In medicine and ophthalmology, as in all spheres of human interaction, effective communication is paramount for success. Patients rely on physicians to communicate effectively for reassurance, knowledge, guidance, motivation, and most of all, the best health outcomes.
“As physicians, we have the ability to meaningfully impact the lives of many every day.”
To this end, it is imperative that we convey information appropriately and in a manner that allows our target audience to fully understand the message.
Key Points for Effective Patient Communication & Education:
Enter the room with a plan
Being well-informed about a patient’s history and reason for the encounter is important to ensure a smooth, efficient visit.
Greet the patient and introduce yourself to all
Do not presume how other individuals are related to the patient. Kindly ask how everyone is related and introduce yourself to all.
Maintain good eye contact
Without good eye contact, patients may not be able to connect or feel in tune with the physician. Patients are less likely to “buy in” if lack of or inadequate eye contact gives them a sense of physician apathy.
With electronic medical records, it is especially important to avoid spending a significant amount of time speaking to the patient with your back turned or while staring at a computer screen.
Set clear expectations
Explain to the patient what the goals of today’s visit are and what to expect. Avoid excessive medical jargon but when used, also explain in layperson's terms.
Abbreviated script: I understand that your optometrist identified a retinal hole in your left eye. Given that you have no symptoms and no change in vision, our plan for today will be to review the retinal photos together and then, I will examine your eyes with a light and a lens. We will then discuss options and allow you to make an informed decision on whether to treat the retinal hole or not.
Sit down
Take a moment to sit and avoid towering over your patient. Make yourself approachable and affable. It is well-known that patients feel that the physician spent significantly more time than actual time spent when the physician communicates from a seated position.
Listen
Allow the patient to speak. Do your best to avoid interrupting or cutting off the patient. The patient is frequently concerned and has many emotions running through their mind. Allowing the patient the time and opportunity to freely communicate is therapeutic.
Acknowledge, validate, and reassure
No matter how astute or seemingly outlandish a patient’s complaint, avoid judgement and remain objective. Acknowledge the patient’s concerns, validate their experience, and reassure where appropriate.
Educate
Explain the reason for the patient’s symptoms, name the diagnosis, and discuss it in a way that is easy to follow and understand. Explain clearly and concisely what the next steps are, what the patient should expect, warning signs to look out for, how to get in touch with you if there is an acute change, and what the plan for follow-up will be.
Demonstrate
Where feasible, use models and photos to illustrate what the patient is experiencing. Analogies may be beneficial to enhance a patient’s understanding.
Repeat and reinforce
Repeat key points and summarize the visit, especially when it is clear that the patient does not fully comprehend what is being said. The patient’s body language provides many clues to their level of understanding and satisfaction.
Gauge understanding
When appropriate, ask the patient to repeat back what was discussed to confirm understanding. For example, ask the patient what ocular medications will be used and how frequently.
Provide written instructions
Whether it is a blepharitis handout, age-related macular degeneration brochure, ocular medication instructions, or visit summary, providing patients with a physical (or electronic) copy of their information can be very helpful. Many patients are worried, distracted, and/or overwhelmed that they are unable to retain all that was discussed much less implement it all. Therefore, having a copy of clear instructions goes a long way for many to be adherent to physician recommendations. This is especially important post-procedure (e.g. first intravitreal injection) or post-surgery (e.g. retinal detachment repair with positioning instructions).
Ask for and answer questions
Always make a concerted effort to field any patient questions prior to ending the patient encounter.
Plan the next visit
Coordinate follow-up and provide appointment reminders.
End the encounter positively
Create a positive environment for the patient and do your best to exude optimism but be honest and do not provide false hope. It is frequently better to underpromise and overdeliver. Work on continuing to build a respectful, professional, healthy patient-physician relationship. Make yourself available and establish a good rapport in order to improve patient adherence, consistency of follow-up, and quality of health outcomes.
Parting words:
Always remember that the patient is the most important person in the room. Clear, effective communication is critical to optimize the patient’s health and wellness.
