Dr. Laurie Sorrenson and her father. Photo courtesy of Dr. Sorrenson.
Is how you speak to patients interfering with their understanding?
By Laurie Sorrenson, OD, FAAO
April 30, 2026
I learned many lessons from my dad. This one changed how I speak to patients.
My dad was hard of hearing. He had hearing aids, and he didn’t like wearing them. So I did what most of us do. I talked louder.
One day, he stopped me during his eye exam and said:
“I can hear you fine. You just talk too fast.”
That was it. Not louder… slower.
He didn’t need more volume—he needed more time.
When I slowed down, enunciated my words and gave him a couple seconds between thoughts, everything got easier. He didn’t have to ask me to repeat myself nearly as often.
I realized that my hard of hearing patients, and even my older patients, needed me to do the same thing.
The Science Behind It
As patients age, cognitive processing speed slows down—even when intelligence stays intact.
Studies summarized by groups like the American Psychological Association show:
- Processing speed decline can start as early as the 30s–40s, though it’s subtle early on
- It becomes more noticeable in the 60s and 70s, especially in real-world tasks like conversation
- Overall, speed can decline 15–30% from young adulthood to the 70s*
And here’s the kicker: Processing speed is one of the earliest cognitive functions to decline, often before memory or reasoning.1
Then Add Hearing… and It Multiplies the Problem
Now layer in hearing loss—which most of our older patients have to some degree.
- About two-thirds of adults over 70 have significant hearing loss2
- Hearing loss is independently associated with faster cognitive decline3
- As hearing worsens, cognitive scores drop measurably—even small changes matter4
Here’s what’s happening practically:
If a patient has to work harder just to hear you, they have less cognitive bandwidth left to process what you said.
So now you’re not just dealing with slower processing—you’re dealing with reduced input plus slower processing at the same time.
That’s a tough combo.
The Problem Isn’t just about Hearing
We assume: “They didn’t hear me.”
But often it’s: “They heard you… but you didn’t give them time to process it.”
And if you’re efficient (which most of us are), you’re probably talking faster than you think.
What Actually Works (Simple, But Powerful)
1. Short sentences. Long explanations overload processing.
“Your oil glands aren’t working well.” Pause. “That’s causing your dry eye.”
Done.
2. Slow down, just a bit. If you have a soft voice, yes—speak a little louder.
But more importantly:
- Slow down
- Enunciate clearly
- Don’t run sentences together
3. Pause between sentences—this a game changer.
Almost nobody does this one. I have worked with dozens of optometric students in the exam room. They rarely do this.
Give patients two to four seconds between sentences.
It will feel awkward to you. It feels normal—and necessary—to them.
That pause is where understanding happens.
4. Consider your body language. Don’t forget to face the patient. Don’t talk while walking out. It is easier to hear and to process for the patient if the patient is looking at your face while speaking.
Try this simple framework: Sentence → Pause → Sentence
“Your eye pressure is a little high.” Pause. “I need to do more testing.” Pause. “I want to schedule you to come back in about a month.”
Or try: Chunk → Pause → Confirm
“These drops go in once in the morning.” Pause. “Does that part make sense?”
Why This Matters More Than Ever
Your patient base is aging. Rapidly.
They don’t need less information. They need more time to process it.
When you adjust how you speak to your older patients by slowing down, pausing and enunciating…
- Compliance improves
- You get fewer callbacks
- You have better optical conversations
- The patient has a better overall experience, and it is more efficient in the long run
Change Your Communication in a Meaningful Way
My dad didn’t need me to be louder. He needed me to slow down.
That’s probably true for a lot of our patients too.
Say less. Say it slower. Pause longer than feels comfortable.
Because if they didn’t process it, they didn’t really hear it.
References
* https://pmc.ncbi.nlm.nih.gov/articles/PMC2839847/
1. Archive Ouverte UNIGE
2. Frontiers
3. MedCrave Online
4. ResearchGate
Read another column by Dr. Sorrenson here.
Read more insights from our editors here.
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Laurie Sorrenson, OD, FAAO, ABO, is president of Lakeline Vision Source in Cedar Park, Texas, CEO of ODs Care working with Half Helen, Director of Practice Management and Austin Administrator of Vision Source and the Professional Editor of Review of Optometric Business (ROB). To contact her: lsorrenson@gmail.com |
