CLINICAL

  uv protection

Talking to Patients About UV Exposure

Strengthen the doctor-patient bond and increase patient compliance through effective communication

CRISTINA SCHNIDER, O.D., F.A.A.O., JACKSONVILLE, FLA.

The cumulative effects UV radiation can have on the eyes, such as cataracts and other ocular diseases, is not news to practitioners; however, it may be news to patients. Though there is widespread awareness that UV light damages the skin, some patients are still in the dark about how it can affect their vision.

Educating patients about the effects UV rays can have on the eyes, the impact of environmental exposure to the eyes throughout the day and steps they can take to help protect their eyes from UV radiation is a great way to differentiate your practice. Not only will this education strengthen the doctor-patient relationship, it will also increase adherence to your recommendations and even boost your bottom line.

However, in order to reap these benefits, there must be effective communication. Patients are more satisfied with the quality of their health care when there is effective doctor-patient communication, reveals the Journal of Health Communication. And, research shows that there is a strong positive correlation between a doctor’s communication skills and a patient’s capacity to follow through with healthcare recommendations, manage a chronic condition or adopt preventive health behaviors, such as proper UV protection.

Here, I provide an effective communication approach to educate patients about UV exposure to help improve their compliance to your recommendations and increase patient satisfaction.

Talking with patients

The crux of developing good communication with patients is building a sense of trust and of shared values, or “concordance.” In the vision-correction market research I’ve been involved with through the years, I’ve found that both patients and clinicians identify the same top three priorities, in exactly the same order: (1) health of eyes; (2) crisp, consistent vision; and (3) long-term comfort.

Refocusing your recommendations around the shared top priority — ocular health — can have a positive impact on patient compliance.

Maximize your efforts with these tips:

► Recommend year-round protection. Many people wear sunglasses, particularly in the summer, and may avoid being outdoors during the peak sun hours of 10:00 a.m. to 2:00 p.m. Unfortunately, these measures aren’t always sufficient to protect the eyes from UV rays.

According to tests conducted using UVB sensors mounted on the eyes of mannequins, ocular UVB exposure at many times during the year is actually much higher between 8:00 a.m. and 10:00 a.m. and 2:00 p.m. and 4:00 p.m. than between 10:00 a.m. and 2:00 p.m. This is partly because the facial anatomy protects the eyes from direct overhead sunlight, at least when one is standing upright.

UV radiation is more likely to reach the eyes from the side or below, when the sun is at a lower angle in the sky.

Additionally, total ocular radiation is approximately the same in November as on a longer, sunnier, September day. Because of this, eye protection is warranted throughout the day, every day, when outside during daylight hours.

► Dispel incorrect “facts.” Sunglasses may cut down on glare, and the lenses can be highly effective at blocking UV light hitting the sunglass lenses. However, as much as 45% of harmful UV rays can still reach the eyes from around the sunglass frames from all angles. The most protective style of sunglasses is a wrap-around frame that fits closely to the face. (See Figure 1, page 34.)

Figure 1: Left, fluorescence of the UV-sensitive paint on the eye inserts indicates noticeable UV exposure, even when sunglasses are worn; right, a wrap-around sunglass style that sits close to the face provides better UV protection.

Listing the reasons for your specific recommendations will help patients understand the importance of proper protection and get them on board with your recommendations.

“Patients tend to assume that all glasses or contact lenses are essentially equivalent, so of course they would prefer the cheapest option,” says Scott Gunderson, O.D., who owns a practice inside a Costco store in suburban Denver. “But if you have actual reasons for what you are recommending — say, a better fit or added UV protection — patients see the value.”

In fact, education is key when Dr. Gunderson makes a recommendation that will require patients to pay more or change their habits. “You really have to explain why it’s important,” he says.

► Make it personal. Instead of a sterile, clinical discussion, make your recommendations personal and appeal to what motivates each patient.

“If I can combine what they want with what they need in the same discussion, everyone wins,” says Dawn Hartman, O.D., a clinical instructor at The Ohio State University. For example, say you have a patient who travels often and spends time outdoors, but suffers from seasonal allergies and is struggling in his current toric contact lenses. Here’s how Dr. Hartman might position a recommended change to daily disposable lenses around health issues:

“I’d like to refit you in a daily disposable toric lens that will be a lot more comfortable, give you more consistent vision and provide added UV protection from the sun. A fresh lens every day is a healthy way to wear contact lenses, but it’s especially important for you because you have seasonal allergies. Because you are outside a lot, we also need to take steps to help protect your eyes from UV exposure. Comprehensive protection should include sunglasses, a wide-brimmed hat and, for added protection, UV-blocking contact lenses. I’ll send you home today with a five-day supply of diagnostic lenses, and we will recheck them next week.”

► Eliminate distractions. Deliver your recommendations at the end of the exam so you can focus on the patient. The added attention will help reinforce the importance of your message and elicit patient trust.

“I try to deliver all my advice at the end of the exam, so I am looking at the patient rather than be occupied with tests or charting,” says Sheldon Salaba, O.D., of Hamilton, Ontario, Canada. “People really do want what’s best for their health and for their kids’ health, so these end up being very easy conversations,” he says.

► Take a comprehensive approach. Ideally, patients should rely on multiple layers of protection, including a wide-brimmed hat to shade the face when the sun is high in the sky, high-quality, well-fitting, wrap sunglasses to block UV rays to the eye and surrounding tissues and UV-absorbing contact lenses to provide added protection to the covered portions of the eyes against the rays that sunglasses miss, as that additional layer of “always on” protection. Discussing protection other than eyewear will show that you’re genuinely concerned about their health.

This is especially important for children. Dr. Salaba, for example, says he asks parents to make sure their kids wear a hat and sunglasses and, if they wear contact lenses, fits them in UV-blocking materials whenever possible.

► Include your staff. Have the staff member who will escort the patient to the optical shop in the exam room during the discussion, which will ensure a smooth handoff and that your recommendations are reiterated during frame and lens selection.

A bright outcome

Educating patients about proper UV protection can help set your practice apart. And, a personal communication strategy is an effective way to build trust and increase compliance and profits at the same time. OM

Dr. Schnider is senior director, professional communications for Johnson & Johnson Vision Care, Inc. Send comments to optometricmanagement@gmail.com.