Tag: Patient Communication

Pivot to Patience – Managing the Emotionally Elevated Child in Pre-Testing

Human Resources, Training & Onboarding

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Jade Bodzasy Pivot to Patience July-August 2026

When a child arrives for pre-testing already in a state of “high alert”, whether it’s a full-blown tantrum, silent freezing, or vibrating with anxiety, the clinical data usually becomes secondary to emotional regulation. If you try to force a measurement now, the “noise” from their stress will likely yield inaccurate results anyway.

Here is how to apply EQ to de-escalate the situation and salvage the appointment.

  1. The “Neutrality” Reset

When a child is elevated, the environment often becomes high-decibel and high-stress. As the professional, your first move is to introduce Neutrality.

  • Lower the Volume: Speak at a volume just above a whisper. This forces the child to quiet down to hear you and breaks the cycle of “shouting over” the noise.
  • Minimize the Audience: If the pre-test room is crowded or visible to the waiting area, close the door or move to a quieter corner. Reducing sensory input is the fastest way to lower cortisol.
  1. Narrative Labeling (The “I See You” Technique)

High EQ doesn’t mean “fixing” the emotion; it means acknowledging it. Children often escalate because they feel misunderstood or out of control.

  • Acknowledge the Feeling: Instead of saying “Don’t be scared,” try: “It looks like you’re feeling really overwhelmed right now. This room has a lot of big machines and that can be a lot for anyone. What should we do to help your body calm down?”
  • Give Permission: Tell them it is okay to be nervous. By removing the pressure to “be brave,” you often remove the resistance.
  1. Tactical Agency: Give Them the “Off” Switch

Anxiety is rooted in a lack of control. To get the data you need, you have to give some power back to the child.

  • The “Stop” Signal: Give them a physical signal (like raising a hand) that means you will stop the test immediately. When they know they have an “exit,” they are far more likely to stay in the chair.
  • The Choice Illusion: Ask, “Do you want to do the ‘balloon machine’ (autorefractor) first, or should we take the ‘eyeball picture’ (fundus photo)?” The order doesn’t matter to your data, but it matters immensely to their sense of autonomy.
  1. Utilization of “Collaborators”

In these moments, the parent is your most important Collaborator.

  • Indirectly regulate the Parent: If the parent is frustrated or embarrassed by the child’s behavior, it will escalate the child. Calmly tell the child, so that the parent can hear: “It’s okay, lots of people feel this way about this space. Let’s just give you a minute to calm your body. Maybe your parent could help show you how the chin rest works?”
  • Physical Grounding: If the child is small, have them sit on the parent’s lap for the pre-testing. The physical proximity to their “safe person” can calm them down enough to get a good reading.
  1. The “Pivot” Strategy

Sometimes, the EQ move is knowing when to stop. If you have tried de-escalation for five minutes and the child is still in a “fight or flight” state, pushing forward will only create a traumatic association with eye care.

  • Reschedule with Intent: Pivot the conversation. “I can see today is a big day for your eyes. Why don’t we try one small thing, and then we’ll save the rest for another visit when you’re feeling more like a scientist?”
  • The “Win” Ending: Always end on a successful note, even if it’s just the child successfully sitting in the chair for five seconds. Give the sticker anyway. You are “playing the long game” for their future eye health.

 

Summary for the Team

When a child is elevated, your job title shifts from Technician to Regulator. By focusing on their emotional safety first, you aren’t “wasting time”, you are ensuring that when you finally do get that measurement, it is accurate, and the patient is willing to come back next year.

Want to learn more about Emotional Intelligence, find more resources at www.emotionalintelligenceconsultinginc.com

 

Jade Bodzasy

Jade Bodzasy

Jade Bodzasy, Founder of Emotional Intelligence Consulting Inc., is a dedicated Coach and Consultant for Optometric Practices. Her extensive background includes over 20,000 hours of expertise focused on customer relations, work structure refinement, training method development, and fostering improved work culture within Optometric practices.

Certified in Rational Emotive Behavior Techniques (REBT), Jade possesses a unique skillset that empowers individuals to gain profound insights into the origins of their behaviors, as well as those of others. Leveraging her certification, she equips optometry practices with invaluable resources and expert guidance to establish and sustain a positive, healthful, and productive work environment.

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Children: The Hidden Treasure of Practice Building

Practice

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Diana Monea Children The Hidden Treasure

Practitioners who focus on pediatric eye care can drive lasting practice growth by prioritizing children’s vision, treating children as an essential yet often overlooked source of continuity, personal achievement, and gratification.

Vision is vital for a child’s development and education. About 80% of learning is visual, so even minor vision issues can hinder school performance and self-esteem. Teachers frequently request vision checks when students struggle, showing the importance of eye care in learning.

Lessons from the Real World

Over 50 years, my team and I managed three Eye Health Centres. A constant lesson we have learned is that children build practices. When children trust us, families return. Parents value their child’s care, which creates relationships over generations. Pediatric care gives lasting practice growth through relationships, unlike short-term marketing. Each appointment is a chance to teach families about the importance of eye health, and educating parents is key. Many people do not know that vision cannot be replaced at any price and that hidden eye issues, not obvious to the parent or child, can affect learning and confidence. Explaining vision’s role in a child’s development helps parents see the value of a comprehensive eye health exam.

Discussing with parents the impact of vision and the role genetics plays also increases engagement and adult referrals. When parents see eye health as essential to their child’s development and understand that vision changes as a child grows, they become long-term and consistent advocates for routine care. Educating families about the benefits of regular eye care not only benefits children but also practices by deepening trust and creating lasting loyalty. Soon, annual exams become part of a continuous health care plan for life.

Connecting Through Clear Direct Communication

Proper communication is essential when addressing children. It is important to communicate directly with children using simple terms. Effective pediatric communication means engaging children in their own treatment, not just addressing the parents. For example, instead of “We need to patch the eye,” say, “We cover your stronger eye, so the weaker one gets stronger. Do you see this eye doesn’t see as well?” Even young kids understand simple explanations. When they know why treatment matters, they feel less anxious and have fun in making their “broken” eye see better. Such engagement boosts cooperation.

You may then ask children about their favourite colour, advising the optician in front of the child about the colour and asking to see the child when they have selected the glasses. Such interaction increases child compliance and impresses parents, which builds positive rapport – everyone wants to come back because they are treated “special.”  When children and even adults feel noticed, they cooperate and eagerly want to come back.

These instances build practice success. Happy children make the experience positive and encourage trust. When kids enjoy the clinic, parents return, improving retention and reputation.

The clinic environment matters. A friendly environment turns routine care into memorable visits. Positive experiences encourage children to follow treatment, improving results and trust.

Children who grow up receiving consistent eye care often return as adults and bring their own children. This cycle strengthens the foundation of practice, creating enduring relationships over the course of decades.

Later, practitioners will see that generational continuity is a key factor in succession planning through “goodwill.” Word-of-mouth referrals from satisfied families remain the most powerful and cost-effective form of practice growth. Pediatric eye care is about forming lasting trust and relationships. Prioritizing children’s care is the central catalyst for sustainable, generational growth in practice.

Children are not only patients but also the essential treasure of practice builders, directly shaping lives and guaranteeing the success and longevity of eye care practices.

 

Dr. Diana Mae Monea, OD, FAAO, MHRM

Dr. Diana M. Monea, OD

Dr. Diana M. Monea is an award-winning optometrist, author, and keynote speaker with more than four decades of leadership in clinical practice, business ownership, and professional education. Founder and former CEO of Eye Health Centres, she now focuses on consulting, mentorship, patient care, and public speaking.

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AI and EMR Integrated into an Optometric Practice: The Future of Eye Care

Human Resources

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Diana Monea article AI and EMR Integrated into an Optometric Practice

Optometry has evolved from paper files to digital records, from phone calls to virtual communication, and in the future, perhaps even to robots (bots) assisting humans. Every day, innovation takes on a new dimension as artificial intelligence (AI) is integrated into electronic medical record (EMR) systems. The future of communication and diagnostics in eye care remains uncertain: will AI replace parts of what we do, or simply help us work more efficiently, more accurately, and at lower cost while improving the patient experience?

  1. AI Reduces Office Time, Improves Documentation, and Enhances the Patient Experience

AI can capture the doctor–patient conversation and generate clinical notes automatically. Unlike basic dictation tools, more advanced systems can organize information into the appropriate sections such as chief complaint, history, exam findings, assessment, and plan.

AI can also support tasks such as:

  • Billing and coding support
  • Documenting diagnostic impressions and recommended next steps

Used well, these tools can improve the patient–doctor experience. The clinician can stay more present with the patient, while reducing clerical workload and documentation interruptions. This can also help reduce clinician burnout by making charting more seamless and efficient at the point of care, reducing the need for after-hours documentation.

2. Integrating AI and EMR

When AI outputs can be structured and integrated into an optometry EMR, the system can help identify patterns and automate repetitive, but necessary, tasks. Depending on the platform and workflow, AI-enabled EMR integration may support:

  • Prescriptions and documentation support
  • Referrals and communication templates
  • Treatment plan tracking and management
  • Patient education materials based on clinical findings
  • Interpretation support and clinical prompts
  • Revenue cycle support
  • Analytics and reporting

With thoughtful integration, the EMR can begin to function less like a passive record and more like an active clinical assistant.

3. AI Imaging as Clinical Support

OCT, fundus photography, corneal topography, and visual field data can be analyzed using AI models trained on large datasets. Applications may include:

  • Diabetic retinopathy screening
  • Glaucoma risk and progression monitoring
  • AMD risk stratification and progression tracking
  • Corneal irregularity detection
  • Automated comparison of serial scans

AI-powered support tools may also combine imaging with clinical measurements such as intraocular pressure, pachymetry, and refraction. These tools are not a replacement for clinical judgment, but they can add a layer of insight and help flag subtle changes that are easy to miss in busy practice.

4. AI’s Impact on Practice Management

Administrative inefficiencies are a major source of stress and cost in many practices. AI-enabled systems can assist with:

  • Insurance claim submission, verification, and follow-up
  • Coding support, rejection handling, and resubmissions
  • Appointment scheduling, reminders, and recall workflows

By reducing errors and repetitive front-desk work, AI can free staff to focus on higher-value patient service and practice operations; helping reduce administrative burden and improve consistency.

5. Patient Communication

AI can improve patient understanding and satisfaction by:

  • Providing personalized summaries of findings
  • Explaining recommendations and outcomes in plain language
  • Generating visuals or simplified graphics that help patients understand their results
  • Supporting appointment booking and capturing patient concerns ahead of visits
  • Providing relevant pre-visit or post-visit information for recommended procedures

Practice bonus: when patients are better informed, they are often more confident and more compliant, leading to smoother visits, fewer misunderstandings, and a stronger overall experience for patients, staff, and clinicians.

6. Standardization Through AI and EMR Connectivity

A major advantage of AI is its potential to integrate with EMR systems more seamlessly than older workflows. Historically, many EMRs operated in silos, requiring manual entry and increasing the risk of transcription errors.

With tighter device-to-EMR integration, key data, such as refractions, visual acuities, intraocular pressure measurements, and imaging results, can populate charts automatically. This reduces redundancy, improves accuracy, and supports standardization across the clinical team.

7. The Advantage of an AI-Enhanced Practice

When documentation, scheduling, coding, and routine analysis are partially automated, optometrists gain time to do what matters most: be human. That means having more capacity to educate, reassure, and build trust without sacrificing the operational demands of modern practice.

The future of optometry will be shaped by clinicians who use AI strategically to enhance care, reduce burnout, and elevate the patient experience. Practices that adopt AI, and integrate it effectively into their EMR, will be better positioned to improve efficiency, strengthen resilience, and pursue clinical excellence in the face of tomorrow’s practice challenges.

 

 

Dr. Diana Mae Monea, OD, FAAO, MHRM

Dr. Diana M. Monea, OD

Dr. Diana M. Monea is an award-winning optometrist, author, and keynote speaker with more than four decades of leadership in clinical practice, business ownership, and professional education. Founder and former CEO of Eye Health Centres, she now focuses on consulting, mentorship, patient care, and public speaking.

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The Paper Trail of Frustration: Why Neutrality is Your Eye Care Superpower

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Jade Bodzasy article The Paper Trail of Frustration

You know that feeling. It’s the end of a grueling day of back-to-back refractions, and you’ve just finished with a particularly challenging patient. You sit down at your computer, exhausted and perhaps a bit annoyed. In that high-pressure moment, your Electronic Medical Record (EMR) often becomes an unintended outlet for your stress.

It is incredibly easy for your internal state, whether it’s frustration or pure exhaustion, to “leak” into your documentation. But we live in an era where patients have immediate legal access to every word you type. Because of this, your ability to pivot from an emotional reaction to a neutral, EQ-informed observation isn’t just a nice “soft skill”, it’s a professional necessity.

The Trap of “Emotional Leakage”

Emotional Intelligence (EQ) starts with your own self-awareness. In the context of note-writing, this means catching yourself when your current mood is steering your keyboard. When you’re frustrated, your notes tend to shift from objective observations to subjective judgments.

Keep an eye out for these “red flag” words that signal emotional leakage:

  • “Difficult”
  • “Uncooperative”
  • “Demanding”

These terms don’t actually provide clinical value; they just serve as a digital “vent.” The real danger is the Bias Echo. These labels can follow a patient indefinitely, creating a cycle where every technician or specialist who sees that chart next approaches the patient with the same preconceived frustration you felt.

The Legal Reality: Your Patient is Reading

The medical record has evolved. It’s no longer a private, “behind-the-scenes” dialogue between professionals; it is a shared document. Thanks to patient portals, your patients can—and do—read your notes.

Imagine a patient reading a note that characterizes their behavior as “aggressive” or “hostile.” If they were acting out because they were terrified of losing their vision or didn’t understand the procedure, reading those words can be traumatizing. Once that therapeutic alliance is fractured by a poorly worded note, the professional repercussions are real. A note written in a moment of pique can quickly become primary evidence of perceived bias.

Your New Skill: Neutral Reframing

The core EQ skill you need to master is Neutral Reframing. This is the process of taking the “raw data” of a frustrating interaction and stripping away the emotional adjectives to reveal the clinical facts. You aren’t omitting what happened; you are describing it with such objectivity that the behavior speaks for itself.

Restoring Relational Clarity

When you choose neutral language, you achieve Relational Clarity. You are documenting the truth of the encounter while protecting your professional integrity. Most importantly, you are leaving the door open for a successful interaction next time. A neutral note gives the next professional a baseline to solve the problem (like improving drop ergonomics) rather than just bracing themselves to manage a “difficult” person.

Documentation as a Human Skill

Your success in eye care is increasingly defined by your human skills. High-EQ record keeping is an act of discipline. It requires you to pause, acknowledge your own frustration, and choose a narrative that serves both the patient’s health and your own career longevity. Feelings are temporary, but the record is permanent.

Is Your Team Prepared for the “Open Notes” Era?

Mastering neutral, high-EQ record keeping is essential for protecting your practice and fostering patient trust. I help eye care professionals and team leaders build the relational clarity needed to thrive in high-pressure environments.

Learn more at: www.emotionalintelligenceconsultinginc.com

 

Jade Bodzasy

Jade Bodzasy

Jade Bodzasy, Founder of Emotional Intelligence Consulting Inc., is a dedicated Coach and Consultant for Optometric Practices. Her extensive background includes over 20,000 hours of expertise focused on customer relations, work structure refinement, training method development, and fostering improved work culture within Optometric practices.

Certified in Rational Emotive Behavior Techniques (REBT), Jade possesses a unique skillset that empowers individuals to gain profound insights into the origins of their behaviors, as well as those of others. Leveraging her certification, she equips optometry practices with invaluable resources and expert guidance to establish and sustain a positive, healthful, and productive work environment.

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