What say the penut gallery? :D
Yeah
Neah
Maybeah
What say the penut gallery? :D
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I voted Yeah. My only problem is that it still doesn't put any teeth into the 1-800 places, as that appears to be federal gov. regulated. They set the standard for the 8 business hours reply or don't, and they can do what they want.
I see this as tighter control for people in the industry, but it won't solve a thing.
I for one would rather see some sort of bill that prevents dispensing without some sort of direct care of the patient. If you sell contact lenses you should have a slit-lamp, do regular exams of the contact lens fit and condition of the lenses. You should have inspection equipment in the office and be required to personally inspect each rigid lens prior to dispensing. Be able to see this lens on the eye and see how it fits and performs.
And no I am not suggesting that we circumscribe the prescriber.
But mearly being able to pass the prescriber information on to a manufacturer or supplier should not be concidered fitting or dispensing.
If the prescriber dispenses then he or someone in his employ should comply with the above.
Chip
How 'bout dem apples Harry? Do you want a law that protects our lively hood or one that protects the patient?"
Mail order from someone who never sees the patient or even dispensing in the office by someone in the office that prescrbed should not exist. Mearly saying dumb statements like "I trust my laboratory." should not be the state of the art. All of us that have either worked in a lab or actually do pre-and post- inspect know why.
Last edited by chip anderson; 02-14-2009 at 01:53 PM. Reason: How 'bout dem apples
How about protecting both?Originally Posted by chip anderson
I voted no because I thought a misdemeanor meant causing less than $250 damage and a felony was >$250 damage. (I thought the question was refering to a downgrade in the charge. I still feel it is/should be a felony)
This bill is necessary. There is a record store in our town that sells cosmetic lenses to anyone with a pulse. I logged an FTC complaint but it was completely useless and nothing happened.
Misdemeanor? Why?? It should be a felony.
Who cares there's not any money in the things any more , let someone else take the risk and hassle. The money won't come back with regulation...
Chip,
Honestly its about patient health here and not profits. Hard to believe I know! I saw a girl that got a nasty corneal ulcer a week after wearing a cosmetic lens from said store.
I have seen (at least in pictures and articles) a lot of nasty ulcers in contact "fitted" and sold by OD's and OMD's also. I know today that most prescribers fit contacts by a single observation, of the patient, consulting a chart from the manufacturer, possible application of a trial lens based on this chart, and selling a years supply. Worse yet, the practioner that uses a one size fits all approach. Takes no measurments and sticks and 8.7 on everybody. Tells them "you just can't wear contacts if the patient isn't entirely pleased.
No observation after a week (or other reasonable short period) of wear to see does the lens really fit, can the patient still see as well, etc.
I am not an advocate of mail order or OTC fitting but I am also not convinced that most "professional" dispensing is done on an order that establishes itself as being superior either to either health or vision.
Just as I am not conviced that manditory annual eye exams for either spectacles or contact lenses is for any reason other than econmomics.
Chip
And yeah, I know I will now get lots of comments about OD bashing.
Last edited by chip anderson; 02-15-2009 at 05:19 PM. Reason: Worse yet...
Nah Chip, I doubt you'll get much bashing. We all operate based on our own set of observations. Some of us see more problems than others. I'm sure that some of us that have worked in more than location have observed differences between those locations. When I worked mostly in a commercial practice, I many times felt that I was unnecessarily inconveniencing my patients by making them return for follow up visits. My observation was that hundreds of patients would come in with NO complaint, NO observable problems, and therefor NO reason to have to return except to make a sale (except for the fact that I didn't sell contacts or glasses or charge for the visit - but I guess it might appear that way to the casual observer)....and then IT would walk in. That one in a ?# that would have a problem...a BC change, a power change, a material change (no big deal right?!) or something really bad that required immediate action. So that experience would renewed my personal observation set to require the follow-up visits, even when my gut feeling was it may not be required. I've recently changed to exclusively private practice and went through the same situation with recommending annual exams. It's a new practice and I need to sell some glasses, but patient after patient is showing up for their annual "I don't have any problems" exam. If they don't need new glasses, we don't sell them new glasses, so the dispensary is dead. The thought goes through my head "do they really need annual eye exams"... and then, you guessed it, in she comes. Last exam 14 months ago with the ophthalmologist, retinal photos taken with no signs of the 6 mm malignant melanoma I was starring at (that I caught with an optomap by the way, but it also would have been detected with dilation and a few minutes with a BIO. I doubt I would have seen it with a direct ophthalmoscope). I think I'll stick with annual exams, annual CL fits, annual dilation or optomap, and suggesting upgrades to spectacle Rx's when they are needed. All of this based on MY set of observations. YMMV.
(BTW, back in the old days I didn't like disposable contacts. Now I only fit 10 or so "annual replacement" lenses a year. So it is possible for me to change my mind once in a while, just not ready to yet.)
IndianaOD yes it is for health but Chip is right. Here the problem we have is that in NY state they could care less about these as well as non-licensed opticians, there is no enforcement at all. The biggest problem is on collage campuses where they get sold for $30 a pair especially (the "wild eye's ). One rep told me it's a big problem.
Why do we need an Rx for Lipitor or Prozac? They have a high safety profile. Why an Rx for birth control? Is it just economics?
Why should opticians be licensed? Just so we have to pay them more?
A lot of folk are buying ONE box of contacts every 6 to 8 months and then wear their last lenses until they start having problems and then come into the "chain" store and ask for a sample pair to do them until they can get an appointment. Then they ask for a "sample" bottle of solution. They really do.
A lot of chains will sell them all the lenses they want on the LAST DAY of expiration.
I think we need the FTC to pass a law that when you present your new RX you must buy what is considered a years supply and then prove to the examiner that you are getting a yearly exam before you can buy more. It's time to put a stop to this idea that one or two boxes is an 8 to 12 months supply.
If the records of all the discount chains were audited it would scare the hell of you as a prescriber.
I refuse to sell a single contact lens anymore and I never will.
The FTC passes rules but never enforce them, i.e."The Prescription Realease Law". What a joke.
Its may not be all we could have hoped for, but it is something. As IndianaOD said, we have record stores, and other various shops selling these lenses, and we even have gaming conventions selling them to help you get in character, or to enhance your costume.
Hopefully we will get the enforcement we need for it too!
"Some believe in destiny, and some believe in fate. But I believe that happiness is something we create."-Something More by Sugarland
Chip,
We operate much in the same way you preach. We require patients to come back for a one week follow up, and with new to contacts patients, we ask for 2 follow ups. You would be suprised how many patients gripe that this is inconvienent.
Bill,
I also get disgusted with this. Patients always seem suprised when the doc asks, "You have been wearing your lenses for longer than 2 weeks at a time, correct?"
They always try to dance around that response, but then when he points out the redness, and signs of neo.. they will admit.."yes, I stretch them out to a month" and they promise to do better.. but...the next year we go through it all over again.
Until we refuse to fit them with cls anymore, and then they go to Walmart, and come to us for everything else. :hammer:
"Some believe in destiny, and some believe in fate. But I believe that happiness is something we create."-Something More by Sugarland
Mr. West:
Other than guaranteeing that you make a sale of a years worth your proposal would accomplish nothing. Patient's would still streatch that "years worth" out for two to five years and still would only come in where there is a problem.
Unfortuantely one of the problems with disposable lenses is that they don't even come in when there is a problem! They are going to try two or three new lenses first because We have them believeing that a new lens cures all!
That's one of the things I always liked about rigid lenses, rigid lenses had the decency to hurt when something was wrong.
Chip
Deregulate CLs *entirely*, i.e., let anyone buy them anywhere, from anywhom.
Two results are possible:
1. "so" many people have eye/cornea health issues, damage or the like that a consensus that there is a *crisis* in CL fitting is obtained, and people agree (ha!) that there should be uniform regulations, education and monitering of CL delivery, just like drugs (i.e., other medical devices), or...
2. There's no real health issue/danger "statistically", and the sham of education/regulation with CLs is exposed.
Which one do you think will happen?
My two cents!
Barry
I really wonder sometimes if many of the posters on this site realize how powerful prescription lenses are.
Prescriptions (especially prism and plus) can affect the autonomic nervous system. There is some interesting stuff coming out about this relationship soon.
Ophthalmic lenses can also greatly change how you perceive the environment around you.
Indiana:
So can tinted shades without Rx. And a whole lot of other things. Even drinking too much water can have effects on this. Can't we digest Obummer's people outlawing ATV's and children's rider toys because they may have lead in the batteries and circuits today?
Wonder if dem new contacts with the TV build in will have illegal materials in the circuits?
Chip
Way to sound professional,Chip.
Open your mouth and remove all doubt.
DragonlensmanWV N.A.O.L.
"There is nothing patriotic about hating your government or pretending you can hate your government but love your country."
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