Communication in the optometry practice

-Does your patient understand you?

Helmer SchweizerPresident EUROMCONTACT

Chairman European Contact Lens Forum (ECLF)Head Professional Affairs Distributor Markets,

Alcon Vision Care, EURMEA, Switzerland

Two people, who have nothing to say to each other anymore, should start talking with each other, again.

Werner Mitsch (German Aphorist 1936 - 1986)

AgendaCommunication: • General • In the practice / during CL fitting • Some personalities• Summary

• Differentiation• Attractiveness for patients / customers• New patients / customers (mouth-to-mouth adv.)• Patient / customer satisfaction• Patient / customer Loyalty • Increases in efficiency• Increase in the fitter‘s self-esteem (and that of all

her / his employees!)

Better communication results in …

Communication is an essential means to pass on and gain knowledge.

All behavior is communication.

„One can not not communicate“(Paul Watzlawick)

Communication

• Mass communication• Group communication• Individual communication• Interpersonal communication

• Vocal communication • Non verbal communication• Visual communication• Spoken language• Para language• Supporting communication• Gesture supporting communication• Supported communication

Types of Communication

• Nonverbal parts yields 80% of the reaction (mimic, gesture, but also posture (effect on the other, but also on one self!))*

• Spoken word only has about a 10 - 20% share of the achieved effect.

Nonverbal vs verbal parts

* Samy Molcho

• Especially important: Attitude / Empathy*• Dealing with one’s own emotions• How we listen to others, • Integrate & communicate own emotions

Empathy, Emotions and Attitudes

* Daniel Goleman: Emotional Intelligence, EQ

• Effect (of being in a face-to-face situation)• Reflective: timely, factual and social• Presence => observation => behavioral communication

=> interpretation => perception • Interactive, reciprocal, intentional Prerequisite is a minimum level of:• Understanding • A common and congruent set of symbols, signals,

characters => common language

Characteristics of the „Face-to-Face“ Communication

• Audio• Visual • Tactile (sense of touch)• Sense of smell• Thermal • Sense of tasteThe more one uses / serves, the better the degree of

reflection, the more precision is in the communication.

Channels of „Face-to-Face“ C.

The Sender-Receiver-Model adapted from Claude Shannon and Warren Weaver (1949):

Sender –Receiver -Model

Interaction (communication) takes part “between” two active people and is not identical with them

Stock of symbols, characters

Sender

Encodes message (verbal/nonverbal)Communication media /

information channelsEncoded feed back (verbal/nonverbal)

Receiver

Interference/disturbance

Situational context, environmental conditions

Stock of symbols, characters

Multi layers characteristics of a human messageThe four layers / levels of a message• Factual layer, objective content • Appeal • Relationship• Self-revelation

Four–Layers-Model

as per Friedemann Schulz von Thun

Starts exclusively with the content.Does not include the particulars of the people or the type

of gesture, etc.. The factual information includes • Purely factual messages • Dates and Datathat are part of a message. „What is it, that I inform about?“ News often contain a factual message. Task for the sender: Communicate the facts clearly,

objectively, understandable and neutral.

Factual Layer

The Appeal includes a wish or a call to action. - What I want to prompt you to do- The effort to exert influence, can be more or

less open or hidden- In the later case, it is called manipulation.

Appeal Layer

Expresses and captures how, how the two parties feel about the relationship.

You-Message: What I think about you andWe-Messages: How we think about / value

each otherHow do I treat the people around me with

my way of communicating?

Relationship Level

The sender transmits – consciously or unconsciously – something about her- /himself, his motives, values, emotions etc.

I-messages: What I tell about me myselfThus, each message does become a small

„sample“ of the sender’s personality.

Self-revelation

ExampleWoman drives the car. Man sits on passenger seat.Man (sender): „Maria, the traffic light is on green.“Factual information: “The traffic light indicates ‘you can

go (now)’.“ Appeal: „Go, start moving!“ - May be a little bit more

polite: „Can you please start going, now!“ Relationship : First name basis => personal relationship

„You react slower then me.“ Self-revealing: I am impatient. - I want to drive myself. -

I am in hurry. - …

Causes more than 80% of the reaction!1 Many are not aware about the importance and the

consequent need of control of body language.Important: • Internal attitude / views towards the other party

(empathy) • Dealing with / handling one’s own emotions (EQ)2

1 Samy Malcho2 Daniel Goleman

Nonverbal Communication

Autonomous body functions can not be driven, controlled by will (sweating, pupil size or pulse) and are recognized by the other party, as we can recognize them ourselves.

Pacing: Aligning in tonality, gesture, mimic, posture, …

Some can actually ”read” in a face.

Nonverbal Communication

Conscious body language: Gesture, mimic (areas around the eyes and the mouth, …)

Here especially important: The smile! - Expression of pleasure, joy, delight, … - To come in contact- To take the tension out of difficult situationsConfident handshake when greeting, welcomingPoker-face, smile at somebody (to come in contact), clothes,

smell, …Self-conditioningExample: picking up the phone

Nonverbal Communication

ATTENTION: Cultural differences in the meaning of gestures etc.- Nodding with the head is a rejection in Greece!- Direct eye contact is an annoyance in Islamic countries- Palms angled downwards is an invitation in Africa/Asia

Nonverbal Communication

Distance zones/-spheresPublic distance

(> 3 m)Near distance

(1 – 3 m)Intimate distance

(about arms length)

Public sphere (> 4 m)

Social sphere (1.3 – 4 m)

Personal sphere(0.5 – 1.3 m

Intimate sphere (0 – 0.5 m)

Difference between frontal and sideways=> Be conscious on how you approach in CL fitting and specs adjustments

Communication … … is: share, tell, invitation to participate, doing things together, merge… is reciprocal exchange of thoughts in language, gesture, mimic, word and image… can release forces, power, bring zest for life, but can also be a burdenBeing consciously aware about the above helps to recognize one’s own condition, allows some control in it and thus to become more effective and efficient.

Summary part 1

Your internal conditioning is your responsibility!In case you want to have a good day, than expect to have a good day!

The power of internal conditioning

To communicate effectively and efficiently with a customer, adapt yourself to / align with him.

For example, speak at similar speed (needs a lot of practice!)

Get rid of your own preferences.

Listen actively !

Building customer relationships

• Keep „eye contact“ (attention: culture!)• Let the customer speak out, finish.• Do not interrupt unnecessarily (e.g. when

customer is doing a monolog). • Show during the listening, that you are paying

attention: at appropriate times, say things like : ah, really?, is that so?, oh!, mhh, …

• „Show“ that you listened, reflect back what you „heard“.

Active listening

• Take a small pause, before you answer (if answer at all!).

• Sometimes it is a good idea to reflect what you heard in a heavily summarized version, get confirmation of your summary (allows you refer back to it).

=> This is especially important with people that are difficult to understand, talk a lot

• Using some of the customer’s own words shows that you really listened „well“

Active listening

• Always remember the name!• Tip: Use the name in the beginning several times. • When not sure about the spelling (filling in a

form), ask! (Schmidt, Schmitt, Maier, Meier, …)• Fauxpas: Ah, yes, you are the one with the funny,

crazy spelled name! (Watch your body language, too! No grinning!)

Active listen

• Do not discuss, most of all, do not argue with the customer. This does not necessarily mean that you have to agree with them, but let them have their (wrong, faulty?) opinion.

People are usually more convinced by reasons they discovered themselves than by those found by others.

Blaise Pascal (1623 - 1662) French mathematician, physicist

Dealing with customers

• First encounter• Avoid judgments on the basis of stereotypes

(Feeling surprised is a hint that you may have done so!)• Do not condition yourself negatively => Smile!

• History and Symptoms• Listen actively! • Pay attention, remember details

The examination

• Measurements and questioning techniques• During Anamneses, watch out for the

nonverbal communication, subtle notes within the talk.

• The quality of the answers is directly proportional to the quality of the questions.

The examination

• Communication of the results • Split the exam’s results in „small“, easy

to understand parts.• Adapt your style to the customer’s one.• Use all communication layers and

channels.

The examination

• Closing the examination• Many people only remember what was said at

the end, last. • Agree on the next steps and the associated

appointments • Friendly “good-bye” (address customer with

name, hand over your business card, brochures, …)

The examination

“I find that what I say has as much to do with my ultimate success in working with a patient as anything I do clinically”

“It was mind-boggling to think that not only what I say has an impact on my patients, but also what I fail to say.”

Dr. Stephen Cohen

Communication

“You really need to be able to tailor your specific

recommendations to each patient.”“For any recommendation that we make to have

value and validity to our patients, we have to be able to tie back into what their needs are.”

Dr. Gary Gerber

Communication

Are you understood?

Þ verify, repeat, phrase new, …

Þ ‘Team-up’ with the customer

The information you give will thus become more

specific, relevant, it must be correct and verifiable.

Communication

The greatest success factor :• Knowledge• Enthusiasm• Persistence• Practice • Experienceand: COMMUNICATION!

YOU!