Book Description
What I Say: Conversations that Improve the Physician-Patient Relationship is designed to help cataract surgeons to hone their verbal interactions to be as sharp as their surgical skills. Muddled, clumsy, or impromptu explanations diminish the doctor-patient relationship and could prevent patients from receiving the surgery they need or appreciating the results they get.
Knowing in advance which words to use in difficult situations is analogous to knowing how to manage a complication before it occurs. The results are inevitably better when a physician has considered every possible outcome instead of attempting to come up with exactly the right solution on the spot. Rather than figure out the right words by trial and error, however, What I Say has recommendations on exactly what to say to build strong and trusting patient relationships.
Drs. Robert Osher and Jack Parker have compiled conversational scripts from Dr. Osher’s 40-year career in ophthalmology, as well as contributions from over a dozen international mavens of bedside manner into a strategy guide through even the most difficult patient conversations that inevitably surround cataract surgery.
Topics include:
- Lowering Expectations for Spectacle-Free Vision
- The Torn Posterior Capsule
- Postoperative Refractive Surprise
- The Dropped Nucleus
- The Unhappy Patient Despite a Good Result
Containing examples of conversations with cataract surgery patients where informing and reassuring take top priority, What I Say: Conversations that Improve the Physician-Patient Relationship was created to aid cataract surgeons in their pre-operative, intra-operative, and post-operative interactions with patients. With the advice contained inside, surgeons will be able to motivate patients, calibrate expectations, and diffuse frustrations in every possible scenario.
More Information
Contents
Dedication
Acknowledgments
Expert Contributors
Preface
Foreword by Richard L. Lindstrom, MD
Introduction
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Chapter 1. Preoperative Conversations
The High Myope
Robert H. Osher, MD
Significant Astigmatism
Robert H. Osher, MD
The Patient on Flomax or Similar Type of Intraoperative Floppy Iris
Syndrome-Producing Drug
Robert H. Osher, MD
The Patient on Anticoagulation
Robert H. Osher, MD
Pseudoexfoliation Syndrome
Robert H. Osher, MD
Posterior Polar Cataract
Robert H. Osher, MD
History of Previous Trauma
Robert H. Osher, MD
History of Previous Vitrectomy
Robert H. Osher, MD
History of Previous LASIK, PRK, or RK
Robert H. Osher, MD
The Patient Interested in Presbyopic Correction
Michael E. Snyder, MD
The Patient Interested in Monovision
Graham D. Barrett, MBBCh, FRANZO, FRACS
I Want My Cataract Removed by Laser
Samuel Masket, MD
Lowering Expectations for Spectacle-Free Vision
Robert H. Osher, MD
Coexisting Blepharitis
Robert H. Osher, MD
Coexisting Dry Eye
Robert H. Osher, MD
Coexisting Epithelial Basement Membrane Dystrophy
Robert H. Osher, MD
Coexisting Keratoconus
Douglas D. Koch, MD
Coexisting Fuchs’ Corneal Dystrophy
Robert H. Osher, MD
Coexisting Macular Degeneration
Robert H. Osher, MD
Coexisting Diabetic Retinopathy
James M. Osher, MD
Coexisting Epiretinal Membrane
James M. Osher, MD
Coexisting Risk Factors for Postoperative Cystoid Macular Edema
Robert H. Osher, MD
Coexisting Ocular Hypertension
Anup Khatana, MD
Coexisting Glaucoma
Iqbal “Ike” K. Ahmed, MD
The Patient With a Cataract So Advanced, the Fundus Cannot Be
Visualized
Robert H. Osher, MD
Complications in the First Eye
Robert H. Osher, MD
The One-Eyed Patient
Robert H. Osher, MD
The Terrified Patient
Robert H. Osher, MD
The Nasty Patient
Robert H. Osher, MD
What’s the Worst Thing That Can Happen to Me During Surgery?
Robert H. Osher, MD
Routine Patient Discussion at the Conclusion of the Initial
Examination
Robert H. Osher, MD
​
Chapter 2. Intraoperative Conversations
What I Say to the Patient Before Surgery When He or She Is
in the Preoperative Area
Robert H. Osher, MD
Draping and the Claustrophobic Patient
Robert H. Osher, MD
When the Patient Is on the Operating Room Table
Robert H. Osher, MD
The Moving Patient
Robert H. Osher, MD
How to Talk to the Anesthesia Person Assigned to my Room
Robert H. Osher, MD
When the Phaco Machine Fails…And It Will, Sooner or Later
Robert H. Osher, MD
The Torn Posterior Capsule
Robert H. Osher, MD
Can’t Place Premium Intraocular Lens
David F. Chang, MD
Can’t Place Any Intraocular Lens
David F. Chang, MD
The Dropped Nucleus
Robert H. Osher, MD and David F. Chang, MD
Can’t Place Microinvasive Glaucoma Surgery Device
Jack S. Parker, MD, PHD
The Patient With a Bruise
Robert H. Osher, MD
What I Say to the Patient Immediately After Routine Surgery
Robert H. Osher, MD
​
Chapter 3. Postoperative Conversations
What I Say to the Patient on the First Postoperative Day
Robert H. Osher, MD
Bonus: Postoperative Instructions and Medication Sheet
Robert H. Osher, MD
One Day Postoperative: My Vision Is Worse Than Before Surgery!
Robert H. Osher, MD
Dysphotopsias
Robert H. Osher, MD
When the Patient Complains About the High Cost of
Postoperative Drops
Robert H. Osher, MD
Posterior Capsular Opacification
Robert H. Osher, MD
Refractive Surprise
Robert H. Osher, MD
When a Laser “Touch-Up” Is Necessary After Cataract Surgery
Richard L. Lindstrom, MD
The Unhappy Patient Despite a Good Result
Robert H. Osher, MD
The Unhappy Multifocal Patient
Richard J. Mackool, MD and Robert J. Cionni, MD
When the Patient Asks for a Second Opinion
Robert H. Osher, MD
When the Patient Comes to See You for a Second Opinion... 91
Warren E. Hill, MD, FACS
Dislocated or Wrong Power Intraocular Lens
Robert H. Osher, MD
Retained Chip
Robert H. Osher, MD
Cystoid Macular Edema
Robert H. Osher, MD
Persistent Postoperative Inflammation
Robert H. Osher, MD
Decompensated Cornea
Jack S. Parker, MD, PhD
Endophthalmitis
Christopher D. Riemann, MD
​
Chapter 4. Bonus Chapter: What I Say to the Referring Physician
or Optometrist
Before Surgery, If I Agree With the Plan for Cataract Surgery
Robert H. Osher, MD
If I Disagree With the Indication for Cataract Surgery
Robert H. Osher, MD
Immediately After Surgery
Robert H. Osher, MD
At the Postoperative Visit
Robert H. Osher, MD
​
Financial Disclosures
Index