Power of Three

Improve patient communication by focusing your lens discussion

Much of what I learned about patient communication came from my pastor. On Sunday mornings, he always limited his sermons to just three points. He realized that, at best, people can only remember three things after they hear a presentation. When I do a case presentation to patients following an eye exam, I structure my recommendations similarly. While having the ability to choose between options improves the quality of our patients’ lives, too many choices can overwhelm them. Consumers become less and less satisfied as the number of choices expand. This is the place where less is more and distilling what you want to say to your patients down to three things helps communication.


I invite patients to learn about the pros and cons of my three recommendations and demonstrate these technologies with patient education tools, for example an illustration, diagram or animation. As an example, how can one illustrate the different lens options available to the presbyope who works on a computer most of the day? Here’s a three-step method that makes it simple for patients to understand:

  1. All-purpose progressives: I explain how the lens design has minimum intermediate zones.
  2. Enhanced single vision lenses: Low add power lenses offer the ability to see the computer and the desktop, but far vision is blurred.
  3. Computer progressives: These have enhanced intermediate zones with the ability to look up to distance and walk around.


The second thing I learned from my pastor about case presentations is what he calls “The What, So What and Now What.” The “What” describes the problem. The “So What” is why the patient ought to be concerned about it. The “Now What” is where to explain the patient’s options and what the O.D. is going to do.

This use of three steps at the end of an exam repeats back to the patient what brought him in, explains the relevant aspects of the problem and offers solutions. For example:

  • What: “You’ve said you’re doing a lot of computer work at your new job, and it’s giving you some problems.”
  • So What: “If you don’t address these problems, you’ll continue to have headaches, neck pain and eyestrain. This could affect your productivity and job performance.”
  • Now What: “Let’s explore some computer lens options that will make this easier for you.”


Patient communication is all about making the problem and its solution clear and concise. I’ve found that patients are most likely to remember things in threes, especially when you take the time to write it. OM