Diana Canto-Sims, OD, is a believer in fostering an empowered staff. She has been at the helm of her practice, Buena Vista Optical Boutique in Chicago, Illinois, for nearly two decades, says that maintaining excellence in care and the practice relies heavily on systems, processes and scripts. But the focus of those is to help staff “exercise self-governance.”
This clinic serves a low socioeconomic, fully bilingual community. Nearly every patient interaction requires translation, and this reality has shaped how she approaches both patient care and staff development. “We invest time, energy, and resources in motivating staff,” Dr. Canto-Sims says, describing her method of teaching self-governance and fostering a shift in mindset. This training goes beyond the technicalities of optometry. It touches on persuasion—distinct from manipulation—and emotional intelligence.
PREDICTABLE ISSUES
Many of the complaints and questions that come into a practice are fairly predictable. Using established protocols and scripts to handle those ensures consistency. “Eyeglasses break or they aren’t ready. These are the challenges we hear so often,” she explains. With each staff meeting, they revisit procedures, ensuring everyone is ready to manage these issues calmly and confidently.
Dr. Canto-Sims has also built a training program that equips her staff with life skills they can apply beyond the workplace. “What I’m going to teach you today, you’ll use every day in your life—with kids, their teachers, spouses or neighbors,” she says. She adapts learnings from her own Mastermind life and business coach and distills them into lessons for her staff. This holistic approach helps her staff learn how to stay calm, manage emotional situations and not take things personally.
CALMING THE RIGHT BRAIN
From her coach, she learned that the “right brain response” to conflict is often anger or strong emotion. Her goal is to help staff transition from this right brain response to a left-brain or more logical thinking. Staff are trained to offer patients two options, listen without interrupting and avoid escalating the situation by telling them to “calm down.”
Here’s how that works. Let’s say a patient arrives later than the 15-minute grace period for an appointment. The doctor can no longer accommodate that patient. The options are presented this way. “We can reschedule you for another day. Would you prefer a morning appointment time or an afternoon appointment time?”
“This phrasing allows the patient to switch from their right ‘emotional brain’ of being outraged the doctor will not see them because they are late to their left brain and think logically to figure out if morning or afternoon works for them,” she says. There are variations on the options – such as a weekday or weekend appointment, but it’s important to provide two choices. “Offering two options gives the patient the opportunity to subtly shift from right brain to the left brain faster because they have to stop and think,” she says.
AVOIDING CONFRONTATION
If the conflict continues or escalates, despite the training the staff has receiving on how to present options, another staff member may take over the conversation.
If patients cross a line and become abusive, the staff has clear scripts for ending the interaction respectfully but quickly. She has a zero-tolerance policy for patients verbally abusing her staff.
That script in part reads that the patient is welcome to come in, but the phone conversation ends here. “Most of the time, they do come in, and they’re still angry,” she says. The strategy is to move this person into an exam room where they are alone for a few minutes. “In that time, they are already making the transition to their left-brain thinking,” she says. By the time she or a manager come in, the patient is in a better headspace to discuss the issue more rationally.
“Our staff retention rate is great,” she says, attributing it to the skills and self-assurance her staff gain over time. Many of her team members have been with her for years—some for 16 years—and have grown personally and professionally during their tenure. In that time, they’ve had families of their own and are now applying the same skills in life that they learned on the job.
PERSUASION, NOT MANIPULATION
Dr. Canto-Sims says that her staff is taught the skills of persuasion versus manipulation. Here’s an example of that in action.
The patient asks for the pupillary distance (PD) measurement, saying that they need it so they can buy their eyeglasses on line. “The manipulative response would be to say, ‘No. You can’t have it.’ Or ‘That’s not part of your prescription, so we’re going to charge you.’”
Because this comes up fairly regularly, there’s also some proactive education built into the system. Patients are presented this information upon check-in. They understand that the PD is not a part of the exam, and if they want it later, here’s the charge for that.
But the persuasive response encourages asking questions and listening. Why does the patient want to order online? Why might ordering online not yield excellent results? Her staff will say, “The doctor prescribed [brand] lenses, so be sure that whoever fills this can give you this high-quality lens.” Or they might offer, “This is your first time wearing progressive lenses, so we’d like to be the ones giving you the training or making any adjustments, which we cannot do if someone else makes these glasses.
This provides the patient with a greater understanding of the complexity of the prescription, for example. And this proactive, training-heavy approach not only ensures her staff are prepared for the day-to-day challenges of optometry but also fosters a deep sense of personal growth and loyalty within her team.
Related: See the WO Pop-up Poll responses on how to show staff appreciation.
