Patients asking for PD's to order online...what do you do?

[m0002a]

m002a, you don't think that a personal injury lawyer would eat everyone in the food chain for lunch if there were a product liability tort or personal injury tort, from the prescriber to the optician to the seller to the laboratory? They would indeed.

You're being a little too reasonable, sir. You must not understand what happens out there in this world.

Talk to a malpractice attorney sometime and see what they think.

I certainly agree that personal injury lawsuits are out of control, and I favor tort reform.

But given that ECP's are already required by law to give out the Rx, are there seriously going to be lawsuits for when a patient gets a PD from ECP, orders online using that PD, and does not like the end product from online optical?

I understand that there are crazy consumers out there who want to blame anyone they can for their own bad decisions, but I just think that in the case of PD's the potential problem is being blown out of proportion. But I am not advocating that a PD be supplied for free, and if you don't want to give it out because you think you will lose business, that is OK with me.

[drk]

I'm not giving it out, NOT BECAUSE I CARE ABOUT MONEY, but because I care about good eye care.

Online ain't it.

If you have different standards of risk tolerance and professional responsibility, that's your prerogative.

[m0002a]

I'm not giving it out, NOT BECAUSE I CARE ABOUT MONEY, but because I care about good eye care.

Online ain't it.

If you have different standards of risk tolerance and professional responsibility, that's your prerogative.

Just because the patient has the PD (in addition to the Rx) doesn't mean they will be purchasing online eyewear. I always compare my previous Rx and PD from previous exams whenever I get a new one.

Like I said, giving out the PD pales in comparison to giving out the Rx in terms of the concerns you raised about standards of risk tolerance and professional responsibility.

[drk]

Yes, but since I'm obligated to give out the Rx, what am I gonna do? I sure would like to control the treatment plan that I prescribe, but it's been wrested from me.

Why would I pour gas on that?

[CNG]

Opticians and dispensing optometrists do not work for free..but since we are part of the health care, we should be compensated accordingly for our time. Our leaders shall start making the ground for a new CPT code for the fitting and a cpt code for adjustment.

I think this is what Barry keeps pushing for...

The fitting of eyeglasses shall require the trial frame of the written prescription for each distance that it is intended for including all measurements. By doing so the patient benefits because they can personally see how they will see at distance, intermediate and near as well as getting the correct PDs and counseled in beneficial coatings and designs to enhance the eyewear. Follow Up shall include the verification and adjustment of eye wear. Every one wins...the consumer gets his PD and knows what he should be getting. Opticians continue to do business as usual but have an ethical way to provide the PD and keeps them in the loop. Non dispensing optometrists and ophthalmologists are off the hook of providing a measurement that in reality is not part of the eye exam but of the dispensing optician or dispensing optometrist.

The time is now before the big players integrate online into their business plans without oversight. Remember there is a frame company going online, A vision discounting plan going online and there is a lens manufacturer going online...online eyeglasses may rule but they still need the pd and suggest their buyers to use us for free in selection, adjustment and repair. We do not work for free.

CNG

[Hayde]

Why is the patients who ask me for PD measurements have at least 4 diopters of spherical correction or 2D prism OU?


*

I see two basic attitudes of approach to the issue--One is to embrace the internet and glide gracefully into the new age (and try to look professional and genial doing it.) The other is to be risk averse about participating in that "new age's" growing pains for the sake of professional caution.

I for one side with risk aversion.

If memory serves, "Duty to Warn" came about due to a lawsuit here in the Lone Star state. We can dismiss the merits of any potential suit over PD and be justified in doing it. But at the end of the day, I don't want to have my toe anywhere near it whenever/wherever it goes down. Being right can be just as expensive as being wrong. Either way, not the publicity I want. Yes, the possibility is remote...but the thought experiment IS a good gut check about your philosophy of patient care.

Had planned to charge for PD measurements, but I just don't want to invite post-purchase drama. Sure, I could look at Zennis-gone-bad like a sales opportunity--but let's face it: I'm on the complete other half of the market as an internet shopper. If experience dissuaded them from internet glasses, their next step up is the corporate optical "2 pair for $50!" Sure it's a step in the right direction, but I'm going to land so few of those disgruntled internet shoppers after their specs turned out bad it's just not a labor-effective strategy to loop myself in that far down on the customer's learning curve. The internet shopper who drank the koolaid of the internet's negative advertizing against us brick-n-morters is going to suspect we sabatoged the PD anyway just to land the sale. (If you think I'm being ridiculous, I'd respond with all due respect--you haven't met NEARLY enough of these kids.) Since they're going to malign my motives anyway, I'd much rather them write me off as having sharp elbows by refusing to provide PD measurement than using my wizardly powers to sabotauge their $7 specs like a Luddite.

I consider myself like the sorting hat in Harry Potter. Since I've accepted I can't be all things to all patients, I'll take my part of the market that likes one-stop shopping, trusts their docs, and/or has the saavy to detect I'm worth the price. I don't chase the rest. They have a learning curve ahead of them--and they'll know my value only on the other side of it. If they're happy with their $7 pair, then great. All hail Competition. Two years later when the $7 thing goes wrong, they learn their lesson and go to McGlasses. Maybe I'll see 'em a few years after that.

I'm not sailing gracefully into validating new competion, nor shall I participate in the pageantry that eye care is reliably accomplished by mystery men in phone banks. Instead, I like the fact the competion's growing pains continue to be my best source of advertizing.

To answer the OP:

"We do take PD measurements for the glasses we make and take responsibility for. Some opticals will charge you a fee to just take your PD so you can get them done elsewhere, but to be honest we'd rather not take the money--just avoid being in the loop of glasses that don't turn out right and the patient has to wonder where in the proccess something went wrong." (It sounds better than it reads.)

It is difficult to decline a patient who's already bought glasses from me! But if I did my sales cycle as well as I should, then there's enough rapport for them to understand me and respect my position. If not, then we're back to 'sorting hat' and I've done my job that the glasses they bought from me are the best ones they ever had and still will be after they try the competition.

[Happylady]

Half the opticians I work with take the PD and put it on the prescription they give the patient. I don't, but if I'm asked for it I take it and write it as a total PD, not mono. I am rarely asked.

[Fred Dagg]

I am not advocating online eyewear purchases, nor advocating self PD measurements. But I did express my opinion that if a patient used a PD provided by a B&M ECP during an online purchase, it is unlikely that the patient could blame the B&M ECP if patient not satisfied with the eyewear.

Since you apparently did not supply the PD to previous patient who purchased online, I don't understand what your story has to do with anything I said, or why you would make personal attacks me.

You've got hold of the wrong end of the stick. My post was not intended to follow on from yours, and the mild term of abuse was directed at the pt, not you.

Thanks mods, I will endeavour to keep my language above reproach in the future.

[Paul Smith LDO]

You Kiwis are a brash lot, picking on the sensitive Yank's, shame on you. Now then, lets talk about the America's Cup and 8 Wired Imperial Stout.

[DazeyReign]

I know this is a Hot Button issue and there are good points all around. Frequently, we see return buisness from disenchanted online buyers. If we have it on file or the time to take it, we usually do. The conversation usually goes thusly:

"Your PD is 29.5/30. See you next year."

And we usually do, for an in office purchase.

In our area Coastal gave a free pair of glasses to all of our Hospital employees last year. Results? Cracked drill mounts, poor fits, unusable segs, and SALES for us. Frequently chorused with "That was the dumbest thing I've ever done."

[Chris Ryser]

In our areas l Coastal gave a free pair of glasses to all of our Hospital employeeast year. Results? Cracked drill mounts, poor fits, unusable segs, and SALES for us. Frequently chorused with "That was the dumbest thing I've ever done."

This whole thread has become such boring item with the continuous hitting of the on-line opticals and that they will all die soon because of the bad quality they are supplying.

I have been watching their website rankings for the last few years, and their rankings are going only one way ........................and that is UP.

Up..................... means only one thing, that the public interest is still mounting after quite few years in business. There are glasses sold in the multi millions and still going up, and OB members are talking about them going away soon because their quality stinks.

When are opticians going to wake up to the facts that by doing nothing instead of finding a solution to live with the facts and maybe even make some money doing, it instead of treating them as a minor disturbance.

[Robert_S]

When are opticians going to wake up to the facts that by doing nothing instead of finding a solution to live with the facts and maybe even make some money doing, it instead of treating them as a minor disturbance.

Because the majority of people on here run practices that aren't influenced by online. I know you struggle to deal with that concept, but within the market, as with ANY market, there are customers who want the best and customers that want the cheapest... we lost the ones who want the cheapest to the multiples some time ago, and whilst we don't take any business for granted, our customers are generally loyal because we give them reason to be.

[optical24/7]

I'm sure the executives at Breyer's and other ice cream makers are kept up at night, worrying about the thousands of ice cream trucks cruising neighborhoods, playing come hither, enticing music, stealing their customers! You know, I've got a lot of other things to worry about other than online.

[Chris Ryser]

... we lost the ones who want the cheapest to the multiples some time ago, and whilst we don't take any business for granted, our customers are generally loyal because we give them reason to be.

You know, I've got a lot of other things to worry about other than online.

This year they are going for an increase of 10% in sales which would amount to adding another
2 million pairs sold to the 22 million sold last year....................so we better worry about other things than on-line opticals.

[buckeyedr]

In my state, our state board of optometry states that the PD is part of the prescription so that we must give it out along with the prescription. We do that and take the opportunity to talk to patients about how vital measurements are to eyewear and the odds that their online eyewear may not match those measurements.

[Chris Ryser]

In my state, our state board of optometry states that the PD is part of the prescription so that we must give it out along with the prescription. We do that and take the opportunity to talk to patients about how vital measurements are to eyewear and the odds that their online eyewear may not match those measurements.

With Essilor being the highest single owner of most large optical labs in North America as well the highest single owner of the larger on-line opticals as well as their supply industries, I would bet that their production and quality control is the same as it has always been = top notch.

Furthermore all the other on-line opticals that might have supplied other than top notch quality will now be forced to keep up with their quality concept in order to compete.

Less costly retail prices will not be a valid quality issue anymore since " hail to the glory of Essilor " has been sung right here on OB for the last 14 years and is on the records.

If PD measurements are wrongly given they will be supplied wrong by any optical in this world, and can not be blamed for it.

So the blame for any faulty PD give to the on-line opticals will backfire soon to their source.

This continuous issue on wrong PDs by on-line suppliers will also result into the faster development
of good and valid do it yourself ways to produce a valid system of doing it.

Time will tell.

[drk]

In my state, our state board of optometry states that the PD is part of the prescription so that we must give it out along with the prescription. We do that and take the opportunity to talk to patients about how vital measurements are to eyewear and the odds that their online eyewear may not match those measurements.

Do you have a link for that? That is certainly news to me.

[drk]

Time will tell.

Time is telling.

My experience is that essilor labs are no better nor worse than other labs. It seems to come down to the lab employees being good at what they do, and giving a crap.

If online contract labs are getting low-dollar, I would think there would be a problem with quality.

[Paul Smith LDO]

Time is telling.



If online contract labs are getting low-dollar, I would think there would be a problem with quality.

As Mr B, Pointed out earlier, if that is all they require for adequate glasses then the consumer should expect nothing less then an "adequate" pair of glasses. For the consumer who is expecting more, the onus falls upon us.

[Den]

Let me tell you my opinion.:)
There's a saying: "If the process can not be stopped, it should be lead".
And while I was reading this thread I was just convinced in that.

At first, why don't you think of any expansion of the web? The part of the online sales will only grow in future, so what's the point in standing out with head held high proudly? I think you risk to stay overboard in future...
Second, maybe it sounds too fantstic, but can you /offline optics/ reach agreement with online retailers? If they'll pay you for writing the right (I think giving a patient wrong PD isn't right, it doesn't show you as a truly specialist) and complete prescription for glasses?
The onliners got the sale, you got your pay for your job, the client has the entire service. Everyone's pleased.:)
However, I guess- second way can be provided only in "Never-Never land". There must past some time, I think, that both of online & offline optics should get the point that they shall not be enemies, but lead partnership.
Sorry couldn't bury this idea inside without sharing it with you.

[globaljp]

We charge $15 to take it. We offer to adjust the glasses and verify the RX when they come in. If they complain about the money I tell them their our online tools to check your PD but it won't be as accurate as mine. I understand glasses are expensive but so is our time. Usually offer them a beer while they wait....:)

[drk]

Well, then, I guess you charge your "paying" customers $15 over wholesale for the same services, too?

Cost + $15 = Retail?

That's ridiculously low for quality control, frame adjustment, and one of several measurements.

[m0002a]

We charge $15 to take it. We offer to adjust the glasses and verify the RX when they come in. If they complain about the money I tell them their our online tools to check your PD but it won't be as accurate as mine. I understand glasses are expensive but so is our time. Usually offer them a beer while they wait....:)

I think if patients realized that the PD is unlikely to ever change once a person reaches about 18 years, that would be a bargain price.

[globaljp]

$15 for 2 minutes....80% don't come back. The person isn't upset leaving and I get $15. I fail to see where this isn't logical. we sell luxury and don't compete with such garbage. We also don't compete with crappy frames either from the Docs office down the street or WP. Its easy for us. WP is great for $100. If the RX is right.....

[mervinek]

I had an interesting one the other day...pt got her glasses online. Rx is about -9.00 sph -2.00 cyl SV. Although the RX was accurate, the pt measured her own pd and used binocular. She ended up scheduling an apt with the OD because she couldn't see with her new glasses. Glasses were made with an OTC reader frame... not adjustable plastic with hinges that had screws that would not be replaced if they should come out. The kind that you would buy in a 3 pack at Costco. The OC was way off and the only way she could see was if she pulled her glasses sideways half off her nose. Even if we had given her Pds, she wouldn't have seen right anyway because of the OC and poor fit of frame. So... I guess I am thinking maybe not such a big deal to hand out Pd (maybe with warning about ordering online). We currently charge in our office. She did ask about her Pd and I told her we charge for that to discourage people from buying online and she had a sudden look of "well I guess now I know why!"