View from the High Street: Learning the soft skills
Judy Lea considers the experience required to gauge the best way to tell a patient difficult news
Author: Judy Lea
We have seen a different pattern to trade on the high street, following on from the World Cup, where even non-football fans can’t have failed to notice that the England team did the country proud for a change. There seemed to be a general change in the mood of patients attending for eye examinations over that time.
As with the first few sunny days of the summer, everyone seemed a lot happier and had more of a spring in their step. Rather than the usual doom and gloom, it brought a degree of hope and pride to people and a bit more unity.
England’s success reminded me of how important it is that in practice we work as a team and remember that we are all there to work together, supporting each other’s weaknesses and helping each other to develop and use our own strengths for the benefit of the business.
This could not be more true as our pre-registration optometrists start in store. While they have the academic knowledge, they lack the experience of day-to-day practice, of how different patients respond differently and how to judge reactions and gauge their response to the patient accordingly.
I recently examined an elderly lady who could have taught them a lot about adapting their findings and explanation to the individual. She had macular degeneration and corneal dystrophy, which had meant she needed a corneal graft. Unfortunately, despite the graft, her vision hadn’t come up to beyond 6/15 on the letter chart due to her other eye problems.
She was a straight-talking 80-year-old who had many stories to tell and, I think, enjoyed her outings to the various health professionals that she was under the care of. It was very difficult to stop her from digressing during the examination with her various stories such as the one about the benefits of olive oil in her diet and to get her to focus on the eye examination in hand.
Finally, we managed to get through it. I knew she was a driver and that I needed to have the difficult conversation about her no longer reaching the driving standards. I have had many of these conversations over the years and they are never easy when you are suggesting to someone that they give up some of their independence. I usually try and slowly introduce the idea by pointing out the standards that are set and how insurances are not valid if they don’t meet the standards. I sympathise with them how it can be hard, but maybe it would be the right thing to do?
However, this time as I started to gently introduce the limits that are set for driving I realised that I needed to go about it differently with this particular patient. She was someone who wanted to be told ‘as it is’ so rather than take it gently, I just pointed out the standard needed for driving and said that she no longer met it and unfortunately she would have to consider what she was going to do about it. I have never been so blunt with previous patients in this situation, and probably will not be again, but for this lady it was what she needed. She just replied with, ‘Well if that’s what you’re saying, I need to stop driving then.’
I saw her again recently and she was singing our praises and saying how wonderful the health service is compared to the issues around insurance cover that her friend has in America. She said that when I told her that day about her driving she was so grateful to me and it was exactly the way she needed to hear it: ‘no pussy-footing around it’ were her exact words.
She compared it to a hospital doctor who started her on some painkillers which she didn’t like taking and when she had the conversation with him about not wanting to take the medication. He replied: ‘Well I am the doctor and I’m telling you that is what you need to do.’ She said as I am her optometrist, I am the one who should be telling her what she needs to do and she will do it.
I am not too sure how we teach our pre-reg optometrists the soft skills of how to read a patient and adapt to their personality, but it is certainly something that makes us more successful as clinicians. I hope that as a practice team we can continue to work together and learn from observing one another’s strengths, just as the England team did in (almost) all their matches just a few weeks ago.
Judy Lea is optometrist director of Specsavers, Longton, Staffordshire.