The PD Battle Has Begun

[drk]

If they are still determined to try online they will do it with or without the endorsement. Personally, I'll be banking on them not being as satisfied with their decision to go *anywhere* else. I want the door open for their return, not left with a perception that I'm not here to really help them (you know,the greedy ECP, in their eyes). I've seen it many, many times over the years with other B&M's around me, and I'm worried about a faceless computer? The best way for your patients to appreciate what you bring to the table is to let them sample service/products/knowledge elsewhere.

As far as #2, I know, for you, it's not about the competition. It's about the ethics of delivery that online lacks. But the facts are, online isn't going away and our government will not be stepping in to stop them. If they step in it will most certainly not be in a way you would like. To my knowledge there is not a study published on safety of the public from wrongly made eyewear. If such a study is possible British Columbia would be a great start since they've de-regulated eye wear. But can you imagine, if they find no dead bodies in the street? We very well could be de-regulated as well.

Some people may think I'm greedy, but I defy anyone to interact with me or my staff for a short time and think we're out for our own interests. If someone is worried about the "greedy" charge sticking to them, then maybe someone should re-double their efforts and re-analyze how they do business. We are advocates. We are professionals. Yes, we charge a fee, but how can we be greedy? By selling stuff a patient doesn't need? By overcharging? By overpromising and underdelivering? We don't do that.

We don't know what the future will hold regarding regulation. It's ridiculous to suggest that anyone does. Self-fulfilling prophecies do occur, though, and, dammit, we are the eye care professionals, aren't we? I know we're used to grabbing the ankles a lot, these days, but let's not get cowed or cynical. Man up. We have a public to serve.

[optical24/7]

Greedy ECP's aren't my words Doc, it's in tons of posts by consumers in the comment section of the OP's source. And I'll admit my views may be different than some others here, mainly because still, to this day I have not been asked to take or give out a PD or any info to order glasses elsewhere.

[drk]

Well, I would presume you are not a greedy *******. In fact, there are relatively few of them in our industry; most of us are very professional. What an outrageously defamatory thing for essilor and Warby et al to perpetrate. But they do, so they can make money the unethical way.

Patients aren't without blame for being so gullible, and a vast Leslie Stahlian conspiracy about how we're all getting rich off the backs of the public one job at a time is pathetic and laughable, especially if they'd check out the cars we're driving. She's looking for a story, and these onliners are trying to justify their low prices so their stuff doesn't look like cheap crap. Hence, the "greedy middlemen ECPs". Yeah, that's it. Cut them out. And don't feel bad about doing shady stuff on the internet, because we'll supply you with the moral justification.

[fjpod]

In this scenario, if the patient has paid the optician to measure his or her PD (through, at the very least, the purchase of eyewear in which this cost has been factored), this might be the case. However, if the patient has not paid for this service, which is often the case for those planning to make an online eyewear purchase, how could the FTC or any other federal agency require the optician to work for free?

Best regards,
Darryl

I was only referring to the case where the optician had the information in their files from a previous encounter. I don't envision opticians being forced to measure a PD for free or a fee...although, a few states have adopted the rule that a PD must be included on the prescription. So, optometrists are already being forced to provide PDs as part of their exam and Rx...whether the patient purchases eyewear from them or not.

What goes around, comes around.

[Darryl Meister]

although, a few states have adopted the rule that a PD must be included on the prescription.

I wonder whether this is the result of Independent Optometry's decreasing interest in optical dispensing. Optometry has managed to secure TPA and DPA certification in every state through legislation, and glaucoma treatment in quite a few. I would find it surprising that they were unable to block such a requirement, if they had aggressively pursued it.

Best regards,
Darryl

[Stan Tabor]

I was just looking at a website for a retailer in the UK. Has an online pd measurement tool.

[Traci]

Hmm. If you are a doctor's office, why not just do the measurement on everyone, and add the fee on the exam charges as a usual and customary fee. If you are an independent optician, how about charging a fee on everyone's bill as a customized measurements fee. In many cases we are using digital lenses which use PD + VD, panto, and wrap measurements. Just make a separate charge line for the customized measurements. No more should we incorporate the measurement as part of the glasses purchase, but its own fee. Then, it would truly be the patients, and not complimentary, and you get paid every time whether or not the patient requests it. Just my thoughts.

[chuckbednarik]

Not sure how many ophthalmologists have commented, but to me, and I'm sure to the vast majority of ophthalmologists, the PD is not part of the prescription, and never will be...I don't take it, and I won't take it. It isn't what I was trained to do, although I was briefly instructed on how to do it. Just like surgery, if it's not something you regularly do, don't do it, or you'll end up getting yourself in trouble and harming the patient. It's the job of the optician, and that's what I tell the rare patient who asks for it. I explain that they can go to any optical shop they want, and for the specs to be made, the optician will take all the necessary fitting measurements. It is a fitting measurement, not a refractive measurement. If they choose to purchase online, they are in essence becoming their own optician, and they are responsible for any errors.

[Happylady]

I give the PD if requested, my company wants me to.

I wish I could give it in inches rather then mm!

[Fezz]

PD measurement?

You better bet that I give them out!

Where should I start?

Parkinson's disease
peritoneal dialysis
Paget disease
palladium
Pancreas divisum
pancreatic duct
panic disorder
Parkinson disease
pars distalis
personality disorder
phase difference
Pick disease
poorly differentiated
postural drainage
preferred direction
prism diopter
progression of disease
progressive disease
protein degradation
proton density
pulmonary disease
pupil diameter
Pupillary Distance
pyloric dilator
Pyrimidine dimer
interpupilllary distance
paddle
Paget disease of bone
Paget's disease
Paget's disease of bone
paired domain
pancreas disease
pancreatic diabetes
Pancreaticoduodenal
pancreaticoduodenectomy
pancreatoduodenectomy
Panhypopituitary Dwarfism
panic disorders
papilla diameter
papular dermatitis
Paracoccus denitrificans
paralyzing dose
parental ditype
parkinsonian dementia
parkinsonism-dementia
Parkinson's disease patients
Parkinson's disease with dementia
Parkinson's disease without dementia
Parkinson's diseases
paroxysmal discharge
paroxysmal discharges
partial deficiency
partial denture
partially dependent
passive diffusion
patent ductus
patient day
Patient-Days
Pattern Deviation
PDte
pediatricians
penetration depth
percentage difference
percentage dissatisfaction
perceptive deafness
percutaneous device
Percutaneous devices
percutaneous discectomy
percutaneous drain
Percutaneous drainage
Perfusion defect
perfusion defects
perinatal death
Perineal descent
periodic disease
periodontal disease
periodontal diseases
periodontitis
perioral dermatitis
peritoneal dialysate
peritoneal dissemination
peritoneal drainage
peroxides
perphenazine decanoate
persistent defect
persistent defects
Persistent diarrhea
persistent diarrhoea
personal database
personality disorders
personality-disordered
Peyronie's Disease
pharmacodynamic
pharmacodynamics
Phosducin
phosphate dehydrogenase
phosphate depletion
phosphate dextrose
phosphodiester
phosphodiesterase
phosphorus depletion
photodetection
photodiagnosis
Photodissociation
Photoreceptor dysplasia
photosensitivity dermatitis
Physical Database
physical development
Pick's disease
pirfenidone
piribedil
PK-pharmacodynamic
plasma defect
plasma density
plasma desorption
plasma-derived
plasmodesmata
plastid-dividing
pneumatic dilatation
Pneumatic dilation
pocket depth
pocket depths
Polistes dominulus
polydextrose
PolyDypsia
PolyDypsic
polymeric diet
population doubling
population doublings
positive deviance
posterior deltoid
posterior descending
posterior descending artery
posterior descending coronary artery
posterior division
postnasal drainage
postnatal day
postnatal days
Postpartum Day
postpartum depression
Postprandial dip
Potential derived
potential differences
power densities
power Doppler
power of definition
power of discrimination
Predicted Differences
predilatation
prednisolone
prednisone
Pregnancy Diagnosis
premature delivery
Prenatal diagnosis
Prenatal diagnostics
prescribed dose
prescription dose
presenile dementia
present disease
pressor dose
pressure-diameter
Preterm delivery
primary dysmenorrhea
primidone
prism diopters
prism dioptres
Prisoner's Dilemma
probable disease
Probing depth
probing depth reduction
Probing depths
problem drinker
problem drinking
prodynorphin
progestin-dependent
programmed death
progressed
progressing disease
progression disease
Prolidase deficiency
proliferative disease
protease domain
protein deficient
protein deposition
protein deprivation
protein deprived
protein diet
protein digestibility
proton density-weighted
protopanaxadiol
provocation dose
proximal-distal
proximodistal
pseudodeficiency
psychiatric disorders
psychological debriefing
psychological distress
psychotic depression
pulse duplicator
pulsed diastolic
pupillary diameter
pupillary distance, peritoneal dialysis
purine derivatives
putidaredoxin
P-wave dispersion
pyloric diameter
pyridinoline
pyridostigmine
pyridostigmine bromide
pyrimidine dimers


That's all I have to say about that!

[chuckbednarik]

PD measurement?

You better bet that I give them out!

Where should I start?

Parkinson's disease
peritoneal dialysis
Paget disease
palladium
Pancreas divisum
pancreatic duct
panic disorder
Parkinson disease
pars distalis
personality disorder
phase difference
Pick disease
poorly differentiated
postural drainage
preferred direction
prism diopter
progression of disease
progressive disease
protein degradation
proton density
pulmonary disease
pupil diameter
Pupillary Distance
pyloric dilator
Pyrimidine dimer
interpupilllary distance
paddle
Paget disease of bone
Paget's disease
Paget's disease of bone
paired domain
pancreas disease
pancreatic diabetes
Pancreaticoduodenal
pancreaticoduodenectomy
pancreatoduodenectomy
Panhypopituitary Dwarfism
panic disorders
papilla diameter
papular dermatitis
Paracoccus denitrificans
paralyzing dose
parental ditype
parkinsonian dementia
parkinsonism-dementia
Parkinson's disease patients
Parkinson's disease with dementia
Parkinson's disease without dementia
Parkinson's diseases
paroxysmal discharge
paroxysmal discharges
partial deficiency
partial denture
partially dependent
passive diffusion
patent ductus
patient day
Patient-Days
Pattern Deviation
PDte
pediatricians
penetration depth
percentage difference
percentage dissatisfaction
perceptive deafness
percutaneous device
Percutaneous devices
percutaneous discectomy
percutaneous drain
Percutaneous drainage
Perfusion defect
perfusion defects
perinatal death
Perineal descent
periodic disease
periodontal disease
periodontal diseases
periodontitis
perioral dermatitis
peritoneal dialysate
peritoneal dissemination
peritoneal drainage
peroxides
perphenazine decanoate
persistent defect
persistent defects
Persistent diarrhea
persistent diarrhoea
personal database
personality disorders
personality-disordered
Peyronie's Disease
pharmacodynamic
pharmacodynamics
Phosducin
phosphate dehydrogenase
phosphate depletion
phosphate dextrose
phosphodiester
phosphodiesterase
phosphorus depletion
photodetection
photodiagnosis
Photodissociation
Photoreceptor dysplasia
photosensitivity dermatitis
Physical Database
physical development
Pick's disease
pirfenidone
piribedil
PK-pharmacodynamic
plasma defect
plasma density
plasma desorption
plasma-derived
plasmodesmata
plastid-dividing
pneumatic dilatation
Pneumatic dilation
pocket depth
pocket depths
Polistes dominulus
polydextrose
PolyDypsia
PolyDypsic
polymeric diet
population doubling
population doublings
positive deviance
posterior deltoid
posterior descending
posterior descending artery
posterior descending coronary artery
posterior division
postnasal drainage
postnatal day
postnatal days
Postpartum Day
postpartum depression
Postprandial dip
Potential derived
potential differences
power densities
power Doppler
power of definition
power of discrimination
Predicted Differences
predilatation
prednisolone
prednisone
Pregnancy Diagnosis
premature delivery
Prenatal diagnosis
Prenatal diagnostics
prescribed dose
prescription dose
presenile dementia
present disease
pressor dose
pressure-diameter
Preterm delivery
primary dysmenorrhea
primidone
prism diopters
prism dioptres
Prisoner's Dilemma
probable disease
Probing depth
probing depth reduction
Probing depths
problem drinker
problem drinking
prodynorphin
progestin-dependent
programmed death
progressed
progressing disease
progression disease
Prolidase deficiency
proliferative disease
protease domain
protein deficient
protein deposition
protein deprivation
protein deprived
protein diet
protein digestibility
proton density-weighted
protopanaxadiol
provocation dose
proximal-distal
proximodistal
pseudodeficiency
psychiatric disorders
psychological debriefing
psychological distress
psychotic depression
pulse duplicator
pulsed diastolic
pupillary diameter
pupillary distance, peritoneal dialysis
purine derivatives
putidaredoxin
P-wave dispersion
pyloric diameter
pyridinoline
pyridostigmine
pyridostigmine bromide
pyrimidine dimers


That's all I have to say about that!

Most of these, when given out, lead to litigation.

[Wes]

PD measurement?

You better bet that I give them out!

Where should I start?

Parkinson's disease
peritoneal dialysis
Paget disease
palladium
Pancreas divisum
pancreatic duct
panic disorder
Parkinson disease
pars distalis
personality disorder
phase difference
Pick disease
poorly differentiated
postural drainage
preferred direction
prism diopter
progression of disease
progressive disease
protein degradation
proton density
pulmonary disease
pupil diameter
Pupillary Distance
pyloric dilator
Pyrimidine dimer
interpupilllary distance
paddle
Paget disease of bone
Paget's disease
Paget's disease of bone
paired domain
pancreas disease
pancreatic diabetes
Pancreaticoduodenal
pancreaticoduodenectomy
pancreatoduodenectomy
Panhypopituitary Dwarfism
panic disorders
papilla diameter
papular dermatitis
Paracoccus denitrificans
paralyzing dose
parental ditype
parkinsonian dementia
parkinsonism-dementia
Parkinson's disease patients
Parkinson's disease with dementia
Parkinson's disease without dementia
Parkinson's diseases
paroxysmal discharge
paroxysmal discharges
partial deficiency
partial denture
partially dependent
passive diffusion
patent ductus
patient day
Patient-Days
Pattern Deviation
PDte
pediatricians
penetration depth
percentage difference
percentage dissatisfaction
perceptive deafness
percutaneous device
Percutaneous devices
percutaneous discectomy
percutaneous drain
Percutaneous drainage
Perfusion defect
perfusion defects
perinatal death
Perineal descent
periodic disease
periodontal disease
periodontal diseases
periodontitis
perioral dermatitis
peritoneal dialysate
peritoneal dissemination
peritoneal drainage
peroxides
perphenazine decanoate
persistent defect
persistent defects
Persistent diarrhea
persistent diarrhoea
personal database
personality disorders
personality-disordered
Peyronie's Disease
pharmacodynamic
pharmacodynamics
Phosducin
phosphate dehydrogenase
phosphate depletion
phosphate dextrose
phosphodiester
phosphodiesterase
phosphorus depletion
photodetection
photodiagnosis
Photodissociation
Photoreceptor dysplasia
photosensitivity dermatitis
Physical Database
physical development
Pick's disease
pirfenidone
piribedil
PK-pharmacodynamic
plasma defect
plasma density
plasma desorption
plasma-derived
plasmodesmata
plastid-dividing
pneumatic dilatation
Pneumatic dilation
pocket depth
pocket depths
Polistes dominulus
polydextrose
PolyDypsia
PolyDypsic
polymeric diet
population doubling
population doublings
positive deviance
posterior deltoid
posterior descending
posterior descending artery
posterior descending coronary artery
posterior division
postnasal drainage
postnatal day
postnatal days
Postpartum Day
postpartum depression
Postprandial dip
Potential derived
potential differences
power densities
power Doppler
power of definition
power of discrimination
Predicted Differences
predilatation
prednisolone
prednisone
Pregnancy Diagnosis
premature delivery
Prenatal diagnosis
Prenatal diagnostics
prescribed dose
prescription dose
presenile dementia
present disease
pressor dose
pressure-diameter
Preterm delivery
primary dysmenorrhea
primidone
prism diopters
prism dioptres
Prisoner's Dilemma
probable disease
Probing depth
probing depth reduction
Probing depths
problem drinker
problem drinking
prodynorphin
progestin-dependent
programmed death
progressed
progressing disease
progression disease
Prolidase deficiency
proliferative disease
protease domain
protein deficient
protein deposition
protein deprivation
protein deprived
protein diet
protein digestibility
proton density-weighted
protopanaxadiol
provocation dose
proximal-distal
proximodistal
pseudodeficiency
psychiatric disorders
psychological debriefing
psychological distress
psychotic depression
pulse duplicator
pulsed diastolic
pupillary diameter
pupillary distance, peritoneal dialysis
purine derivatives
putidaredoxin
P-wave dispersion
pyloric diameter
pyridinoline
pyridostigmine
pyridostigmine bromide
pyrimidine dimers


That's all I have to say about that!

Could the measurement for Peyronie's Disease be given as radius of curvature? Also, I didn't see Pelvic Diameter listed. Why the oversight?

[huskypaul]

Not sure how many ophthalmologists have commented, but to me, and I'm sure to the vast majority of ophthalmologists, the PD is not part of the prescription, and never will be...I don't take it, and I won't take it. It isn't what I was trained to do, although I was briefly instructed on how to do it. Just like surgery, if it's not something you regularly do, don't do it, or you'll end up getting yourself in trouble and harming the patient. It's the job of the optician, and that's what I tell the rare patient who asks for it. I explain that they can go to any optical shop they want, and for the specs to be made, the optician will take all the necessary fitting measurements. It is a fitting measurement, not a refractive measurement. If they choose to purchase online, they are in essence becoming their own optician, and they are responsible for any errors.

Amen, I have had patients bring me a prescription with a PD assigned, for arguments sake let us say Mr Doe has 30/30. When taking my own IPD measurement via their corneal apex reflex, I come up with 33.0/33.5. Am I too Assume that the prescribing Dr is using a different tool, they want horizontal prism, the patient has been accustomed to the OC set this way, is the RX for near, is it the method they use or is it my method for taking IPDs. Who's do I use and who is responsible. Thus begins the circle of life.

[LandLord]

If someone put a gun to your head and told you to dig your own grave, would you do it? Not me. I'd dive for the gun and try to shoot the guy. Then I'd dig his grave.

Online retailers got successful by first breaking the rules. Why would you follow a new rule that was made up to accommodate them?

Charge a $100 PD measurement fee or no deal.

[MakeOptics]

If someone put a gun to your head and told you to dig your own grave, would you do it? Not me. I'd dive for the gun and try to shoot the guy. Then I'd dig his grave.

Online retailers got successful by first breaking the rules. Why would you follow a new rule that was made up to accommodate them?

Charge a $100 PD measurement fee or no deal.

Comprehensive eye exams cost less at some offices, how could anyone possibly justify charging $100 for a simple measure.

[fjpod]

I do believe some states require the PD as part of the Rx. It is a small minority, but I suspect it will grow. Not sure if it is required of ODs and OMDs. Perhaps someone from those states can elaborate.

[Barry Santini]

I think it's time to restate a sentiment I find increasingly attractive:

Just de-class eyewear as a medical device. It's already at the bottom of the lowest risk class now, so a small nudge shouldn't be a big political deal. And OTCs and online delivery of Rx eyewear have already shown no evidence of coughing up bodies. Today, at the dawn of OTC, user-adjustable "Rx" eyewear, it really makes no sense to continue to regulate this product category. Exams yes. Eyewear no.

So with eyewear no longer regulated, the whole suite of PD/Rx/EHR/compliance/Insurance issues simply evaporates. No longer do private eyewear stores have to deal with business-busting dog****. As eyewear margins are heading downward anyway, I can't see where such a change would make the pricing dynamics free market change in any significant way.

Zenni already defines the bottom. There'd still be a quality hierarchy, linked to price.

A simple solution. I say don't resist it. In fact, you shoud lobby for it.

B

[optimensch]

I agree with Barry.... deregulation is the way to go. The simplest reason is that people are increasingly making eyewear purchases online, with or without a PD measurement from a professional. People are even shipping their old glasses to an onliner to "duplicate" the Rx.
At the same time real professional establishments are being handcuffed by regulators (here in Quebec it is forbidden for anyone other than a licensed OD or optician to handle even the simplest frame adjustment) in a manner that simply keeps costs high and further drives people to onliners. it makes no sense.
The next frontier will be unregulated online eye exams delivered by the likes of Zenni. But let's leave that for another thread...
you want your pd? there is an app for that anyway -

[Christopher]

You are not going to stop advances in technology. The pace of change continues to accelerate. The eyewear industry has largely been late to the game with respect to changes brought about by e-commerce and consumer based technology applications. You can adopt an attitude of "glasses are special, you need personal measurements, they are medical devices, blah blah blah" and refuse to innovate. Ultimately you will get wiped out.

Consolidation in the eyewear industry was inevitable. It happens in virtually ALL INDUSTRIES. As an example, when cars were first invented, there were literally hundreds of auto manufacturers. Ford and later GM and Chrysler drove innovation and you had the big three. Same thing happened in radio and TV.

If you think the same was not going to inevitably happen in eyewear, you have not learned from history. Mature businesses consolidate. In the lab business, you now have E, Z, and H. In frames, you have Lux, Saf, and Marchon. You can make the same lists for optical retailers and insurance companies. Any little guy who wants to compete in a mature industry is a niche player and better do one thing very well. Embracing a new technology can be your ticket to success.

So get beyond worrying about PDs and start thinking about the future of your business.

This is the smartest thing I've read yet in this thread....