Roughly five years ago, an older gentleman with his eyes fixed on his shoes presented to Susan Watson, MD, who, at the time, worked in a large multi-doctor practice. “He had severe facial and ocular rosacea and practically barked at me that he was unable to get it under control, despite seeing an array of eye-care providers,” she remembers.

To treat the patient, Dr. Watson performed an eyelid debridement and prescribed LipiFlow (Johnson & Johnson Vision), Restasis (Allergan), the supplement De3 Dry Eye Omega Benefits (PRN), and intense pulsed light (IPL) treatments.

“He went from this grouch to extending his arms for a hug and holding his head high,” says Dr. Watson. “He told me I was meant to do this.”

Dr. Watson listened to the gentleman and opened Watson Dry Eye Center, an exclusive dry eye disease (DED) practice in Raleigh, N.C., where the culture has, from day one, revolved around replicating that patient’s satisfaction and happiness.

Here, Dr. Watson’s staff explain how.

Preparing for visits

Watson Dry Eye Center found that patient wait times decreased, and satisfaction and happiness increased, when the practice began preparing for patient visits before the day starts, says Samantha Kwiatkowski, patient advisor. “Daily schedules go out to the staff regarding what patients are coming in and their situation, so we can be ready,” she says. “For instance, if a patient is coming in for an IPL treatment, I make sure a face wash kit, which the patient uses before the treatment to remove any oils and such, is available. That way, we’re not scrambling to find it when the patient gets here.”

Developing a strong relationship

Once the patient arrives, the schedule, designed by Dr. Watson, allows staff to spend time with patients, says Christa Sorlin-Davis, COA. For example, the staff member stays with the patient throughout much of the visit, performing such tasks as the work up, scribing, and counseling, tasks that traditionally may be done by several technicians. This builds strong one-on-one relationships between staff and patients and allows the patients to get a better understanding of their DED.

Staff are also tasked with giving patients a questionnaire and helping them fill it out. “We follow the guidelines of the Tear Film & Ocular Surface Society’s Dry Eye Workshop (DEWS) II report, which, partially, recommends the use of a validated questionnaire,” says Dr. Watson.

Ms. Sorlin-Davis says patients appreciate this time with designated staff members, because it allows the patients to feel heard and taken care of in a unique way.

“Compassion is so important with these patients because so many of them have been suffering for a long time and feel like they haven’t been heard,” adds Kristin Schumacher, patient advisor.

Providing patient education

At Watson Dry Eye Center, patient education helps set expectations, increase patient satisfaction and happiness, and improve patient compliance with therapy. The practice focuses on four areas of patient education:

1. Informing patients on the purpose of the diagnostic device and what to expect. “When performing meibography, for example, we explain to the patient that the device will look at the glands in their lids to assess the lids’ ability to express oil. Oil is essential for a healthy tear film, stable vision, and ocular comfort,” says Sheena Thomas, CPO.She adds that providing patients with the reason behind the individual diagnostic tests and setting their expectations helps facilitate the testing process. In addition, this increases the accuracy of the results because patients are not apprehensive and thus more cooperative with the testing procedure. (For a listing of the diagnostic devices used by Watson Dry Eye Center, see “Tools of the practice,” p. 15.)
2. Showing pathology. Dr. Watson shows patients an image of their clogged meibomian glands, for example, because patients want to see what’s going on with their eyes, says Ms. Sorlin-Davis.“In actually seeing pathology, patients understand the importance of Dr. Watson’s prescribed treatment plan, which increases the probability that they’ll use it, get relief, and, thus, be satisfied and happy with the care provided,” she notes.
3. Explaining the purpose/cost of treatment and how it’s employed. Regarding the former, the staff may tell patients, for instance, that because their meibomian glands are not releasing the oil needed to produce healthy tears, Dr. Watson is prescribing a LipiFlow treatment to open the meibomian glands, explains Ms. Thomas.When it comes to in-office treatments, Watson Dry Eye Center staff go over with the patients the documentation on the purpose of the treatment, its cost, and how it’s used, Ms. Sorlin-Davis says. The documentation on IPL, for instance, explains, in part, that the treatment uses pulses of light to decrease ocular inflammation and redness, she offers. (For a listing of other offerings, see “Tools of the practice,” below.)
4. Providing take-home materials. Because the amount of information the practice provides during the visit can be overwhelming, patients are given take-home materials so they can “revisit all the information we provided during their visit,” Dr. Watson says. “We’ve found that, otherwise, they’ll go wild searching on Google and may read a lot of misinformation.”

Ongoing learning

Dr. Watson provides continuous learning opportunities to the staff, so they can remain up-to-date on the latest DED research and related devices. Specifically, staff acquire their education via dryeyeaccess.com , equipment representatives, videos, webinars, podcasts, meetings, articles Dr. Watson shares with staff, and an ongoing reference binder that contains DED-related resources, such as an explanation of grading corneal staining.

“In part, these learning opportunities enable us [staff] to understand what DED patients are experiencing, allowing us to genuinely empathize with them and answer their questions,” Ms. Sorlin-Davis explains. “Patients are grateful for that.”

Ms. Thomas notes that pre-COVID-19, Dr. Watson sent most staff to the Toyos Clinic Dry Eye & Aesthetics Seminar in Nashville with Drs. Rolando and Melissa Toyos and to the BlephEx Certification/Lid Hygienist Course in Chicago with Dr. James Rynerson.

Patient pampering

Another way the Watson Dry Eye Center staff achieve patient satisfaction and happiness is by pampering patients, notes Ms. Sorlin-Davis.

An example: “Prior to exfoliating the lid margins with BlephEx, we place an eyecloud warm compress goggle on the patient while they sit in one of the practice’s reclining treatment chairs and listen to spa-type music,” she describes. “We also take requests. In fact, we have one patient, in particular, who always asks for Bruno Mars. The practice strives to create a relaxing atmosphere because undergoing in-office treatments can be intimidating.”

Another example: After a patient undergoes an IPL treatment, staff use Èyes Are The Story refreshing towelettes to remove the ultrasound gel residue from the patient’s face and eyelids, instill preservative-free tears and Lumify (Bausch + Lomb) to brighten the sclera, and apply mineral-based sunscreen.

“Patients love this because they have a couple minutes to relax, and they don’t have to worry about leaving the practice with residual gel from the treatment,” Ms. Sorlin-Davis explains.

That defining patient

Dr. Watson says she continues to see that patient who presented to her with severe facial and ocular rosacea close to five years ago.

“He’s now on a once-every-six-month maintenance schedule for IPL, and he’s doing great!” she exclaims. “I have seen so many patients since him, and I can’t even begin to tell you how great it is to have such a dedicated and passionate team. There’s an African proverb that ‘it takes a village to raise a child.’ I can tell you that it absolutely takes a village to provide exceptional care to those who suffer from dry eye disease. I couldn’t do it alone, and I wouldn’t want to do it alone.” OP