Introducing a Monty Vickers Wanna-be

Have you noticed that some patients just dont want to cooperate? We all talk about patients who ask to see previous lenses and those who tell you that both lenses are blurry. However, I have discovered a few very specific patient types that manifest themselves during different parts of the exam.

The first of these patient types reveal themselves during refraction. I call them Number 2 Pickers and Even Pickers. These patient types are closely related but definitely different.

Number 2 Pickers always want to pick the second lens, no matter what you call it (e.g., A or B, John or Jane). These patients seem to think that we are showing them progressively better lenses, and if they pick the last one every time, theyll be able to see road signs from 10 miles away. To confirm the diagnosis, just switch the lenses you previously showed the patient to see if he or she selects the opposite lenses this time.

Sometimes, if I am not behind schedule, I keep showing these patients the same two lenses, reversing the order each time, to see how many times they pick the second lens. One of us eventually gets bored with this, and we can move on with the exam (thank goodness for autorefractors).

Be sure to inform the dispensing staff that a Number 2 Picker is coming. They can present lens options like this: Would you like SR or AR coating? and How about plastic or high-index? You get the idea.

Even Pickers just like even numbers. My wife is like this. When we were discussing how many children to have, she said two or four. I asked, why not three? Because its not an even number, she said.

When you encounter Even Pickers, simply give them a choice of number 1 or number 3. Watch the smoke as they ponder this seemingly impossible choice. Youll get a very long pause, followed by Can I see number 2 again? To get a good refraction, simply switch to using only even numbers. I feel a tiny victory over my wife because we have three kids. However, I know Im only victorious until shes pregnant again.

Another patient type I have encountered is the Rocket Scientist. This patient likes to look up when I say, Look down. We expect this from kids, but not adults. An exam with a 90D lens sometimes goes something like this: Macula looks good. Ill check the nerve head. Hmm, another macula. Okay, lets see what the arcades look like. Hmm, another macula.

Before calling the journals to report the patient with infinite maculae, peek around the slit lamp and tell them to watch the other light and not the one that is moving around. Always be sure to ask these patients what they do for a living. If they answer, instrument mechanic for Air Canada, make a mental note to fly with anyone but Air Canada.

Brent Allen, O.D., British Columbia, Canada

Marketing vs. Advertising

I enjoyed the article, Promote Your Practice More Effectively, in the August issue. I was wondering if Dr. Shaw-McMinn would explain the difference, if there is one, between marketing and advertising?

Randall S. Bernstein, O.D., Indianapolis

Dr. Shaw-McMinn responds:

Most health care providers tend to think advertising is the same as marketing. However, this is untrue.

Marketing is the process of planning and executing the conception, pricing, promotion, and distribution of ideas, goods, services, organizations, and events to create and maintain relationships that will satisfy individual and organizational objectives. (Boone LE, Kurtz D. Contemporary Marketing Wired. Fort Worth: Dryden Press, 1998.)

I think that the best definition is: Marketing is communicating what you have to offer to the consumer.

What you have to offer is your brand. You can communicate your brand in many ways, including the appearance of your office, your staff, what you say and how you say it. Communicating can also include advertising, but advertising is just a small part of marketing. Marketing also involves determining who the consumer is.

We are always communicating something to our patients, so it makes sense to control how we project our brand to our patients. This is what marketing is all about.

Peter Shaw-McMinn, O.D., Riverside, Calif.