How to politely refuse to give a PD?

**tdj** · 08-18-2010, 05:33 AM

How can I politely tell my patients that I will not take and give out a PD directly to them?

I don't work in a state where this is part of the Rx; my optometrist doesn't measure for it; therefore, I would have to waste my time taking a PD on a patient who is not purchasing anything and still expecting to use my services. I'm not down with that, and I am completely against online glasses (especially as my store services 90% presbyopes)

I haven't had a patient come in and directly ask for PD and get snippy since I worked at ***, but I know it will come soon.

At my current shop, I've written out rxes for a few pts who asked "is my pupil space measurement on there?" (or some such question) and I always say "no, it isn't a part of the od's prescription; any qualified optician will take that measurement when you order glasses *big smile*" and no one has argued -- *yet*. My position is slightly more difficult at my new shop, because while I don't work for the OD, I am capable to release/write out Rxes from the chart.

So how do I tell the pts who will inevitably come in, tell me they are ordering online glasses, and demand a PD: "no, I will not give that to you, I feel it is ethically inappropriate" --without sounding like a huge b**ch?

**Craig** · 08-18-2010, 06:57 AM

I would simply say that is not part of the exam and for $25 you would be glad to provide your serives to ensure the measurements are as accurate as possible.
We charge a $10 donation to charity for repairs and adjusments with a $25 diagnostic fee to figure out why glasses that were not purchased from me do not work. Why would we be expected to do anything without compensation?
Craig

**WFruit** · 08-18-2010, 09:53 AM

Tell them that the PD measurement is taken at the time of order and ask them which frame they've picked out.

**Diane** · 08-18-2010, 10:28 AM

[QUOTE=misslindsay;355884]

At my current shop, I've written out rxes for a few pts who asked "is my pupil space measurement on there?" (or some such question) and I always say "no, it isn't a part of the od's prescription; any qualified optician will take that measurement when you order glasses *big smile*" and no one has argued -- *yet*. My position is slightly more difficult at my new shop, because while I don't work for the OD, I am capable to release/write out Rxes from the chart.

QUOTE]

To answer your initial answer, the responses above would be sufficient. However, you have made a statement within the body of your comment...sorry... that indicates that this practice could be in violation of federal HIPAA laws. If you don't work for the OD, there could be a conflict with your having access to the "charts" of these patients. You may want to verify if you would be within violation or if you would somehow fall within the definition of a "business associate", and should you have access to the entire chart. By law, only information is to be view by any person that would be required for them to perform a specific task for that patient. You may want to go to the website that would identify this for you.

Diane

**Johns** · 08-18-2010, 11:27 AM

Originally Posted by misslindsay

How can I politely tell my patients that I will not take and give out a PD directly to them?

How does your mechanic "politely" refuse to fix your tire for free? I think that by the way you worded the question, using the word "refuse" that you and many others are of the mindset that you owe it to the patient, or that it is their's for the taking.

Don't refuse if you're not comfortable saying no. Instead, say, "No, that is not part of the Rx, but we'd be happy to take that measurement for you. It's $35 for monocular, and $50 for binocular. We also have a plan you can purchase (for $90) that will allow you to bring the glasses (one pr.) in for us to verify for you."

Personally, I don't give out any measurements that pertain to the fabrication of the glasses. I don't care whether I'm making them, or the sweatshop in China. I don't do it, and have no problem explaining why.

**tdj** · 08-18-2010, 12:03 PM

The problem with charging is that I do work for a chain, and while I have the right to refuse it, I also do not have the right to charge for it.

**tdj** · 08-18-2010, 12:04 PM

[QUOTE=Diane;355921]

Originally Posted by misslindsay

At my current shop, I've written out rxes for a few pts who asked "is my pupil space measurement on there?" (or some such question) and I always say "no, it isn't a part of the od's prescription; any qualified optician will take that measurement when you order glasses *big smile*" and no one has argued -- *yet*. My position is slightly more difficult at my new shop, because while I don't work for the OD, I am capable to release/write out Rxes from the chart.

QUOTE]

To answer your initial answer, the responses above would be sufficient. However, you have made a statement within the body of your comment...sorry... that indicates that this practice could be in violation of federal HIPAA laws. If you don't work for the OD, there could be a conflict with your having access to the "charts" of these patients. You may want to verify if you would be within violation or if you would somehow fall within the definition of a "business associate", and should you have access to the entire chart. By law, only information is to be view by any person that would be required for them to perform a specific task for that patient. You may want to go to the website that would identify this for you.

Diane

It's not a violation. I am considered office staff. We work TOGETHER; he does not employ me and I don't employ him.

**gmc** · 08-18-2010, 12:06 PM

Tell them that it is the responsibility of the optician fitting the glasses to take all appropriate measurements.

If you don't want to do that, someone in an earlier thread said that they offer to take measurements, verify the glasses are made correctly upon arrival, do an initial fitting, and offer adjustments for the life of the glasses for a fee of $25.00 - $35.00.

Have them sign an agreement saying that you are not responsible for any breakage that occurs while adjusting their glasses.

**gmc** · 08-18-2010, 12:09 PM

Didn't see your last couple of posts prior to my last post. If you work for a chain, you might be bound by their policy.

**tdj** · 08-18-2010, 12:13 PM

Originally Posted by gmc

Didn't see your last couple of posts prior to my last post. If you work for a chain, you might be bound by their policy.

As far as charging, yes. I am allowed to refuse anything having to do with online glasses, though, thank goodness. I just want a way to do it without sounding like that mean, mean evil b*tch at The Optical.

Although someone who is cool with theft of services is likely not gonna care whether I'm nice to them or not...

**Chris Ryser** · 08-18-2010, 12:23 PM

Originally Posted by gmc

Tell them that it is the responsibility of the optician fitting the glasses to take all appropriate measurements.

If you don't want to do that, someone in an earlier thread said that they offer to take measurements, verify the glasses are made correctly upon arrival, do an initial fitting, and offer adjustments for the life of the glasses for a fee of $25.00 - $35.00.

Have them sign an agreement saying that you are not responsible for any breakage that occurs while adjusting their glasses.

Chrage them whatever your profesional time is worth. Craig and Johns are right and each has his own way of settig professional fees.

However as good optician with all the diplomas I would not have them sign a paper. Either they have a good new frame or a dried out old one you should know if it breaks when you touch it and then just refuse to handle it. Having customers sign release papers looks as if you don't trust yourself doing your professional job.

**Johns** · 08-18-2010, 12:25 PM

Originally Posted by misslindsay

Although someone who is cool with theft of services is likely not gonna care whether I'm nice to them or not...

It's not "theft" if you are giving it away. Some people see more value in the services they offer than others; and often w/good reason. If you truly see value in what you do, you have no problems in collecting the fees associated w/those services.

Nice? Who cares? Like you said, they're not sticking by you anyway...

**bren_03825** · 08-18-2010, 12:27 PM

Am in full agreement, I do not give out their pd, as it is used in the order, and since it is not part of the prescription, I am not bound by any law to give it to them. I let them know, if they decide to purchase their glasses elsewhere, that we are not responsable for any miss-fittings, incorrect Rx's, etc, but I would be happy to verify that they were made correct to standards that the National standards institute sets.

**tdj** · 08-18-2010, 12:28 PM

Originally Posted by Chris Ryser

Chrage them whatever your profesional time is worth. Craig and Johns are right and each has his own way of settig professional fees.

However as good optician with all the diplomas I would not have them sign a paper. Either they have a good new frame or a dried out old one you should know if it breaks when you touch it and then just refuse to handle it. Having customers sign release papers looks as if you don't trust yourself doing your professional job.

I would never have them sign a paper. I will warn them verbally if I feel there is a risk of breakage and let them make the call. If I break a good quality frame with no problems, that's on me.

**Barry Santini** · 08-18-2010, 12:40 PM

I don't measure or give out PD for anyone ELSE to make eyewear.

This is how I see it: When we currently make eyewear, according to the given prescription, when the client doesn't see to their satisfaction, who do they call FIRST? The Dr., or US?

"It's "your" glasses."

Same thing.

B

**MikeAurelius** · 08-18-2010, 01:23 PM

The only thing so far that I don't agree with here is the statement that the PD is not part of the prescription. I call B.S. on that.

The OD tests the eye for its focusing ability and creates a prescription based on his findings. He is testing the eye itself. Each eye is a given distance apart and need to be measured to complete the prescription. Therefore, the PD is an inherent part of the prescription, for without it, it cannot be properly fabricated. Several states have already recognized this fact and require the PD be given as part of the written prescription.

Say what you will, but I truly believe the PD is absolutely part of the prescription.

**scriptfiller** · 08-18-2010, 01:27 PM

We tell folks it's the responsibility of the dispenser of the specs. If they belabor the point we simply say we don't want to be caught in the middle of a dispute between prescriber and dispenser.

Definition of a Spec. RX

Sphere power, Cyl. power if needed, axis if needed add power if needed.

**drk** · 08-18-2010, 03:55 PM

I think there's an opportunity to educate and editorialize.

"Sorry, that's not part of the prescription; that's part of fitting you for glasses. Whomever is designing your lenses should be measuring your p.d and several additional measurements."

I think it will show that there is a professional service that they need.

As to offering to provide services to someone else's materials, I say "good luck". Let's refuse to do it. If we participate, even for a fee, we feed this phenomenon.

**uncut** · 08-18-2010, 04:04 PM

Originally Posted by drk

i think there's an opportunity to educate and editorialize.

"sorry, that's not part of the prescription; that's part of fitting you for glasses. Whomever is designing your lenses should be measuring your p.d and several additional measurements."

i think it will show that there is a professional service that they need.

As to offering to provide services to someone else's materials, i say "good luck". Let's refuse to do it. If we participate, even for a fee, we feed this phenomenon.

agrreeeeeeee! Wholeheartedly!

**Specs** · 08-18-2010, 04:11 PM

Sorry Mike, PD is not part of the prescription unless the Dr. puts it there. Maybe I see one every other year with that. As I am not the prescriber, and the PD is not on the written Rx., don't know how you can say its part of the script. Its part of your finished product. Dr. and I don't co-write an Rx. If its part of the Rx tell the patient to call the doc who prescribed. He doesn't have it. Case closed. Nothing for nothing. Charge!!

**edKENdance** · 08-18-2010, 04:35 PM

As Mr. T would say "I PD the fool who would buy their glasses online!"

/I've been trying to work that into something for some time now

**PhillyEyes** · 08-18-2010, 04:42 PM

to make it easy for me to say no, i just bring the law into play.

I tell them i will not take and give a pd to someone who is getting glasses elsewhere, if the pd on the finalized specs turns out to be inaccurate and something happens like the patient getting into a car accident I can be held liable and i wont do it.

**kat** · 08-18-2010, 04:52 PM

I agree, it is the responsibility of the place that is making (ordering) the glasses to provide the PD. I simply smile and tell them that I will charge a proffessional fee of $30 for their PD, but I will waive that fee if they purchase theor eyewear from me. I also let them know that seg heights (for MF wearers) are always determined by how the frame fits on the face after proper adjustments to insure accuracy. Never had a problem!!!

**MikeAurelius** · 08-18-2010, 05:29 PM

Originally Posted by Specs

Sorry Mike, PD is not part of the prescription unless the Dr. puts it there. Maybe I see one every other year with that. As I am not the prescriber, and the PD is not on the written Rx., don't know how you can say its part of the script. Its part of your finished product. Dr. and I don't co-write an Rx. If its part of the Rx tell the patient to call the doc who prescribed. He doesn't have it. Case closed. Nothing for nothing. Charge!!

Well, you should have that discussion with the fine ECP's in Kansas and a few other states where it is REQUIRED that the Dr. put it on the Rx. That's my point. The PD is just as much a part of the prescription as the sphere cylinder and axis for each eye. When any one part is missing the prescription cannot be fabricated.

**MikeAurelius** · 08-18-2010, 05:30 PM

Originally Posted by PhillyEyes

to make it easy for me to say no, i just bring the law into play.

I tell them i will not take and give a pd to someone who is getting glasses elsewhere, if the pd on the finalized specs turns out to be inaccurate and something happens like the patient getting into a car accident I can be held liable and i wont do it.

Sorry, don't buy it. If the PD is inaccurate on the finished specs, you won't get sued, the lab/dispenser elsewhere will get sued.