Opinions wanted re: Problem customer

[jefe]

A friend of mine who works for a chain store just called me for advice regarding a problem customer -- or, I should say, his mother.


The mother called the chain store's home office before coming into the dispensary. She wanted to buy eyeglasses with CR-39 lenses for her 15 year old son. She is unwilling to sign any waiver of liability.


The optician hasn't seen the rx yet. Trivex is not an option at this store. The mother doesn't want poly. The home office says go ahead with the order if the doctor writes on the rx, "CR-39 OK".


The optician is concerned about personal liability. He's also worried about losing his job if he refuses to go through with the order. The question is this: What should he do?


I told him I would post this thread to try to get opinions from the members of Optiboard.

[Moneyeca]

From my understanding, if the doctor writes "CR 39 Okay" on the Rx, then the optician will not be held liable for using that material. I would tell him to just make a copy of the RX and keep it on file if something comes up in the future.

[opticianbart]

From my understanding, if the doctor writes "CR 39 Okay" on the Rx, then the optician will not be held liable for using that material. I would tell him to just make a copy of the RX and keep it on file if something comes up in the future.

seconded, by writing CR39 ok, the Dr. takes responsiblity for it.

p.s- what was mom's reason for not wanting poly?

[SailorEd]

Have him xerox a copy of the Dr.'s Rx where the doctor (in his absolute stupidity) wrote "CR 39 ok". Have him save it in his personal files at home. As long as the Dr. ok's it, then the responsibility of dispensing it is taken off the optician. Also, make sure he gets a written notice from the store manager that the Company has said it was ok.

He should have no worries then.

Here, in our practice, the doctor would never write such a statement on the Rx (or anywhere else) and if the adult refuses to sign a waiver, then we tell them they can go elsewhere because it's not worth a lawsuit for hundreds of thousands of dollars because the child was blinded by shattering plastic.

[Now I See]

I'm wondering what the store manager thinks about this?

In any corporate store I have worked in, it has been one of two things

1. No waiver, no sale

or

2. Nothing but poly for kids...period...no waiver's allowed.

To answer your question...I'd be talking to my store manager first. But the most important thing for your friend to do is DOCUMENT!!!! Get a copy of that RX (if it says 'CR39 OK') and keep it on file somewhere.

[jefe]

I've found if a parent is convinced she has had problems with poly, she will assume her kids will have problems.

[jefe]

My friend is the store manager. The go-ahead came from the home office.

[obxeyeguy]

I don't get the hang up with having an outside Doc write Ok for cr-39, and thinking that puts him on the hook. You make them, your responsible period. The lawyers will follow the money trail, that just opened the door for the Doc to get dragged in, right next to you.


In North Carolina, the state provides medicaid glasses (made by the state) to children under 18 with Cr-39, so this becomes a standard of care here, so liability reduced, not gone. Remember, the glasses break, someone is harmed, you will get sued, I don't care what type of lens it was.

[optical24/7]

* Duty to Warn is not a law.

* A waiver can be worthless (plausability of not understanding what they are signing)

* CR 39 is not a boogy man!

If you are that worried either put them in poly at no extra charge or make the CR lenses with a 3.0 center/edge thickness.


side note; I've seen CR hold up to a hardball impact from over 150 ft, destroying the glasses, not a scratch on the lenses.

[opticianbart]

In North Carolina, the state provides medicaid glasses (made by the state) to children under 18 with Cr-39, so this becomes a standard of care here, so liability reduced, not gone.

We get this at my shop (in DC) drives me nuts. Although if the child is an infant or the individual is missing/has low/no vision in one eye we can get the poly (after waiting an extra week or so for the insurance to get back to us)

[Uncle Fester]

I'm still confused over why we have no issue fitting a teenager with contacts yet the eyeglasses must be poly/trivex for the 1 in a million chance of catastrophic eye injury.

I'll bet mom is concerned with the poly in baby bottles controversy.

Too bad there is no site to keep statistics on cause of death of benchman/opticians exposed to poly dust. We could be a first indicator that it really is harmful.

[jefe]

Good point

[Chris Ryser]

* Duty to Warn is not a law.

* A waiver can be worthless (plausability of not understanding what they are signing)

* CR 39 is not a boogy man!

If you are that worried either put them in poly at no extra charge or make the CR lenses with a 3.0 center/edge thickness.


side note; I've seen CR hold up to a hardball impact from over 150 ft, destroying the glasses, not a scratch on the lenses.

Another perfect and sensible post................................

This all got started in the 70s at LC who had people sign off if they would not purchase Poly lenses.

In no other parts of the world where this habit this has become a rule. Just look at the on line websites, they give you what you want.
Specially a 15 year old who probably already looks like a grown up.

I also don't see that the doctor should prescribe a certain material, that is the opticians job. An Rx is for the lens power and not materials.

[hipoptical]

I'm still confused over why we have no issue fitting a teenager with contacts yet the eyeglasses must be poly/trivex for the 1 in a million chance of catastrophic eye injury.

I'll bet mom is concerned with the poly in baby bottles controversy.

Too bad there is no site to keep statistics on cause of death of benchman/opticians exposed to poly dust. We could be a first indicator that it really is harmful.

(Emphasis mine)
1.I've always been confused for the same reason. (I've also been confused for other reasons, too, but that's another story.)
2. Have you noticed there are also no stats on eye injuries due to non-poly lenses? Even where glass is used- even at 1mm CT- there are no reports or stats to rationalize the poly debate.

Only when you live in a litigious-happy society do you have concerns like the one expressed in this thread. However, this is how I would counsel my friend:
Tell him to say "Mom, if you don't sign, I can't do it."
Or "Mom, if I do this and something happens, you'll be suing me. Why do you hate me?"
Or, tell him to put poly in the glasses and keep his mouth shut, since she won't know the difference, anyway. (I don't recommend this, you should respect your mother.)
Or, put plastic in them since she requested it, and get on with his life. You can't live in constant fear, and if his fear is that his mother will sue him if something happens, he's got bigger problems than poly vs. plastic.:bbg:

[MarcE]

You wasted so much damn time and consternation worrying about the poly/CR39 issue.

It doesn't matter what they order. Just GIVE them the poly. You wasted $74 worth of time and wages. The "patient" probably won't come back because you gave them a hard time.

In our shop, if someone (a child) doesn't want to pay for poly, we say "OK". Then they get poly as a "FREE UPGRADE".

The patient doesn't have to sign anything. A simple note in the chart will protect you during discovery, if it ever goes that far. (this is just my opinion, I'm not a lawyer)

We save time. We impress a client. We protect the patient AND ourselves. And I spend less time worrying about what some lawyer may or may not do.

If they don't want poly for OPTICAL reasons, then they get CR or Trivex.

I guess I'm getting old, but I do tire of hearing about people worrying about being sued over CR-39. You have a duty to warn (not legally, but tort-wise). You do not have a duty to arm-twist, call the Dr, argue, pull a guilt-trip, or any other tactics. It's just bad business.

Many states won't even allow you to bill poly through Medicaid. Hmm, sounds like the state has established the "standard of care". Kansas will deny the entire claim if you put V2784 on it anywhere. We give poly away everyday.

Oh, I just saw that I made many of the same points as obx and 24/7. Sorry for the redundancy, but great minds think alike.

[HarryChiling]

Why worry have a friend in the business send you the lenses in poly or trivex, chuck the CR the home office sends you and your done. Sure it'll cost you a few bucks outta pocket but you'll be able to live with yourself. That or order the CR lenses 3.0mm thick.

[SailorEd]

I think this person works for a "Chain Store". Prices are fixed and payment is expected for what is actually dispensed. So, if poly is ordered, the payment for that poly will be expected at the cash register. I don't think he wants to reach into his own pocket to pay the "extra" for the poly v. the CR39 lens.

The other thing is what is to protect HIM! Making sure that the doctor and the "Chain" endorses dispensing CR-39 will protect him from being the object of a lawsuit. In other words, he was told to do it and the doctor said it was ok.

Now, working for an Independent ECP is a little different. Yes we can dispense poly and charge for CR-39 ... but why should we?????? Have the person sign the waiver or don't dispense ... It's as easy as that. Why should some idiot who wants to disregard the safety of a child be given ANY more consideration than a patient who happily realizes that poly is a good choice for safety sake.

Anyways, that's what I think.

[FullCircle]

Another perfect and sensible post................................

This all got started in the 70s at LC who had people sign off if they would not purchase Poly lenses.

In no other parts of the world where this habit this has become a rule. Just look at the on line websites, they give you what you want.
Specially a 15 year old who probably already looks like a grown up.

I also don't see that the doctor should prescribe a certain material, that is the opticians job. An Rx is for the lens power and not materials.

LC wasn't around in the 70's (if memory serves me correctly, we started around 1983) and I know we didn't start doing poly here in the midwest until 1989/90. And I don't recall anyone ever having to sign a waiver if they didn't get poly lenses.

You can't blame us for everything.

[Uilleann]

So....uhh......

I'd like to know precisely HOW many of us have been directly sued and lost over a catastrophic eye injury...exactly??

How many??

As most of us know all too well - simply giving the patient "what they want" can often be a horrible decision on our part. Time to properly educate Mom there - clearly she's as sharp as a bag of marbles. And it takes what...two minutes of your time?

If that doesn't work, and you're still worried about litigation - just ask your manager or some other associate to take the sale. It's not worth your time or the headache & associated grey hair. :bbg:

[k12311997]

Why worry have a friend in the business send you the lenses in poly or trivex, chuck the CR the home office sends you and your done. Sure it'll cost you a few bucks outta pocket but you'll be able to live with yourself. That or order the CR lenses 3.0mm thick.

sorry to derail thread.

Harry,

Judging by your avatar, Change of job? Congrats if they are in order.

[regional_manager]

There is no law saying that kids have to have poly. Besides if we are so concerned then just give them poly for the same price. Doesn't cost very much more at all. It's not even worth the time or energy to argue or try to explain anything to this type of patient. Charge them for plastic and give them poly at no charge. Now that's customer service!!

[chip anderson]

Don't be such a woose. Make the glasses in CR-39 or Glass or whatever he wants. Do caution him not to wear them for sports. Take his money and smile.
Chances of your being attacked by a liabiltiy lawyer are practically nil.
If he looses an eye, I'll comp one for you.

Chip

[tigerlilly]

Have him xerox a copy of the Dr.'s Rx where the doctor (in his absolute stupidity) wrote "CR 39 ok". Have him save it in his personal files at home.

Not a good idea. Copying patient information and taking it out of the store would be a terminable offense, not to mention a HIPAA violation.

I'd say documentation is the best thing to do. Well, certainly the manager should be handling this order, but everywhere it should be documented that pt's mother demanded CR39 despite having the risks and safety concerns explained to her, and that the regional manager and whoever else at corporate said to give it to them despite it being in violation of company policy. In that environment, you do what you're told if you want to keep you job, and you CYA by keeping a written record naming what you were told to do and who exactly told you to do it.

[Jubilee]

I have been doing some research into the "Standard of Care" for impact resistance in children, and have been having issues getting _real_ references for this.

However, I did come across a lawsuit from the 80's in regards to a minor being dispensed glass, and having the glasses break while in gym playing volleyball. The boy received some serious gashes after glass was imbedded in the cheek and around the eye. The optician and insurance company settled, but when trying to get some compensation from the school, it was determined that a jury never had a chance to see if Duty to Warn was indeed an issue and it was kicked back for trial. I didn't have a chance to continue the chase the case to see what became of it but there are some court cases involving this issue.

I will post the link tomorrow at work when I have access to the print out I made of it. http://bulk.resource.org/courts.gov/...5.87-3490.html


Cassandra

[chip anderson]

Tigerlilly:

Are you trying to say that copying an Rx and giving it to the patient, and letting the patient take it out of the store is a Hippa violation? If you are you are bad, bad wrong. Not giving the origional to the patient and letting him take it out of the store is in violation of Federal Eyeglass 1, which has been discussed many times on this this board.
The fine for not giving the patient his Rx (no matter what it says) is still
$10,000 per violation.

Chip