Contact Lens Practice Pearls

Reinforcing Your Treatment Plan

contact lens practice pearls

Reinforcing Your Treatment Plan


In my November 2008 column, I outlined an approach to take when presenting a treatment plan to a patient. This month's column describes some reinforcement strategies.

Language Arts

Up to 53 percent of patients admit to not understanding what their doctor has told them. Studies suggest the number is actually higher — up to 89 percent — because patients believe they understand when they don't.

Simplicity is the solution. Minimize the number of recommendations presented at one time and use common words. Even though you may feel proud of your mastery of technical jargon, using it reduces the effectiveness of your message.

Use "feeling" words that help patients know you care about their well-being. For example, during the case history ask, "What are you hoping I will be able to do for you today?" This questioning communicates empathy, which improves patient adherence to your treatment plan. It will also provide you with a clearer understanding of what patients want from you.

Put it in Writing

Written information provides patients with the opportunity to study your recommendations after the office visit in a more relaxed, familiar environment.

Informational handouts that explain disease conditions in greater detail than you're able to delve into during the office visit can help give patients better perspective on their condition. As a general rule, an informed patient is a more compliant patient.

Instructional handouts also can help ensure that patients follow directions correctly. With the online version of this article at, I've posted an example of a Medication Sheet that itemizes a tapering schedule for a steroid drop prescribed for a patient.

Offer Tips

You treat and prescribe medications every day. But for some patients, it's very unfamiliar territory. Utilize your experience and share the practical tips you've learned from other patients.

For example, rather than simply telling patients to instill a drop four times a day, link the activity to something familiar. Ask them to instill the drop at breakfast, lunch, dinner and bedtime. This strategy not only helps them remember, it guarantees the instillations will be adequately distributed throughout the day.

For monthly lens wearers, link lens replacement to the calendar with, "New month, new lenses." For wearers of two-week lenses who are forgetful, it may be helpful advising them to replace the lenses on the first and the 15th of the month.

Perform a Follow-up Visit

Any time you treat a condition, perform a follow-up visit. Not only does this provide quality service and give you a chance to monitor progress, it demonstrates concern on your part.

At the follow-up visit, ask open-ended questions such as, "How's the treatment plan working for you?" This approach lets patients take the discussion in the direction that will best address their concerns.

Open-ended questions also prevent you from biasing patient response. For example, you're likely to get a more valid answer if you ask a lens wearer, "How are you caring for your lenses?" rather than, "Do you remove and clean your lenses nightly?"

A Simple Strategy for Success

Offer a simple treatment plan that works for patients and their life situations and is supported by ideas like those expressed above, and you'll be well on your way in guiding patients to successful treatment outcomes. CLS

To obtain references for this article, please visit and click on document #158.

Dr. Quinn is in group practice in Athens, Ohio. He is a diplomate of the Cornea and Contact Lens Section of the American Academy of Optometry, an advisor to the GP Lens Institute and an area manager for Vision Source. He has served as an advisor or consultant to Coopervision, CIBA Vision and Vistakon and has received research funding from AMO, B&L, CIBA Vision, Coopervision and Vistakon.