Building Patient Trust Through Communication

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7 min read

Drs. Hura, Mueller, and Venkateswaran discuss how refractive surgeons can build trust and a lasting partnership with patients through thoughtful communication.

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.

Interventional Mindset is an educational series that gives eye physicians the needed knowledge, edge, and confidence in mastering new technology to grow their practices and provide the highest level of patient care. Our focus is to reduce frustrations associated with adopting new technology by building confidence in your skills to drive transformation.

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.
Nandini Venkateswaran, MD
About Nandini Venkateswaran, MD

Dr. Nandini Venkateswaran is a member of the Cornea and Refractive Surgery Service at the Massachusetts Eye and Ear Infirmary and an Instructor of Ophthalmology at Harvard Medical School. She is a fellowship-trained cataract, cornea and refractive surgeon. Dr. Venkateswaran earned her medical degree with a distinction in community health from the University of Rochester School of Medicine and Dentistry, where she was inducted into the Alpha Omega Alpha medical honor society. She completed her Ophthalmology residency at the Bascom Palmer Eye Institute/University of Miami, after which she completed a fellowship in cornea, external disease and refractive surgery at Duke University.

Dr. Venkateswaran truly enjoys employing her clinical and surgical expertise and research background to treat patients with a compassionate, customized and multidisciplinary approach. She specializes in complex cataract surgery, femtosecond laser assisted cataract surgery with intraoperative aberrometry, most advanced techniques in corneal transplantation (DMEK, DSAEK, DALK, PKP), laser refractive surgery (LASIK and PRK), corneal cross-linking, anterior segment reconstruction (including secondary IOL implantation and iris repair), dry eye disease and ocular surface lesions and tumors.

Dr. Venkateswaran is an active member of the American Academy of Ophthalmology and American Society of Cataract and Refractive Surgery and currently serves on several committees in these organizations. She has co-authored over 40 peer-reviewed publications and numerous book chapters early in her career. She has received several awards for her excellence in research and clinical care and has presented her scientific work at numerous national and international meetings.

Outside of work, Dr. Venkateswaran enjoys spending time with her friends and family, learning to cook, and riding her peloton bike.

Nandini Venkateswaran, MD
Arjan Hura, MD
About Arjan Hura, MD

Dr. Arjan Hura is a cataract, refractive, and anterior segment surgeon at the Maloney-Shamie Vision Institute in Los Angeles, CA. Dr. Hura is passionate about providing his patients with the highest possible medical and surgical vision care and is committed to the American Academy of Ophthalmology‘s mission of protecting sight and empowering lives. His research and clinical interests include working with the latest cutting-edge technology to constantly try to improve patient outcomes.

Prior to joining MSVI, Dr. Hura completed his fellowship at the Cleveland Eye Clinic where he performed the full spectrum of vision correction, including advanced lens laser cataract surgery, laser vision correction through LASIK, PRK, and SMILE, implantable contact lenses, corneal cross-linking, and MIGS surgery.

During his residency at the University of Cincinnati, Dr. Hura was involved in several award-winning research studies and investigator-initiated trials. He received a National Eye Institute grant to present at ARVO during his internship, and he presented at ASCRS during all three years of his ophthalmology residency and was awarded Best Paper of Session at ASCRS 2019.

Arjan Hura, MD
Brett Mueller II, DO, PhD, PCEO
About Brett Mueller II, DO, PhD, PCEO

Brett H. Mueller II, DO, PhD, PCEO is a board-certified and fellowship-trained ophthalmologist who specializes in and has performed thousands of cataract and refractive eye surgeries. With advanced fellowship training in refractive surgery through the world college of refractive surgery and visual sciences, he hones a comprehensive range of skill sets needed to diagnose, address, and treat the full spectrum of refractive surgery.

After receiving his undergraduate degree from Texas A&M University, he then received his medical degree and PhD from the University of North Texas Health Science Center. His scientific work and academic accomplishments enabled him to author over 45 publications and book chapters, present at national and international meetings, and be a recipient of several grants (including an NIH grant). He was then accepted to attend an ophthalmology residency at the University of Louisville, where he developed a reputation for being a leader amongst his colleagues, serving as chief resident, and a skilled surgeon. After finishing residency training, Dr. Mueller then completed a one-year refractive, cataract, and anterior segment fellowship through the Refractive Fellowship Network and the World College of Refractive Surgery and Visual Sciences. He now specializes in state-of-the-art laser-guided cataract surgery and advanced lens implants that reduce or eliminate the need for glasses. He also specializes in the full spectrum of refractive surgery, which includes: modern LASIK, SMILE, EVO-ICLs, Refractive Lens Exchange, PRK, and Cross-Linking.

Brett Mueller II, DO, PhD, PCEO
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