Doctor Patient Relations

The Art of Doctor-Patient Discourse: Avoid Over-Sharing

By Ally Stoeger, OD

I recently examined a patient who had been seeing an ophthalmologist for monitoring her cataracts and glaucoma. She’s also a contact lens wearer, but when she asked her doctor for a contact lens exam, he responded, according to this patient, like this: “I don’t do that any more because it’s not profitable.” The doctor may have just thought he was being upfront about the realities of the day–but the patient was completely turned off by his response.

The problem wasn’t that this doctor no longer performed contact lens exams. He could have said he is so busy with surgery he does not have time for contacts. The problem was that the patient no longer felt comfortable with a doctor who made a point of telling her that profitability guides his decision-making. No matter how much the economic realities of eyecare practices are shifting, patients still want to feel cared for.

When she came to my office for the contact lens exam, she asked for the name of another cataract surgeon.

There’s no question that as eyecare professionals we are frustrated by vision plans competing with each other to see who can drop our fees the most; by online vendors who take advantage of our goodwill by informing buyers that you can get spectacle adjustments and measurements for free or for a few dollars from local eyecare professionals; by the uncertainty of how the Affordable Care Act and Accountable Care Organizations will affect access to patients for optometrists; or by the myriad hoops we have to jump through in order to comply with medical insurance rules.

But before we choose to vent to a patient about how frustrated we are, we should ask ourselves this question: “What will my patient and my practice gain by venting or sharing unnecessary negative information?”

In this case, that ophthalmologist lost a very pleasant patient, who was coming in quarterly for glaucoma follow-ups, and who will need cataract surgery soon. Was it worthwhile “venting” that contact lenses were no longer profitable? No. Am I going to be a lot more careful about the information I share with patients? Yes.

How do you balance the desire to be honest and upfront with your patients with the need to maintain professionalism and not undercut the patient’s faith in you?

Ally Stoeger, OD, was a founding and managing partner of a multi-doctor practice and has recently opened a new practice in Gainesville, Va. Contact: ally@realpracticetoday.com. You also can follow Dr. Stoeger on Facebook at http://www.facebook.com/gheyedr.

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