Fresnel on OTC readers!

**bmintzer7** · 11-12-2009, 04:27 PM

I work for a M.D. who writes a lot of Rx's for Fresnel prisms. Okay. I'm dealing with it, and I'm now good at it.
Lately, he has been telling people to just have them put on their otc readers! What???!!! Literally, they come to me with scratched +1.00's from the dollar store, and are willing to spend $49 to put prisms on them?
I'm just not gonna do it. It is so wrong in so many ways.
Thanks for giving me a place to vent.
Barb

**Now I See** · 11-12-2009, 04:35 PM

wow, it sounds like you'd be better off just grinding a SV +1.00 (or whatever) with the prism in....for about the same money, they'd have a sparkling new pair!

**DragonLensmanWV** · 11-12-2009, 04:38 PM

Ask him how many of his patients have OU Rxs.

**bmintzer7** · 11-12-2009, 04:49 PM

Originally Posted by Heather A

wow, it sounds like you'd be better off just grinding a SV +1.00 (or whatever) with the prism in....for about the same money, they'd have a sparkling new pair!

I know it, and even when I show the doc the price/lack of price difference, he says, well, we just want to try it out and see if it works. Umm, how about using a trial frame?

**Johns** · 11-12-2009, 05:18 PM

Originally Posted by DragonLensmanWV

Ask him how many of his patients have OU Rxs.

He's an MD. He probably will say they have NO rx (because he's such a good surgeon).

**Striderswife** · 11-12-2009, 05:31 PM

Originally Posted by bmintzer7

I know it, and even when I show the doc the price/lack of price difference, he says, well, we just want to try it out and see if it works. Umm, how about using a trial frame?

I once worked with a gal who didn't think we should charge the patient for press-on prisms. "We're just trying it to see if they'll work," were her exact words.

That's the whole point!!!!

Never mind that we had to pay for those prisms. If your PCP gave you an Rx for blood pressure medicine, at first, it's to see if it will work! If it doesn't, you try another medication, but you still have to pay the pharmacy for those pills, even if they didn't work! People don't think of glasses and materials that way. It really irkes me.

**Robert Martellaro** · 11-12-2009, 05:35 PM

Schedule 10 minutes with the doc some morning before patients and tell him you're starting a half-eye package that will have a sell price of $50 to $100. Maybe throw in the final Rx change with surfaced prism (if possible) with any additional fees limited to the upcharge for prism. Explain all of the reasons why in a matter of fact way- calm, cool, and collected.

**AdmiralKnight** · 11-12-2009, 06:33 PM

That's a great idea, Robert.

I just don't understand how you can get any accurate results out of a set of OTC readers with fresnels. Is he taking into account the induced prism from the improper PD on those OTCs? What the heck?

**flexonman** · 11-13-2009, 04:40 PM

Originally Posted by bmintzer7

I know it, and even when I show the doc the price/lack of price difference, he says, well, we just want to try it out and see if it works. Umm, how about using a trial frame?

Trial framing does not work. Some patients can not tolerate them and sometimes the prism power need accelerates and sometimes decompensates quickly. They can not tolerate the effects coming from the prism. Such as feeling that they are standing on the top of a hill for example. We often check the patient after 2 weeks with the Fresnel in place and then decide to either increase decrease, remove or grind the prism in the lens.

**FVCCHRIS** · 11-13-2009, 09:17 PM

Originally Posted by bmintzer7

I work for a M.D. who writes a lot of Rx's for Fresnel prisms. Okay. I'm dealing with it, and I'm now good at it.
Lately, he has been telling people to just have them put on their otc readers! What???!!! Literally, they come to me with scratched +1.00's from the dollar store, and are willing to spend $49 to put prisms on them?
I'm just not gonna do it. It is so wrong in so many ways.
Thanks for giving me a place to vent.
Barb

I feel for you! No Dr. should be advocating that kind of sloppiness.

And I must then assume any Optician filling one of his rx's can pretty much stick any 'ol PD they want on there right? Since that's what he's allowing when he lets them use OTC's ??

**rdcoach5** · 11-13-2009, 09:52 PM

[QUOTE=bmintzer7;319049]I know it, and even when I show the doc the price/lack of price difference, he says, well, we just want to try it out and see if it works. Umm, how about using a trial frame?[/QUOT

This is normal procedure for a Prism Rx. It takes a week or two for the patient to adapt.

**rbaker** · 11-13-2009, 10:05 PM

Originally Posted by bmintzer7

I work for a M.D. who writes a lot of Rx's for Fresnel prisms. Okay. I'm dealing with it, and I'm now good at it.
Lately, he has been telling people to just have them put on their otc readers! What???!!! Literally, they come to me with scratched +1.00's from the dollar store, and are willing to spend $49 to put prisms on them?
I'm just not gonna do it. It is so wrong in so many ways.
Thanks for giving me a place to vent.
Barb

OK . . . You have vented . . . Now just do what the boss tells you to do. I am quite sure that he is aware of all of the ramifications, good and bad, that his methodology implies and has reached the conclusion that what he is doing is in the best interest of his patients and his practice.

I do have sympathy for where you are coming from but believe me your concerns are not worth getting fired. Remembering that we seldom win an argument with an MD start looking around for a job that will meet your standards.