My approach to counseling patients centers on guiding them through complex decisions rather than expecting them to master every detail in a single visit. The more patients recognize that my staff and I understand their visual needs and lifestyle, the more likely they are to trust and follow our recommendations.
Effective patient education cannot be limited to a 10- to 15-minute consultation. Cataract surgery involves intricate choices—the lens, toric correction, multifocal versus monofocal optics—that patients simply cannot fully grasp on the spot, regardless of how much time they spend reading webpages and AI summaries. Surgeons must recommend what they believe is best for each individual.
A DESIRE FOR EXPERTISE
Patients seek out health care professionals for their expertise. They do not want to be handed brochures and asked to make choices on their own. Patients who conduct extensive research may arrive with preconceptions that do not align with their visual system or lifestyle. The surgeon’s role is to step in and provide clear direction.
With standard glaucoma care, for example, specialists do not list four drop options and ask patients to decide among them. Instead, providers prescribe the drop they believe is best suited to the individual and discuss cost or alternative medications if needed. The same principles apply to refractive and cataract surgery.
My philosophy is not to hand over reams of technical information and leave patients to make a decision alone. That would be unfair. Instead, I provide clear, personalized guidance so that patients feel heard, informed, and confident in the plan we develop together.
GUIDED FROM FIRST VISIT TO FINAL OUTCOME
Our patient counselors are integral from start to finish. At the initial consultation, patients first meet with a counselor who outlines the entire journey: the sequence of diagnostic testing, the optometrist exam, and finally the surgeon consultation. The counselor remains involved at every step.
During testing, counselors explain each test’s purpose, the information gathered, and how it informs the surgical plan. After diagnostic data collection, the optometrist reviews all findings with the patient and previews the surgeon’s likely recommendation.
Patients then have time—hours or even days—to process that recommendation, review educational materials, and prepare specific questions before the final surgeon consultation.
SHARING THE WHY BEHIND THE WHAT
We deliberately avoid presenting multiple equal options. Instead, we convey the single recommendation that we believe is best. We discuss test results in detail, with diagnostic reports used alongside visual aids such as animated illustrations in Rendia (Rendia) with on-screen annotations. These tools bring clarity and help patients visualize their eye health and treatment path.
For patients to embrace the provided recommendation, they need to understand the thought process behind it. We share the options we are considering, explain how each one aligns with their specific visual demands, and then present the solution we have chosen based on that shared understanding.
Of course, cost considerations are relevant, but they come later. I make my recommendation based solely on clinical factors; if financing or expense becomes a barrier, we explore alternatives and clearly explain what visual benefits will be forgone. For many patients, however, the investment in refractive or cataract surgery is modest compared to the value of restored vision.
TIME INVESTMENT AND ALIGNMENT OF GOALS
Our specialty is a unique slice of medicine: surgeon and patient goals are aligned. Both parties want to achieve better vision without glasses or contact lenses. Contrast this with most fields of medicine, such as hypertension management, where patients may resist treatment despite the doctor’s recommendation. In refractive cataract care, everyone is on the same page.
Providing expert guidance requires the necessary chair time. I do not view this as a return-on-investment calculation; it is simply the time it takes to gather all the data, understand the patient’s needs, and make a sound recommendation. Our current model—diagnostic testing, optometrist consultation, digestion period, surgeon follow-up—has proven efficient in delivering comprehensive information without shortcuts.
Surgeons who skip this process—by delegating education to brochures and asking patients to choose on their own—do patients a disservice. Without guided discussion, patients will not access the best technology or outcomes, because no one has tailored a recommendation to them. If chair time constraints lead to defaulting to standard cataract surgery, that may suit a practice model, but it compromises the goal of delivering optimal vision correction.
