Today’s ophthalmologists admit they do not have as much time to spend with patients as they wish. Maximizing meaningful interactions with patients can be challenging, but doctors who are finding ways to increase their efficiency have been able to free up valuable chair time. We spoke to several doctors who shared some of their best tips.
Relying on Your Staff
Scribes and other staff members truly contribute to moving patients more efficiently without negatively impacting their experience.
For example, Lawrence Woodard, MD, a board-certified ophthalmologist and medical director of Omni Eye Services of Atlanta, uses a patient counselor who is dedicated to education. This team member also handles the practice’s marketing and is a skilled communicator — something that Dr. Woodard says is invaluable in a role like this.
“Our patient educator is one of the biggest contributors to my success in maximizing the patient experience and also converting more patients to premium services,” he says. “She is trained to initiate the conversation with patients regarding their options and find out about their goals. She can then tailor the education and document the patient’s preferences for me to review prior to entering the room. I am then able to streamline my discussion with the patients when I go in.”
Dr. Woodard says that he sees anywhere from 50 to 55 patients per day with 40 of them being cataract evaluations. There’s simply not time for him to handle all the education with each patient. But it’s also a task that makes sense to delegate to a trained communicator.
“When you’re educating a patient about a procedure, you need someone who is an excellent communicator while also being very good at comforting and reassuring people,” Dr. Woodard says. “Sometimes that person isn’t the doctor. So not only does this save time, but it often ends up supporting the best possible patient experience.”
Priya S. Vakharia, MD, in private practice with Retina Vitreous Associates of Florida in Palm Harbor and St. Petersburg, says that using a scribe allows her to devote her undivided attention to patients.
For example, Dr. Vakharia says that her staff talks to patients when she’s not in the room, which contributes to the overall positive patient experience while also making sure their questions are answered. She urges that it is critical staff is well-trained on what to say to patients. This can be done during staff training, but also by rotating staff members into the room.
“Our staff is cross-trained for everything so that I can always have someone rotate in the room with me as a technician or a scribe,” Dr. Vakharia explains.
Michael Patterson, DO, of Eye Centers of Tennessee, says that he also leans heavily on his support staff to ensure that patients still have a top-notch experience even though his time is limited.
“It’s important to have quality people who understand the mission of getting patients in and out without feeling rushed,” Dr. Patterson explains. “There is a delicate balance there. It’s also important to have enough people. Whereas many doctors only have two scribes, we have four. The scribes walk them through their diagnostic testing before I come into the room so that I don’t have to use time up on that task. Patients do spend time communicating with the scribe throughout the process, so they’re getting interaction and feeling heard. I don’t have to spend nearly as much time on education because they are already well-prepped.”
Steven M. Silverstein, MD, FACS, a cornea specialist in private practice at Silverstein Eye Centers in Kansas City, Mo., agrees that scribes can be incredibly valuable to increase efficiency and maximize quality patient time.
“Patients do not like doctors having their back or side to them as they type away in silence,” he says. “Using a scribe allows the patient to hear about their condition a second time — after I first explain it to the patient and their family — while also creating clinic efficiency and allowing for greater clinic patient volume.”
Dr. Silverstein says that dictating to a primary care physician or referring doctor in front of patients also gives him a chance to spend more time with them.
“This allows the patient to hear about their condition an additional time, confirms that a letter truly was dictated and gives me more patient time in the room,” he says.
Turning to Technology
These days, advanced technology is also helping practices to be more efficient. One way to do this is to utilize technology to assist with patient education. To maximize time, Dr. Vakharia uses technology to make sure that patients are already educated on what they need to know.
“We know that patients have many of the same questions that we answer every day,” she explains. “As a retina doctor, I get questions like ‘Will I be under anesthesia?’ or ‘What is the procedure like?’ Taking the time to use a hand-out or a video that already answers these questions is incredibly helpful. I particularly like video, as a lot of our patients are already dilated or cannot see well. Being able to hand them an iPad with a pre-made video that explains a procedure they need can save so much time.”
In addition, Dr. Woodard says that his clinic runs more efficiently thanks to a streamlined preoperative diagnostic testing process.
“There are now machines that perform multiple types of tests by one device, so instead of having to move the patient around to different machines, that process goes quickly and smoothly in one place,” he says.
Dr. Woodard adds that on the surgical side, improved technology has allowed him to perform surgical planning much more efficiently. Being able to plan remotely on devices that incorporate the cloud allows him to analyze information from various diagnostic tests in one location.
“It allows us to plan more efficiently with all of the information readily available — even outside of the office,” he says. “I spend less time doing surgical planning in the office and work on it when I have free time at home. These tools help give me more quality time with patients and less time doing cumbersome tasks.”
Adding a Personal Touch
While doctors do not have time for lengthy conversations with patients, it’s important to still maintain personal connections, urges Dr. Vakharia. The way that you handle the time that you do have is important.
“Make direct eye contact and give the patient a chance to talk without interrupting,” she says. “Often doctors come in and feel rushed. But the truth is, patients usually only talk for about 30 seconds to a minute and making them feel heard is important. If you let them have that time, they typically feel like they spent more time with you than they really did.”
Dr. Patterson also tries to make personal connections with patients, despite his jam-packed days.
“I make it a goal to learn one thing about each patient that I document in their chart and bring up when I see them next,” he shares. “For instance, I might ask Mrs. Smith if she still enjoys gardening. If a patient is a veteran, I always make a point to ask where they served, what branch they were in, and to thank them for their service. And if a patient’s family member passes away, I document the day it happens so that I can mention it next time. These are small things that go a long way. We want patients to know that even though we are busy, we really do care.”
Accepting the "New Reality"
While every doctor would like to feel less rushed, Dr. Patterson points out that the days of only having to see 20 patients are sadly long gone. While it’s important to make patients still feel like they had quality time, it’s also not a bad idea to be transparent about this new reality.
“I see 90-95 a day, with the ODs in my office seeing another 60-65 — and that’s just a necessity of the rural area that we live in and the way that the federal government pays,” Dr. Patterson says. “With the help of a robust staff, we try not to make patients feel too rushed. But every once in a while someone will complain that they didn’t have enough time. And in those circumstances, instead of trying to sugarcoat it, we are transparent in saying that we agree with them.
Also, I tell them “the way our system works, and with how many people need care, if I slow down, many patients wouldn’t be able to receive the care they need.” This transparency works the majority of the time. But along with that, Dr. Patterson says that it’s important for patients to see “purposeful movement by the doctor.”
“We keep all doors open until I’m in there so that patients can see I’m not aimlessly walking around or chatting on my phone,” he says. “That is one of the most critical things that I do that helps people to understand that I am truly very busy and doing the most I can with my time. Nothing is worse than being put in an exam room, having the door closed, and then not being sure what is going on or when you’ll be seen. Everyone has had an experience like that at a doctor’s office at some point. While we have to move through our day quickly, we make every effort that we can to make sure patients know we’re still committed to offering them the best possible care.” OM