About 10 or 15 years ago, I made an appointment with a new eye doctoran ophthalmologist (yes, this was before I started working at an optometry publication). I was there for an annual eye exam and thought I might need a new pair of glasses.

I waited at least 45 minutes before my name was called. I didnt mind, however, because the dispensary was near the reception area. and the optician let me try on frames during my wait. (See Make a Spectacle of Yourself, for more on how the location of your dispensary can affect your bottom line and patients overall experience in your office).

After I made a tentative decision to purchase some fantastic Gucci sunwear, plus a high-end imported Italian frame for my regular ophthalmic lenses, I sat back down in the waiting room. Seconds later, the technician called me in for a first round of testing, which she performed.

Next, I was transferred to another exam room, where I waited for the doctora friendly-looking older gentleman, I thought, when he first walked in the door. He was cordial in his greeting, introducing himself with a smile and shaking my hand. Things were going well. That is, until he began commenting on my patient history form.

You smoke? he asked.


Cigarettes will kill you, you know. And, he added, in what I suppose was an attempt to play on my vanity (after all I had chosen some of the most expensive frames in his dispensary), they make you smell terrible.

Words cannot describe how angry his comments made me. I stood up and said, Hey, youre an eye doctor, not a cardiologist. What business is it of yours if I smoke? I left before he could answer, shouting on my way out, I may smell terrible, but you smell like a bitter, judgmental old man.

Im a little more mature now, and I quit smoking years ago, but I often reflect upon how that doctor might have gotten through to me had he approached the subject differently. Patients most likely dont know that smoking affects their ocular health. So, unless your discussion is centered around this, they may not pay much attention to what you have to say, especially if you criticize them.

While smoking is not the focus of this months issue (were saving that topic for next year), diabetes and obesity are.

Annual Diabetes Report
The number of Americans with diabetesand diabetic retinopathyis multiplying.
Go to page 65 to earn 2 CE credits learning how you can diagnose and help manage these patients.

Obesity is the fastest growing epidemic in the United States and, like smoking, it has serious ocular and systemic implications. In The Obesity Epidemic: A New Role for O.D.s? (page 51), obesity lecturer Hal Bohlman, O.D., provides detailed information on how to identify which patients require education and counseling and offer them ideas about how to lose weight or seek additional help.
As your role as a health-care provider grows, its critical that your chairside manner develop along with it. You have important information to share. Dont let it fall on deaf ears.

Vol. No: 143:09Issue: 9/15/2006