Argument with ophthalmologist, am I wrong?

[HarryC]

Harry, I clearly understand your point. So, Dr Z writes an rx for Z pal in polyvex. You don't carry Z pal, in polyvex material because it's Dr Z's special house brand that you or no one else can get. What are you going to give the patient?

You call the doctor and ask him to rewrite the rx so that the consumer is not strong armed into buying only his lenses.
There are in house brands for a reason. To use the laws against the consumer.
The real question is this. If you substitute your lens for the "prescribed" lens who is going to turn you in? Will the patient file a complaint? Will the doctor? Both would have a legitimate right to do so. And if they do, what would the board of health do about it? Would they say harm was done? Would they fine you? Perhaps suspend your licence?
I am from a licenced state. I routinely have management from competitors stopping in to perform licensing checks. They don't even do it in secret. We try to keep our noses very clean around these parts.

[tmorse]

Why not simply write a note to the Doctor confirming that he agreed to patient X receiving CR39 lenses on his RX dated ________. Then date, sign and mail it, with a copy left in Patient's file.
For a few cents and very little time your butt is covered. Asking that he produce another Rx? I don't blame the Doctor for his being angry that you find his verbal OK is not sufficient.

[FVCCHRIS]

This topic has a lot to consider from both Dr's and Optician's perspectives. I agree with Harry's points mostly and usually prefer to stick with a fairly strict interpretation of the Rx. We all know there are tactful and professional ways around a lot of things we see written on Dr's prescriptions but when you think about it- and this is what always ticks me off- LOOK AT WHAT WE ARE TALKING ABOUT HERE!! A simple discussion about what a written Rx actually is!! How long have we all been at this and there are questions about it? Shows you how loosely regulated the world we live in really is.

[spectaclegal]

think about it like this. If a dr. wrote an Rx & you could not tell if he/she wrote +175 or +125 & you called their office & betty-sue the receptionist said yes, it is suppose to be a +175. Then cool! I wouldn't make the Dr. in that case rewrite the RX. If you really want to play it safe, document that Betty-Sue, @ the Dr's office confirmed +175.

Soo, just document that he said poly was just a recommendation & that Cr39 was ok. BUT make dern sure you obviously make the cr39 in a 3.0 minimum thickness so it's still up to industrial safety regs.

but seriously, great question!!

just my thoughts & precisely what I'd do.

[spectaclegal]

ouch, now that i read all the responses! I must say!! FDA safety

nothing i have said has changed, But!!!

FDA...I'd only put pt. in z87, but i'd still put him in cr39, 3.0 min. E.T.

I don't believe they pass FDA saftey in a dress frame unless fda safety only refers to the lenses. I think fda means safety frame/lenses. But I absolutely believe 3.0 cr39 E.T. falls into z87. safety right there with 2.0 poly min. E.T.

[spectaclegal]

sorry to blow this thread up.

if the Dr. specifies a +3.00 add, you can use a +2.00 or +2.50 or a +150 add for intermediate or whatever.

It's called, I do believe"Voluntary Formulary Permitted". I do believe that applies to all Rxs unless specified, "Dispense as Written."

[chip anderson]

Harry: The board of Health wouldn't care. Now the Board of Optometry if they see an opportunity to infringe the duties or opportunities of Opticians in general, they'll sue.

Chip

[doctorjmjb]

As has been stated by many of you, if a doctor writes something on a prescription and it is not listed as a recommendation then it should be filled as written. But, it is possible to get verbal modifications, just document it all (be thorough.) In Massachusettes we are a licensed state, so an optician is required to speak to another optician or Dr. to verbally get the prescription, or modify it. The reasoning of an optician to optician conversation is so that no errors are made with untrained individuals. If one of my opticians gets a verbal Rx from another office then I expect that they will record the person's name (and license number.) It is not required to rewrite the Rx after the conversation. I do this all the time with the pharmacy when a med. is not covered by a patient's insurance, and medications are much more tightly controlled than eyeglasses. (BTW asking me to rewrite the Rx after I gave you a verbal ok would irritate me.)

[cwinma]

Am I the only one here that would have just filled this in Poly and thanked the patient for his business? That's what would have happened in my office.

[pseudonym]

Am I the only one here that would have just filled this in Poly and thanked the patient for his business? That's what would have happened in my office.

The patient wanted the rock bottom sale price where the lens had to be plastic or pay more for poly. Would you make up the $35-40 difference from your pocket?

[spectaclegal]

As has been stated by many of you, if a doctor writes something on a prescription and it is not listed as a recommendation then it should be filled as written. But, it is possible to get verbal modifications, just document it all (be thorough.) In Massachusettes we are a licensed state, so an optician is required to speak to another optician or Dr. to verbally get the prescription, or modify it. The reasoning of an optician to optician conversation is so that no errors are made with untrained individuals. If one of my opticians gets a verbal Rx from another office then I expect that they will record the person's name (and license number.) It is not required to rewrite the Rx after the conversation. I do this all the time with the pharmacy when a med. is not covered by a patient's insurance, and medications are much more tightly controlled than eyeglasses. (BTW asking me to rewrite the Rx after I gave you a verbal ok would irritate me.)

totally love it. yes, dr.s especially if you have a relationship with them wouldn't want you to question what they told you on the phone.

[spectaclegal]

and this was still a great question for many new in the business to learn by!
+15

[cwinma]

The patient wanted the rock bottom sale price where the lens had to be plastic or pay more for poly. Would you make up the $35-40 difference from your pocket?

You bet and with a smile.

[HarryC]

I would like to respond to several posts if I may.
First I would like to thank the doctor who responded to my question. I would like to point out that in this situation I needed a new written rx because the original one would not have been accepted by my company. I would have put my job at risk, even with a verbal ok.

And Cwinma:
If I owned my company I too would have just ate the cost of poly. It would have been so much easier than fighting with the doctor.

[pseudonym]

You bet and with a smile.

I'm assuming you'd pay wholesale for it. Working for retail, you might not be so quick to take it out of your pocket.

[CME4SPECS]

Harry, had you asked the real question...Should I put my job at risk and not follow company policy? You would have probably gotten a whole bunch of NO WAY!

I would like to respond to several posts if I may.
First I would like to thank the doctor who responded to my question. I would like to point out that in this situation I needed a new written rx because the original one would not have been accepted by my company. I would have put my job at risk, even with a verbal ok.

And Cwinma:
If I owned my company I too would have just ate the cost of poly. It would have been so much easier than fighting with the doctor.

[tmorse]

I would like to point out that in this situation I needed a new written rx because the original one would not have been accepted by my company. I would have put my job at risk, even with a verbal ok.

This puts a totally different slant on things. If your job was really at risk, then you should have asked your company superior to decided things. Alienating an ophthalomologist wouldn't impress your company under any circumstances.

[chip anderson]

If I were the prescriber and told "my company wouldn't accept" the verbal Rx or OK, I would just tell you, "So you lose a sale." I would also not be inclined to recommend patients to go to your company.

Chip

[spectaclegal]

good gosh it's no different than asking did the doc write +175 or +125. Verbal is enough. but if your office is that scared, than dot all the "i's" and cross all the "t's" you can find. My time is worth more than that.

[OHPNTZ]

Having read the posts, I think the best first approach is:

1. Ask if the their is a MEDICAL reason for the polycarbonate (specifically to protect a monocular patient, or UV protection for say a patient with ARMD)
2. Document the date, time, and what exactly was said

Now as an OD, how I would react is this:

1. The patient already left my office, to get the "deal", so my investment of any future of my time to him is near approaching zero.
2. The patient has called my office, has bothered either myself or my staff because he can't get his "deal"... I am now annoyed because I have 99 problems, and this guy ain't one.
3. So I begrudgingly call you, because there is some small part of me who cares, but mainly just to make this guy go away...and I really don't care at this point.
4. Then you ask me to take the time to rewrite something and have someone fax it now???...it's not going to happen.

[HarryC]

Attorney: mr. Optician, did you give mr. Smith the safest lenses available as per his doctors reccomendation?

Optician : Um, no. But he wanted the sale and the doctor said it was ok to.......

Attorney: let the record show that if mr. Optician followed the prescription as written by dr. Idiot the lenses would not have shattered on impact causing irraversable eye damage.

Attorney: dr. Idiot, my client states that he received verbal consent to fill that prescription with lenses that are not as safe as you prescribed. Can you confirm that?

Dr. Idiot: I have no written documentation of such a conversation. I expect my prescriptions to be filled as written.

Attorney: thank you, dr.
Lock'em up boys.

[spectaclegal]

but 3.0 Cr39 with z87 printed on lenses passes as safety too, To my knowledge.

[rdcoach5]

Sorry guys, but when it comes to doctors' and their Rxs, a verbal isn't worth the paper its not written on. I've had it come back and bit me in the butt way too many times.

"BEWARE THE FURY OF A PATIENT MAN." EYEMAN , this is a translation of your slogan. What language is it ? Any examples of how you got bit ?

[LENNY]

So what do you do when you see the RX for Izone lenses like this????

OD -2.37-0.89x162.5

The doc wants the patient to have that RX for the best of the patients VA!

[Judy Canty]

So what do you do when you see the RX for Izone lenses like this????

OD -2.37-0.89x162.5

The doc wants the patient to have that RX for the best of the patients VA!

Pull out your copy of the most current ANSI tolerances and explain them to both doc and patient.