Doctor Patient Relations

Serve Children Well to Build a Family Practice

By Rachael Click, OD

February 25, 2015


Build a family practice by making your office kid-friendly in three ways: appearance, communications and procedures.


MAKE CHILDREN COMFORTABLE. Put children at ease soyou can see them alone in exam room.Then invite in parents for a debriefing.

DISCUSS LENSES & LEARNING. Explain how lens features like AR can enhance learning by reducing glare and eye fatiguefrom tablets and smartboards.

KEY IN TO FAMILY SCHEDULES. Offer special discounts on glasses and lens features when it’s back-to-school time. Use your web site and social media to get the word out.

Children are prime patients in our practice.Our EHR system shows that 23 percent of our total patients are newborns to 18-year-olds, accounting for about 15-18 percent of practice revenues. Serving children requires patience and learned skills, but doing so is rewarding both personally and financially. Serve children well, and you build strong family referrals.

Gauge Comfort Level of Child

The level of involvement by the parent in the child’s exam depends on the age and comfort level of the child. We participate in InfantSee, a program that offers free exams for six-month-olds, and, after that initial exam, we recommend seeing kids at ages 3 and 5, and annually, once they enter school if no vision problem occurs. The parents are in the room at the InfantSee exam, and to the exams given to children ages 3 and 5, but depending on the child, the parent may not be in the exam room once they enter school.

Our technician prefers to not have parents in the pre-test room once children are in school. He asks the parents to remain seated, and that once he is done with their child’s initial testing, they can accompany the child, if desired, into the exam room. Some of the kids who have been seen in the practice for many years often will not have their parents in the exam room as the parent already knows what is happening. If the parent decides to wait in the reception area, I will have a conversation with the parent after the exam about the child’s eye health and any vision correction or other product needs. Itry to be flexible based on the child’s and parent’s comfort level, and I also strive to make sure there is an opportunity for the parent to have all their questions answered.

We like giving kids and parents the option of the child being seen alone because we have found that sometimes parents are a distraction. Sometimes children don’t want their parents in the room, while others want them in the room for added security. I tend to get more accurate results if I can do the exam without interruption from parents or other family members, but I try to be flexible.

Editor’s Note: It is always best to have at least one other staff member in the exam room with you when examining a child without a parent present.

Dr. Click shows off one of the finger puppets she uses as a focal point for children during exams. “I ask kids questions about what they see on the puppet to make sure they are focusing on it,” says Dr. Click. “For instance, I ask how many eyes it has, what color it is, and if it has teeth.”

No Additional Instrumentation Necessary

We are a primary care optometry practice, not a vision therapy practice,so most of my tools are things that I already have for adults. I have an automated visual acuity chart that shows symbols and plays movies, which is helpful for small children, shy children and children who don’t know their letters. I also have a couple of finger puppets that I find extremely helpful in keeping the attention of small kids. If I’m using the finger puppets, I’ll ask the kids basic questions about themselves so I can make sure they continue to look at the puppets.

Offer Simple Diversions in Reception Area

We have a desk drawer in the reception area that has crayons, coloring books and activity books, and ask kids if they want to use these things if they didn’t bring anything to keep themselves occupied. In addition to children patients, we also offer these things to the kids who are just here because a family member is being seen. We also have a Highlights magazine on the our coffee table in the waiting area. We do this as a courtesy gesture, so kids can be entertained while they wait. The office has an open concept design, so it can get chaotic when a child gets bored and starts running around or otherwise being disruptive.

DiscussLens Technology & Learning

I always tell parents that 80 percent of learning is facilitated by vision, and new features in lenses, in particular, can enhance learning, so we need to make sure children have great vision to not interfere with learning. I always explain that anti-reflective lens treatments will help the child’s vision by reducing the glare from smartboards and fluorescent lights, which could lead to fatigue and the loss of attention. In our town, the school systems won’t let kids wear plano sunglasses without a written note from the doctor, so I explain that Transitions is a way to ensure that their child is getting the UV protection they need while on the playground. I further explain that it is very important that we protect against UV throughout life, but especially during childhood, as we think most UV damage occurs before 18. Finally, I reassure parents that our products come with a two-year warranty and protect against everything except loss or Rx change.

Explain Need for Annual Exams

Due to patient education about the importance of annual exams for children, we see a lot of kids who don’t need glasses. I try to ask all new adult patients if they have kids. Then I follow up with our guidelines as to when we want to see kids. A lot of parents do not know the importance of annual exams, so most of them are thankful that someone told them. When a child doesn’t need glasses, I stress to the child and parent the importance of wearing UV-protective sunglasses.

If I am educating a new patient who is a parent, I let them know in the handoff to the optical that we want to also schedule their children at their earliest convenience.

Include Parent in Optical Handoff

We treat children the same as adults in the optical hand off, but if the parent was not in the room during the exam, I speak to them first before doing the handoff. The biggest challenge we have with children in the handoff is cost, but usually, once the parent understands the warranty and benefits of advanced lens technology, it isn’t an issue.

Allow Extra Chair Time

The age group that takes the longest is typically 7-11-year-olds as they are the ones who seem to be the most afraid. I try to take it a little slower with them to help with their anxiety. Regardless of age, I always ask kids questions to not only gather information for their exam, but also to have a conversation with them so they aren’t so nervous. I also try to tell everyone, regardless of age, what I’m doing while I’m doing it. I try to keep the mood light and easy going.

Do Back-to-School Marketing & Promotions

Most of our marketing consists of verbal education to parents. However, we have special Facebook and newsletter campaigns during the back-to-school time. This year, we want to do a promo for daily disposable contact lenses. We are going to have an enter-to-win drawing for kids who are successful in their daily disposable contacts.

Rachael Click, OD, is the owner of Preferred EyeCare Center in Mount Pleasant, S.C. To contact her:

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