Ophthalmic technicians know that patient care is about much more than visual acuity and diagnostic testing. We’re not only the first point of contact—we can also be medical knowledge interpreters, educators, and, at times, mediators. Our words and actions can either build trust or escalate tension in seconds. In the case of the latter, it is important to know how to diffuse difficult patient encounters. In this article, I’ll share some of the tools that have worked for me.
Understanding How We Process Communication
Every time we take in data, our brain processes that information by adding or reconciling it to our past experiences and knowledge, and forms conclusions. Patients do the same. Often, our “data sets”—the experiences we draw from—are rarely the same as another person.1, 2
As technicians, we may see a patient’s reaction through the lens of medical knowledge, efficiency, or workflow. A patient, on the other hand, might be responding from fear or frustration. When there’s a gap between how we perceive a situation and how the patient experiences it, communication can quickly break down, causing misalignment, poor reactions, and potential emotional escalations.
Those data gaps are where empathy and curiosity make all the difference. Empathy is more than kindness, it’s the foundation of patient-centered care. The ability to understand that a patient’s emotional response is rooted in their perspective—and possibly their anxiety and fear—can allow us to stay calm, listen deeply, and respond effectively.
Small Shifts, Big Impact
One of the most straightforward ways to strengthen patient communication is by adjusting our wording. I have found that a few simple changes, like the examples below, can completely change the tone of an interaction:
- Instead of “Do you have any questions?” try “What questions do you have for me?”
- Replace “How can I help?” with “How can I support you today?”
- Swap “You’ll need to…” for “Let’s make sure you’re comfortable with…”
These subtle shifts invite patients to participate rather than feel instructed, even in everyday conversations. They signal collaboration—that we’re working with them, not on them. This seems like a minor shift but can make a significant difference in patient response. The words we choose help patients feel respected and heard—which in turn improves compliance, satisfaction, and trust.
Tips for Difficult Communication
“Difficult” communication often happens when expectations and experiences collide or when something has “triggered” an emotion or belief that causes angst. We tend to see conflict as something negative, a situation to avoid. But conflict can be an opportunity for understanding and connection. When a patient expresses dissatisfaction or anger, they’re communicating a need. The challenge is to listen for that need underneath the emotion.
In the clinic, technicians are often the first person a patient turns to when they’re unhappy. In those moments, our goal isn’t necessarily to fix everything; it’s to listen and acknowledge.
Do:
- Listen attentively without interrupting.
- Reflect back what you heard: “It sounds like you’re frustrated with how long today’s appointment has taken.”
- Thank the patient for bringing it up: “I appreciate you sharing that with me.”
Don’t:
- Dismiss their feelings with “I understand.” (In many cases, we truly do not fully understand and using the word “understand” can trigger anger with some patients. If you must use the word "understand,” consider “I can understand how you would feel...”)
- Rush to defend or explain before they’ve finished speaking.
A simple acknowledgment like “I can see this has been frustrating” can calm emotions far more effectively than a detailed explanation of clinic flow. Patients want to feel heard before they’ll be ready to hear us. And frankly, saying that the clinic is shorthanded is not an explanation that helps ease frustration; rather, it can give the idea that the patient’s frustrations are not legitimate considering the staffing numbers are down.
The Power of Curiosity and Validation
Another strong tool to keep dialogue constructive is curiosity. Open-ended questions can turn confrontation into collaboration. This approach invites the patient to share their perspective, reducing defensiveness. Use what and how questions instead of why; “why” can sound like a challenge and invoke defensiveness.
Pay attention to your tone and body language, too. Eye contact, an open stance, and a calm voice show the patient you’re engaged and respectful, even if they’re upset.
Choosing the Right Words
Word choice can either defuse tension or escalate it. Here are a few language swaps that can make tough conversations smoother:
- Instead of “That’s not correct,” Or “I disagree, try “I see it a bit differently; let me explain.” or “May I offer another perspective?”
- Replace “There’s nothing we can do,” with “Let’s talk about what options are still available.”
- When expectations aren’t met, try “I’m sorry your experience didn’t meet your expectations. Let’s see what we can do to make this right/work/better.”
Even small changes in phrasing show respect and empathy, helping patients feel included rather than dismissed.
When You Hit a Roadblock
Sometimes, despite your best efforts, communication reaches an impasse. The patient may be too upset to continue, or you may feel your own frustration rising. In those moments, practice the pause.
Take a breath before speaking. If needed, excuse yourself briefly:
“I want to make sure we get this right for you. I’m going to step out for a moment and ask someone who can help us figure out the next step.”
If another team member—perhaps a physician or supervisor—can better address the concern, explain the situation to them before reintroducing the patient. That prevents the patient from having to repeat their story, which can reduce agitation.
Remember, the patient’s perception is their reality. You’re not presenting evidence to change their mind—you’re showing empathy for their experience.
In Closing
For ophthalmic technicians, effective communication is as vital as accurate testing or proper charting. Every interaction—especially the difficult ones—offers a chance to strengthen trust, demonstrate professionalism, and support quality care.
When we approach challenging conversations with curiosity, empathy, and thoughtful language, we don’t just defuse tension—we create connection. And that connection is at the heart of what we do every day: helping patients see, understand, and trust that we care. OM
References
1. Piaget J, Dantier B. Knowledge of the object of study and knowledge of the studying subject: between assimilation and accommodation. Chicoutimi, QC: J.-M. Tremblay; 2011. doi:10.1522/030181265
2. Brod G, Werkle-Bergner M, Shing YL. The influence of prior knowledge on memory: a developmental cognitive neuroscience perspective. Front Behav Neurosci. 2013;7:139. Published 2013 Oct 8. doi:10.3389/fnbeh.2013.00139