Mind-body connection may translate to new referrals for clinics

April 1, 2008

Joann Dahlkoetter, PhD, licensed psychologist, explains the connection between relieving a patient's surgical anxiety and increasing referrals. Essentially, the more a patient is at ease during surgery, the greater the likelihood of him or her recommending your practice to others.

Stanford, CA-Maintaining a steady flow of new patients and subsequent referrals is likely a concern of any successful ophthalmology practice.

But it's not enough to be concerned only with referrals. Ophthalmologists must examine whether they're doing everything possible to bring new or repeat patients back to the office, according to Joann Dahlkoetter, PhD, licensed psychologist, medical staff member, and consultant based at Stanford University Medical Center, CA.

The mind-body connection

Dahlkoetter practices what she calls "mind-body training" when working with patients and athletes. The principles apply to all. She's currently working closely with surgeons and administrators at several eye clinics. And each of these clinics, she's discovered, is seeking help with the same element.

"What's the number one factor that deters people from coming into the clinic and scheduling their surgery? Fear," Dahlkoetter said. She added that while cost also plays an obvious role, fear is the overriding concern. "If we could present a way to overcome fear, then we could increase the number of patients. What exactly do patients fear? Often, it's fear of unfavorable outcomes, fear of side effects, even fear of the medical procedure itself," she said.

Mental preparation may be the critical "X factor" in diminishing all fears, according to Dahlkoetter, who cited a meta-analysis of 191 studies representing 8,600 patients. It showed that patients who mentally prepare for surgery have fewer complications, less blood loss, recover faster, and have better outcomes.

"Ultimately, we need a solution to the fear factor for eye surgery," Dahlkoetter said. "Less fear equals more patients. Eye patients want the best in quality, value, safety, and service. By improving your patients' perception of these four areas, we can improve their satisfaction and lessen their fears, leading to more referrals."

The fear factor

What happens when fear isn't addressed? Dahlkoetter recounted an example from a clinic for which she consulted recently. A 70-year-old woman was having lens replacement surgery. She was unprepared both mentally and physically. Consequently, she became so anxious during the procedure that it was difficult for the surgeon and staff to continue. They had to have her breathe into a bag.

"An injection of 30 mg of diazepam (Valium, Roche Pharmaceuticals) didn't even begin to calm her down. She was that terrified and unprepared for the procedure," Dahlkoetter noted.

"I hear hundreds of cases like these. But know that there are techniques that can help to create a calmer, more relaxed patient who will later refer others to your clinic," she added.

Often the anxiety begins with the realization that the patient will be asked to actively participate in the procedure, uncommon in most other surgical instances, which means he or she must be alert to follow the doctor's instructions.

Secondly, fear creeps in when the patients, who are often baby boomers, recognize this is often an elective procedure, thereby creating an entirely different decision-making process. "When it's more of a choice, there's automatically more anxiety," Dahlkoetter noted.