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How to ramp up your ocular surface disease practice
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by Agustin L. Gonzalez, OD, FAAO
We all see the dry eyes and allergies, but some ODs are better at communicating their findings and treating the problems than others.
So, you want to be more therapeutic and interventional, but do not know where to start? Welcome to where I was some time ago.
Years ago, I challenged myself to manage dry eyes and allergies better, and finding the way down that road was very lonely. Luckily, you are not alone, and I will share my story and strategy.
Being in a retail office, I was under the impression I did not have “medical cases;” people came in because they wanted eyeglasses or contacts. However, once I developed some skills, I recognized that I was wrong.
The problem was not with my patients, but with me. I saw their problems, but I did not have the tools to communicate effectively with these patients and treat them. The problem was not my knowledge, but my habits, and recognizing and changing bad habits was up to me.
Change your habits
First, do not feel like you are alone. Cut yourself some slack and realize that habits are hard to change because, well, they're habits. And don’t think that just because you want to start treating dry eye and allergy you will become an expert overnight. As with everything, you have to first internalize that your behavior is just not cutting it.
All habits have a function: either saving time or providing a certain comfort level. Try to determine why you are not treating or managing allergies and dry eye. Often it is because we are too busy with our day-to-day routine, and habits become a barrier to adding an extra step in our day. You have to break the pattern, and something as simple as changing a few things in the set-up of my exam room desk served as a constant reminder to change my day-to-day habits.
Remember your education
Second, look at what you are taught. There is no doubt that your education shapes the way you think and the way you practice. There is nothing wrong with the free CE from the neighborhood ophthalmology group or the local up-and-coming speakers at the county society meeting, but if you want to change, you need to invest in your commitment. There is no doubt that high-quality professional education offered by conferences such as the American Academy of Optometry, among others, will give you both the tools and confidence to help shape your practice. The engagement with peers and special interest groups will provide you with enthusiasm and feed the momentum.
Larger meetings offer like-minded individuals the platform to engage in conversations around one topic area. Attend the poster sessions and look for posters in the area where you would like to improve your skills. This platform allows you to find similarly minded individuals and authors with whom you can exchange information. You could even look to be involved in special interest groups that exchange data and could single out mentors that would help guide you down the practice path you seek to expand on.
Communicate with patients
Similarly, your communication with and education of the patient needs to change. This is the step that adds complexity and takes time. This is where you have to practice the change.
Every day I hear, “the eye is shaped like a football,” just to have the patient acknowledge that they have been told this, but they still do not know what that means. Find a new, effective way to communicate with your patients. Script the message in a way that is simple, relatable and efficient. Try scripting and practicing a message for dry eye and allergy on your family to see if it is personalized, trustworthy and believable.
When you talk to patients, assume that they heard you but did not understand. See how receptive they are to your communication style and change it, trying various forms. I have treated many patients who have used me as a second or third opinion only for me to repeat, in my fashion, what the other ODs stated. It’s not that the other ODs were not knowledgeable, it’s just that I developed a reputation of being more “trustworthy.” Practice the skill of communicating with the patient so he or she will like and trust you enough to comply with your recommendations. Learning new communication skills and changing your style requires time and effort. This will pay off with patient trust.
Consult with other ODs
Do not travel down this road by yourself; take some company, and it will be a more enjoyable ride. Talk with other ODs and join and engage in special interest groups at meetings. I am sure that you will not be alone and that other ODs struggle with the same hurdles in shifting their habits. Doctor alliances can also provide you with a community of peers with whom to exchange ideas on what works best in their offices and even how they script their messages.
Give yourself time
Lastly, think of this transition like a diet, allowing for slips. You will not see a change over a few days or a week, but you will be surprised of the significant impact that managing allergies or dry eye will have in your practice over time. Give yourself enough time to learn and acquire new communication skills, train staff and start on this road to becoming more therapeutically engaging.
You already have the knowledge, and once you accept the commitment and acquire the skills to better communicate therapeutic interventions with your patients, you will gain a newfound sense of caring for your patients, break the monotony of the day and enjoy your new practice.
For more information:
Agustin L. Gonzalez, OD, FAAO, ABCMO, practices at Eye and Vision’s North Texas Center for Dry Eye and Ocular Surface Disease. He also founded a dry eye clinic in the North Texas area and has a special interest in cornea and external disease. Gonzalez is a member of the Primary Care Optometry News Editorial Board. He can be reached at: gonzalez.agu@gmail.com.
Disclosure: Gonzalez reports no relevant financial disclosures.