4. Meeting the mentor(s)
The only way for patients to overcome the fear of doing something is to do the thing that scares them. Jeffers adds:
“When you do it often enough, you will no longer be afraid in that particular situation. You will have faced the unknown and you will have handled it. Then new challenges await you, which certainly add to the excitement in living.”
The idea of feeling the fear and doing it anyway is the basis of systematic desensitisation, a well-proven treatment of phobias. This therapy aims to remove the fear response of a phobia by systematically exposing the anxious subject to more anxiety-producing stimuli of the thing that induces fear and substituting a relaxation response to the conditional stimulus gradually using counter conditioning.
- Rewarding patients for their demonstrated courage in booking the first appointment can help them to remain consistent with their prior actions and keep their scheduled appointments.
- For many patients, merely walking into a clinic where surgery is performed will cause anxiety. Initiating a warm welcome call a week before to let them know you’re eager to see them and calm their worries (buyer’s remorse) serves to reduce DNA rates.
- Meeting the mentor (that is, the surgeon – or an extremely credible optometrist) is crucial. Importantly, the mentor needs to demonstrate their authority to guide the patient, providing a map and the empathy the patient requires to submit to their instructions.
Many clinics seek to save time and costs so they skip these steps. I feel that’s an error for various reasons – number one is that the patient fails to meet the mentor who helps them get over their fear (ergo, more delay and more declines).
5. Crossing the threshold
At first calls and appointments, seek to identify what the patient fears explicitly. As an exercise, ask them to rank the aspects of the surgery that causes them to be anxious.
Give them, or direct them to, a resource to help them learn simple relaxation or coping techniques such as meditation, tensing and relaxing parts of the body (progressive muscle relaxation), and breathing exercises. Many smartwatches, like the Fitbit and the Apple iWatch, have built-in relaxation routines patients could use. YouTube is full of videos that demonstrate and guide people through meditation, progressive relaxation and stress management approaches.
Understand that many patients feel like crossing the threshold is a liberation of sorts. They’ve finally made a commitment, taken a risk in even showing up, and begin to anticipate the resolution of their problems with excitement and positivity. Take advantage of this state to show the patient that you can measure up to their expectations of a mentor who can confidently lead them towards the conclusion of their journey.
6. Tests, allies and enemies
Systematically expose prospective patients to what they fear (from least to most) and have them connect the successful coping mechanism with each increasingly fear-inducing stimulus. For example:
- Calling some of your measurements “test-drives” for those who fear people touching their eyes can help.
- Guiding patients into the surgical suite and asking them to relax on the treatment bed might be useful to help the anxious cope with the unknown.
You don’t need to be a trained psychologist to carry out these techniques. Many people, myself included, practice approaches to calm themselves in the face of fears to successfully transcend them. For example, I have a little ritual I practice whenever I’m about to lift a weight I feel is a new challenge: I will typically silently mouth the words “I can do this” and then proceed to do it. When I’m about to throw myself down a challenging hill on my snowboard, I’ll similarly clap my gloves together two or three times before I lean into it.
After the initial period of optimism generated by simply crossing the threshold, the patient needs to acclimatise to the special (clinical) world. These can include inconveniences like:
- Sitting idly in a waiting room without much to do but worry,
- Waiting much longer than is seemingly necessary,
- Overhearing reception and clinical staff carry-on about trivial pursuits,
- And generally, feel like a stranger in a strange land.
This stage is an opportunity for your staff to position themselves as the hero’s team – like a Fellowship to Frodo, Luke’s fellow rebels aboard the Millennium Falcon, or Neo’s crew-mates on the Nebuchadnezzar. Everything the patient sees “on-stage” should feel to them like it’s designed to help them on their journey. If it doesn’t, stop the behaviour and move it “off-stage”, out of the patient’s scope of observation.
Your front desk staff’s number one job at initial appointments is to ease the patient’s tension, focus on their comfort, reduce their anxieties and ensure they are kept abreast of what to expect – especially when things change from the expected norm.
Patient liaisons must assume the role of an ally, walking alongside the patient on their first appointment pathway, introducing them to the other allies and mentors along the way.
Hero’s often have an ultimate sidekick they can trust, which is why I always encourage you to invite your patient’s significant others to travel alongside them on their journey. Having a friend or family member accompany the patient into theatre might seem like a needless inconvenience (especially if they’re anxious themselves!). Still, it can help an anxious patient feel a sense of familiarity in unfamiliar surroundings.
7. Approach to the inmost cave
The big day has arrived and your patient, accompanied by their ally, have made their way to your practice. At this stage, don’t underestimate the soothing power or human touch. A permitted touch on the shoulder can go a long way to reassure someone who is anxious.
A designed-for-purpose room complete with dim lighting, essential oils and a head and shoulder massage from a massage therapist, is a wonderful extra touch that can go a really long way in relaxing your patient and making their experience a pleasant one.
8. The ordeal
The Ordeal in any hero’s journey is sometimes a dangerous physical test or a deep inner crisis that the hero must face to survive or for the world in which the hero lives to continue to exist.
As nearly everyone who’s had laser eye surgery knows, the imagined ordeal is significantly more terrifying than the event itself:
This is, of course, the main event. For most, it’s over before they know it.
If you want to make their experience even more comfortable, provide them with:
- A plush toy to hold onto during the surgery can help to alleviate patients common anxiety symptoms such as muscle tenseness, trembling and sweating.
- A heavy blanket can help to keep the patient warm in what is often a cool room and prevents them from reflexively lapsing into self-protection mode by bringing their hands up to their face in a panic.
- The magically reassuring power of well-timed words can make the patient feel like they’re doing everything right while doing nothing but lying there like a stone.
- A need to know basis (the empty silence is scary)! Informing the patient of everything they need to know, only a moment before it happens, irradiates any doubt that may be in their mind.
The surgery is now complete. With LASIK, patients typically experience the “Wow Effect”. It’s a powerful moment that you should help celebrate.
It can be an emotional experience for many. The sense of relief (it worked!) is palpable and reinforced at that moment. You want to make your patient feel like King Arthur who’s just pulled Excalibur from the Stone.
10. The road back
The road back can be so much more than post-op visits. Imagine different ways to celebrate your patient’s return to their ordinary world to keep it as special as possible. Recognition, token gifts or cards, follow-up calls in between appointments, all can help to lend your hero assistance as they recover from their ordeal.
According to Jeffers:
“This is the one truth that some people have difficulty understanding. When you push through the fear, you will feel such a sense of relief as your feeling of helplessness subsides. You will wonder why you did not take action sooner. You will become more and more aware that you can truly handle anything that life hands you.”
Patients want to be understood and empathised with. They need their guide (that is, their surgeon or clinic) to appreciate what they have, how they feel, what their daily life is like, and their status before they guide them to where they want to go.
Most importantly, they don’t want their surgeon or their clinic to be the hero. That’s not an effective way to calm their fears. They already expect the surgeon to be fearless. They, the patient, must overcome their own anxieties and transform into the hero and protagonist of the story, with the aid of the guide.
12. Return with the elixir
The patient will return with an elixir of clarity, destined to bring hope to those they left behind, re-convinced of a direct solution to their problems and a fresh perspective for you – the readers – to consider.
“This should be a relief. You are not the only one out there feeling fear. Everyone feels fear when taking a step into the unknown. Yes, all those people who have succeeded in doing what they have wanted to do in life have felt the fear – and did it anyway. So can you!”
This truth relies on social proof, which is a psychological phenomenon where people assume the actions of others in an attempt to reflect correct behaviour for a given situation.
One of the worst things you can do is to tell people that they shouldn’t be afraid, or that they’re alone in their fear. In truth, most people are fearful of eye surgery, and that’s OK!
People assume many coping strategies to assuage their fears through social proof. For example, one of the primary reasons people look at reviews before making a purchase is because they are anxious to know how others experienced and overcame their fears.
When soliciting reviews, I advise prompting your patients to cite their fears and how they overcame them before surgery as the central theme of their reviews. For example, when asking for reviews, ask the happy patient:
- What are the problems you experienced before you discovered what you could do about your eye problem?
- What did you want to do or accomplish after surgery? (What was your call to adventure?)
- Did you at first refuse the call? If so, why, and for how long?
- What frustrations did you experience when trying to solve your problem?
- What’s different about dealing with us compared to others you tried?
- Take me to the moment when you realised that the treatment worked?
- Tell me what life looks like now that you’ve solved or are solving your problem?
- What would you tell someone who was scared about eye surgery?
Social proof is powerful. One study, cited in the Washington Post, even showed how positive social proof can be more influential than saving money.