Doctor Patient Relations

Prescribing Change: 7 Ways to Enact Positive Change in Patients

By Steve Vargo, OD

Sept. 2, 2020

Part one of two-part series

In my new book, “Prescribing Change: How to Make Connections, Influence Decisions and Get Patients to Buy into Change,” I focus on enhancing patient outcomes by getting patients to not just hear the information that doctors provide, but act on it. Information alone can be surprisingly ineffective in getting patients to “change” in ways that benefit their vision, health and quality of life. If you want to truly make an impact with the patients you serve, something has to change!

In the book I use the acronym C.O.N.N.E.C.T. to describe an approach to clinical care that drives improved compliance, enhanced outcomes and greater financial success.
Curiosity is Caring
Ouch! Where Does it Hurt?
No Involvement. No Improvement.
No Time Like Showtime
Earn Trust
Conquer Objections
Tell Me What to Do

Curiosity is Caring
A friend once told me about a recent eye exam he had with an optometrist. He proceeded to tell me how disappointed he was with the experience. When I asked what went wrong, he told me the doctor was nice and thorough. The staff was friendly. The office was high-tech with a lot of impressive technology. They also had a large, impressive selection of designer frames to choose from.

So, what was the problem?

“Well,” he said, “They never asked me about ME!”

He said the doctor and staff made a lot of assumptions about what he needed, but never asked for his input. They recommended the best eyewear for all their patients, but my friend failed to see the value in all their recommendations, especially considering these tended to be the most expensive options.

My friend said that while they provided a lot of information, they never asked him about his occupation. Didn’t ask about his hobbies. Never inquired about how often he used a computer or phone. There was no curiosity about him or his needs.

“They never asked me about me!”

If you want to have influence over your patient’s health-care decisions, you need to first connect with them. Start by getting curious about the patient and what’s important and relevant to him or her.

Ouch! Where Does it Hurt?
People are wired to want solutions to their own problems. The disconnect in healthcare is often that doctors provide all their reasons for wanting the patient to do something, but fail to uncover the patient’s motivations for change.

In the book, I use the analogy of peeling back the layers. Below is a three-layer approach to asking questions that allows a practitioner to get to the core of the patient’s concerns.

Layer 1 – uncover thoughts, facts and details

These questions are designed to gain a basic understanding about the patient.

How old are your glasses?
How often do you wear contact lenses?
Do you have sunglasses?

Layer 2 – assessments and explanations

Ask patients to further assess and explain the information they provided from the Layer 1 questions.

Would you ever consider wearing contact lenses?
How does that problem affect you at work?
How did that condition impact your grandfather?

Layer 3 – uncover desire for gain, fear of loss

From a human behavioral standpoint, desire for gain and fear of loss are considered the two dominant motivators for change. These questions also uncover the patient’s emotional reasons for change. Studies have found that nearly all our decisions are made in a part of the brain responsible for feelings and emotion, not logic and reason.

You can offer people logical reasons for change, but to be effective you must first connect with the patient’s emotional reasons for change. Below are a few examples of questions that get patients to reveal this information:

If we could treat your dry eye, how would that impact you at work?
What impact would this condition have on your quality of life if it worsened?

No Involvement. No Commitment.
Research has discovered that patients are more agreeable and compliant with health-care decisions when they have a sense of involvement and control over their decisions. Instead of dictating treatment options to patients, make them active participants in their own care. Now the desired outcome becomes a shared responsibility between patient and doctor. Studies have also found that when people verbally commit to taking action, they are more likely to follow through.

Below are a few questions that elicit both involvement and commitment from the patient:

Do you agree with what I’m saying?
Are you OK with what I’m suggesting?
Are you open to trying this?

This might seem counter-intuitive to doctors who have always taken a more directive approach with patients, dictating treatment options and not seeking the patient’s involvement or buy-in. Sometimes doctors do need to be directive, but there are also times outcomes would improve when the patient has a sense of control and involvement in his or her health-care decisions. This is validated by numerous studies.

No Time Like Showtime
The part of the brain responsible for decision making responds to specific stimuli. As health-care professionals, our approach with patients is often to present a lot of medical information, facts and data. This is important, but if we want to enact change, then we have to connect with the emotional side of the brain first. Below are tools you can use to make a more effective presentation.

• Keep it simple – Strive for compactness, not oversimplification. If we overwhelm the decision-making brain, the result is often no decision.

• Visuals – Think of the decision-making part of the brain as an image processor, not a word processor. The optic nerve is connected to the decision-making part of the brain.

• Contrast – The emotional part of brain struggles with words and descriptions. Contrast helps the brain make quick decisions. (ie. with/without)

• Stories – Stories create emotions and feelings which motivate action. Collect patient success stories and share with patients.

In part 2, we will review the final three sections of the C.O.N.N.E.C.T. Method.

Steve Vargo, OD, MBA, is a practice consultant, speaker and author. His latest book is “Prescribing Change: How to Make Connections, Influence Decisions and Get Patients to Buy into Change.” To contact him: SVargo@idoc.net 

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