55 year old diabetic patient has had three doctor changes to Rx in the past year, takes over an hour to choose the perfect pair, complains nonstop about how bad her glasses have worked for her in the past, finally sits down to buy. Then we find she doesn't have enough in her FLEX account to buy today. I am relieved to hear it and hope she never comes back.
Is that so wrong?
nopeI am relieved to hear it and hope she never comes back.
Is that so wrong?
"You can please some of the people some of the times ..."
Have a bear and enjoy your evening, you deserve it.
Fraid that's just part of the business. Diabetics can have changes in rx at different times of the day. Did you ask her if she needed the Rx change? Then ask her if she wanted to pay for them out of pocket.
Chip
She said the doc had adjusted her prescription three times this year. Strange expression, but I believe she may have heard that term associated with some of her other meds. She checked the metal frames for strength by bending them in at the bridge. She pulled off one of the temple covers to "test" it, then she couldn't get it back on.
We often required 3 stable Glucose readings before we would make new lenses for diabetics. It doesn't eliminate diabetic RX changes, but it really reduces it. If her Diabetes is not under control her old glasses could be better than the new. With todays great meds, I don't see many unstable patients though.
In her case I would refer her to her Endocrinologist with a note explaining your concerns. If she is non-compliant with her meds I wouldn't make eyewear until she is, that is the biggest cause of unstable diabetics today.
They don"t have the right to manipulate the frames in a way that could damage them. She needs to be informed of your youbreakayoupaya policy, Lol. Really though we have a policy 1st Dr. Change with in 60 days no charge second Pt. pays 1/2 3rd. Pt. repays in full.
I'm with Sharpstick here, only I would prefer to see the last and most current A1C. It's much more telling of the daily changes.
sounds like a pleasant patient.
any update?
I didn't know it until I sneaked a peek at what a doc was writing, but you guys put those actual words "pleasant patient" in people's file. Makes me curious what you put for the other kind.Originally Posted by phaco
No word from my potential problem patient.
Had an old old old man wink at me through the pupillometer, though. And when I marked his seg height, he crossed his eyes. Some days, I think I'm a nut magnet.
I once worked with a doc who labeled certain patients as P.I.A. in their charts. Naive as I was, it took me asking him to find out what it meant, lol.
3 changes in 1 year means she has 3 options....
1. Control her A1C.
2. Have cartaract surgery to reduce fluctuations.
3. Continue on the same path and pretty soon she'll never have to worry about changes in her vision.
Hopefully she's smart enough to realize there's only 1 option.
PS
She may want to rethink the HSA account and opt for the higher premiums, better coverage.
I'm glad it's Friday.
Funny, 30 years ago I worked for a doc who would mark his chart P.I.A. for pain in the a$$, the next year I went to work for another optical who put P.I.A. in their chart which meant paid in advance, lol
Not wrong at all. We all have patients with a few or all of these traits. When they come in again I detach myself as soon as possible. No way am I spending valuable time with these people so I tell them to let me know when they have chosen a frame, write the order up with minimal conversation and get them out the door. Most of them crave attention and not giving it to them is the best way I know how to deal with it. Our charts used to say "VWP" very weird person, which pretty much covers it.
Nah, I can't say it's wrong. At the end of the day we're running a business, not charity.
Even though our work resembles social work every now and then ^_^
Diabetic patients are ususally fracted 3 times with us. Unless their condition is stable and they know it.
With three refractions we can determine if it's (fairly) stable or not and take an average if needed.
Personally I don't have a problem with diabetic patients. I find that they like it if you take them seriously, a lot of opticians around here keep sending them back to the doctor for teststing. So the diabetics really appreciate it if we take the time to fit them a nice pair of glasses.
There are however patients, diabetic or not, that take you hostage for the entire afternoon. Don't take notion about closing times. These ones I can't stand. 'Couple of weeks ago I had a married couple that did just that. The misses had the habit of singing or wisteling songs when I was talking... If I'm not interesting enough just leave, please leave! But You don't say that of course... When the both of them decided the didn't want to buy anything I got ******. Claiming so much of my time and just leave? No you don't! I had to put all my charm at work and keep the conversation as tight an quick as possible, leaving ampel time for them to get second thoughts and closed the deal on four multifocals, two regular and two sun.
Ah well, it does keep our jobs intresting doesn't it ^_^
Interesting indeed..............
Uncut's Top 10 "Patients you don't want"..........
1) The "I have a friend in the business" discount hound.
2) The "I"ll just drop in late Friday afternoon, just in case my eyeglasses need adjusting"
3) The " I really liked the contact lens brand I wore in the 80's better than these newer ones" contact lens wearer.
4) The "when I look down at the floor it is magnified" multifocal wearer.
5) The farsighted presbyope that says "Yes, but I can't see the sparrow, sitting on the fence post at 100 feet away, blinking......like I used to"
6) The 366th day warranty patient.....with a I year warranty.
7) The "I'll never do that again" patient. Why did you, in the first place?
8) The "I'd like to return these glasses I bought online, they don't fit.......But I thought you were a (insert brand) dealer.....Do you do exchanges? Trade-ins?"
9) The it's Thursday at 4:00 p.m. and I'm leaving Sunday for Florida (SNOWBIRD), and I need.................
10) The Christmas Carol Singing On The Floor of The Exam Room......New Patient.
Too funny uncut. Here's some of mine....
The "I used to be in this business and I know all about...." (I was a receptionist for an OD 20 years ago)
The "I'm a half hour away stuck in traffic and I know you are closing, can you leave my glasses outside the door?" (why is this always on a Friday night?)
The "I have to ask my wife/husband so can you hold that order?" (why don't I just cancel it now and save us both the trouble)
The "This nosepad is 2cm off on the right side" (engineer)
The "My husband/wife/co-worker/neighbor told me I will hate progressive lenses so I don't want them". (sighhhhh)
The "I bought "scratch proof" lenses and there is a scratch" (double sighhhh)
The "Can you write all this down so I can take it to Costco with me?" (@%*&!!)
The "All these frames look exactly the same". (Seriously?)
The "I don't know, I can't decide, nothing looks good on me, maybe I'll shop around". (Ok come back when you're through menopause)
The "The last place I was at had to remake my glasses five times" (uh oh)
The "The last time I was here my glasses were wrong/service was bad/hated my frames/everything was screwed up/ I hate this place..." (so why are you here?)
Gotta love this business.
I love this business but I'm not so sure I love contact lens wearers.
Contact lens wearers who don't get that a BOX is not a prescription.
Contact lens wearers who alter their prescription to get out of paying for the required annual fitting.
Contact lens wearers who buy one box at a time, month after month.
Contact lens wearers who wait until they get down to their laaaast lens to buy their box, 5 minutes before closing. And their last lens is torn. And they don't have any back up glasses. And they're a -5.00 OU.
Contact lens wearers in general have made clear to me what an optician here means whose siggie says "Lack of planning on your part does not constitute an emergency on mine." I get it.
But wait, there's the glasses wearer who lets me go into my whole song and dance about the current sale, then gleefully waves her specs at me saying she got them at Zenni for twelve bucks. Tra la la.
It is the great unspoken response to patients in this industry.
A lack of planning on your part DOES NOT constitute an emergency on mine!
Every customer is an opportunity (potentially many). Please! Bring your emergencies to me.
Yes there is what I call......Inter Office Acronym's that one must learn when starting at a new location. Those acronym's are not admitted to but are spoken and understood by all. One used in a office I was at, back in the day, was just a simple Bull's Eye target hand drawn very small on the outside corner of the file. You then knew that patient was going to be a joy to work with. ;-)
Tee hee. I've worked in offices that used IOA's in the past, before I came to an electronic records-office. Most commonly used were PHB (psycho hose beast) and NTB (not too bright). If asked, NTB stood for "not taken binocularly," and the doctor would explain he tested each eye individually. We also used two sizes of circular stickers, one on top of the other, that ended up looking like a bulls-eye.
Now that we're paper-free, anytime you see "SEE NOTES," that's your heads-up.
It's nice to be important, but it's more important to be nice.
My, my you folks that work for someone else or are on salary, sho is persicity. Own your own indepent (not prescriber affilliated store) and you will take anything that comes in the door. A few months ago I had an artificial eye patient who had ****** his pants, and I was glad to have the work!
If you don't want to get your hands dirty or have a little hassel now and then, be a bookkeeper.
At least 1/2 the people I see, I would never want to live next door to, or have any social dealings with, but it's the job.
Chip
I'm very sure I don't love them. Serial non-compliant abusers who think the whole world owes them a favor when they run out of lenses or Rx expires (Glasses? Are you kidding me?).
-Tony
I just had a "talking to" because a Pt faxed over a letter to our office stating that, because of me, he and his wife will never come to our office. This would trouble me if it held any water- this is one of several threatening letters over the course of nearly 10 years. Pul-eaze, make good on your threat and go annoy someone else.
I'm all about making difficult people happy (I specialize in cranky old coots) but some people are happier when they are being a time suck and/or complaining about how they percieve the world treats them. I don't have time for that attitude at work or in my personal life.
"Strictly speaking, there are no enlightened beings; only enlightened activity." -Shunryu Suzuki
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