Rx issue

**carlos83eye** · 09-10-2008, 12:03 PM

I have a client who wants me to copy an RX.....I ask how old is the script, he says 4 years old......I get the # of the store he went to and they tell me, can't give the script.....over 4 years old......so I ask him to go to the doc since my lensometer hasn't come in yet.......doc gives him a new scipt but client says, he doesn't like the new rx.....to give him rx from glasses or he won't purchase glasses from us. Whould I be wrong to rx his old glasses to keep the job.....i mean, ethically it's ok?:hammer:

**Jacqui** · 09-10-2008, 12:11 PM

I would tell him to back to the OD and ask him if it is OK. I don't think you should do it without approval.

**DragonLensmanWV** · 09-10-2008, 12:34 PM

Chances are if he'd just wear them a week he'd like the new Rx.

**Now I See** · 09-10-2008, 12:50 PM

Don't do it...from your post it sounds like you have already asked and the doc said, nope, it's 4 yrs old. If the pt is unhappy, he should go back to the doc.

**EyeFitWell** · 09-10-2008, 01:10 PM

Have you actually made and dispensed the new Rx?

**HarryChiling** · 09-10-2008, 01:18 PM

I'm just curious if an exam has a subjective portion and this person is obviously very picky about what he wants, why wouldn't making the original Rx be OK? I wouldn't have a problem doign it just make sure the patient understands that their is no remake warranty since they would be going against doctors advice, either he will come around and use the new Rx or take his chances with the old either way he gets what he want's.

**carlos83eye** · 09-10-2008, 02:34 PM

Originally Posted by EyeFitWell

Have you actually made and dispensed the new Rx?

No, but by wha the doctor showed him, he doesn't like it, and it was at that time that the client asked to have the old rx done.......I don't want to make it for him, but at the same time i want him to be happy, and i don't want to lose thebuisness to an optical that WOULD do it for him......

As harry said, would it be correct to let the patient know and let him take the toll of an outdated rx?

**peregrinerose** · 09-10-2008, 02:46 PM

What if the patient sees 20/50 with the old Rx (not legal to drive in most states) and is driving? Filling an expired prescription could actually get you into hot water with issues like that. Have the patient see the OD... that's why ODs get the big bucks, to deal with nightmare patients like that.:)

**HarryChiling** · 09-10-2008, 02:56 PM

Originally Posted by peregrinerose

What if the patient sees 20/50 with the old Rx (not legal to drive in most states) and is driving? Filling an expired prescription could actually get you into hot water with issues like that. Have the patient see the OD... that's why ODs get the big bucks, to deal with nightmare patients like that.:)

From what I got from the post the person did see the doc and still wanted the old Rx, so under:

Originally Posted by http://www.op.nysed.gov/article144.htm#def

§7121. Definition of practice of ophthalmic dispensing.

Replacements or duplicates of such lenses may be adapted and dispensed without prescription.

It's practiceing opticianry to the full scope.

**carlos83eye** · 09-10-2008, 03:08 PM

Jew Da Man Harry
:cheers:

**CME4SPECS** · 09-10-2008, 03:33 PM

You shouldn't be doing anything optical without a lensometer!

**EyeFitWell** · 09-10-2008, 03:50 PM

Originally Posted by CME4SPECS

You shouldn't be doing anything optical without a lensometer!

You can hand-neutralize.

**CME4SPECS** · 09-10-2008, 04:00 PM

Originally Posted by EyeFitWell

You can hand-neutralize.

I guess not since he sent the guy to Dr.

**ADO** · 09-10-2008, 04:10 PM

What is the law on neutralizing glasses in NY? When I worked in Kansas you could not do it, but in CO, MO, and IA you could.

**Jubilee** · 09-10-2008, 04:22 PM

Call me crazy here..

But if he didn't like the RX the doctor did in the exam? Why didn't he speak up and say so? Isn't that part of the "subjective" portion of things?

I would still probably call the doc to just give him a heads up.. in case patient makes his way back there to complain if they aren't as ideal as he thinks they will be.

**Barry Santini** · 09-10-2008, 04:32 PM

Originally Posted by peregrinerose

What if the patient sees 20/50 with the old Rx (not legal to drive in most states) and is driving? Filling an expired prescription could actually get you into hot water with issues like that. Have the patient see the OD... that's why ODs get the big bucks, to deal with nightmare patients like that.:)

Interesting...

Most states have a vision-screening (pass/fail) threshold of 20/40.
Most states have a vision-screening frequency of 8 years.
Alot of things can happen to the fluidity of focus in 8 years

Q: How do we logically reconcile Rx expiration dates of 2 years, and DMV *expirations* of 8 years? Is either "correct"?

Opinions?

Barry

**HarryChiling** · 09-10-2008, 04:39 PM

Originally Posted by Jubilee

But if he didn't like the RX the doctor did in the exam? Why didn't he speak up and say so? Isn't that part of the "subjective" portion of things?

That's exactly what I was thinking, I assumed that they discussed that they wanted the old Rx especially since that was the original discussion on the phone with teh other office. I know that in our office a phone conversation and the history don't always contain all the same data, btu I would think that if the patient was that adamant about having the old Rx they would have voiced that to the doctor. If they did, I am real real curious how many doctors would allow the patient to make the choice when it comes to an old Rx compared to a new Rx and what's the threshold (VA or Diopter) if you do allow it?

**Barry Santini** · 09-10-2008, 04:55 PM

Originally Posted by ADO

What is the law on neutralizing glasses in NY? When I worked in Kansas you could not do it, but in CO, MO, and IA you could.

NY (I think) understands that no real harm comes from duplicating an Rx. And if we shouldn't be allowed to duplicate, should we then also arrest those who don an older, spare (expired?) pair from time to time? Or should the old pairs be confiscated before the new eyewear can be dispensed?

?????

Barry

**HarryChiling** · 09-10-2008, 04:58 PM

Originally Posted by ADO

What is the law on neutralizing glasses in NY? When I worked in Kansas you could not do it, but in CO, MO, and IA you could.

See my above post for link and reference.

Originally Posted by Barry Santini

And if we shouldn't be allowed to duplicate, should we then also arrest those who don an older, spare (expired?) pair from time to time?

Me and Fezz will pack the guns you coral the horses, we're going spare pair huntin'. :D Maybe a reminder card every 2 years, "your glasses are now illegal, should you be caught wearing them in public the optical police may be forced to shoot"

**peregrinerose** · 09-10-2008, 05:02 PM

Originally Posted by HarryChiling

That's exactly what I was thinking, I assumed that they discussed that they wanted the old Rx especially since that was the original discussion on the phone with teh other office. I know that in our office a phone conversation and the history don't always contain all the same data, btu I would think that if the patient was that adamant about having the old Rx they would have voiced that to the doctor. If they did, I am real real curious how many doctors would allow the patient to make the choice when it comes to an old Rx compared to a new Rx and what's the threshold (VA or Diopter) if you do allow it?

I can't speak for other docs, but for me it comes down to safety driving. If they are legal and safe to drive with the old rx, I'd probably ok it. If not, there's not a chance of me writing the script for the old one because then I'm responsible if there's an issue. I'm not taking responsibility for someone elses' stupidity. And that's the problem with bypassing the doc's new rx and just copying the old rx... there's a slim chance it could come back to bite the optician later. It's better to send the patient back to the doc for an rx check and let him take the brunt of the problems. Although from the post it sounds like the patient is complaining about a script they didn't even get yet.

**Barry Santini** · 09-10-2008, 05:07 PM

Originally Posted by HarryChiling

See my above post for link and reference.

Me and Fezz will pack the guns you coral the horses, we're going spare pair huntin'. :D Maybe a reminder card every 2 years, "your glasses are now illegal, should you be caught wearing them in public the optical police may be forced to shoot"

And, fer chrys sake, what about all those old (expired) pairs we used to (I hope used to) tint into sunglasses...for...(ta-dah!): DRIVING!

YIKES!

Barry

**LENNY** · 09-10-2008, 05:29 PM

Originally Posted by cme4specs

you shouldn't be doing anything optical without a lensometer!

omg!

**obxeyeguy** · 09-10-2008, 07:11 PM

Originally Posted by Barry Santini

And, fer chrys sake, what about all those old (expired) pairs we used to (I hope used to) tint into sunglasses...for...(ta-dah!): DRIVING!

YIKES!

Barry

Barry!! Barry!!! Please stop. All this rational thinking will get us absolutly nowhere. Just make the old Rx,(which is legal by the way) and stop confusing me with the moral parts of what we do.;)

**NavyChief** · 09-10-2008, 07:24 PM

If you have a trial frame & lens available, you could always put the new Rx in and have the patient read the chart. Then compare to the old one. Even if they don't see as well in the old as new, you have peace of mind of knowing how far off it is.

**HarryChiling** · 09-10-2008, 08:09 PM

Originally Posted by peregrinerose

I can't speak for other docs, but for me it comes down to safety driving. If they are legal and safe to drive with the old rx, I'd probably ok it. If not, there's not a chance of me writing the script for the old one because then I'm responsible if there's an issue. I'm not taking responsibility for someone elses' stupidity. And that's the problem with bypassing the doc's new rx and just copying the old rx... there's a slim chance it could come back to bite the optician later. It's better to send the patient back to the doc for an rx check and let him take the brunt of the problems. Although from the post it sounds like the patient is complaining about a script they didn't even get yet.

That's kinda what I was thinking that there would be a threshold for the OK or No go and it makes sense, I am thinking the same thing this guy is a bit too picky, might be a lose lose situation either way.