Dr RX

[abocandy]

Hey
You know when the Dr writes out an RX and they often make material suggestions?
Is it law to go by what the Doc has marked(suggested) on their or is it simply a suggestion and up to the Optician what is best.??
Please advise.
Thanks-
In the state of Florida..

[For-Life]

I always get a negative rep when I say this, but the doctor has no right making suggestions in the refraction room. It is a major conflict of interest.

edit - I know that is not your question, but I needed to vent.

[HarryChiling]

Just a suggestion.

[Johns]

I always get a negative rep when I say this...

I can see why!

(Do you consider it a conflict when a dr. tells a patient they need surgery as well?)

ABOCandy:

I approach it as a suggestion only. Of course, if it doesn't work, and you didn't follow the suggestion...

[For-Life]

I can see why!

(Do you consider it a conflict when a dr. tells a patient they need surgery as well?)

ABOCandy:

I approach it as a suggestion only. Of course, if it doesn't work, and you didn't follow the suggestion...

Only if the surgery is completely elective, there are several other choices, and may not be the best person to make that decision.

The thing is, it is perceived by many patients that what is written on the script and what is mentioned in the exam room is not a suggestion but a prescription. Prescriptions mean to must must not could.

[MarcE]

Don't know anything about FL, but just a suggestion. How could it be anything else?

Our OD only puts a material when the patient has told her something in that dark room. A suggestion, but you wouldn't be smart to go against it.

Another guy in town isn't so genuine. He will "prescribe" the material, lens type, manufacturer, brand and style in the exam room. Patient has had NO conversation about it. For some opinionated fun review this thread:

http://www.optiboard.com/forums/show...+substitutions

[Johns]

Only if the surgery is completely elective, there are several other choices, and may not be the best person to make that decision.

I see...so if a girls got a nose that she just can't stand, and she goes to a plastic surgeon, he can't make a reccomendation?

[LENNY]

I see...so if a girls got a nose that she just can't stand, and she goes to a plastic surgeon, he can't make a reccomendation?

Not for Poly!:D

[For-Life]

I see...so if a girls got a nose that she just can't stand, and she goes to a plastic surgeon, he can't make a reccomendation?

She is going to see him for cosmetics. He is giving cosmetic advice. They expect advice, because that is what they are looking for. Now if I went to the doctor looking to help me with depression. If he turns around and starts pushing an herbal tea that he owns a stake in, then it is unethical.

Patients go see eye doctors for refractions and health of the eyes. They give advice on coatings, type of PAL and materials.

[Johns]

They expect advice, because that is what they are looking for.

'Nuff said.;)

[chip anderson]

Doctors have always been opinionated on this sort of thing. Often depends on what seminar they last attended. Some think everyone should have Poly, same doctor may not have heard about trivex. Some insist on line type lenses because they have had negative results or heard negative opinions from colleges at meetings.
As to surgery we all know those who are knife happy and those who will let cataracs go til the patient stumbling blind.
We all know we are in a bind whenever we have an opinion different than the doctor, especially some doctors.

You gotta know when to hold 'em and you gotta know when to fold 'em.

Remember rule #1 of the optical business and rule #2.

#1 Don't trust anybody.
#2 The doctor is always right.


Chip

[abocandy]

Hey everybody! Thanks for the info.
I always thought it was a suggestion.
But a local Optician had called a Dr and asked him to rewrite the script since he marked hi-index material and she wanted to put the pt in poly.
His argument was poly is hiindex.
I argue that even though it is a higher index then CR-39 to some Opticians to specify Poly would be more appropriate then just saying hi index.

Anyway,

Thanks

[HarryChiling]

I am curious now, with Duty to Warn and all, if the optician were to dispense high index as it was marked and the lenses were to shatter and damage the patient who holds the liability in that case? Especially since the optician in some cases opticians may not be aware that it is only a suggestion.

[opti-refractonator]

As a rule, I always go over with the patient what the doctor has written on the prescription. This has two main benefits, firstly, the patient sees that I undrstand what the doctor has recommended and to show that I am a part of their visual success within the three O's. Secondly, once I explain why the doctor has recommended something, I can let them know what other features may infact work better for them. The more you can build a rapport with new customers, the more likely you are to pursuade into what you want. ( obviously it benefits them to)

[For-Life]

Told you I would get dinged on this one. Always happens.

doctor has every right, and at times an obligation

Lets debate this anonymous comment that someone did not want to own up to.

The first question is do Doctors have the right to do this? I do not think anyone is disputing it. If they did not have the right, then we would not see this. Though to have the right does not make it right. I believe it confuses patients with subjective information. I have had situations where I knew the OD was flat out wrong, but the patient believed him because it was written on the script.

Next part is obligation. I have never heard that the doctor had the obligation to do this. If anything, the doctor should have the obligation to not do this. It is the Opticians obligation to inform the patient about glasses, not the ODs.

[Barry Santini]

Since its on the Rx, and you referred to it as a "suggestion"...well I think that that's what the whole Rx shebang is...a suggestion to start with that I refine with the help of the client.

Yes?

Barry

Hey
You know when the Dr writes out an RX and they often make material suggestions?
Is it law to go by what the Doc has marked(suggested) on their or is it simply a suggestion and up to the Optician what is best.??
Please advise.
Thanks-
In the state of Florida..

[kws6000]

Told you I would get dinged on this one. Always happens.



Lets debate this anonymous comment that someone did not want to own up to.

The first question is do Doctors have the right to do this? I do not think anyone is disputing it. If they did not have the right, then we would not see this. Though to have the right does not make it right. I believe it confuses patients with subjective information. I have had situations where I knew the OD was flat out wrong, but the patient believed him because it was written on the script.

Next part is obligation. I have never heard that the doctor had the obligation to do this. If anything, the doctor should have the obligation to not do this. It is the Opticians obligation to inform the patient about glasses, not the ODs.

Like it or not ,it is the DR's discretion whether to make eyeglass material and design recommendations or not.

As for the credibility gap ,that is part of the business .We face the same thing occasionally with some ophthalmologist recommendations that we dont necessarily agree with.

[For-Life]

Like it or not ,it is the DR's discretion whether to make eyeglass material and design recommendations or not.

As for the credibility gap ,that is part of the business .We face the same thing occasionally with some ophthalmologist recommendations that we dont necessarily agree with.

and I never denied that the doctor has that discretion. I said it is a wrong thing to do.

[LandLord]

It depends on the recommendation. If the doctor is next to Lenscrafters and prescribes 4 separate pair of glasses, I'm going to take that with a grain of salt and let the patient decide.

If the prescriber writes slab-off, OS, I'm highly inclined to reinforce it.

[AdmiralKnight]

I see...so if a girls got a nose that she just can't stand, and she goes to a plastic surgeon, he can't make a reccomendation?

Of course he can. He can't, however, say she HAS TO HAVE an entire face lift, nose job, boob job, and liposuction (NO SUBS!) when all she wanted was a little nose tweak.

Like it or not ,it is the DR's discretion whether to make eyeglass material and design recommendations or not.

Sure, recommend. Recommend all you want. I welcome some recommendations, but don't dictate when there's no medical need for it. If I get a script saying a person needs a specific lens, or lens material, I'll call the OD to get a reasoning behind it, and as a professional courtesy, but if it doesn't make any sense, or they can't justify it, I'm going to take it as just a recommendation. I'll explain the advantages and disadvantages of using what was asked for, and leave the final choice to them.

[chip anderson]

I'm not sure there is a medical reason behind any lens with the possibility of those to correct strabismus.

[Johns]

Told you I would get dinged on this one. Always happens.

Lets debate this anonymous comment that someone did not want to own up to.

I'm not getting where the comment is from. Is this from another forum?

And no, I don't think there is an obligation to do anything beyond giving the exam, explaining the findings, and recommending the best way to correct the error.

[For-Life]

I'm not getting where the comment is from. Is this from another forum?

And no, I don't think there is an obligation to do anything beyond giving the exam, explaining the findings, and recommending the best way to correct the error.

it was an anonymous negative rep

I thought instead of going the negative route, we could debate it.

[Johns]

it was an anonymous negative rep

I thought instead of going the negative route, we could debate it.

A regular "hit & run" huh?

I'll toss you a greenie to neutralize it!;)

I prefer the debate route as well.

(Wanna bet it wasn't an optician? Now watch, I'll get smacked to!)

[HarryChiling]

If anyone gets a negative mark I will drop my big green hammer and make it right so no sweat.:cheers:

I think it undermines the doctor, let them focus that time and energy on provideing a accurate refraction and assesing the patients health, let e do the same with the frame and lenses.

I am still curious if a doctor recommends a lens such as CR, Hi-Index, or material other than Trivex or Poly who is held responsible for any potential eye injuries as a result of the material recommendation?