Practice Advisory: Your Patients, Your Staff, Your Responsibility

The Optometric Practice Reference (OPR) (Optometric Practice Reference – Oct 2021) places the responsibility for all services provided by optometrists and their staff squarely on the shoulders of the optometrist. Most service aspects incorporate communication between your staff and your patients. Given that you are responsible for the content and tone of this communication, it is of utmost importance to every optometrist that their staff understands the need for professionalism, sensitivity and respect in all their dealings with patients.

In addition to you being responsible on an individual basis for the actions of your staff, you are also responsible for treating each patient as an individual with his or her own idiosyncrasies. Having established office policy certainly makes most situations simpler. However, to fit each patient into a strict policy is neither always wise nor always possible. To help your staff project an atmosphere of understanding and caring, it would be advisable to create flexible policies that allow staff to adapt to situations that warrant such change. This reduces the likelihood of them being put in an unwinnable situation and increases the likelihood of you being perceived as a professional that cares.

Every practitioner will agree that it is unreasonable to expect staff persons to be in a bright and cheery mood every working day of the year. However, personal ups and downs cannot be used as an excuse for less than courteous interactions with patients. Every practitioner will also agree that it is unreasonable to expect every patient to be on their best behavior during the course of every encounter they have in an optometrist’s office. However, the patient’s attitude and tone cannot be used as an excuse for disrespectful or discourteous behavior on the part of staff members. While this double standard may well seem burdensome, it is the same burden each of you carries. Belligerence, vulgarity, or unreasonableness on the part of a patient are never an excuse for unprofessional behavior. The OPR delineates the expectations of your peers that you alone are responsible for fostering the patient/optometrist relationship. As an extension of you, your staff’s behavior is considered your behavior by the College and will be treated as such.

It is often apparent that staff members are not aware of the facts outlined above. It is also frequently obvious that they are not aware of the many regulatory requirements governing the varied aspects of patient care. For example, your staff must be aware of the requirements that deal with the proper manner by which services to a patient may be discontinued (College policy – Discontinuation of Service). If, in a moment of frustration, one of your staff members sees fit to tell a patient that they are no longer welcome in your office, you have discontinued care for that patient. Needless to say, it did not meet either the requirements under the Optometry Act or the expectations delineated in the OPR. It is incumbent upon each optometrist to make their staff members familiar with the requirements of the Regulation insofar as they impact upon their daily tasks.

The ability to maintain an office environment that is congenial to and respectful of patients’ needs begins with office staff. It is them that incoming patients first see and interact with. Your staff provide the first impression of your office for most patients. A pleasant demeanour can go a long way to enhancing both your reputation and the reputation of the profession. One of the many ways your staff can contribute positively to the overall ambiance of your office is to schedule appointments in a manner that is considerate of your patients’ time. Unnecessary waiting time in offices brings out the worst in some patients. If emergencies or other unexpected upheavals of your well-planned schedule cause long waits, empower your staff to explain the reason for the wait and to reschedule if the wait goes beyond a certain length of time.

Waiting rooms are often the place of egregious breaches of confidentiality. Your staff should be reminded that all conversations with patients or about them concerning their personal information should be carried out in private or at a level that prevents others from hearing the details. A personal health history should never be taken verbally from a patient in a waiting room. Written responses that you can elaborate upon in the examining room serve to prevent a breach of confidentiality.

With respect to those tasks your optometric assistants are allowed to perform under the Optometry Act, make sure that they are fully trained in every aspect before allowing them to interact with patients. It is important that they understand that patients are to be given the freedom and counsel to make informed choices about their treatment and ongoing care. They need to know what tests are being performed on them, how these tests will proceed, and what to expect. Foreknowledge can prevent patients from reacting negatively to unexpected text experiences. The patient has the right to know, and your staff need the information to be able to impart the knowledge in a manner that is understandable to the patient.

Your staff members are frequently the last people your patients interact with as they leave the office. That interaction will colour the patient’s final impression of the services you provide. Make certain that your staff understands the regulatory requirements, so that no misunderstanding ruins a solid patient/practitioner relationship.