Doctor Patient Relations

5 Exam Room Conversations That Move You From 1 Patient to the Whole Family

By Jessica Goldman, OD

April 14, 2021

When a patient comes in for an exam, you have the opportunity to provide the best care and products possible. You also have the chance to bring in the patient’s whole family for care. Here are conversations that can help you do that.

Take a Minute or Two Just to Chat: How Are You Doing?
An eye exam has become a much-needed social interaction for many people during the ongoing pandemic. It’s a chance to finally have a conversation in-person. Especially for our geriatric patients,  a conversation with the eye doctor may be the only human contact they have had in a long time. Conversation is an organic connection to your patient’s life, and to their family as well. Engaging a patient in brief conversation about their life will bring to light all of the ways you can help them, and it will also likely bring up children, parents, siblings, and even friends, who also need your services.

Note Aloud the Patient’s Visual Acuity
The eyecare portion of the conversation can start by noting the patient’s visual acuity. Is your patient nearsighted or farsighted? Either way, odds are it runs in the family. Who else is wearing glasses?

If they are fairly myopic, I often ask about their children. I segue into progressive myopia prevention in children, and emerging trends in this field. Even people without kids find this information interesting, wondering how it could have helped them, had that treatment been available to them when they were young. Maybe they have cousins, friends with kids or grandchildren in the early stages of myopia. People generally like to help other people, especially by offering information about new technology and treatments they wish had been available to themselves.

Do You Wear Contact Lenses? What Is Your Wear & Care Regimen?
Does your patient wear contact lenses? Perhaps they are seeing you for a corneal condition and are unable to wear them during treatment. This leads to a discussion about appropriate contact lens hygiene, wear schedules and contact lens solution. Who else in the family wears contact lenses? Are they also following these guidelines? Perhaps they would benefit from daily disposable lenses, or maybe they need to be reminded of the best way to prevent eye infections and irritations while wearing contact lenses.

Tell the Patient What You Are Seeing During the Slit Lamp Examination
Progressing through to the slit lamp examination furthers your opportunities to make connections. Are cataracts beginning to form? UV protection can slow the progression and help prevent early formation for everyone in the family. Side note: If you’re going to bring up UV exposure, it would be pertinent to discuss blue light emission at this point as well! Especially now that we are on devices significantly more, especially students.

Educate on the Genetic Component of Some Eye Diseases
The conversation on preventing harm from blue light emitted by electronic devices easily leads to a conversation about macular degeneration. The prevalence of AMD is increasing every year. If you’re not seeing more of it, odds are good you’re missing it. All macular degeneration patients should be counseled on nutrition, UV protection and smoking cessation, certainly, but they should also be counseled on genetics. AMD is hereditary. When you diagnose it, you should automatically be discussing family members and talking about their risk as well. Family members should be screened and counseled about making appropriate preventative changes too.

The impact of genetics is also pertinent in talking about glaucoma. I counsel every patient I diagnose with glaucoma about genetics. I recommend they discuss their glaucoma diagnosis with all siblings and children, whose known risk just went up. They all need to be evaluated and monitored. It’s important to educate patients that glaucoma tends to be a symptom-free disease until fairly advanced.

Sharing this information with your patients doesn’t just kill the awkward silent moments when you’re charting; it creates value. It builds a medical-based platform from which patients trust you enough to ask questions, interact, and ultimately, refer their family and friends.

Jessica Goldman, OD, practices at Eye Physicians Medical/Surgical Center in Chula Vista, Calif. To contact her: goldmanx2@gmail.com

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