Look at me when I'm talking to you!"
Do you remember hearing this demand when you were a kid? Or do you ever just stop talking until someone looks up at you? It is natural to want to be looked at when you are saying something that matters.
Looking at someone when they are talking to you is a big deal and we all know it. We all grumble when we talk to the top of someone's head while they are staring down at their phone. And we are all guilty of thinking that we are engaging in two conversations at the same time, when we really aren't in either.
Do our Exam Rooms make this problem worse?
My grandfather was an optometrist and today's exam room looks just like his did 60 years ago. Except now, exam rooms have a computer where my Granddaddy kept his cigarettes.
As more doctors bring technology into the exam room, more of us are turning a cold shoulder to our patients. We all worry about it and say that we aren't doing it, but we are. Using laptops and tablets helps some, but the reality is that if we are using a computer in the exam room, we are turning away from our patients more than they like.
I visit a lot of practices and nobody is doing it well. Everybody says, "Well, I sit like this and twist my body so I am facing blah, blah, blah......" No, Doctor, you stick your nose in that computer and ignore your patient while you try to find that button that gets you MU points.
We have tried it all
We have been experimenting for the best way to overcome this challenge in my practice for well over a year. I have seen many concepts and tried them all.
We built a "robot" to act as a computer stand that rolled around the room, but we kept bumping it into things. We mounted a monitor to the pole in the exam lane, but the patient kept looking behind them to see what we were looking at. We tried balancing laptops, but I am clumsy. Tablets were OK until you needed to type something, plus you have a tendency to stare at that thing longer than you think.
I have come to the conclusion that the big desk in the exam room is the real problem. In every exam room, the desk is against the wall and that's where you put the computer. A quick Google search of Optometrist Exam Rooms proves scientifically that all rooms have the same design since Granddaddy's time.
Here is a solution that really works:
We removed the desk and replaced it with a small, rolling computer desk that can be moved around the room. We put the monitor on an arm that protrudes from the wall. The wireless keyboard is on a tray that can be placed comfortably in our laps or stay on the rolling desk top. Since the big desk is gone, we can put our backs to the wall, face the computer and the patient.
And if we want to show the patient the monitor, we just shift it. The arm has enough flexibility so the uncorrected myope can lean in to see it.
We keep a second keyboard in the room for the scribe to use. (Two keyboards/1 computer -- it works.) To hide all the junk that was in the desk, we keep a little drawer cabinet, and put a printer on it, so we won't try to use it as a desk.
I tried to create a professional diagram showing you our new concept, but I've got stuff to do. So, here is a quick sketch for you.
Let's "show" our patients we are listening again.
Optometrists have always seen themselves as doctors who "get to know their patients." It is time for this big data collection "experiment" to come full circle. So we have collected and entered all of the necessary information to get paid and meet MU requirements. We know the meds, the conditions and the A1C. But now, let's concentrate on the person again and look them in the eyes when they are talking to us.
Let's talk soon,
P.S. If you want one of those big refraction desks, I have a couple for sale. And some computer robots.