Establishing trust with new patients

No matter how advanced an optometrist’s clinical knowledge is – if a patient does not feel comfortable sharing relevant information, then the appropriate tests, diagnosis and management may be delayed.

For locum optometrists, there can be an additional barrier in establishing trust with patients compared to resident practitioners as they are often seeing patients for the first time.

OT shares guidance from our panel of experienced locum optometrists on building rapport through effective communication.

Back to basics

Locum optometrist, Usman Beg, emphasised the importance of first impressions when seeing new patients.

“I think remembering the basics is really important here. Right off the bat, a warm, polite greeting with a formal introduction seems to work wonders,” he said.

Beg highlighted the value of active listening in establishing rapport with patients.

This could involve exploring a patient’s presenting symptoms and lifestyle to see where the locum optometrist can help.

“Tying all of that up at the end of the sight test with personalised advice and recommendations fosters trust,” Beg emphasised.

Beg acknowledged that there can be a misconception among members of the public that standards may drop when they see a locum practitioner.

“It is a mindset that locums have to be mindful of and unfortunately the only tonic to this is to simply be the best optometrists that we can be,” he said.

As a locum, Beg takes care to review a patient’s previous records before calling them into the testing room.

He shared that being able to reference previous eye care issues and lifestyle factors gives patients a sense of continuity.

“Simple questions like ‘last time you were here you were having trouble with the computer at work – did the office specs take care of that for you?” or ‘are you still cycling?’ lets patients know that you’re looking at their case as a whole and rather than as a fleeting, one-off interaction with a locum,” Beg shared.

“Most won’t remember me, but they’ll remember how they felt about our interaction, and that will inform future interactions with the practice and profession”

Making each interaction count

Locum optometrist, Rebecca Rushton, shared that most of the patients she sees do not realise that she is a locum optometrist.

While she misses the opportunity to create a deeper rapport with patients over interactions, she makes the most of each appointment.

“I try make them laugh or at least smile during my consultations. Most won’t remember me, but they’ll remember how they felt about our interaction, and that will inform future interactions with the practice and profession,” she observed.

She highlighted that patient confidence in a practitioner can improve the clinical care that is given.

“It’s vital to make a patient feel at ease during a consultation so they feel comfortable sharing important information, and so they’re receptive to any guidance I give,” Rushton said.

Locum optometrist, James Brawn, highlighted that sometimes patients can be cautious when seeing a locum optometrist – particularly, for example, in a small practice with a sole resident optometrist.

“Patients can be a little bit guarded in their interaction as they had a longstanding relationship with ‘their’ optometrist, so to see me would be unexpected,” he said.

When establishing trust with patients in a new practice, Brawn will ensure that he introduces himself and starts the interaction with an open question.

“A really good technique I have picked up over the years is to summarise a patient’s main concern back to them so that they know I have listened to their concerns, and also to make sure that I haven’t misunderstood what they meant,” he said.

Locum optometrist, Frank Eperjesi, told OT that clear communication can help patients who are anxious about having their eyes checked.

“A good chairside manner is important. People need to know that they have been listened to,” he emphasised.

“Some people are worried about having their eyes examined for fear of bad news. If there is no bad news, then it’s important to let people know as soon as you can,” Eperjesi highlighted.

To establish trust with patients, Eperjesi is courteous to every patient he sees.

“I speak slowly and clearly. I give patients time to answer my questions, look them in the eye and listen actively,” he said.

He is careful to give patients clear recommendations without using jargon.

“At the end I always ask if they have any questions about anything I’ve said or done,” Eperjesi shared.

Locum optometrist, Hammad Mansoor, observed that some patients can mistrust locum healthcare professionals.

“Some people have the belief that you are just there for the day and you are going to rattle them in and out,” he said.

Mansoor will reassure patients who ask whether he is a locum that he is familiar with the practice and its processes.

“You need to listen to their concerns and show them that you are empathetic and caring. Once you have that trust, they don’t really care if you are a resident or a locum,” he said.

 

I speak slowly and clearly. I give patients time to answer my questions, look them in the eye and listen actively

The value of follow up questions

Rushton shared that follow-up questions can help her to differentiate between benign and serious conditions, as well as saving time on unnecessary investigations.

“Asking how long a patient has had symptoms is my favourite question. Most things they’ve had for months or years are not a concern,” she said.

Beg noted the importance of asking follow-up questions in relation to headaches.

“I think the easiest symptom to overlook can sometimes be headaches as patients themselves don’t always take them as seriously,” he said.

Beg added that follow-up questions can help to identify whether the headaches are likely to be caused by eyestrain or something more serious that requires an emergency referral.

Eperjesi recalled a patient who mentioned that he could see what looked like a light bulb filament in the top corner of his right eye.

While Eperjesi initially thought it could be a migraine aura, the patient reported that the symptom had been present for the last six months.

“Migraine aura comes and goes in about 30 minutes,” Eperjesi explained

“I carried out visual field testing and found a homonymous superior quadrantanopia,” he said.

Following a referral to hospital, the patient underwent surgery to remove a brain tumour.

Brawn shared the example of a patient who described their vision as ‘misty.’

“Usually patients will say blurry or foggy, so I asked them to explain further. They described that when they looked at lights, they saw rings around them like headlights on a misty day. Turns out the patient had been experiencing intermittent angle closure,” he recalled.