Article Date: 7/1/2006

fix this practice
How Do You Define "Strange?"
Even unconscious, unusual behavior sends a message to your patients.
RICHARD S. KATTOUF, O.D., D.O.S.

Q: I am one of four O.D.s who own two large practices. Some of my partners' habits seem bizarre to me. What are normal and abnormal behavior patterns?

 ----Dr. J. L. Simon Via E-Mail

A: Interesting question! Working as a consultant for more than twenty years has awarded me the opportunity to work with many offices in all fifty states. Each time I think I have seen it all, a new bizarre behavior appears. As I was observing an optometric practice in the Midwest, I noticed one doctor enjoyed snacking between patients. The problem was when he walked into the next exam spewing small particles of food at the patient. This is way up on the bizarre scale. It reaches the level of unconscious. Behavioral patterns are learned. No staff member ever corrected the doctor. Patients are grossed out but silent — they simply do not return. His physical plant (office) was run down and a "throw back" to the 1950s. Most patients will not tolerate such crude and rude behavior. However, the majority of his patients were Medicaid. As his consultant, I made him aware of why he could not retain "private pay" or "insured" patients and had excessive staff turnover. (The staffing issues were partly due to his lack of personal awareness.)

Where does it come from?

My on-site management visits often include observing the doctor in consultation (closing) with the patient. Dr. Fry* had a habit of placing his hand in front of his mouth when he spoke to patients. It was difficult to hear him and annoying to the patient. Certainly I classify this as a bizarre behavior. Some of these issues are not as simple to solve as identifying the action and instructing the person to stop. Many times the client and I have to search for the root cause in order to correct it.

Here is one for the books: In a period of one month, on two different consultation visits, I observed a behavior I had never seen. Two O.D.s had developed a habit of calling patients who missed their appointments. It's entirely appropriate for an assistant to call a patient who is ten to fifteen minutes late but never the doctor! This action, on the part of the doctor, embarrassed the staff. They knew it was not proper and felt their employer did not trust them to do their job. Is there even a question as to whether a patient will return after such a call from her doctor?

Pet peeves

Other strange behavior patterns:

•   Doctors who eat between patients and fail to purge themselves of food odors

•   Doctors who workout at lunch and perspire profusely for thirty or forty minutes

•   Doctors who are seriously obese and wear undersized clothes

•   Doctors who are unkempt

•   Doctors who take personal phone calls in front of a patient.

Why it matters

Re-reading these bizarre behaviors, some seem almost fictional. But I have observed them all.

Optometry has its history in retail. As a profession, many times we are not perceived as "real doctors." There is no question that we need to be more aware and pay strict attention to detail to send the proper message to our patients.

*Names changed to protect the odd.

DR. KATTOUF IS PRESIDENT AND FOUNDER OF TWO MANAGEMENT AND CONSULTING COMPANIES. FOR INFORMATION, CALL (800) 745-EYES OR E-MAIL HIM AT ADVANCEDEYECARE@HOTMAIL.COM. THE INFORMATION IN THIS COLUMN IS BASED ON ACTUAL CONSULTING FILES.



Optometric Management, Issue: July 2006