By Gina M. Wesley, OD, MS, FAAO 
Ensure a productive, beneficial patient visit that keeps traffic flowing in your office with the right pre-patient exam preparation.
With the heavy patient load that many optometrists carry, an important step in the patient exam process often is overlooked–the preparation that should occur prior to appointments. Familiarity with the patient’s medical history and the record of the patient’s past visits including past purchases and likes and dislikes with eyewear and contact lenses, makes a meaningful exam more likely. It also increases the potential for purchases in the optical shop by giving the doctor and staff the background information they need to better direct patients to the products that will best suit them. Outlined here is how my office prepares before the patient ever arrives to ensure their visit exceeds their expectations.
With effective patient prep and the addition of many private-pay pre-test options for preventative eyecare, we have seen our per-patient revenue go up about $50 on average per patient over the last three years, which puts us well above the $500 mark in per-patient revenue. A more efficient exam leaves added time for the traditional last step: selecting eyewear in the optical shop.
Prep Starts When Appointment Made
Prep starts with the staff member scheduling the appointment by gathering any pertinent notes about reason for visit, any concerns the patient has and products they are using. We then gather medical and vision insurance information and ask if they have any family members they need to schedule as well. If the appointment is for an established patient, we are updating any demographic and insurance information. Then, when I review the patient information the day before or the day of the exam, I’m looking at their past exam(s) and noting what drops I will use to dilate their eyes, what preventative tests I would recommend (like screening retinal pictures or nutritional counseling), and what products they’ve purchased and what I’ve recommended. I will also make notes about the contact lenses they are wearing, along with what I may suggest they try, so my staff can be prepared for pricing.
Doctor Just Needs to Take Additional Few Minutes
If the patient is new, it’s fairly simple because we don’t have much history other than what they’ve reported, so I only need a minute or so to state my intentions for myself and my staff during the exam. If the patient is established, then it may take me a minute or two per patient to really hone down what they need. By doing so ahead of time, my staff knows what tests to run, saving us all time and energy and making our office flow more efficient.
Know Details of the Patient’s Past Eyewear Purchase
I think it’s important to know the technology of the lenses in the eyewear the patient last purchased. Fashion choices come in a far second, simply because that’s style taste as opposed to the actual medical prescription. It’s also important to know what they DIDN’T purchase the last year, especially if it was prescribed or they had expressed a need. This then may be the year they will invest in that purchase, so you need to be prepared.
Don’t Prejudge Patient’s Ability to Purchase
We attempt to always show patients a range of price points and get a feel of where they need to be or want to be in terms of money spent. You can never pre-judge on past purchases. Again, I think we pay less attention to what frame they purchased than the lenses that are in the frame, as that is where the visual experience is coming from and their overall success.
Look at Notes Made in EHR About Past Complaints About Both Eyes and Product
We look at what has been attempted to improve the patient’s comfort and their experience overall. If the issue still hasn’t been remedied and we have other options, those are pursued as necessary. If all avenues have been tried, we then move to other options. For instance, if a patient has a contact lens that isn’t working, we explore all other lens types and/or solution changes that may assist. We then address any other anterior segment problems (such as dry eye) that could be contributing. We can then also prescribe the appropriate eyewear/sunwear that could help. As I tell patients, they have hired me to be their ocular consultant. It’s up to me to make prescriptions and recommendations that could help them, and there will also be areas where I will give them information, yet they need to make educated decisions themselves.
What Happens When We Remember Something the Patient Doesn’t?
Sometimes your records of past patient complaints will be better than the patient’s memory so that when you point out the patient’s past dissatisfaction with a lens they are now expressing interest in, they may not remember anything about it. I just try to be diplomatic and mention what has been tried per our records and/or what has been recorded per patient report. If they don’t agree or don’t remember, I’m happy to have them try that option again, but usually when mentioned to patients that it’s in their records, they concede that point. I don’t push it, but I also don’t want them wasting their time again on something that hasn’t worked in the past.
Do You Try to Get Patient’s to Accept What They Already Have Rejected?
In some cases, when I know that they will truly benefit from a newer product or design technology, I will still bring the product up and preface the conversation as, “I’m just going to review all your options now, and then help you make an educated decision about where you want to go from there.” People are sometimes ready to move forward, but are afraid to say so because they said no the year before. It only takes a moment to say, “Just wanted to check with you this year, although you said no last year, are you interested in contact lenses?”–or something of the sort. The worst they can do is say no, but at least you asked! I always follow a “no” statement like that with: “I’m glad to know, and it’s something I will just review with you again next year to make sure we are always on the same page.”
Take Steps to Prepare for Each Patient Visit
Review the patient’s needs including the eyeglasses, contact lenses and sunwear they are currently wearing, and what you’ve prescribed in the past (also means taking good notes at the previous exam).
Train your staff to mention relevant points before the patient sees the doctor about the patient’s products and what your office could change or update about those products that would make them better.
Use Information to Focus Exam Room Interaction. Talk again about the products and services that your staff has already introduced the patient to. This plants the seed, so by the time the doctor is in the exam room, the patient may be ready to go. No sale is easier than the one that’s already made!
Related ROB Articles
Educate Patients to Promote the Value of Your Products and Services
Improve Communication in a Pediatric Eye Exam
Getting to Know You: Take Time to Get to Know Your Patients
Gina M. Wesley, OD, MS, FAAO, is the owner of Complete Eye Care of Medina in Medina, Minn. To contact her: drwesley@cecofmedina.com.
