Book Description
Physicians of all disciplines know (or quickly learn the hard way) that effective and compassionate communication is arguably the single most important determinant of patient satisfaction. For cataract surgeons, the words said before, after, and even during the operation are often more important to the patient's happiness than the objective quality of the surgical result.
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
- 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 preoperative, intraoperative, and postoperative 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
Chapter 1. Preoperative Conversations
The High Myope
Significant Astigmatism
The Patient on Flomax or Similar Type of Intraoperative Floppy Iris
Syndrome-Producing Drug
The Patient on Anticoagulation
Pseudoexfoliation Syndrome
Posterior Polar Cataract
History of Previous Trauma
History of Previous Vitrectomy
History of Previous LASIK, PRK, or RK
The Patient Interested in Presbyopic Correction
The Patient Interested in Monovision
I Want My Cataract Removed by Laser
Lowering Expectations for Spectacle-Free Vision
Coexisting Blepharitis
Coexisting Dry Eye
Coexisting Epithelial Basement Membrane Dystrophy
Coexisting Keratoconus
Coexisting Fuchs' Corneal Dystrophy
Coexisting Macular Degeneration
Coexisting Diabetic Retinopathy
Coexisting Epiretinal Membrane
Coexisting Risk Factors for Postoperative Cystoid Macular Edema
Coexisting Ocular Hypertension
Coexisting Glaucoma
The Patient With a Cataract So Advanced, the Fundus Cannot Be
Visualized
Complications in the First Eye
The One-Eyed Patient
The Terrified Patient
The Nasty Patient
What's the Worst Thing That Can Happen to Me During Surgery?
Routine Patient Discussion at the Conclusion of the Initial
Examination
Chapter 2. Intraoperative Conversations
What I Say to the Patient Before Surgery When He or She Is
in the Preoperative Area
Draping and the Claustrophobic Patient
When the Patient Is on the Operating Room Table
The Moving Patient
How to Talk to the Anesthesia Person Assigned to my Room
When the Phaco Machine Fails…And It Will, Sooner or Later
The Torn Posterior Capsule
Can't Place Premium Intraocular Lens
Can't Place Any Intraocular Lens
The Dropped Nucleus
Can't Place Microinvasive Glaucoma Surgery Device
The Patient With a Bruise
What I Say to the Patient Immediately After Routine Surgery
Chapter 3. Postoperative Conversations
What I Say to the Patient on the First Postoperative Day
Bonus: Postoperative Instructions and Medication Sheet
One Day Postoperative: My Vision Is Worse Than Before Surgery!
Dysphotopsias
When the Patient Complains About the High Cost of
Postoperative Drops
Posterior Capsular Opacification
Refractive Surprise
When a Laser “Touch-Up” Is Necessary After Cataract Surgery
The Unhappy Patient Despite a Good Result
The Unhappy Multifocal Patient
When the Patient Asks for a Second Opinion
When the Patient Comes to See You for a Second Opinion... 91
Dislocated or Wrong Power Intraocular Lens
Retained Chip
Cystoid Macular Edema
Persistent Postoperative Inflammation
Decompensated Cornea
Endophthalmitis
Chapter 4. Bonus Chapter: What I Say to the Referring Physician
or Optometrist
Before Surgery, If I Agree With the Plan for Cataract Surgery
If I Disagree With the Indication for Cataract Surgery
Immediately After Surgery
At the Postoperative Visit
Financial Disclosures
Index