Individualization at Every Touchpoint

The term surgical counseling often refers to a conversation that happens after the surgeon has made a recommendation. At Waring Vision Institute, we view it differently: counseling begins before the patient walks through the door, continues through the workup and surgeon conversation, and remains active through surgery and postoperative care.

That structure matters because a clinically appropriate recommendation does not automatically become a meaningful decision for the patient. The recommendation must be connected to what the patient values, what they hope to improve, and what problem brought them to the practice in the first place.

My background is in social work, and one principle in social work practice that has shaped the way I think about surgical counseling is individualization. Every patient arrives with a different history, personality, expectation, and definition of a successful outcome. A procedure or lens selection may look identical on paper, but it will not necessarily have the same impact on every patient.

START BEFORE THE VISIT 

The counseling process begins when a patient’s visit is scheduled. Whether the patient was referred to our practice or found us through our website or social media, a member of our team will call the patient and review what they can expect at their initial evaluation.  

About 1 week before the evaluation, one of our surgical counselors reaches out to confirm the appointment, introduce themselves, and ask whether the patient has questions or concerns to note before their appointment. This call gives our team a chance to learn what is at the forefront of a patient’s mind.  

Some patients have a fear of surgery. Others are focused on cost, recovery time, independence from glasses, or whether they will be able to perform a specific task after surgery. Those priorities should not be discovered at the end of the visit; they should shape the conversation from the beginning. The point is simple—we want patients to know that our team is here to support them through every step of the surgical process, beginning with the initial phone call.  

We also recently began asking patients to complete a Surgical Evaluation Intake Form upon arrival at their appointment. The questions are straightforward, but they are designed to identify what the patient values most when considering vision correction.  

MAKE THE RECOMMENDATION VISIBLE 

After check-in, a technician warmly greets the patient in the lobby and brings them to the diagnostic suite for an advanced vision analysis. This advanced imaging series is then reviewed and presented to the surgeon to begin the clinical thought process for surgical recommendations.  

The surgeon’s conversation with the patient is the clinical anchor of the visit. In our practice, the surgeon often uses an iPad (Apple) to take the patient on what we call a tour of their eye, showing the patient the imaging taken during their advanced vision analysis. The patient may not understand every image, but the visual helps the surgical recommendation feel less abstract.  

The surgeon continues to explain what the advanced vision analysis showed, what the patient is a candidate for, and what the recommended procedure or lens option(s) might do for them. Just as importantly, the surgeon is able to connect their surgical recommendation to what the patient shared is most valuable when considering vision correction, bringing the conversation full circle and reinforcing a patient-centered decision.  

This is the first convergence of clinical expertise and patient values. The surgeon can say, in effect, “Based on the health of your eye and what you have shared is important to you, this is my recommendation.”

TRANSLATE THE PLAN INTO THE PATIENT’S LIFE 

After the surgeon’s discussion, the patient meets with a surgical counselor. The conversation is shaped by a thoughtful blend of the surgeon’s recommendations and the patient’s individual goals, values, and priorities. This ensures the conversation is both medically informed and personally meaningful.  

The counselor first reviews the logistics—where surgery will take place, how long the patient can expect to be at the facility, what the first few hours and days after surgery are likely to look like, and what the postoperative schedule will be. The counselor then reviews the financial breakdown, discusses financing when appropriate, and ultimately helps the patient schedule surgery.  

A patient may understand the surgical recommendation but need help picturing how the procedure fits into their current lifestyle. How much time will they need? What will the recovery feel like? What will the cost be? When those questions are addressed clearly and through a patient-centered approach, patients are better equipped to make informed decisions about their care.  

Counseling is not just that standalone moment but rather part of an ongoing conversation and continuum of patient support. Within 1 day of the patient’s evaluation, the counselor sends an email or makes a phone call thanking the patient for coming in and summarizing what they were found to be a candidate for.That touchpoint is important in the continuum of care model because patients often think of questions after they leave the office.  

KEEP THE LINES OPEN BEFORE AND AFTER SURGERY 

Once surgery is scheduled, we continue to create predictable touchpoints. Approximately 1 month before surgery, the counselor calls to remind the patient of their upcoming procedure and ask whether they have new questions to talk through. Two weeks before surgery, our billing specialist contacts the patient to review pricing and collect payment. Lastly, a few days before surgery, the counselor calls to review surgery-day details, the surgery time, and any preoperative instructions.  

Postoperative care depends partly on whether the patient is comanaged with a referring optometrist. Those who are not comanaged typically return to us for visits at 1 day, 1 week, 1 month, and 3 to 6 months after surgery, with a possible 1-year visit for refractive surgery patients. Comanaged patients, in contrast, may return to their comanaging physician at 1 day or 1 week, depending on whether that physician’s practice is local.  

The exact timing may vary, but the principle is consistent: patients should know what happens next. Clear expectations reduce uncertainty and reinforce trust.  

RECOGNIZE INDIVIDUALIZATION AS THE CENTER

A practice that wants to improve its counseling process quickly should start by understanding each patient’s priorities and desired outcomes. Their answer influences the conversation. A patient who values independence from glasses, a patient who is anxious about recovery, and a patient who wants to resume a specific activity may hear the same surgical recommendation differently. When patient values are not incorporated into the conversation, even the most appropriate surgical recommendation can be misinterpreted, leaving patients overwhelmed and unable to see how it applies to their individual needs and circumstances.  

I often think of it in terms of a pen and a pencil. I am unlikely to persuade someone who prefers a standard pencil to use a more enhanced pen unless I understand what they value about the pencil. Once I understand their preference, I can explain the benefits of a pen in terms that matter to them.  

The surgeon possesses clinical expertise. The patient is the expert on their own life. The counselor’s role is to connect the surgeon’s recommendation to the patient’s goals, expectations, and everyday concerns.  

When counseling works well, patients feel heard. They understand the underlying cause of their visual changes and how the recommendation can address the obstacles they experience in daily life. They feel educated because the surgeon reviewed their own imaging and clinical findings with visual guidance. They feel confident because they know what to expect. Most importantly, they trust the process because it has been built around them.