Sometimes you can do everything right and still the patient isn’t happy. 

I tested an older lady a few weeks ago, she was very nervous about having an eye test and asked for one of my colleagues (who is retired) to do the test.  Eventually, she was persuaded to see me instead.  She came into the room flustered and took ten minutes to calm down enough to be able to read the chart.  Her prescription was in the region of +9.00DS with an add of +2.75.  She had a problem with her glasses at the last test and the lenses were lost in the post.  She brought this fact up again and again.

When the eye test was finished, I explained that there was a significant change in her prescription and that she would benefit from a new pair of specs.  Her PD was very small (in the mid-50s) so I advised her to go for a small frame with a 1.67 index lens.  She ignored my frame suggestions, instead going for large eyesizes.  Anyway, we ordered in the blanks.

Every day from the day of her test until today, she called the store to ask if her glasses were ready. Every single time, she would tell me or the receptionist that we’d lost her last glasses.  I can’t understand why someone who was so unhappy with us previously decided to come back (unless it was to punish us).  Anyway, she came in today to collect her new glasses and wasn’t happy with the thickness of her specs.  She, again, brought up her experience with the lost glasses (“Three years I’ve waited for these glasses!”).

There’s really nothing you can do when a patient refuses to follow your advice, listen to your explanations or even listen to sense.  She kept repeating that her “friend” had bad eyesight but her friend’s glasses were not as thick as hers.  God knows what the friend’s prescription was.  She was now also unhappy about her partner’s glasses (which he’d collected and been wearing for the last month, without issue) because one lens was thicker than the other.  I explained that the difference in thickness was due to the difference in prescription between his eyes (there was more than a dioptre in it).

Basically, she wasn’t happy and there was nothing we could do to fix it.  Not only was she finding fault with her own (poor) choices but she was now trying to find fault with everything else we had done.

I called the store owner and asked what to do.  He was exasperated.  He’d ordered the lenses, glazed them himself and, at some point along the way, given her the opportunity to go for a smaller frame (which she, again, refused).  As the patient had not paid a deposit, he said to just tell her that we couldn’t do anything to help her and give her another copy of her prescription.

All you can do in these cases is to be clear with the patient as to why you can’t help and write what you’ve advised on the record card.

It’ll be interesting to see if she returns in a year, after trying the patience of another optometrist.

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