is on the front lines with patients all day long, I know they are a great source of new ideas to improve the service we provide. I'm frustrated because I'm always asking for their input but they never speak up!"

Invariably, the staffs in these offices tell our consultants (but never the doctor directly) that they are afraid to speak up for fear their ideas will be met with "That will never work here" or perhaps worse, "Great idea" — one that is never implemented.

This same culture is invaluable when delivering bad news. Consider a staff member who needs to tell you that because of continual errors made by your eyeglass lab, a patient just stormed out to the office while you were in the exam room with another patient.

A tale of two offices

In an office with poor trust and an unreceptive doctor, the staff member might say, "Mrs. Jones left because her glasses weren't ready. It was her fault. I told her they wouldn't be ready today."

In an office with a doctor who has fostered a culture that invites the airing of complaints, the staff member would say, without fear of being punished, "We really blew it. I'm sorry. We didn't have her glasses ready when we promised we would. To avoid this in the future, we'll be changing the way we notify patients."

It is crucial to note that in this second explanation, when allowed and encouraged to do so, that not only has the staff member owned up to the mistake, but she has volunteered a solution.


Optometric Management, Issue: June 2005