I visited a physiotherapist for a few months a while ago and at one of the early consultations she asked me “What do you want to get from this consultation today?” I thought that was a really good question and it got me thinking whether it would be useful for me to ask my patients that. I suspect we tend to think we know what patients want, but asking this question directly may be helpful. It may be that all your patient wants is the cheapest pair of reading specs. Alternatively, they may want to have the best possible vision, regardless of cost. Why not ask them? Similarly if you have an unhappy patient you need to understand what it is they want to achieve. Knowing this can help you tremendously – it may be that they want something quite straightforward, such as for you to repair their frame, or reglaze the lenses. Or it may be something much more challenging, such as to have clear comfortable vision with a pair of toric soft lenses, when you have tried 20 different types, none of which they are happy with.