Here's a scenario I ran into recently-
A patient comes in complaining that he feels dizzy in his new glasses, worn for about two weeks. He's wearing flat top bifocals, new prescription has a moderate amount of cyl that the patient has never been prescribed before. I look in the chart, history of glasses goes back a few years. The gentleman has always been fitted in bifocals, plastic, no tints. Same as what he has now. The only difference is the cyl. Patient complains that he feels ok wearing the glasses while sitting, but gets dizzy when he stands or walks in them. He also complains that he can not see his computer. I look at the original Rx, and the doctor does note recommendation for progressives.
In the back of my mind I'm thinking, if this man is already struggling with the new cyl, he's going to be miserable in a PAL, especially since he's a previous bifocal wearer. But the man says, "I want a progressive so I can see my computer, and that's what my doctor told me I should have."
We discuss his new Rx briefly and the patient insists that he wants a recheck. I schedule him with the doctor for the next day. After the appointment, doctor comes and says to me, right in front of the patient, "there's nothing wrong with this prescription, and I want to know why he wasn't fit with progressives".
At that point, with the patient standing there hearing every word, I can't exactly tell the doctor I think he's wrong. Nor do I think it's appropriate to elaborate on how the gentleman is a non-adapt waiting to happen. So we (the opticians) apologized for our error and told the man we'd be happy to re-fit him with progressive lenses. Just like the doctor ordered.
My question is, how helpful is it when doctors do an optician's work while in the exam room? I've had patients brought out to me more than once already asking for specific lens brands and materials that "the doctor said would be good for me". In some cases that's great. In other cases, like the one above, it's a redo waiting to happen. The problem I find is that I'm put in the uncomfortable position of having to either disagree with the doctor in his infinite wisdom, or just be a glasses fitting drone who doesn't do anything but take measurements and collect money.
I'm interested to hear other people's opinions on this. What are your thoughts?
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