Imagine this scenario: You bring your car in for routine maintenance. The basic services are covered under your warranty, so you don’t expect to lay out any cash unless there’s a repair needed. The car’s in good shape, so you figure you’ll be out of there without much hassle. But before you’ve even gotten your complimentary cup of coffee, the receptionist hands you some intimidating forms. Apparently, there are several optional tests the mechanic can do if you’re willing to pay. One detects engine problems sooner. Another could make your steering more responsive. A third will get you out the door today faster—and might also reveal wear and tear better. But maybe these tests do nothing. It’s confusing. And the decision is on your shoulders.

You study the forms quizzically, trying to parse the technical jargon, and worry about making the wrong call. It feels like a lose-lose situation: either you waste money on unnecessary tests or risk missing out on valuable information. 

Sound familiar? This is exactly how some patients feel when presented with the array of options for elective diagnostic screening tests.

This didn’t really dawn on me until a few weeks ago when my wife needed an eye exam, her first in several years. After checking in with the receptionist, she was asked to make three decisions about her own care—and wallet—while still in the waiting room. Like many practices, this one offered wavefront scanning, visual field screening and ultra-widefield retinal imaging. Other offices might offer OCT and macular pigment optical density too, either bundled into a “wellness package” or offered a la carte.

It’s a lot of info to absorb, especially before the patient has spoken to anyone with clinical expertise. 

I know this is common practice. That doesn’t make it good practice, however. Shouldn’t the patient be able to discuss these procedures with the doctor or a well-informed tech, to make a better decision or at least put their mind at ease? My wife was busy texting me for advice instead of having a conversation with a healthcare professional.

There’s nothing wrong with offering elective services or out-of-pocket charges. Many patients are happy to pay top dollar for high-fashion eyewear, multifocal contact lenses, “spa-like” dry eye treatments and other lifestyle enhancements. But when an optional fee concerns diagnostic data, it’s harder for patients to gauge the value on their own, especially if the handouts imply a possible missed diagnosis for those who decline the test. They need personal attention, not form letters.

Give patients the courtesy of a conversation. Look at their history. Talk about their goals. Make recommendations. Let them know they have an advocate at the practice; otherwise, they may consider it a stressful, “hard-sell” experience instead of the chance to take advantage of some cutting-edge technology to learn more about their eyes. 

New technology enables many great things. Make sure good patient communication is one of them.