Communication lessons in practice

What are the keys to supporting patient confidence, clarity and care through communication in the practice?

This was explored at Specsavers PAC through a session which saw actors portray a series of communication-focused scenarios between patients and practitioners.

Claire Strachan, associate facilitator from Actors in Industry, began the session by asking delegates to reflect throughout the sessions on one question: “Do we think that patients walk away thinking more about what we said – or how we make them feel?”

Scenes portrayed a history and symptoms conversation, recommendations for treatments and lenses in the consulting room and with a dispensing optician, and a handover.

1 Ask TED questions

Considering the history and symptoms conversation in the consulting room, Strachan acknowledged that it can be easy to fall into a pattern of yes and no questions. She introduced the TED model of questions, which stands for: tell, explain, and describe.

These might look like requesting from a patient: “Tell me about how you use screens. Explain how in your day-to-day life you are using screens. Or describe to me when your headaches come on.”

Strachan suggested the TED method can be more beneficial in digging a little deeper into history and symptoms, as well as building a rapport with the patient.

2 Watch out for assumptions

Strachan highlighted the role that assumptions can play in conversations between patients and practitioners, introducing the Ladder of Inference, which can be used to examine reasoning and consider whether assumptions are being made.

She gave the example that, if a patient says they are looking for the “cheapest” option, “We might automatically think: ‘We must only show them the cheaper range of glasses that we offer.’ But actually, what cheap means to them might mean something else to you.”

Using the TED questions can help practitioners to dig deeper into what the patient means and requires.

3 Making recommendations is a responsibility

In a conversation on making recommendations to patients, Dr Parth Shah, lead clinical performance consultant for Greater London at Specsavers, highlighted: “It’s part of our duty of care as clinicians.”

Discussing recommendations with patients is an important aspect of supporting patients to make informed decisions, he noted.

“Patients have come to see us to seek professional advice, so it’s our duty of care to ensure we do it,” he emphasised.

4 Consider non-verbal communication cues

Actors portrayed several scenarios of handovers between an optometrist and a dispensing optician using different communication styles.

A technique called ‘warm and strong’ can help practitioners to present themselves in the best way to a patient to form a positive impression, Strachan recommended.

She said: “It’s a line we have to walk, and we need to balance both because we can come across extremely warm and friendly, but not strong. If we do that, we have the effect of not having enough credibility in order to make the recommendations. On the other end of the spectrum, we can come across as really strong, but therefore not friendly or approachable.”

A balance between ‘warm’ and ‘strong’ is therefore necessary, she outlined: “You want to be warm, so you are friendly and approachable, but also strong to bring in that credibility. That’s really where the customer relationship begins.”

Strachan also illustrated the importance that tone and body language can play in communication, highlighting a study by Dr Albert Merhrabian, who suggested that the words used in a conversation only make up about 7% of an initial first impression.

More of an impression is built on the way something was said, such as the tone of voice, and the body language with which it was expressed.

5 Transfer trust and credibility between colleagues

Presenters emphasised the benefits of highlighting the expertise of colleagues as part of the handover process.

Strachan said: “We want to credentialise and highlight the expertise of the DO.”

Kirsteen Newman, head of dispensing advancement at Specsavers, commented: “I think in many practices everything hangs on the optometrist’s recommendation and if we don’t deliberately transfer that trust and credibility to our dispensing colleagues, the customer perceives that the clinical journey has ended when they left the test room and everything that follows is a sales conversation.”

She emphasised that this is not the role of dispensing colleagues, sharing: “Our DOs have their own professional expertise to offer and will often uncover needs that have not been revealed in the test room as they perform their visual task analysis.”

Newman said: “It is imperative that the handover sets them up for success as they continue that clinical conversation.”

The handover is about how the practice connects as a team of trusted experts, she added.