How to avoid the 'door-handle' remark

31 January 2022
Winter 2022

It’s frustrating when a patient reaches the consulting room door only to bring up a new topic, writes Steve Smethurst. How can communication be improved to avoid this?

While researching communication skills, Dr Dirk vom Lehn, Professor of Organisation and Practice at King’s Business School, King’s College London, video-recorded 62 consultations across seven optometric practices. He found seven examples of ‘door-handle’ remarks. 

They ranged from questions about contact lenses to a story about a lorry running over a pair of glasses. Thankfully, these instances were minor and didn’t have a significant impact on the running schedule for the day, but that isn’t always the case.

Dr Paramdeep Bilkhu MCOptom, Clinical Adviser for the College, recalls a patient who, on the threshold of his consulting room on their way out, told him they had flashes and floaters in their eyes. “This obviously rang alarm bells as it’s a potential sign of a retinal detachment,” he says. 

“I brought the patient back into the consulting room, did the history assessment again and investigated further. They had a small retinal tear, so I had to arrange an emergency appointment. It all took a significant amount of extra time, but it was important because their sight was at risk.”

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