Tips4EyeDocs Daily No. 10 for 12/27/2011 – What will you do for me today?


The end of the year holidays are upon us. We may even be aglow from our good fortune. How about our patients? Unlike our brethren, patients not only feel their own good fortune, but also must decide whether their visit to you will be their last? What will cause them to return to your office again and again? What can a doctor do to keep this patient from looking elsewhere? I hope that doctors everywhere will be prepared to answer this question for every one of their patients.


  1. Can optometrists fight competitors who rely on price alone? Spotted on Twitter @OpusVO: How to Compete — and Win — When Rivals Cut Prices”
  2. Social media content can go a long way in helping your patients understand complicated eye problems and procedures. In this day and age, written materials may not be good enough. Think about videos.


Clinical Significance: How patients perceive a face-to-face interaction with you is something that can bring significant insight into your effectiveness as a doctor. We seem to feel that a returning patient is all that we need to know. However, without insight, we may never know when they leave. What kind of process do you use to improve your doctor-patient communications?

Citation: Neeman N, Isaac T, Leveille S, Dimonda C, Shin JY, Aronson MD, Freedman SD. Improving doctor-patient communication in the outpatient setting using a facilitation tool: a preliminary study.

Int J Qual Health Care. 2011 Dec 21. [Epub ahead of print]


Quality problem: Patients often do not fully understand medical information discussed during office visits. This can result in lack of adherence to recommended treatment plans and poorer health outcomes.

Choice of solution We developed and implemented a program utilizing an encounter form, which provides structure to the medical interaction and facilitates bidirectional communication and informed decision-making.

Implementation We conducted a prospective quality improvement intervention at a large tertiary-care academic medical center utilizing the encounter form and studied the effect on patient satisfaction, understanding and confidence in communicating with physicians. The intervention included 108 patients seen by seven physicians in five sub-specialties.

Evaluation Ninety-eight percent of patients were extremely satisfied (77%) or somewhat satisfied (21%) with the program. Ninety-six percent of patients reported being involved in decisions about their care and treatments as well as high levels of understanding of medical information that was discussed during visit. Sixty-nine percent of patients reported that they shared the encounter form with their families and friends. Patients’ self-confidence in communicating with their doctors increased from a score of 8.1 to 8.7 post-intervention (P-value = 0.0018). When comparing pre- and post-intervention experiences, only 38% of patients felt that their problems and questions were adequately addressed by other physicians’ pre-intervention, compared with 94% post-intervention.Lessons learned. We introduced a program to enhance physician-patient communication and found that patients were highly satisfied, more informed and more actively involved in their care. This approach may be an easily generalizable approach to improving physician-patient communication at outpatient visits.

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About Richard Hom OD, MPA

Dr. Hom holds Doctor of Optometry and Masters in Public Administration degrees and practices family eye care and consults on public policy, health information technology and program evaluation.
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