How would you handle this?

**mrmac** · 01-28-2016, 01:16 PM

A woman came in today and she was very upset. She purchased her first progressives from me and was having difficulty adapting. She went back to her opthamologists office and this is what they wrote on the new rx...
" Today our optician"s measured this pts glasses and they said there is no reading segment in these glasses. Please remake"

1 Laser marking were difficult to see
2 Upon putting them in the lensometer, it was clear that they ARE progressive
3 They dispense glasses
4 They changed rx to increase total reading power by 3/4 diopter

I brought the patient into the lab to show her on the auto-lensometer that they were indeed progressive, and now she is ticked at doctor

I called the office to ask who wrote the note, only to have the office manager accuse me of being rude

**BigGuy** · 01-28-2016, 01:28 PM

Do you depend on this ophthalmologist's office for prescriptions? If so tread lightly. They do not like to be called out on mistakes. You've shown the patient that they are indeed progressive. I'd also show her the 2 prescriptions, side by side so she can see that the Dr did make a change in Rx. As long as she understands the error was not yours I wouldn't take it any further. Just my 2 cents.

**mrmac** · 01-28-2016, 01:33 PM

BigGuy, I already did what you suggested. As far as depending on prescriptions, he is my biggest competitor.

**Lelarep** · 01-28-2016, 02:31 PM

Shows you how good their people are if they can't even tell if something is a progressive or not... They can't be much competition.

**mervinek** · 01-28-2016, 03:21 PM

An optician should be able to tell if it is a progressive without seeing the markings! (even without the lensometer!)

**Uncle Fester** · 01-28-2016, 03:34 PM

I feel your pain!!!

You wind up wondering if they're under pressure to make us look bad. If I see this from them I'll do the same thing. (But less rudely.)

**Paul Smith LDO** · 01-28-2016, 03:35 PM

It might serve a better purpose to schedule an appointment with the Doc, bring the lenses in and quickly demonstrate to the Doc exactly how to mark up, neutralize, and identify the lens. I had a similar experience with an ophthalmology practice and their tech was not up on FF PAL designs. Initially they were bent out of shape but I explained to them, that in lieu of me telling the patient that the OMD staff was under qualified, it might be prudent to meet and have a professional dialogue.

**chaoticneutral** · 01-28-2016, 04:15 PM

Originally Posted by BigGuy

Do you depend on this ophthalmologist's office for prescriptions? If so tread lightly. They do not like to be called out on mistakes. You've shown the patient that they are indeed progressive. I'd also show her the 2 prescriptions, side by side so she can see that the Dr did make a change in Rx. As long as she understands the error was not yours I wouldn't take it any further. Just my 2 cents.

Truth is the ultimate defense

**jc17777** · 01-28-2016, 04:55 PM

If he is your biggest competition and is throwing you under the bus. Then I would have just shown the patient that there was a change to the rx and that you did your job correctly in the first place. Word of mouth goes a long way

**Robert Martellaro** · 01-28-2016, 05:32 PM

Moral to the story- don't let a general ophtho surgeon troubleshoot your work. Tell your clients to come see you first if they need follow up service.

It's likely that the .75 D bump in add power is bogus. Post the RXs and include the client age. Note the PAL design, and if variable, include the fitting height as well as the distance to the bottommost part of the lens at the near reference point.

**himmeroo** · 02-02-2016, 10:45 AM

Don't make a big hoop-de-doo about it. Just remake the lenses in the new rx. They don't want to admit they made a mistake so they point the finger at you. Over time people will figure out who knows what their talking about and who does not.

**rbaker** · 02-02-2016, 11:19 AM

As the medical and retail eye care business gets dumber and dumber and greedier and greedier we will see a lot more of this monkey business. Problem is, there ain't no referee. Who screwed the pooch; the doctors office or the optician. You have a choice here and one of you is going to come out the chump.

**smallworld** · 02-02-2016, 02:07 PM

One of my patients gets glasses from me, but has an outside doctor. Six months after getting his VSP glasses, he had a stroke, and a new prescription. We did a no-charge warranty. A month or so later, he came in with a new prescription, saying the doctor had made a mistake on her prescription but had told him we would replace the lenses at no charge. I carefully explained that his insurance only covers one prescription remake at no-charge. He insisted the outside doctor had told him we would redo the lenses at no charge due to her mistake. I told him he could ask her to redo the lenses if she made a mistake, but we had already used his warranty.

The next day I received a call from the outside clinic asking me to do a "professional" courtesy and remake the lenses at no charge. I restated that the VSP one time remake had already been done, and that we would be charged full price for the remake, which I had explained to the patient. Then the person who called me said, "By the way, I'm the office manager, and I find your attitude and tone abrasive. "

After the call , I myself called the patient to verify that they understood the insurance policy. The patient said, "yeah, but the other office said they would call you to get you to do another remake at no charge".

Moral of my story: Get your glasses at the same place you get your exam.

**rbaker** · 02-02-2016, 02:29 PM

More of the monkey business that I refer to. You not only have to bow down before the doctor you have to kowtow to an insurance company. I wonder what's next.

**Mizikal** · 02-02-2016, 02:46 PM

I would remake them but I would explain the RX change warranty. I would also try and point out they were made correctly and were in fact PALs but try to did it professionally and without finger pointing.

SmallWorld That is why you always get your information from the horses mouth. I have trained all my doctors and techs to tell the patients to ask me directly . I would also never make assumptions about another businesses policies. I might state they might remake them but would always direct them back to the business for a definitive answer.

**brandonlef** · 02-02-2016, 04:24 PM

Originally Posted by mrmac

BigGuy, I already did what you suggested. As far as depending on prescriptions, he is my biggest competitor.

I think your professionalism and showing the px indeed the correct lens was made should be enough to ease her mind. And what does an Opthalmologist have an Optician working at their practice for?

**brandonlef** · 02-02-2016, 04:33 PM

Originally Posted by smallworld

One of my patients gets glasses from me, but has an outside doctor. Six months after getting his VSP glasses, he had a stroke, and a new prescription. We did a no-charge warranty. A month or so later, he came in with a new prescription, saying the doctor had made a mistake on her prescription but had told him we would replace the lenses at no charge. I carefully explained that his insurance only covers one prescription remake at no-charge. He insisted the outside doctor had told him we would redo the lenses at no charge due to her mistake. I told him he could ask her to redo the lenses if she made a mistake, but we had already used his warranty.

The next day I received a call from the outside clinic asking me to do a "professional" courtesy and remake the lenses at no charge. I restated that the VSP one time remake had already been done, and that we would be charged full price for the remake, which I had explained to the patient. Then the person who called me said, "By the way, I'm the office manager, and I find your attitude and tone abrasive. "

After the call , I myself called the patient to verify that they understood the insurance policy. The patient said, "yeah, but the other office said they would call you to get you to do another remake at no charge".

Moral of my story: Get your glasses at the same place you get your exam.

Which lens manufacturer do you use? We use Nikon and they'll take just about anything back within 120 days. Write it off as Dr. change as per their policy?

**Uncle Fester** · 02-02-2016, 04:36 PM

Originally Posted by brandonlef

I think your professionalism and showing the px indeed the correct lens was made should be enough to ease her mind. And what does an Ophthalmologist have an Optician working at their practice for?

Becoming common here. Get ready for it North of 49 and elsewhere. Vertical integration.

**Lelarep** · 02-02-2016, 11:51 PM

My OMD has an optician in-house.

**smallworld** · 02-03-2016, 01:31 PM

Originally Posted by brandonlef

Which lens manufacturer do you use? We use Nikon and they'll take just about anything back within 120 days. Write it off as Dr. change as per their policy?

I had already done a one time prescription change for this patient. VSP only allows one prescription change in the first six months. The second prescription change was more than seven months from the original purchase. So there was no warranty left on this pair of glasses.

**Paul Smith LDO** · 02-03-2016, 02:03 PM

Originally Posted by smallworld

One of my patients gets glasses from me, but has an outside doctor. Six months after getting his VSP glasses, he had a stroke, and a new prescription. We did a no-charge warranty. A month or so later, he came in with a new prescription, saying the doctor had made a mistake on her prescription but had told him we would replace the lenses at no charge. I carefully explained that his insurance only covers one prescription remake at no-charge. He insisted the outside doctor had told him we would redo the lenses at no charge due to her mistake. I told him he could ask her to redo the lenses if she made a mistake, but we had already used his warranty.

The next day I received a call from the outside clinic asking me to do a "professional" courtesy and remake the lenses at no charge. I restated that the VSP one time remake had already been done, and that we would be charged full price for the remake, which I had explained to the patient. Then the person who called me said, "By the way, I'm the office manager, and I find your attitude and tone abrasive. "

After the call , I myself called the patient to verify that they understood the insurance policy. The patient said, "yeah, but the other office said they would call you to get you to do another remake at no charge".

Moral of my story: Get your glasses at the same place you get your exam.

Fragmented care is a reality and here to stay. Put a call into VSP and let them have that conversation with their member. Bottom line, the policy is that of the VCP, not yours, and certainly not the office were the refraction originated from. Let VSP's customer service handle it; if there is a benefit to taking these plans that would be one.

**Chris Ryser** · 02-03-2016, 02:38 PM

Originally Posted by brandonlef

Which lens manufacturer do you use? We use Nikon and they'll take just about anything back within 120 days. Write it off as Dr. change as per their policy?

There are no freebies in the manufacturing world, and if they say so, they have a percentage of returns/replacements calculated into their selling price.

**smallworld** · 02-03-2016, 03:04 PM

p.s. why wouldn't an ophthalmologist have an optician?

**Barry Santini** · 02-04-2016, 07:15 AM

Look: ask any B&M retailer that has a generous return policy what their return rate is. I have. For example, at the Nordstrom's where I shop on LI, the men's Dept salespeople all agree that, of $100,000.00 in sales, 15,000 to 17,000 will come back/be exchanged for *whatever* reason. So it is reasonable to expect the same of the transactions optical does. When I review this metric for me, it reveals about 15% of all unit sales will be returned/exchanged for whatever reason.

If someone tells you otherwise, like lens companies who say return rate is lens than say 7%, they're simply not grounded in the reality of retailing.

B

**wmcdonald** · 02-04-2016, 07:51 AM

Originally Posted by smallworld

One of my patients gets glasses from me, but has an outside doctor. Six months after getting his VSP glasses, he had a stroke, and a new prescription. We did a no-charge warranty. A month or so later, he came in with a new prescription, saying the doctor had made a mistake on her prescription but had told him we would replace the lenses at no charge. I carefully explained that his insurance only covers one prescription remake at no-charge. He insisted the outside doctor had told him we would redo the lenses at no charge due to her mistake. I told him he could ask her to redo the lenses if she made a mistake, but we had already used his warranty.

The next day I received a call from the outside clinic asking me to do a "professional" courtesy and remake the lenses at no charge. I restated that the VSP one time remake had already been done, and that we would be charged full price for the remake, which I had explained to the patient. Then the person who called me said, "By the way, I'm the office manager, and I find your attitude and tone abrasive. "

After the call , I myself called the patient to verify that they understood the insurance policy. The patient said, "yeah, but the other office said they would call you to get you to do another remake at no charge".

Moral of my story: Get your glasses at the same place you get your exam.

So in your opinion, every independent Optician should simply close? Some do not have an OD, or other provider and depend on the outside Rxs. As an Optician yourself should be aware of this issue. In the not-to-distant past, it was the goal of every Optician to open their own office, and while I know that independent Opticians are being slowly eliminated, there are still a number that are in business and doing well. I have spent my career defending this wonderful breed, and have a different take. I feel that every OD should not dispense what they prescribe, and like pharmacies, Opticians should handle that function. How about that?