Following the last episode of Interventional Mindset on refractive surgery mentorship opportunities, Drs. Venkateswaran, Mueller, and Hura review tips for discussing refractive surgery procedures with patients and how to enhance their surgical experience through communication.
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Browse through our videos on a variety of topics within cataract and refractive surgery, glaucoma, and ocular surface disease to learn practical insights into adopting a variety of new surgical techniques and technology.
The value of detailed patient communication
To start, Dr. Mueller highlighted that there is a fair amount of nuance when it comes to refractive surgery. He noted that in refractive surgery, 50% of the treatment success relies on the surgical outcome, and 50% relies on everything else, such as patient communication, pre- and post-operative evaluations, and the intra-operative experience for the patient.
Further, he added it’s key for surgeons to thoroughly explain the benefits of refractive procedures, as well as the potential risks, to allow patients to make informed decisions. Dr. Mueller explained that he learned a lot from shadowing other surgeons as they discussed refractive procedures with patients to better understand various approaches to pre- and post-operative patient communication. Luckily, communication skills are easy to take back to your refractive practice and quickly implement to improve surgical outcomes and the overall patient experience.
Tips for ensuring patient comfort from start to finish
Similarly, Dr. Venkateswaran emphasized that each time she performs laser in situ keratomileusis (LASIK), she asks the patient what music they want to listen to during the procedure. This tends to put the patient at ease as they listen to familiar music that calms them. Additionally, she noted that the value of “verbal anesthesia” cannot be underestimated. The power of how surgeons and everyone else in the surgical suite (i.e., scrub nurses, ophthalmic technicians, operating room support staff, etc.) speak and generally communicate with patients plays a huge role in making the patient feel comfortable and secure.
At Dr. Venkateswaran’s practice, the ophthalmic technicians in the surgical suite are the same people the patient sees pre-operatively, which helps with establishing trust and creating a relaxing environment for them. During the procedure, while the surgeon is focused on performing the surgery, the support staff can focus on tending to the patient’s needs by holding their hand or saying comforting things. It further helps Dr. Venkateswaran to know that the staff has bought into the value of the refractive procedure; doing so puts forth a cohesive message from the pre- to post-operative period that ensures the patient has a positive experience and feels confident in both the procedure and the surgeon’s capabilities.
She added that following the procedure, it’s essential to make sure that the patient has clear instructions for how to proceed while healing. Providing patients with educational resources and a phone number to call (or email) if they have any symptoms can make them feel supported through the healing process. This, in turn, can generate a strong patient-doctor relationship.
The art of patient communication for refractive procedures
Dr. Hura mentioned that the art of communication and human connection is just as important as clinical skills for a successful surgical outcome and patient experience. While connecting with patients may not seem complicated, every patient is different and human beings express apprehension and exhibit anxious behavior differently depending on the circumstance, especially when in healthcare settings. This means that there are many personality types that a refractive surgeon must become adept at understanding and accounting for across the patient journey.
Ultimately, the goal should be to make every patient feel seen and heard. He remarked that the way surgeons connect with patients is best received when it is congruent with who they are as a person. What works well for one surgeon might not work (or feel disingenuous) for another if they have different personalities.
A key factor in refractive surgery is knowing how to artfully build a bridge with patients, which is something surgeons can work on both in and outside of the clinic. One of Dr. Hura’s pearls was for anyone who feels anxious about speaking with patients: set a goal of speaking to strangers when going out and doing tasks, such as grocery shopping. This is a good way of honing communication skills and identifying approaches for connecting with patients across any walk of life.
The art of saying “no” to patients with unrealistic expectations
Conversely, Dr. Venkateswaran mentioned that if a surgeon is struggling to connect with a patient, it could be a red flag for moving forward with the procedure. She highlighted that it is very important for the surgeon and patient to be on the same page because if the patient’s post-operative expectations are not realistic or in line with what can be provided by the surgeon, it is critical that this be communicated.
Letting the patient know that the surgical results they envision are not feasible, and perhaps staying in glasses or contact lenses, or tackling the issue with a different approach, can be helpful in making the patient understand the limitations of each treatment modality. Using strong clinical judgment and conveying this to the patient is crucial to understanding when to say “no” to patients. This, too, is part of communication, as simply agreeing to whatever procedure the patient desires could negatively impact them and the practice itself. Surgeons in this kind of situation could recommend offering a second opinion, postponing the surgery, or simply taking it off the table.
Understanding different patient personality types
Dr. Mueller remarked that over the past few years, he has taken an interest in researching different personality types to better understand patients and match their communication needs. He explained that he is an energetic person, and not every patient will respond to that well, so if appropriate, he changes his approach if he feels that the patient's personality would be better suited to a different demeanor.
Dr. Venkateswaran mentioned a presentation from the American Society of Cataract and Refractive Surgeons (ASCRS) from Refractive Day about personality-guided decision-making in refractive surgery, which outlined how to identify various personality types and provide them with the feedback they need to feel comfortable with a given procedure.
Conclusion
Building a genuine connection with patients is essential to ensuring strong surgical outcomes and positive patient experiences.
Ultimately, understanding the patient (and understanding yourself as a surgeon and individual) is key to fostering an enduring partnership with the patient.
