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Effective patient conversations in eyecare
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By Steve Vargo, OD, MBA
March 12, 2025
Two of the challenges eyecare professionals must tackle today are what seems like too little time to spend in discussion with each patient, and how to make this interaction more thoughtful and meaningful for both the patient and doctor.
As ECPs, we have information that we want to convey to the patient around specialty care, multiple pairs, additional tests and even upgrading to quality frames and lenses. There’s not a lot of time to accomplish all these objectives, which means the way you structure the patient conversation is critical.
The objective is to educate AND motivate the patient to invest in the solutions that we talk about and recommend during the exam.
Maximizing Time Spent with Each Patient
The road to successful conversations is built upon a foundation of asking better questions, being a better listener and even knowing what to listen for from the patient. This means the ECP really needs to lean into the psychology and nuances of this patient conversation.
The key is to work at how you structure the patient conversation and to understand how you can maximize the limited time for this interaction.
During my career, I’ve done extensive research about how to be a better listener and how to become more influential in patient conversations. One result is that a lot of preconceived notions we as ECPs have about these things don’t hold up under closer examination.
Typically, as ECPs, we think the more we talk to somebody, the more likely they’re going to agree and go along with our recommendations.
Ironically, many patients leave the office feeling overwhelmed with all the information presented and confused about what they’ve been told. They also likely didn’t have an opportunity to express what’s important to them.
As ECPs, we should strive to make sure this doesn’t happen. We need to ask more questions, listen better and learn more from the patient (instead of just spouting complex information or diagnosis to an overwhelmed patient).
At the conclusion, the goal is to present a solution that solves the patient’s problem, which we have now identified through our questions and follow-ups. This is a more successful approach than asking a few rudimentary questions and spending the rest of the time trying to convince patients to do something that maybe they’re not ready to do.
How do you achieve the success that comes with the former approach and avoid the latter scenario?
The Three Parts of the Patient Exam Conversation
For me the process is straightforward. I break down an exam into three different parts.
First, there’s what I call the discovery phase, which is just trying to discover the patient’s main concerns and issues. And through that, we tend to ask more open-ended questions. We’re really trying to get into the emotional impact that the problem is creating. What we know from research in neuroscience is that it’s emotions that drive the majority of our decisions. Indeed, roughly 95 percent of our decisions are driven by emotion.
Once you understand not only the problem the patient is experiencing, then you can explore how it’s affecting them on an emotional level.
I’m a big advocate for asking more questions in the beginning to really understand the patient. I call it peeling back the onion.
The second step is what I call, “labeling.” Once you think you have a deeper understanding of what the patient is going through, you repeat or paraphrase back to them what you think you heard.
This creates an opportunity for one or two things to happen. Either you didn’t hear it right, and the patient will correct you (which is fine and gets you closer to complete understanding), or you do get it right and the patient discovers you are a good listener and you have heard what they said.
Listening intently also has a carryover effect. Indeed, in patient surveys, “listening” is one of the top qualities patients say they are looking for in their doctor, and it comes out at or near the top consistently in various surveys when patients say they prefer doctors “who make me feel heard and understood.” (What better way is there to build strong relationships and prompt positive word-of-mouth referrals?)
The third step in the exam conversation is to present the solution to the patient. If you understand the problem well, this part gets much quicker and much easier, and helps you recapture some productive patient time.
This is where a lot of ECPs get it backwards. They ask a few questions and then they spend the rest of the exam trying to convince the patient to do something, instead of taking more time in the beginning to understand everything the patient’s going through and how it’s affecting them.
Wrapping Up by Enabling Care Recommendations
At the end it’s important to tell the patient you understand what they’re experiencing and to explain that you can solve that problem and here’s the solution I’m going to prescribe for you. Then give them a way to move forward with your recommendations.
For example, even though you accept general-purpose credit cards, accepting a credit card that offers promotional financing, such as the CareCredit credit card, may make the patient more amenable to the proposed care recommendation, More Successful Patient Conversations in Three Easy Steps.
This option also may fill any financial gaps between insurance coverage and out-of-pocket costs and provides the patient a way to finance treatment over time. *Subject to credit approval. See CareCredit.com for details. It can also help open the door to the sale of multiple pairs or prescription sunglasses.
Steve Vargo, OD, MBA, is a consultant, author and speaker. In 2014, he joined Prima Eye Group (now IDOC) as Vice President of Optometric Consulting. Since transitioning to full-time practice management consultant, he has delivered more than 3,000 consultations and coaching sessions with hundreds of independent optometry practices across the country.
