RX Sabotaging

**PAkev** · 03-04-2011, 03:53 PM

I have recently filled RX's for a local MD office which proved to be in error on at least three occassions (which I know of):

First one the axis on the written RX was 134. However when the patient put his new eyewear on I got an instant ..."Wow somethings wrong." Upon checking his current eyewear, I found the axis on his current eyewear to be 35. Upon contacting the Dr office they first claimed that it was written 134. I informed them my two alternatives were sending him back sponge the docs time and be rechecked or duplicating the RX he was wearing. After about an hour, I got a call back confirming the correct axis was 34. I remade as a Dr. RX change with no cost imposed on me the doc or the patient.

Next, a woman brought me an RX to fill late last summer which had a -.50 cyl. I filled the RX and after 6 months she has a followup appointment at which time the doc also tells her the RX was made wrong. It turns out, it was supposed to be a -1.50 which was written incorrectly on the supplied RX. Since we were outside the remake parameters, I sent the doc a bill and am still waiting to be paid.

So I figure they have a problem writing and understanding 1's......The final straw was when a patient contacted me for a fitting appointment and conveyed that he misplaced his RX. I called the docs office and had them fax the RX directly to me before the scheduled appointment. I received the fax (-3.00 OU) before his appintment and thought all was fine. Ironically, the gentleman found the RX supplied to him and showed me the RX supplied to him was -3.50 OU. I contacted the office to inquire about the discrepancy and my call was never returned.

Another interesting fact is that this doc is known for intimidating patients to purchase at their overpriced dispensary and has stamped on his RX "Not responsible for eywear orders filled elsewhere." I cringe everytime I have to call this place because unless you are putting money in their pocket they exhibit an attitude that you are bothering them.

I have developed and exercised a successful business model which has captured many patients from this practice and can't dismiss the idea that it may be an intentional sabotaging of RX's coming to me. However, my biggest concern is compromising patients' vision in the process of giving me a black eye. If indeed this is intentional sabotaging, I believe it is a criminal issue and am considering compiling my evidence for review by our local district attorney's office. Just wondering if anyone else has had a similar situation and how you dealt with it.

**chip anderson** · 03-04-2011, 03:57 PM

Surely you realize that his education and license makes him entirely ethical, you must be mistaken.

**Audiyoda** · 03-04-2011, 04:01 PM

Originally Posted by chip anderson

Surely you realize that his education and license makes him entirely ethical, you must be mistaken.

'Like' Button pushed and bathed in sarcasm :cheers:

**uncut** · 03-04-2011, 04:10 PM

I feel your pain. I, too, have been a victim of optical bullying. I'm not in your country, so different rules apply, but you could start by confronting your aggressor, and state your case. What's he gonna do....refer less people than the zero he refers now? At least you've called him on it.

**GOS_Queen** · 03-04-2011, 05:07 PM

What if you used a trouble shooting form (I used to use one so I could compare glasses 'side by side' when issues arose) but what if you did it ahead of the sale (whenever you saw an Rx come in from that office?) Preemptive strike, of sorts?

**NeGlassesGirl27** · 03-04-2011, 05:13 PM

What if you just made your life easier and stopped taking Dr so and so's RXs??

**Wes** · 03-04-2011, 05:31 PM

Preemptive measures for this office:
At the very least, check the old glasses against the current rx.
Trial frame every rx from said office.
I doubt you'll have a lot of luck as an optician going up against an MD. You might want to just watch all of the rxs from there closely.
One last thought, are you certain this isnt a "techs" fault that the doc should be made aware of?

**Judy Canty** · 03-04-2011, 05:33 PM

Why not schedule a friendly lunch with said doc and talk about it?

**For-Life** · 03-04-2011, 09:33 PM

Remember, ODs and MDs have an ethics course, so they are always ethical. Opticians do not, so they are always unethical.

(no one take this personally. This is what one former poster used to hint at).

**chip anderson** · 03-04-2011, 10:19 PM

Don't know about everywhere but I was told that at the University of Mississippi School of Medicine, ethics hasn't been taught for 15 years. Now the School of Law Still has the course, go figure.

Chip

**jefe** · 03-04-2011, 10:24 PM

There are a couple of offices in my area from which I seem to get a lot of bad rxs. There are problems with what I get from one office about 50% of the time. I am certain to neutralize any glasses worn by people with a prescription from that office. I have to make many calls to clarify issues I see.

I'm presently dealing with another office which is doing its best to make it seem as though I did something wrong. They sent back a form asking me to re-check the PD; oh, they just also happened to slip in an rx change with a 30 degree axis change on a -1.25 cyl. *******s!!

Interesting how I typed the word *******s, but the letters were automatically deleted.

**cocoisland58** · 03-04-2011, 10:24 PM

A phone call to verify the Rx might work. "I am calling to verify Mr. F's Rx, could you please read it to me?"

**Wes** · 03-04-2011, 11:56 PM

Originally Posted by chip anderson

Don't know about everywhere but I was told that at the University of Mississippi School of Medicine, ethics hasn't been taught for 15 years. Now the School of Law Still has the course, go figure.

Chip

Yeah I thought ethics classes were pretty much standard for most medical professions. Maybe not. Of course, I took calculus, and I don't remember a thing of that, so... Will a "course" really matter compared to the person's character?

**CNG** · 03-05-2011, 02:25 PM

Make sure you document everything and that you have a case of continous errors. Send a certified letter as a warning. Next is to go to the BBB and raise a complaint. Lastly fire a letter to the to his state board and his professional association. Lastly make a deal with your refractionist to offer a free refracton at no charge and you absorve the cost with a good verbal explanation of why why you are doing so and lastly refuse to see his patients.

CNG

**chip anderson** · 03-05-2011, 03:48 PM

Remember: No matter what you do, if you do anything you won't be getting any more Rx's from his office good or bad. He will stay in practice. If his peers say anything, they will just say that's what old Bob got in trouble over a while back.
You need to decide whether you would rather have his work with the occasional error or whether you are willing to live without him entirely.

RT · 03-05-2011, 07:36 PM

Sounds like the real loser in this situation is your lab, who eats remakes while you and this office can't communicate.

**Judy Canty** · 03-05-2011, 07:43 PM

Yup.

**pseudonym** · 03-05-2011, 08:18 PM

The doc's handwriting probably doesn't resemble typical Arabic numerals. I finally quit chasing after my doc in the hall to find out what the Rx was supposed to be when I figured out that a left leaning 8 is a 4. Her 2s are 5's and her 0's look like 1's with no hole.

**walleye** · 03-06-2011, 02:55 PM

I have the same problem with local MD multi doctor office. When I see a suspicious axis change or a decreased add for an older patient I quickly re-refract them and then SHOW THEM with trial lenses over their Rx what the MD prescribed and what I am finding. The reaction is astonishing. Thank goodness it does not happen too often and works the best when I have seen the patient in the past and they wandered away and come back because "I take their insurance" for the glasses. ARRGGHH.

**idocbrent** · 03-06-2011, 06:28 PM

This was a drug Rx? Then what? I think both the pharmacy and the patient would be VERY angry, OR, the patient could get hurt by the wrong medication. Its NOT the same thing, true, BUT, its CLOSE......ethics should be part of this picture, but patient safety should be paramount. I know a few MD offices(and a few OD offices) that do the same thing. ITS JUST NOT RIGHT.......:angry:

**chip anderson** · 03-06-2011, 07:37 PM

In this case you will always find that one follows the golden rule: "He who has the gold rules."
The doctor has all the power, all the gold and all the political and professional clout. He's gonna win, there are many that will not even speak to a mear technician on the phone now. David might have slew Gloliath but the hired help never slays the doctor.
It's been done once or twice but a lot of time an money was involved and the rulings against the doctor were a tender slap on the wrist and no lasting teeth were applied to the result.
Think very long and hard before you pull the tiger's tail.

Chip

**idocbrent** · 03-06-2011, 07:49 PM

Chip.....that's so true. BUT in the long run, I've found over the years that lies have a way of coming back at you HARD. The truth is just that, and more than "sets you free" also can go back to again, and again, and no one is hurt, and no one gets a slap on the wrist or worse. You could loose a patient(a doc who used to "push the envelope" would tell me) if you DON'T relay the incorrect script, but I've found you not only angered that patient ultimately, and would loose them, or have some legal consequences. Who needs all that aggravation? If someone wants to go to another optical, I look it as their right to do so. If they're happy with the new optical, and with you(their doc), they'll come back. And they'll refer. That's how a practice is made, I think. Pharmacies and medical docs have known this for a long time. Your thoughts?:bbg:

**kcount** · 03-06-2011, 07:51 PM

Its times like these that I'm happy to be in the wild west of optics. A screwy Rx comes in, I trial frame, if patient complains I 'refine' the Rx. Simple.

20+ years I have never had an OD or MD come back and yell at me.

**chip anderson** · 03-06-2011, 08:13 PM

I'm just sayin' the words: "Doctor you're wrong." are the most foolish thing an optician can say. With the better ones you can make points, but a little subility never hurts.
Take it from a man that was anything but subltle and at war with the world for probably forty years.
With a doctor that is "out to get you and anyone else that he feels he is getting a dollar he could have gotten his hands on." You have a BB gun and he's got a tank.
Now if a patient comes in with a pair of minus glasses and an Rx, I'm not saying don't call and ask if they failed to cross the sign. And if the patient suddenly has a 40 degree change in axis, or a three diopter change in cylinder, ask. But as far as open confrontation or insinuating that you may be smarter on a particular point, don't.
And if the doctor gets huffy and says: "Fill it the way I wrote it." I fill it the way he wrote it, even if I feel certian it ain't gonna work. He might know something I don't and he won't be near as PO'd on the remake if I was nice.

Chip

**fjpod** · 03-07-2011, 06:13 AM

These wild Rx shifts that seem to be the topic here are endemic in doctors offices that are not terribly refraction minded. They typically use technicians to refract, who do nothing more than look at the auto-refraction tape and "refine" it. They know nothing about how these readings can be skewed by small pupils, early cataracts, and the like. These practices have never had to "eat glass" (as we used to say before there was CR39), due to silly errors in refraction. And they don't care a lick if you do.

Chip,I don't imagine you would be willing to change at this stage in your career, but you really should adopt a business model that is less dependant on getting referrals from the almighty OMD.