Online sales

[opty4062]

True story from an optician very close to me- A women is rushed to the hospital in critical condition from a stroke. Her only pair of glasses are missing. Patient services asks the optical department to make her a new pair so she can see her family members if she regains consciousness. Call to the OD gets a stern rebuke that it can only be released if she fills out a request. Release of Rx denied...

Similar situation happened in my family. My uncle and aunt were in an awful car accident, both in critical condition in ICU. In the crash, my uncle lost his glasses. He is @20/200 without them. He is also has profound hearing loss. When he "came to" he was combative and confused and desperately needed his glasses. This happened in the next state over. My cousins contacted his OD office and were told his rx was expired and there was nothing they could do for him. Cousins called me, I called the OD office, pitched a fit and actually got the doc on the phone. He ok'd releasing the rx to me via fax and I made up the glasses and delivered them to the hospital the next day.

We have patients in nursing homes who lose glasses and we remake them, rx expired or not, to just serve the needs of our patients. What else is the point of all this anyway?

[chip anderson]

But Mikey, you work in all glass lab. The lenses last 10 years so your patients don't have the dimishied vision from micro-scratches on the lenses. Little if any coating failure. No scratch coat failure. Not as much opportunity to sell them into something new anyway.

Chip

[Mizikal]

I just think people are adults and should be able to decide for themselves if they need an exam. That would mean people have to be responsible for the out come of said glasses. No prescription change warranty. I guess expecting adults to be adults is a little much.

I too have seen people with tumors , glaucoma and one lady having a ministroke. These are the exceptions though and not the rule. Why not have medical eye exam then have refraction.

[MikeAurelius]

But Mikey, you work in all glass lab. The lenses last 10 years so your patients don't have the dimishied vision from micro-scratches on the lenses. Little if any coating failure. No scratch coat failure. Not as much opportunity to sell them into something new anyway.

Chip

Well Chippy, that makes no never mind. If the patient can still see with the current prescription lenses, an expiration date on the Rx is meaningless, especially since it is being used ONLY AS AN EXCUSE to get the patient back in the office.

[CCGREEN]

And since I own an older car (1989 Lincoln Town Car, aka the "pimpmobile"), I know almost to the mile when it's time to put in another quart.

"Pimpmobile" LOL I commend you in knowing to the mile when it's time to put in another quart. There are those out there who have that ability and then those out there who even when the idiot light come on and it clearly showes the word OIL in big bold letters they still have no idea what to do next. Its those people that we have to protect from themselves and ourselves. They are the ones the attorney is going to use to fill his bank account at our expense.

[MikeAurelius]

... and then those out there who even when the idiot light come on and it clearly showes the word OIL in big bold letters they still have no idea what to do next. Its those people that we have to protect from themselves and ourselves. They are the ones the attorney is going to use to fill his bank account at our expense.

I would put it to you that you really don't have to protect them from themselves. They will get along just fine without outside "help". If they don't want another exam, it's not your problem. If they don't want to go to the dentist, it's not your problem. If they don't want to put oil in their car, it's not your problem.

Concentrate on the person in the store/office that wants to be there and forget about everything else.

But forcing them into your office because of a made-up "expiration date" on a spectacle Rx is just plain wrong.

That's my two cents, for what it's worth.

[CCGREEN]

Now here is another take on this subject. Is the thread talking about a "Exam" which in my mind entails looking at the health of the eye and addressing any issues there may be. That of course should be motivated by a simple recall system. Or are we talking about a simple "refraction" Now I agree that if you do not have enough sence about you to go have a refraction then you do not deserve to see any better then you do at the moment and its not my position to look out for you.............untill im rocking down the road on my motorcycle and you screw up and pull in front of me because you did not see me at all or you could not really tell how far away I really am because you have not had a "refraction" in ten years.

[becc971]

this is becoming a super fun discussion i like it not intending to start an all out war on expiration dates on glasses RX's ... personally i view glasses as a medical necessity (most of the time!) and i also feel that it is good that there is an expiration on the RX because you SHOULD be getting the refraction and your eye health checked on a regular basis. it is convenient that all of these things can come in a neat little package we call a comprehensive eye exam. not as a ploy to get them to buy stuff, more as a preventative measure. at an office i used to work at, we had a woman wearing a -10.00 and a -10.50 come in who hadn't had an exam in over ten years, and at that point her RX had increased by 3 diopters. the only reason she came in was because her eye doctor refused to make her a pair in the expired RX. Even though she felt that they "hadn't changed." once she picked them up and realized the difference she had changed her tune a smidge

On the other hand, i also understand that there are extenuating circumstances, we have made lenses for patients in nursing homes or who are incapacitated because they need them to see and could NOT make it into the office. There are always exceptions to every rule.

[MikeAurelius]

Now here is another take on this subject. Is the thread talking about a "Exam" which in my mind entails looking at the health of the eye and addressing any issues there may be. That of course should be motivated by a simple recall system. Or are we talking about a simple "refraction" Now I agree that if you do not have enough sence about you to go have a refraction then you do not deserve to see any better then you do at the moment and its not my position to look out for you.............untill im rocking down the road on my motorcycle and you screw up and pull in front of me because you did not see me at all or you could not really tell how far away I really am because you have not had a "refraction" in ten years.

In either case, IMO. Using a phony "expiration date" on a prescription to get the patient back in the office is just plain wrong. In your example above, once again I'd posit that it's not your problem if the nard on the cycle hasn't had a refraction in 10 years. What will trip him up is when his insurance rates go up because of the accident (or he's cancelled...). And given that most states require at least a spot check of your vision during a renewal every couple of years, I'd say that flunking the eye check during a license renewal will get the patient back in your office pretty fast.

[becc971]

In either case, IMO. Using a phony "expiration date" on a prescription to get the patient back in the office is just plain wrong. In your example above, once again I'd posit that it's not your problem if the nard on the cycle hasn't had a refraction in 10 years. What will trip him up is when his insurance rates go up because of the accident (or he's cancelled...). And given that most states require at least a spot check of your vision during a renewal every couple of years, I'd say that flunking the eye check during a license renewal will get the patient back in your office pretty fast.

so their insurance rates go up, and the person they hit gets a broken leg ... totally even?

[optilady1]

None of this matters if we as opticians work for a company or doctor who's office policy is not to fill an Rx after 2 years.

Quite frankly, I'm shocked that so many of us are saying how silly an expiration date is on a prescription, when on other threads we all moan and groan when we do fill an rx that is creaping up there in age, and then the patient comes back complaining that they can't see. While I do think that people should be able to choose when the do get new exams, I think ultimately it should be at the discretion of the dispenser whether to fill an older rx.

[MikeAurelius]

this is becoming a super fun discussion i like it not intending to start an all out war on expiration dates on glasses RX's ... personally i view glasses as a medical necessity (most of the time!) and i also feel that it is good that there is an expiration on the RX because you SHOULD be getting the refraction and your eye health checked on a regular basis. it is convenient that all of these things can come in a neat little package we call a comprehensive eye exam. not as a ploy to get them to buy stuff, more as a preventative measure. at an office i used to work at, we had a woman wearing a -10.00 and a -10.50 come in who hadn't had an exam in over ten years, and at that point her RX had increased by 3 diopters. the only reason she came in was because her eye doctor refused to make her a pair in the expired RX. Even though she felt that they "hadn't changed." once she picked them up and realized the difference she had changed her tune a smidge

On the other hand, i also understand that there are extenuating circumstances, we have made lenses for patients in nursing homes or who are incapacitated because they need them to see and could NOT make it into the office. There are always exceptions to every rule.

becc -- I'm not taking this as a war, just an enthusiastic discussion ;-). But to your point: I totally understand where you are coming from as far as a "eye health" exam is concerned, but IMO, an expiration date on the spectacle shouldn't be the way to do it. Your example to prove your point is based on a scrip that's an outlier, not a central distribution scrip. Of course people who have high corrections need to get checked more often, I don't dispute that! And I don't dispute that people need to get into the office to be checked for glaucoma, infections, and what-not. What I do dispute is using the spectacle expiration date as the only way to "force" the patient into the office. That smacks of coersion and to a certain extent, blackmail (although "legal" blackmail).

Especially in today's economy (and for the last 5-6 years, let's be honest), getting an eye exam for a goodly number of people is very low on their priority list, especially if they are middle-aged, their overall vision has not changed, and they are short on time and money. I think this is why the on-lines are doing so well is that they don't CARE about the expiration date. It doesn't even enter into the discussion at all. If someone has been refused new lenses because of an expired Rx and they can't afford an exam, what are they going to do? Head straight to the on-lines. And you've lost them pretty much forever unless the on-line operation has totally screwed the pooch on the Rx.

If we look at the expiration date on medicines as a comparison, there is a very good reason for them. You DO need to see an MD at least once per year for refills on your medications. The doctor needs to be sure that the current dosage is meeting your bodys needs. But spectacles are not medicine, they are devices. And a goodly percentage of people don't require an Rx change every year or even two.

IMO, we can't hold peoples eyewear hostage to a phony "expiration date" if we want to keep them as patients. They WILL find alternatives. There has to be a different way of getting them back into the office somewhat regularly. Not everyone has vision insurance. Not everyone can afford exams for the entire family every year or two. Not everyone can afford new eyewear every year or two. There has to be a different way to do this.

[MikeAurelius]

so their insurance rates go up, and the person they hit gets a broken leg ... totally even?

Nope, not even at all, and again, that's where the lawyers come in. "Oh, so you didn't go in for a routine eye exam?" And the attorney adds another $100K to the settlement. But that's not the opticians problem!

[MikeAurelius]

None of this matters if we as opticians work for a company or doctor who's office policy is not to fill an Rx after 2 years.

Quite frankly, I'm shocked that so many of us are saying how silly an expiration date is on a prescription, when on other threads we all moan and groan when we do fill an rx that is creaping up there in age, and then the patient comes back complaining that they can't see. While I do think that people should be able to choose when the do get new exams, I think ultimately it should be at the discretion of the dispenser whether to fill an older rx.

Thanks Annie! You bring up a very good point. I agree with you 100%. All scrips should be dated (usually are). And it should be at the opticians discretion whether or not to fill them if they are beyond a certain date. And this would be a good time to have a frank discussion with the patient and advise them that the prescription is old(er), and there may be not only changes in their vision, but also the possibility of eye disease. And tell them that if you do make new lenses, all you are doing is guaranteeing that they will be the same as the prescription, but if the patient can't see, they will need to schedule an eye exam and have new lenses made - and you aren't going to do the redo for free.

It's about communication with the patient. They have to be part of the process and part of the decision making. Maybe they can't afford an exam for the near future. They just lost their job, or their spouse has severe medical problems that is eating up all the cash in the family. Refusing to remake an Rx just because of an arbitrary date without full and complete disclosure to the patient will result in the loss of that patient to your practice and the gain to an on-line business.

[Uncle Fester]

None of this matters if we as opticians work for a company or doctor who's office policy is not to fill an Rx after 2 years.

Quite frankly, I'm shocked that so many of us are saying how silly an expiration date is on a prescription, when on other threads we all moan and groan when we do fill an rx that is creeping up there in age, and then the patient comes back complaining that they can't see. While I do think that people should be able to choose when the do get new exams, I think ultimately it should be at the discretion of the dispenser whether to fill an older rx.

Page 2 and it's time to bend the thread a little-

So we all agree a regular exam for the health of the eye is necessary. Why not lobby to include it as a covered part of the universal health law?

[MikeAurelius]

Page 2 and it's time to bend the thread a little-

So we all agree a regular exam for the health of the eye is necessary. Why not lobby to include it as a covered part of the universal health law?

Careful there, Uncle Fester, you will have the Teabaggers picketing your office!

[GokhanSF]

Well we always mentioned ODs putting down an expiration date. How about your state regulation? In my state OD doesn't have to write down an expiration date. RX expires two years from the exam date.

Plus, there are some cases that we are probably not aware. Like patient may have a health issue that needs to be monitored and OD might be trying to enforce patient to come back with expiration date. This is probably very rare though :)

The part that really gets to me is ODs writing down a progressive lens brand and AR brand on the Rx....

[Barry Santini]

Page 2 and it's time to bend the thread a little-

So we all agree a regular exam for the health of the eye is necessary. Why not lobby to include it as a covered part of the universal health law?

Oh yeah? Where's the money gonna for that coming from?

REEEDIculous!

If people individually want that frequency of eyecare gatekeeping, let them pay for it!

B

[Uncle Fester]

Here's a place to start. Of course eye care would just be a small fraction of this pie-

http://www.ippnw-students.org/NWIP/pdfs/costs.pdf

[becc971]

Nope, not even at all, and again, that's where the lawyers come in. "Oh, so you didn't go in for a routine eye exam?" And the attorney adds another $100K to the settlement. But that's not the opticians problem!

it is if the opticians the one with the broken leg ;)

[MikeAurelius]

it is if the opticians the one with the broken leg ;)

lmao!!!!

[CCGREEN]

lmao!!!!

Mike you need to go back a read my post using the guy on the motorcycle.

I its ME the optician or the "nard" as you called me who is on the motorcycle. I have rode bikes since in was 14 years old dirt and road. I grew up and now its only on asphault I ride. I share the road with thousands of others. I want to know that THEY are seeing their best. I do not want them doing something that endangers ME the one on the bike. Surely that is not expecting to much.

How do we motivate the elderly to go for a refraction? Working with a MD I see it at times. Elderly will go to any expense to keep the license and we all know why, it gives them freedom. But if they are not motivated to get the refractions they endanger you and I and all our loved ones. Is it really worth losing a loved one because people think it to much to have a Rx expire?

One thing I do not understand about people we do catract surgery on, one of the first things they do is want to run down and have the "corrective lenses restriction" removed from their drivers license. Why? If its never been a issue for you before now then why after surger is it an issue? Are you up to something? Its just one of those things I cant wrap my mind around.

[optical24/7]

Keep in mind 20/40 will pass most vision restrictions in most states. Put about a +1.50 over you're current correction to get an idea how bad your vision can be and still qualify for a license!

[MikeAurelius]

Mike you need to go back a read my post using the guy on the motorcycle.

I its ME the optician or the "nard" as you called me who is on the motorcycle. I have rode bikes since in was 14 years old dirt and road. I grew up and now its only on asphault I ride. I share the road with thousands of others. I want to know that THEY are seeing their best. I do not want them doing something that endangers ME the one on the bike. Surely that is not expecting to much.

How do we motivate the elderly to go for a refraction? Working with a MD I see it at times. Elderly will go to any expense to keep the license and we all know why, it gives them freedom. But if they are not motivated to get the refractions they endanger you and I and all our loved ones. Is it really worth losing a loved one because people think it to much to have a Rx expire?

One thing I do not understand about people we do catract surgery on, one of the first things they do is want to run down and have the "corrective lenses restriction" removed from their drivers license. Why? If its never been a issue for you before now then why after surger is it an issue? Are you up to something? Its just one of those things I cant wrap my mind around.

My apologies. I **DID** read it incorrectly. And yes, bikers do need to get more respect on the road. But there are also bikers who think they exclusively own the road as well, so it does go both ways.

You've nailed a very important issue here as well. I think part of it goes back to the oldster's upbringing. Nowadays, for the "kids", owning a car and driving it is no big deal, but back 60+ years ago, it was a VERY big deal.

[kentmitchell1961]

In New Hampshire the RX is good for 2 years and we are not allowed to read the old pair and duplicate. And when I was at LC the doc quietly came out of his office one day and had us call 911, his patient was about to slip into a diabetic coma. The PT thought he had flu...... So am all for a 2 year lifespan for RX.