One of the most difficult things we must do in our practices every day is simply communicating with our patients. It is the foundation of the care that we swore an oath to provide. We come into our practices with our own expectations, strengths, weaknesses, biases, and hopes. Our patients do the same. We enter with different cultural mores and different connotations for the same words. Through these filters, we must determine what our patients need from us and then act to foster a solution.

How we frame questions is one of the most important aspects of communicating with our patients. Our inquiries must use words that our patients understand. We must ask questions that disarm objections and fears. In past columns, I have described how our patients are often reluctant to admit that they are experiencing lens discomfort and decreased tolerance. Why is that?

The Heart of the Problem

Our patients value their lenses and want to keep them despite the cost and necessary upkeep. They value them because their lenses provide the functional normalcy our patients desire. But, our patients worry that if we discover that they are not as successful as we want them to be, we might take their lenses away.

Therefore, we must ask questions in such a way to let patients know that it is OK to discuss problems. Instead of asking whether they are having any problems with their contact lenses, ask how many times per week they have dryness, redness, or end-of-day discomfort. Mentioning problems upfront tells patients that we know the problems may exist and that it is OK to talk about them.

Convey that you and your patients are in it together to solve any problems they might have. Tell your patients that solving their problems is our goal. You would think that our patients already understand this concept. However, as their reluctance to confess their difficulties implies, they generally do not.

Get Your Ducks in a Row

Lay the groundwork for this conversation with staff education. Scripting questions is a good place to start. Thinking through questions beforehand helps us to envision follow-up questions that really get to the heart of the matter. When we have scripts that formalize the primary and the follow-up questions, we also ensure that we don’t miss an important inquiry.

We have to remember that in our busy day, we cannot short cut any patient’s care. Even with a flood of pre-authorizations and a staggering number of new lenses from which to choose, we must still create the illusion for the patients in front of us that they are the only patient about whom we have to worry. However, it is becoming more difficult for us to do just that. Whether we are behind or simply turning away from our patients to check a box in their electronic health record, we endanger our ability to do the very thing that each of our patients need.

There is no more important diagnostic test that we can run than the case history. As we turn our focus to the Physician Quality Reporting System, Merit-based Incentive Payment System, Health Insurance Portability and Accountability Act of 1996, Fairness to Contact Lens Consumers Act, Yelp reviews, and any number of other distractions, we often fail to do the very thing we most need to do. We have to set up processes in our offices that protect this sacred covenant between us and our patients. When was the last time you sat down to contemplate these questions? CLS