Welcome to question of the day #297

Eyetools question of the day #297

I have recently opened my first community eye care practice. I want my patients to tell people how good my practice is and I want them to come back for their next eye examination. Do you have any tips?

My short answer is to get good word-of-mouth publicity and get repeat business, making every patient feel special. It’s easy to say but harder to do.

What is often called ‘chairside manner’ is very important. ‘Chairside manner’ is how the eye specialist behaves when they sit by the side of the chair the patient is sitting in. This counts for a lot and can affect the chances of the person coming back to the practice for future eye examinations, and telling their family and friends what a good experience they have had.

Eye specialists often spend a lot of money to persuade people to come into the practice and surprisingly very little on what then happens in practice. What happens in practice is key to developing a successful and prosperous practice. The business side is made or broken by repeat business and positive word-of-mouth advertising.

Sadly, in my experience, some eye specialists are lacking in the ability to make the patient feel special. Some people are attracted to the job of an eye specialist because it suits their natural character of quietness and shyness. They perceive the job as working single-handed in a small confined space and that is what appeals to them. What they don’t realise is that the nature of the job means that there will be someone else in the room with them; the patient. This can come as quite a shock to some novice eye specialists who often do not have the soft skills to cope in this environment. Those with little experience communicating with people from different walks of life don’t realise how complicated communication can be.

Here are the elements of communication by the eye specialist which I think are the most important.

Making polite conversation before and after the eye examination. Making polite conversation is becoming more uncommon in the world; conversation itself is rare enough. Social niceties are considered by some to be too trivial to bother with.

Be a patient listener. The absolutely worst thing an eye specialist can do at an examination is to monopolise the conversation. The focus has to be on the patient and what they have to say. Every patient believes what they have to say or express is important; maybe it is, maybe it isn’t but the patient has to be given the opportunity to speak and to finish speaking. Quietly listening to someone else is the highest form of flattery, and perhaps the greatest way to win long-term patients. It may be difficult to hold your tongue, but if you value the other person you will choose to say less and listen more.

 Never look bored. Easier said than done, especially if the patient is your 200th of the week. However, you may feel, appearing bored and disinterested in the other person is the quickest way to offend them. Be engaged and animated at what the other person is saying. At the very least, you may adjust your facial expressions to hint at prompts from the conversation, shock, surprise, humour, or disgust.

 Be neutral about politics, religion, and your liking or disliking of animals. Religion and politics are often two important parts of a patient’s life, and also the most controversial due to the closeness to which they are held. Don’t bring up these topics. Rarely does it benefit the relationship as a whole to be the one to initiate a discussion of such intimate topics. If these topics arise naturally allow the patient to present their thoughts without worrying about your own. You don’t need to agree with the other person; however, you should suspend judgment. If they have a different opinion there’s no reason you have to attack or agree with it. In polite conversation, these topics need not be brought up at all, especially not by you.

Don’t be tempted to describe conquest or intimate encounters even as banter with a person of your gender and age group.

Don’t initiate a conversation about your own troubles or difficulties. Never discuss an illness you have, unless some special concern is shown by the patient. If you have a bad cold, stay at home, if you have a light cold take medicine and blow your nose before greeting the patient. Don’t refer to your symptoms. If you have an aching back or stiff knees don’t mention them unless the patient asks and then make a very brief acknowledgment and move on.

 If the patient tells you of a personal loss then offer commiserations and leave it at that.

Never boast. Boasting is tacky and obnoxious, leading your audience to become bored and irritated at your belief in your own self-importance and success. Whenever in conversation, the eye specialist should not focus on sharing about themselves and their accomplishments. The emphasis should be on the patient.

 Never be untidy. Your appearance when speaking with someone denotes something of the respect you have for the place and people you are with. Your appearance is an instant indication of how you respect yourself and your surroundings, as such being a slob in public says more about who you are as a person than you may care to admit. A patient may be left with the impression if you can’t button your shirt correctly, how can they entrust you with their eye health? Being tidy and clean-cut is not a matter of vanity or fitting into societal social norms, it is a matter of respecting the people you are with and demonstrating it in how you choose to appear.

During the examination, I think it’s sensible to make a note at the top of the clinical records of such things as any exceptional weather at the time, of any parking troubles the patient mentions, or some personal loss, if the patient is going on holiday or coming back from holiday. You can then refer to these notes at the next examination and use them to remind you of the patient and also mention to them the patient. Some people will think that this is inauthentic and insincere. However, my point is that they are simply reminders to you about the previous examination and by mentioning them you can help the patient feel comfortable and relaxed.

Noticing and mentioning an upcoming or recent birthday (you have the date of birth on the record card) helps initiate early polite conversation, especially with children who are often surprised that you know when their birthday is.

Making polite conversation can be learned. See how other eye specialists and other practice staff talk with patients and copy the good ones. Go on a communications skills course, and/or buy a book, and/or look online for tips. Try, learn and improve.

Each interaction and conversation should be to make the other person feel at ease, to put the focus on them and their story, and to build rapport by caring about what they say and do. By making the patient feel special, they will trust you, have confidence in you, and feel relaxed. A relaxed patient helps lead to a good examination. A good examination is more likely to lead to a repeat patient and positive word-of-mouth promotion.