I work as an eye specialist in community practice. I’ve noticed that some of my patients tell me important eye symptoms at the end of the examination when they are on the way out of the consulting room. How can I ensure I get all the eye symptoms at the start of the examination so I can tailor the examination to determine the cause of their symptoms?

I have been doing my own professional development and this topic came up in an article I read. I have also noticed that some of my patients also give me new important information right at the end of the examination and wondered how I can avoid this.

In the article, I read this was referred to as ‘door handle remarks’. Important things the patient mentioned about their eyes as they had their hand on the door handle about to leave the consulting room.

My own practice is once I have made the customary greeting and the patient is settled in the consulting chair I ask: ‘How are things with your eyes and glasses? Are you having any problems with your distance or near vision?’

One thing I learned from the article was at the end of the history and symptoms was to ask:

‘Is there something else about your eyes that you would like me to know about?’

And not:

‘Is there anything else about your eyes that you would like me to know about?’

Use of the word ‘something’ instead of ‘anything’ reduces the incidence of ‘door handle remarks’.

Interesting how a change of one word can have a significant effect on patient behaviour.

I will be changing my personal practice the next time I’m in the clinic.


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