O.D. to O.D.


How better communication skills can help lead to happier, healthier patients

The in-office experience we provide our patients is what will ultimately determine our success. My study of the patient experience began in school with a lesson in communication: I found I could get to the heart of patients’ problems faster if I took the time to stop and lis-ten. In fact, the better I listened, the happier my patients were.


In a landmark 1984 study published in the Annals of Internal Medicine, authors Howard B. Beckman, M.D., and Richard Frankel, Ph.D., describe how physician behavior affects data collection during the patient’s opening statement (see ). The authors found:

  • The patient was given the opportunity to complete an opening statement of concerns in only 23% of the visits.
  • In 69% of visits, the physician interrupted the opening statement or directed questions toward a specific concern. During these 51 visits, only one patient was given the opportunity to complete an opening statement.

“The consequence of this controlled style is the premature interruption of patients, resulting in the potential loss of relevant information,” conclude the authors.

Fortunately, such in-office communication need not be time consuming. In his book, Risk Prevention in Ophthalmology, author Marvin Kraushar, M.D., cites a study that found active listening added only one minute to the total time for the patient visit. Active listening includes using statements such as “I can see why you are concerned. I am sorry to hear that. It must be very difficult for you.”


So, how can a doctor do a better job of communicating with patients? Here are eight lessons I have learned:

  1. Welcome your patient with a smile, introduction and handshake, always maintaining eye contact.
  2. Thank your patients for choosing your practice. Reassure them that you will do everything you can to meet their needs.
  3. Ask your patients why they are here today and what their goals are for their visit.
  4. Stop and make eye contact as your patient talks to you, so they know you are sincerely listening and that you care.
  5. Show concern (empathy) for patients, and take notes on paper, if possible, or write on a digital device, so they know you will remember.
  6. Ask questions to clarify the patients’ statements, then repeat a summary back to your patients when they are finished, asking them if you heard them correctly and if there is anything you missed.
  7. Explain your findings to patients, and address each of their initial concerns individually, as well as any additional findings.
  8. Thank your patient once again and explain your treatment plans, including when and why they should return and what to expect at the next visit.


“Achieving the triple aim of improving quality, lowering costs and enhancing the patient experience can only be done with a significantly altered and improved communication strategy,” state Emme Deland, M.B.A., Jonathan E. Gordon, M.B.A., and Robert E. Kelly, M.D., in the Columbia Medical Review article, “Let’s talk about improving communication in healthcare” ( ).

The study of the patient experience is ongoing and one for the entire team. As technology changes how we communicate, we will have to adapt to stay relevant. The joy of this is that your success will result in raving fans and in better outcomes for your patients. OM


Twitter: @OptoManagement

Facebook: @OptometricManagement