Rx for physio 360 -no subs!

**michelle** · 02-04-2007, 11:38 PM

If the patient is not having a problem with the progressive they are wearing keep them in that. The only time a doctor can write no substitutes is if it is a child and they need polycarb lenses or if the patient has vision in one eye than they would need polycarb lenses. If you talk to the patient about the different types of progressive especially the new ones they may want to try it, if they can't get use to it than you could always do a non adapt and put them back in the one they wore.

**sharon m./ aboc** · 02-05-2007, 11:18 AM

Whenever a Dr. writes Crizal or a specific brand of progressive I always look at it as a "suggestion" and use my own judgement. I think that contact lenses are the only thing that have to be exactly what is prescribed by brand, base curve,etc.

**shellrob** · 02-05-2007, 11:38 AM

I know what we do, but my question is, what is legal? Is it illegal to fill the rx not as written when it comes to the lenses and such?

**Lillith84** · 02-05-2007, 11:40 AM

I've found the Perfas lens to be MUCH better then that Physio and it's less expensive :)

**erosthedog** · 02-24-2007, 12:16 AM

:finger: I remember when I graduated 15 years ago another private O.D. very respected in the field told me his secret of making sure the lens on the prescription was:finger: an expensive lens to make him look good. While he was molding no name lenses in his office as CHEAP as he could.

This is just wrong. When I write an rx I only put down a brand name or a material if it will benefit the patient and then I put optional by the recommendation. I expect the optician to see the option and have the same conversation that I would in my office. The patient decides.:finger:

The only time the O.D should specify a type or material in my ethical opinion is when the patient may be harmed. For example polycarbonate for a monocular patient. Or a patient that truly needs a certain lens style to function.

Making life difficult for your fellow optical people and patients makes me burn!:angry:

**rdcoach5** · 03-02-2007, 09:55 PM

If he specifies base curve you have to follow unless you call him.Anything specified on a Rx must be followed exactly as written in any state of the Union or World UNLESS you have verbal or written permission from the Dr's office.The savings grace is, if you work for a Dr., You can do whatever he authorizes you to do. Independent Opticians must be very careful.

**HarryChiling** · 03-03-2007, 01:26 AM

Originally Posted by rdcoach5

If he specifies base curve you have to follow unless you call him.Anything specified on a Rx must be followed exactly as written in any state of the Union or World UNLESS you have verbal or written permission from the Dr's office.The savings grace is, if you work for a Dr., You can do whatever he authorizes you to do. Independent Opticians must be very careful.

Not necessarily so, in the state of Kansas it's true if the doctor wrote no subs then no subs (this is directly from a call placed to the attorney general), however in every state in the US if you can prove or even show how the prescribed lens design or material or whatever is actually harmful or that you provided a product that is better for the patient then you have a leg to stand on. Keep in mind that laws are like double edged swords they can be interpreted both ways it just depends on who the judge is and if he/she is in a good mood or likes your tie that day. :D

I will give an example, if the doctor wrote Polycarbonate - No Subs. Yes it is OK to fill it with Trivex and if the doctor is stupid enough to bring a lawsuit against you he will lose, because you could prove that the material you used has all the same benefits of the material he prescribed and performs better in many more ways. And if the doctor is dumb enough (and some are) to prescirbe Physio 360's for the ones that walk and not for the ones that stay you would have proof of unethical practice which in most states could get a license pulled. The point is doctors are not bullet proof and if you suspect that a doctor is writing erroneous information on his scripts to try and gain a business advantage, you have an obligation to report him/her to their board and if you have proof nail his/her behind to the wall. I fill all Rx's with the patients best interests in mind and I could and will defend any option I present to a patient that they choose, to the fullest.

Originally Posted by rdcoach5

Independent Opticians must be very careful.

Why would you want to try and create fear in independent opticians when there is no fact behind a statement like this? Most independent opticians that I know would have never had an opportunity to start a business if this statement held true.

**rdcoach5** · 03-03-2007, 05:51 PM

Originally Posted by HarryChiling

Not necessarily so, in the state of Kansas it's true if the doctor wrote no subs then no subs (this is directly from a call placed to the attorney general), however in every state in the US if you can prove or even show how the prescribed lens design or material or whatever is actually harmful or that you provided a product that is better for the patient then you have a leg to stand on. Keep in mind that laws are like double edged swords they can be interpreted both ways it just depends on who the judge is and if he/she is in a good mood or likes your tie that day. :D

I will give an example, if the doctor wrote Polycarbonate - No Subs. Yes it is OK to fill it with Trivex and if the doctor is stupid enough to bring a lawsuit against you he will lose, because you could prove that the material you used has all the same benefits of the material he prescribed and performs better in many more ways. And if the doctor is dumb enough (and some are) to prescirbe Physio 360's for the ones that walk and not for the ones that stay you would have proof of unethical practice which in most states could get a license pulled. The point is doctors are not bullet proof and if you suspect that a doctor is writing erroneous information on his scripts to try and gain a business advantage, you have an obligation to report him/her to their board and if you have proof nail his/her behind to the wall. I fill all Rx's with the patients best interests in mind and I could and will defend any option I present to a patient that they choose, to the fullest.

Why would you want to try and create fear in independent opticians when there is no fact behind a statement like this? Most independent opticians that I know would have never had an opportunity to start a business if this statement held true.

Ohio revised code section #4725.53 states violations from which a licensed optician can be fined, suspended or lose his license. Number 9 in this section is " engaging in optical dispensing not pursuant to the prescription of a licensed physician or licensed optometrist." The code goes on to say that this whole section does not apply to anyone employed by a physician or optometrist.This doesn't mean we don't have independent opticians in Ohio, but they are very careful about following the Dr's Rx. This means we make a lot of phone calls clarifying the Dr's Rx. Most Doctors are reasonable and will listen to your point and will allow a change in bifocal style or add power , base curve change etc. But some of them tell us to fill it as it's written and slam the phone down. Then we have no choice.
Bob Taylor

**HarryChiling** · 03-06-2007, 02:37 PM

(9) Engaging in optical dispensing not pursuant to the prescription of a licensed physician or licensed optometrist, but nothing in this section shall prohibit the duplication or replacement of previously prepared optical aids, except contact lenses shall not be duplicated or replaced without a written prescription;

from
http://optical.ohio.gov/pdfs/OhioRevisedCode.pdf

This rule is vague at best and could be read that if the doctor prescribed a progressive (Physio 360) you filled it with a progressive.

**Audiyoda** · 03-06-2007, 03:06 PM

Originally Posted by HarryChiling

from
http://optical.ohio.gov/pdfs/OhioRevisedCode.pdf

This rule is vague at best and could be read that if the doctor prescribed a progressive (Physio 360) you filled it with a progressive.

Vague laws are simply legal fodder. And who has more $$$ to pursue a lawsuit, the independent optician, or the state? The independent must rule on the side of caution - unless he/she has a sugar daddy / sugar momma backing them :bbg:

**HarryChiling** · 03-06-2007, 05:17 PM

Originally Posted by Audiyoda

And who has more $$$ to pursue a lawsuit, the independent optician, or the state?

Our legal system sadly does boil down to who has the mos money or best lawyer. I am curious if one person can give an example of a person in OH hat has been convicted of that very same violation. From what I hear their are more issues of shops practiceing without licenses that nitpicking a law that could be miscontrued against you. The need for caution is not warranted and worst case the fine is $500.00 for the first offense, which is the equivalnt of two pairs of glasses that could be sold if you didn't read the law with a such a paranoid perspective. The outcome you will probably make more money by filling what you think is the correct lens design and if reported and fined you wil lose almost nothing due to the profit you would more than likely make and you would help the optical community by clarifying a law that is vague.