For many years we as optometrists have been taught to “recommend” in the chair. We teach our dispensary staff to also recommend products. So why don’t patients always follow recommendations?
The problem lies with the wording. By definition, a recommendation is a proposition to consider when making a choice. Traditionally, many doctors only recommend ophthalmic products, but they prescribe medications. When patients see a doctor they are paying for the doctor’s expert opinion to resolve their problems. Patients want and expect the doctor to prescribe them something which will address their chief complaint. Here are three rules to follow in moving from recommending to prescribing.
- OD prescribes – It all begins in the exam lane as you communicate to your patients. This change is relatively easy as you change the terminology that you use. You might continue to use “recommend” but it will be
used for those extras that are truly optional. If a patient works on a computer and has complaints of eye strain and fatigue at the end of the day, his resolution may be an anti-reflective coating applied to the computer screen with an updated glasses prescription. So instead of recommending, say: “I am writing a new prescription to address the strain and eye fatigue you are experiencing at the computer. The prescription includes an anti-reflective coating to reduce the strain from glare.” If a patient has an early onset of cataracts you might say: “I am prescribing a pair of polarized sunglasses to reduce the glare for safer driving and protect your eyes from the UV damaging rays that cause cataracts.” - Staff recommends– Your dispensary staff is trained in product knowledge. As staff members converse with patients they will find out the activities
that the patient participates in and recommend appropriate products accordingly. This is an added benefit to the patient but it is not necessarily related to the chief complaint. Your staff members are not doctors and therefore should not be prescribing. They should be trained to recommend. However, if a doctor prescribes a particular feature they need to support the doctor by using that same vocabulary. For example, if Dr. Smith prescribes an anti-reflective coating, the staff should say: “We will want to have the anti-reflective coating on the lens to follow the prescription Dr. Smith wrote for you.” - Less is more – As you transition your vocabulary from recommending to prescribing, remember less is more. Stick to the chief complaints that a patient has given you. Do not prescribe ophthalmic products for complaints that do not naturally exist. Take one or two of the chief complaints and focus on them. You will find that patients feel their concerns have been addressed. Also, you might find that your anti-reflective use or polarized lens use in the dispensary has gone up. The result is a patient who is satisfied with products that address the need, and you are happy that you do not feel like a used car salesman.
An optometrist has spent many years in school to earn the privilege to prescribe. Patients are paying for and seeking your expertise in prescribing. Don’t disappoint them by passively recommending ophthalmic products. Be specific as to what and why you are prescribing, and your patients will appreciate it.
