Tag: Patient Experience

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

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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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Why Hearing Care Makes Sense in an Eyecare Practice

Independent SightLines

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Trevor Miranda Hearing and Vision clinic article image

If eyes are the windows into the soul, perhaps ears are the doorway to the heart. Both vision and hearing play huge roles in enjoying life. Whether it is the ability to read or the ability to participate in conversations, both are central to day-to-day connection and independence. Like vision, hearing deteriorates with age. Early detection and timely intervention can improve long-term vision and hearing health and overall wellness.

One Stop for Vision and Hearing Care

At three of our five clinics at Cowichan Eyecare, we have integrated hearing services. My brother is a Doctor of Audiology and leads our hearing care division.

Our first instinct was to operate in a silo and simply share space. Some of that may have stemmed from a fear of being viewed as nepotistic if we more closely integrated the vision and hearing offerings. Over time, we have continued to integrate both services in a more intentional way, and patient feedback has been overwhelmingly positive. The convenience of addressing hearing needs in a place you already trust for eyecare, or vice versa, has quelled our initial reservations about joint care.

There are also real economies of scale that create efficiency and cost savings with hearing and vision integration. We share a front desk and a call-answering system, which streamlines communication and scheduling. We use a common Practice Management System (PMS) for billing and recalls, which helps us keep patients on track with follow-up care. Shared restrooms and lunchrooms allow for efficient use of space, leaving more room for special testing or retail areas in the clinic.

One of the key differences between vision and hearing is that there is often a significant lag between the onset of hearing loss and the time a patient seeks corrective help. Increasing awareness in both disciplines, and cross-educating our teams, is a practical way to reduce that lag and get people the support they need sooner. In our experience, simply having both services under one roof creates more natural conversations about overall sensory health.

The Role of Hearing and Vision on Cognition

Hearing is inextricably linked to cognition. Audiologists often say the ears collect sound, but it is the brain that hears. There is substantial research highlighting a connection between untreated hearing loss and cognitive disorders. More recent research is also showing that improving hearing can reduce the risk of cognitive decline. Keeping our hearing healthy is an important part of keeping our brain in an optimal state.

Because we cannot fully close our ears the way we can close our eyes, the brain is constantly receiving and processing sound. This ongoing processing keeps the auditory centres of the brain engaged and “exercised.” When we hear, the brain chooses to pay attention to some sounds (for example, conversation) and to tune out others (for example, the hum of traffic). That filtering is work, and it is part of what makes hearing such an active, brain-driven process.

We all have a certain amount of cognitive capacity, or “brain power.” That resource is limited, and the amount we have available at any given time depends on many factors, including fatigue. When we have untreated hearing loss, we use cognitive resources, and often our vision as well, to fill in the blanks of what our ears are not giving us. In conversation, hearing is the first step before we can understand content. A hearing deficiency demands cognitive resources first, and whatever brain power is left over can then be used to process, remember, recall, think ahead, draw analogies, create and understand jokes, and stay engaged in the moment.

Research has shown a significantly higher incidence of cognitive disorder in people with untreated hearing loss. For example, individuals with hearing loss between the ages of 45 and 65 have been shown to have two to five times the risk of reduced cognition and dementia, depending on the severity of the hearing loss (Lin et al., 2011; Livingston et al., 2020). More recent research is beginning to show that when hearing loss is treated, cognitive performance can improve significantly (Jiang et al., 2023).

The primary advantage of correcting milder degrees of hearing loss may be the potential cognitive benefit. When missing sounds are filled in with assistive devices such as hearing aids, it reduces demand on limited cognitive resources. Those resources can then be deployed for higher-order tasks, including comprehension, memory, and social connection. In cases where vision is compromised such as macular degeneration optimizing hearing is even more important due to limited cognitive resource theory.

The Business Opportunity

Our metrics show that hearing care revenue represents about 30% of the eyecare revenue opportunity. That means that, with little added space, a significant additional source of revenue can be available in many eyecare clinic settings. A hearing booth is required, but the footprint is manageable and the impact can be meaningful. A hearing booth is simply a small, sound-treated room that allows accurate testing and fittings in a quiet environment. There are few eyecare subspecialties that can provide this amount of financial upside without major renovation.

Of course, the details matter. The revenue-sharing agreement needs to be worked out, and medical manpower needs to be accounted for, including appropriate compensation for the audiologist. When it is structured properly, the integration can be both clinically valuable and financially sensible.

Wearables as the Gateway

New eyeglasses are coming to market that will be hearing-assistive. These glasses will provide sound enhancement and refinement by cancelling noise and using directional microphones built into the frame. These hearing glasses will likely provide solutions sooner for patients with low to moderate hearing loss.

They will not replace customized hearing instruments, and they are not meant to. Still, as an entry point, hearing glasses can be assistive at a lower cost, while also delivering great vision with prescription lenses. For some patients, that may reduce barriers and normalize getting help earlier.

The Focus on Wellness

Optometry and eyecare will continue to evolve. Technological advancements in wearables, enhanced diagnostics, and individualized solutions will allow ECPs to support better overall health and wellness for our patients. Can you hear it? The future will be clear, and it sounds amazing!

If you have noticed the TV volume creeping up, or you find yourself asking people to repeat themselves more often, bring it up at your next eye exam. We can help you understand what is normal, what is not, and what the next step could be.

2024 Trevor Miranda

DR. TREVOR MIRANDA

Dr. Miranda is a partner in a multi-doctor, five-location practice on Vancouver Island.

He is a strong advocate for true Independent Optometry.

As a serial entrepreneur, Trevor is constantly testing different patient care and business models at his various locations. Many of these have turned out to be quite successful, to the point where many of his colleagues have adopted them into their own practices. His latest project is the Optometry Unleashed podcast.

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

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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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