THE VISION CARE INSTITUTE^TM, LLC
a johnson & johnson company

NEWSLETTER

Director's Update

Vision Care Institute^TM to Open Satellite Learning Centers at Optometry Schools

By Richard Clompus, O.D., F.A.A.O.

The Vision Care Institute^TM LLC (TVCI) is partnering with leading optometry schools and colleges throughout the United States, Canada and Puerto Rico to extend its professional-level training opportunities for optometry students and practicing O.D.s with distance learning and live programming at oncampus satellite centers.

Vision for the Future

At TVCI, our primary mission is to support the education of eyecare practitioners. We fulfilled this mission in 2006 for more than 10,000 attendees at our institutes worldwide, from Jacksonville to São Paulo, Shanghai to Tokyo to Bangkok. We help attendees learn vital clinical skills, practice effective patient communication and discover the latest technologies.

Still, our vision of the potential for professional education is always growing. Today, that vision is focused on using the latest technology to expand our reach. We're building multimedia satellite learning centers on optometry school campuses, and we'll be reaching out to students and practicing O.D.s.

The new college-based TVCI Satellite Centers will mirror Jacksonville's Mertz multimedia conference room. Equipped with two projectors and screens, microphones and Internet connections, the Mertz room can host a class of students from around the globe.

The new TVCI Satellite Centers will mirror Jacksonville's Mertz multimedia conference room, which is equipped with two projectors and screens, microphones and Internet connections.

In each satellite center, attendees will be able to participate and interact with classes occurring in Jacksonville, Fla. They will have the ability to watch lectures and videos and ask questions of the instructors. Each room also will have the option of remote communications with the other college-based TVCI satellite centers. Never before has there been a standard technology platform for communication between optometry classrooms.

The first two satellite centers opened in June 2007 at the Pennsylvania College of Optometry, Elkins Park, Pa., and at the New England College of Optometry, Boston. Additional satellite centers will be built at other optometry schools over time.

Dr. Clompus is director of The Vision Care Institute^TM LLC. He has been a member of the clinical faculty of The Eye Institute at the Pennsylvania College of Optometry. Dr. Clompus's awards include the American Optometric Association's National Recognition Award for Continuing Education and the Optometrist of the Year Award in Pennsylvania.

Pearls of Patient Education

Here are just a few takeaways from this singular learning experience.

By Walter D. West, O.D., F.A.A.O.

At TVCI, we give students and new O.D.s hands-on training that they can't get anywhere else. Our patient communication program is unique, and it's individualized for students and new practitioners. All third or fourth year optometry students and new O.D.s who visit TVCI get one-on-one coaching and takeaways that help enhance their personal communication skills. These five essential messages are part of that education.

1. Become an active listener.

One of the most important rules of patient communication is to truly listen to what people are telling you and demonstrate what's called "active listening." As an active listener, you not only maintain eye contact and give feedback that shows you're hearing and understanding, you also ask questions to get more information about each patient's physical and emotional well being.

For example, a patient might say, "Last week, you said that I had glaucoma, and I want to talk about it some more." Giving the patient your full attention, you might say, "I'll be happy to give you more information or answer any questions you have. Where would you like to begin?" In the course of the dialogue with the patient, you might interject a comment and a question such as, "I know that you are concerned about the diagnosis of glaucoma, and I want to help you in any way I can. We've talked about the diagnosis and treatment but how do you feel about having to deal with all of this?" You want to get to the heart of the problem, learn how the patient feels about it and make sure the patient receives a complete and understandable answer to his question.

2. Shift into layperson vocabulary.

Once we realize that the language we speak among our colleagues is not necessarily the right language to use when speaking to patients, we can start to translate "doctor speak" into "patient speak."

For example, if another eyecare professional asks you how bifocal contact lenses work, you might talk about the variety of designs, eccentricities, add powers and so on. But when you're recommending multifocal contact lenses to a patient, you might say, "Each bifocal lens has two prescriptions in it, one prescription clears your distance vision and one clears your near vision. Because I have the ability to control both prescriptions, I can design the lenses to correct your vision for reading and playing golf."

3. Develop "scripts" for common conversations.

In one week, you might deliver 200 messages to patients, but 175 of them will probably be repeats of the same 10 explanations. I teach students a strategy and a technique for developing "scripts" for messages they deliver over and over again. I don't want them to sound like a tape recording of common answers, but I want to make sure they hit every one of the essential points in the clearest, most effective order.

For example, new presbyopes need to understand the background of the problem and the corrective options available, and this information should be delivered in a positive light. News that's more difficult to deliver, like a glaucoma diagnosis, is especially important to script and practice.

You wouldn't tell a patient, "We've looked at all your clinical data, and you have glaucoma." As soon as patients hear "glaucoma," they stop listening to what you're saying as they try to accept and process the important message that you've just delivered. A better approach is to say something like, "We have all of your test results, and I've had an opportunity to review them. The pressure in your eye is a little high. This can be an indicator of a condition called glaucoma." Then pause to give the patient a few seconds to digest this information before providing a thorough explanation of what glaucoma is and how it can be treated.

4. Send appropriate nonverbal messages.

The words you speak are only part of the overall message you send to patients. Proximity, body language and tonal quality convey your confidence level, your feelings about the patient and your attitudes about the subject you're discussing, among other things. Here are a few examples:

► Body language: Posture is a big part of the nonverbal message we send. If you sit straight in your chair with your hands in your lap, the patient might get the message that you're rigid and detached. By leaning forward slightly, you appear engaged in the discussion.

Sometimes, the message your posture sends can depend on the context. Asymmetric posture — like leaning on your elbow on the arm of the chair — can be perceived as confident, casual, detached or bored. If you're in the process of making recommendations to yotr patient you could be sending a mixed message.

► Proxemics: How close are you to your patients? According to some basic rules of proxemics (the study of spatial relationships between people), a distance outside of 12 feet is considered "public space," 4 feet to 12 feet is "social space," 18 inches to 4 feet is "personal space," and 18 inches or less is "intimate space."

Healthcare matters are personal, and you should discuss them within a patient's personal space (18 inches to 4 feet). This helps you build a personal relationship, it discourages distraction on the part of the patient, and the patient perceives that you're spending more time together than he does if you stand across the room.

► Voice: Your tone of voice is the best way to convey sincere concern, as well as confidence. I've listened to many students tell patients, "I'm finished putting drops in, and they'll take effect in the next few minutes." Some say it with an upturn in tone at the end of the sentence, like a question. Others have a downturn at the end, which makes it a more confident statement.

5. Work on communication as you do any other skill.

Good communication doesn't just happen. You work at it. Sure, some people seem to have a gift for communicating, but even if you don't, you can achieve excellence by working on your skills.

Of course, you probably haven't had much formal training in interpersonal communication. At TVCI, I coach students and enhance their communication skills in a real clinical environment — an approach that yields immediate results. Outside TVCI, O.D.s build on their experience to continue taking an objective look at how they communicate with patients.

Cultivating Relationships

I ask every class at TVCI, "If you're all in the same town, what would bring a patient back to you?"

Every optometrist can do an eye exam — those experiences are all the same to patients. The exam doesn't keep people, but their experience in your practice will keep them. Retention has a lot to do with the relationships you build with patients on a personal level. Through the hands-on learning experiences at TVCI, we're helping doctors effectively educate patients while building strong relationships and thriving practices.

Dr. West founded Primary Eyecare Group in Brentwood, Tenn. He lectures nationally and internationally, teaching leadership, management and communication techniques to enhance optometric practices.

Providing Culturally Competent Eye Care

TVCI helps prepare doctors to better serve diverse patients.

By Derrick L. Artis, O.D., M.B.A., F.A.A.O.

America today is a land of diversity. Many optometry practices serve culturally and ethnically diverse patients who choose to practice the values, customs and beliefs of their respective cultures. Culture extends well beyond race and ethnicity. Culture reflects shared experiences among members of a given group, family or community and is manifested as learned languages, values, behavioral patterns and religious practices.

Diversity in America has extended far beyond the central cities to suburban and rural areas. As eyecare professionals, we may be aware of the clinical implications of treating patients of various cultures, but practice success also can depend on whether we provide an office environment that is sensitive to the cultural needs of our patients. We call this providing culturally competent eye care.

Providing culturally competent eye care includes making sound clinical decisions based on demographics, but it also includes communicating in a sensitive manner and incorporating patients' customs and beliefs into the management of our practices. For example, when communicating to a patient who isn't fluent in English, it's vital to ask the patient to repeat what you've just said to ensure that he understands. Studies show that poor doctor-patient communication often leads to noncompliance and dissatisfaction.

Some cultural differences aren't as obvious as language and often we're unaware of them. Creating awareness of these differences and providing tools to enable the doctor and practice to better serve a diverse patient base is one of our objectives at TVCI, so we've developed a doctor and staff training DVD that illustrates some of the cultural challenges faced in an optometry practice today. Our hope is that the training DVD will increase awareness and enable practices to improve the care and health outcomes of culturally diverse patients. We believe this ultimately will increase patient trust and satisfaction, and eventually will yield strong optometric practices.

Understanding Attitudes, Perceptions

One of the keys to providing culturally competent eye care is to first understand the patient and his perception about the care that we provide. The Americans' Attitudes & Perceptions About Vision Care national survey, conducted by Harris Interactive on behalf of TVCI, focused specifically on African American, Hispanic and Asian American populations. To obtain an executive summary of this survey please e-mail a request to VisionCareSurvey@visus.jnj.com.

► Asian Americans: In comparison to Caucasians, African Americans and Hispanic Americans, Asian Americans are least satisfied and see less value in eye exams or optometrists. The study found that Asian Americans are least likely to agree that eye health problems can be diagnosed during the exam. More than nine out of 10 Asian Americans (93%) agreed that maintaining proper vision is an important priority, but more than a third (36%) believe that they don't need an eye exam unless they're having a vision problem.

Some of these attitudes exist because in many Asian countries, the optometrist isn't involved in the medical care of the eye. It's important that we communicate that we're providing a thorough eye health examination in addition to prescribing contact lenses and eyeglasses.

The survey also indicated that Asian Americans are more likely to believe that contact lenses are only healthy for people in the ethnic groups studied in clinical trials. This offers an opportunity for the culturally competent practice to educate and reassure these patients that contact lenses are healthy when used appropriately.

► African Americans: Among groups surveyed, African Americans were most likely to strongly agree that maintaining proper vision is a high priority (72%) and that taking care of their eyes is as important as other health issues (50%). However, African Americans were most likely to report that they don't have a regular eyecare professional (21%).

The African Americans surveyed held more serious and positive attitudes toward the value of eye examinations and optometrists. They understand the value of an examination. This presents an excellent opportunity for doctors to send frequent reminders to African-American patients to return to the practice for eye health evaluations.

African Americans and Hispanic Americans have a much greater focus on style and appearance and are attracted to offices with designer and fashion eyewear.

► Hispanic Americans: More than one in four (27%) Hispanic American respondents strongly agreed that they are very concerned about their vision getting worse, compared with only 15% of all respondents. Despite concerns about worsening vision, Hispanic Americans were least likely to have seen an eyecare professional in the last year (43%). Hispanic American patients should be reassured that annual visits and compliance can help prevent vision loss.

Additionally, the survey indicated that Hispanic Americans, like African Americans, prefer to have the doctor tell them exactly what to do, and they share a common interest in style and appearance.

Dr. Artis is director of customer development at Vistakon, a division of Johnson & Johnson Vision Care, Inc.