Special contribution from Amy Hellem
Laurie Sorrenson, OD, FAAO, of Austin, Texas, uses these 12 steps to help patients see the silver lining in a diagnosis of age related macular degeneration (AMD) and move in a positive direction.
1. Walk in prepared. Have an organized message and plan before you walk in the room.
2. Deliver the information clearly. Be very matter-of-fact when delivering the details of the testing and diagnosis.
3. Use language that the patient can understand. Don’t initiate a long discussion of the different stages of AMD and how and why it progresses. If a patient has subclinical AMD, you can say, “You have no other clinical signs of AMD, which is great news and means we can slow the process down and probably maintain good vision the rest of your life.”
4. Avoid medical/scientific jargon. Don’t explain all of the science behind dark adaptation and AMD. Keep it simple.
5. Don’t apologize. An apology implies that there’s a reason to feel sad. There’s not. An early AMD diagnosis puts you and the patient in the position of power.
6. Respect the patient’s reaction. It’s very possible that the patient will feel sad, scared or discouraged. Don’t dismiss this or make the patient believe that you think such a response is ridiculous or unwarranted.
7. Make sure the patient understands. If it seems like the patient is confused about the news you’ve delivered, ask them to describe what they think they heard in their own words so you can clear up any areas of misunderstanding.
8. Establish a plan. Present the options and focus on how to move forward. It's much easier for patients to accept a diagnosis if you have a clear plan for how to address it.
9. Make time to respond to your patient's concerns. Never let a patient leave your office with a sense of hopelessness.
10. Encourage questions. Patients will always think of a thousand things they should have asked, but don’t let it be your fault that they didn’t.
11. Offer validation and encouragement. Don’t dismiss a patient’s feelings or reaction. Instead, help direct these emotions in a positive direction.
12. Provide take-home information. Provide handouts, pamphlets, and website addresses, but make sure to warn the patient about ominous details that relate to other, more severe forms of disease.