Over the last six years, I’ve been working on one simple goal: to let patients get surgical outcomes as close as possible to what they expect. This isn’t just about patient education and setting them up with realistic expectations. Both of these things matter, but they aren’t enough if a patient still doesn’t feel heard by their surgeon.
Instead, patients need to be listened to and shown that their requests are properly understood. To build long-term trust with patients – and to understand exactly what it is they are looking for – I spent my time listening first-hand to thousands of post-op stories, implementing all of this feedback into my own projects.
A recurring theme is that patients miss having clear and trustworthy communication during their procedures.
Sound familiar? It might do, but this is just the tip of the iceberg.
Let me share three real patient cases with you:
A 55-year-old senior manager from Texas, planning refractive lens exchange (RLE), found himself unable to make a definitive decision because he was too afraid the surgeon might be angry with him for asking too many questions. The patient’s main concern was that if the surgeon grew to dislike him, found him too annoying because of all the questions he asked, they might perform a less than optimal surgical procedure.
A 63-year-old woman was recommended for cataract surgery by her doctor. The patient canceled the measuring appointment and moved to another clinic to get a second opinion. She felt that her first doctor was pressuring her into surgery, and was scared of the procedure from reading of too many bad cataract experiences online. She was also upset because, while she didn’t want to pay out $12,000 for a premium lens, she also didn’t want to regret taking the basic monofocal option instead.
A 37-year-old woman, upset with the monofocal options offered in the US and in search of better premium options, chose not to complain to her surgeon, but instead travelled to New Zealand where she found a doctor who “had a great page on different lens choices and trade-offs.” Those were her exact words.
What unites all of these stories? It’s the silence in the room. It’s a metaphor – and a warning. It’s how fear sounds when no one is listening.
This silence can perhaps be best explained by understanding the patient’s behavior – facing any kind of surgical intervention will always, to a greater or lesser extent, generate fear. This is the basic thing that we, as healthcare professionals (HCPs), need to keep in mind.
It’s a perfectly natural reaction to the situation – fear of becoming blind, of one’s quality of life decreasing, of significant changes being made to our daily lives. And these fears are not always easily perceived by an external observer.
I believe that HCPs rarely focus on this fear that the patient is experiencing. And of course, this can be quite natural within the parameters of a professional setting – along the treatment pathway, each professional has their own area of expertise and their own focus on the tasks that they need to perform. And this is why communication with HCPs is commonly misaligned with what the patient really needs.
In these types of cases, the patients, who have deep emotional needs during this uncertain period, feel both unseen and unheard by those caring for them.
But instead of the general conversational boundaries presented to them in their pre-operative appointments (e.g., “Would you be happy wearing glasses?” “Do you do any night driving?”), patients instead want to learn about the core things that really matter to them at this stage.
For instance, they want to know:
Does the doctor really see me as a person with individual needs?
Will my vision after surgery really be better than it was before?
How will my post-surgical vision affect my current lifestyle?
I would suggest simply listening to the patient more than talking. This is what I call the Smart Sight Framework, and it begins by opening up the real values of the patient.
You should start by asking them about their life. Focus not only on what they say but how they say it. Don’t ask them about glasses, but rather about what they value most in life. This broader question can open the door to empathy. It’s a trust-building phase, which is crucial because conversion never happens under pressure; it happens when clarity and trust are perceived.
Once you have uncovered the patient’s main values, then it’s time to talk. Start with rephrashing the patient’s values, and then gradually begin to explain the basics of range, far vision trade-offs with trifocals, near vision trade-offs with extended depth-of-focus (EDOF), poor depth of field with monofocals, low light vision, etc.
This is crucial – reflecting what the patient has just said helps to give more clarity about their personality, as well as creating a sense of trust. Despite desperately wanting to, patients are unable to accurately evaluate a surgeon’s professional skill level, but they are able to feel, perceive, and “evaluate” how much the surgeon is invested in their personal story. And it is this perception which translates into a conclusion of whether a surgeon is professional or not. That’s the magic of patient psychology.
Only then is it time to move on to the diagnostic phase and an initial clinical decision. In this final discussion, I strongly recommend that you stick to visual needs and values rather than your subjective judgment about the patient’s financial capabilities. You might be surprised by how people may value different factors of life over money when they feel the perfect match.
I have been listening to ophthalmology patients’ feedback for years now and have seen that trust isn’t built up through explanation, but through attention. This is why I believe that doctors who truly listen to the needs of their patients will always win in the long run. Active listening results in better premium conversion rates, higher satisfaction leading to more referrals, and, last but not least, fewer headaches for the busy surgeon.
