Getting to know your patients: the lifestyle conversation

The scenario

As a practice, we are looking make improvements to steps in our patient journey to ensure that we get to know our patients better and are able to make the most appropriate vision correction recommendations based on them and their lifestyle. Do you have any advice on introducing and documenting the lifestyle conversation with staff across the whole practice team?

Sarah, optical assistant

The advice

Theresa Adamson, optometrist and Johnson & Johnson Institute faculty member

A conversation around the patients’ lifestyle is a key part of each and every consultation as it allows us, as the practitioner, to understand the patient’s personal requirements, ensuring our prescriptions and recommendations are appropriate and specific to them as an individual. It also allows us to build rapport with patients both at the initial visit, as well as at subsequent examinations if this conversation is documented for future reference.

While it is very common for the optometrist to have some form of lifestyle conversation with their patients as part of the history and symptoms, what varies between optometrists is the time taken and depth of these conversations. This can be dependent on the optometrist’s own style of examination, the type of clinic the optometrist works within, and the type of patient they have sitting in their chair.

But the lifestyle conversation doesn’t only have to happen in the testing room. The whole practice team can play a role in these lifestyle conversations at various points throughout a patient’s time in the practice. Again, this helps to ensure rapport is built with the patient both inside and outside of the testing room, ensuring that ultimately the patient leaves with the most suitable form of vision correction and advice for them.

By positioning suitable follow-up questions and conversations around lifestyle, building on information that has been provided by the optometrist, the practice team member dealing with the patient after the consultation can sense check that the eye care solutions recommended best match the patient’s lifestyle needs. It also allows them to offer other possible solutions.

The lifestyle conversation doesn’t only have to happen in the testing room. The whole practice team can play a role in these lifestyle conversations at various points throughout a patient’s time in the practice

Internal communication

Formally, practices can embed some form of questionnaire into the patient journey, which front of house practice staff can go through with a patient on booking an appointment or when arriving in practice. This enables the practice team member to gain insight into that patient and any specific needs they have, allowing them to build information that can be passed over to the optometrist before the eye examination.This can also provide a benchmark for follow up conversations that can be had by the optometrist during the history and symptoms, and can help the optometrist make more efficient use of the time available within the consultation.

The key thing here is to avoid duplication of lifestyle questions, as that potentially opens the patient up to feeling that they are just repeating themselves and not being listened to.For example, if they have had a conversation with a member of the practice team on the practice floor about driving as part of the lifestyle conversation, and then the optometrist goes into a routine set of questions around lifestyle asking, ‘Do you drive?’ they may get frustrated as they have already answered this question with another colleague.

The transfer of captured information is just as important, if not more so, as asking the questions in the first place, so make sure this is done in a way which best suits your practice set up. This may be as a printed or digital questionnaire that is handed over, via notes made on the patient record, or via a direct conversation in a handover between the team member and optometrist.

Informally, any conversation with the patient around lifestyle can be useful for the whole practice team to build a picture of the patients' individual requirements to ensure they are getting the correct personalised eye care solution.Working as a team is key here, so if something is picked up after the consultation around lifestyle requirements that may amend the required prescription or advice and the practice team wants to check this with the optometrist, there should be an open channel of communication, making sure notes are made on any key aspects so this is flagged for future visits.

The transfer of captured information is just as important, if not more so, as asking the questions in the first place, so make sure this is done in a way which best suits your practice set up

Before the practice visit

Having information ahead of a patient’s appointment helps the team and the optometrist tailor the examination appropriately. For existing clients, finding out the reason for booking an examination can alert you to any potential issues they are having which can be useful when planning clinic timings, but also helps build rapport, especially if this is discussed at the outset when the patient arrives within the practice. For new patients, as well as knowing reason for visit, it can be useful to gain insight into current forms of correction and basic lifestyle information so this is known in advance of the patient arriving in practice. This can particularly highlight whether or not they are currently wearing contact lenses and whether this may be a suitable option for them. Advising them at this stage that contact lenses could be another option for them, which the optometrist can discuss on the day, allows them time to consider this in advance so they are potentially more open to the idea, and have thought of suitable questions they may have in advance of the consultation. Again, documenting any information gathered during this conversation or digital questionnaire is key to ensure it is appropriately captured and utilised when they arrive in practice.

A comfortable conversation

I think it is important for patients to understand why we are asking these lifestyle questions. Some patients can feel that these are quite personal questions and without understanding why we are asking them we may not get what we want from the conversation. Phrases such as, ‘So we can provide you with suitable eye care solutions to match your individual needs and lifestyle. Are you happy to share what your typical week looks like in terms of your occupation, and any hobbies and interests you may have?,’ can work well.

For returning patients, it is important to build on information you previously gathered in order to maintain the rapport built at the last visit, making the patient feel it is a more personalised service. Questions such as ‘looking at your previous notes I can see you worked as X when you last visited and in your spare time enjoying doing Y’ – has anything changed from a lifestyle point of view over the last two years as we want to make sure we continue to provide you with the most appropriate eye care solution to meet your own individual needs?’ can work well.