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Thread: I'm not a dick. I'm just cranky.

  1. #1
    What's up? drk's Avatar
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    I'm not a dick. I'm just cranky.

    Or maybe I am a dick.

    If I get one more call from Costco or Warby because their McTicians can't fill my Rxs, I'm going to go nuclear, yet again.

    Nth case in point:
    I get a call from a patient (a physician, no less) because Warby "can't fill your Rx because you prescribed in increments that they can't use. They use 'quarters'. I was wondering if you can (insert some stupid euphemism for change which I don't remember) YOUR Rx."

    So I call Warby Brick and Mortar Inc.:
    "No we can only fill 1/4D."
    "Do you not have licensed opticians on staff?"
    "We do."
    "Is this not within ansi tolerances, anyway?"
    "We only fill 1/4D steps".
    "Well, then, I only write in 1/8D steps, and I'm not 'adjusting' the prescription so you can fill it to your randomly-chosen, dumbed-down standards."


    I'm sure cheap-o Warby is going to sell the patient some lame lens, but what if they tout some stupid digital design with 0.1 D accuracy on surfacing? POINTLESS. What if Warby or Costco or WalMart decide they only like 1/2D steps? Then what?

    What if the online CL suppliers "only supply the 8.4 Acuvue Oasys"? Then am I supposed to deal with that crap, too?

    Fill...my...damn...prescriptions...and...quit...calling...my ...office.

    Or,

    Choose...whether...you...want...your...vision...care...from. ..your...optometrist...or...a...website.


    (And don't get me started about the "we don't make computer glasses from prescriptions...call your doctor to write one"!)

  2. #2
    Master OptiBoarder OptiBoard Silver Supporter
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    Quote Originally Posted by drk View Post
    Or maybe I am a dick.

    If I get one more call from Costco or Warby because their McTicians can't fill my Rxs, I'm going to go nuclear, yet again.

    Nth case in point:
    I get a call from a patient (a physician, no less) because Warby "can't fill your Rx because you prescribed in increments that they can't use. They use 'quarters'. I was wondering if you can (insert some stupid euphemism for change which I don't remember) YOUR Rx."

    So I call Warby Brick and Mortar Inc.:
    "No we can only fill 1/4D."
    "Do you not have licensed opticians on staff?"
    "We do."
    "Is this not within ansi tolerances, anyway?"
    "We only fill 1/4D steps".
    "Well, then, I only write in 1/8D steps, and I'm not 'adjusting' the prescription so you can fill it to your randomly-chosen, dumbed-down standards."


    I'm sure cheap-o Warby is going to sell the patient some lame lens, but what if they tout some stupid digital design with 0.1 D accuracy on surfacing? POINTLESS. What if Warby or Costco or WalMart decide they only like 1/2D steps? Then what?

    What if the online CL suppliers "only supply the 8.4 Acuvue Oasys"? Then am I supposed to deal with that crap, too?

    Fill...my...damn...prescriptions...and...quit...calling...my ...office.

    Or,

    Choose...whether...you...want...your...vision...care...from. ..your...optometrist...or...a...website.


    (And don't get me started about the "we don't make computer glasses from prescriptions...call your doctor to write one"!)
    Come on Doc. I'm usually on your side but get over it. You know you write in .12ths just to irritate the on liners.

  3. #3
    What's up? drk's Avatar
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    90% of my patients are going into my optical, how am I going to know who's going to fragment their care and who's going to let me finish the job?

    I don't KNOW which patients are going to flake out!

    So..with all the nth degrees of digital design, POW, AR coating for maximum acuity, am I supposed to dumb it down for the 10% that are shopping? I think not.

  4. #4
    Master OptiBoarder rbaker's Avatar
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    From one Dick to another, how about notating PD's in furlongs and frame sizes in fathoms.That would really frost their pumpkin.

  5. #5
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    And I thought I was the cantankerous one... Get 'em Doc! lol...

    FWIW; I've always given out PD's when customers asked.... until recently. Now, I politely explain that the PD is a measurement that I use my expertise to obtain and I use it to make your glasses correctly. I further explain that I'm not interested in "Helping you order your glasses online" which is exactly what I'm doing if I give you the measurements obtained in MY office.

  6. #6
    Master OptiBoarder optical24/7's Avatar
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    Man doc, I wish I owned the pharmacy you use, they must be getting rich refilling your BP meds!

    1. 90% retention rate? Celebrate! Roll a fatty! Break open a bottle of Ripple! Heck, go all in and get a case of Busch beer and share with staff! That’s really good compared to what I see in many offices. You’re doing something right, congrats!

    2. You personally answer these random dumb calls?.....Why?.......Don’t you have staff more than capable to answer these simple questions? “ Well hi Mr. Warby! Oh, the doctor only prescribes in 1/8ths. He suggests that locations that can’t fill an Rx as prescribe should refuse to fill...”

    3. Do you slap puppies if they have an accident indoors? (Ah..don’t answer that. Never incriminate yourself on a public forum ). All doctors, in all fields, have patients that don’t take their doctors advice. And yes, they return to these same doctors with the same complaints or new issues because they did not follow the doctors order. That 2nd visit is your opportunity to let them know they “ didn’t follow my plan of treatment”. .... They are your “puppies “. Don’t swat ‘em on the nose, educate them. ( I’ve read peeing a little on the newspaper gives puppies a smell and incentive to do the same...oh, sorry to going off topic...j

  7. #7
    What's up? drk's Avatar
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    The beatings will continue until morale improves. Ok I get your point. Don’t punish the idiot patients.

    What’s so difficult about 1/8 diopter? Phoroptors have those lenses. Trial lens sets have that power.

    Is it because some POS optical software doesn’t have a complete drop down list of sphere powers?

    To Dick Baker: it’s not like I’m prescribing-0.12 DC X 134.5 with a +2.12 add and 0.7^@271 degrees. This is hardly esoterica. I’m clearly not throwing out roadblocks. You’d think these numbnuts just got hired from selling gym shoes and their bosses are not even optical people. Oh, yeah.

    Why should I have to deal? The answer is: “Fill our prescriptions as written or don’t. I don’t get paid to do your job.”

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    I'm really impressed that you test and prescribe that way - I wish I could convince our optometrists to do the same.

    You're basically correct in all your reasoning so don't change for those idiots (the WP crowd).

    Hold your head high.

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    Quote Originally Posted by Don Gilman View Post
    Come on Doc. I'm usually on your side but get over it. You know you write in .12ths just to irritate the on liners.
    And I'm sure he's one of those that regularly prescribes quarter cyls in 0.12D and says the patient notices the difference.

  10. #10
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    Quote Originally Posted by Lab Insight View Post
    And I'm sure he's one of those that regularly prescribes quarter cyls in 0.12D and says the patient notices the difference.
    From now on let's just refer to him as Richard the XII.

  11. #11
    Master OptiBoarder CCGREEN's Avatar
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    When the glasses quit slipping on peoples nose then I will join the band wagon with the Rx's wrote in 12th power and the glasses being ground to the 0.24 of the quarter power. When the glasses slip we all know that vertex changes the power and can do it tremendously, then all your tight fine measurements mean nothing to the patient and its just a warm fuzzy for the refactor.
    Digital equipment may of made the process of making glasses faster and more easy, the computer for sure has taken out the thought process for the Optician. They only know to do what the computer said to do.They have no idea hat it or even how to manually figure power, curves, prisms, thickness, how much materiel to remove much less how to trouble shoot a manufacturing problem or even a visual problem the patient may have with their new high tech digitally processed glasses.
    I have said nothing about how much all the new manufacturing equipment has driven up the cost of a pair of glasses, just not even going to go down that road today.

  12. #12
    Master OptiBoarder AngeHamm's Avatar
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    If you're prescribing in 1/8 diopters where every single other prescribing doctor they work with does 1/4, I'm kind of on their side. You're massively increasing their cost of goods by removing stock SV lenses as an option for a marginal, if not nonexistent, benefit.
    I'm Andrew Hamm and I approve this message.

  13. #13
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    If you're fitting glasses perfectly, and selling high quality customised lenses, an 8th of a diopter difference is relevant.

    Why should he change his philosophy and principles for the benefit of another business?

    DrK, you MUST write a script for your secretary/customer service team on how to answer these calls explaining to the Px why you write prescriptions in this way... You will win back a few customers if you do.

  14. #14
    What's up? drk's Avatar
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    Quote Originally Posted by AngeHamm View Post
    If you're prescribing in 1/8 diopters where every single other prescribing doctor they work with does 1/4, I'm kind of on their side. You're massively increasing their cost of goods by removing stock SV lenses as an option for a marginal, if not nonexistent, benefit.
    Boo hoo.

    I'm NOT saying that 1/8 of a diopter matters very much, typically.

    In fact, few can see the difference.

    But, if I refract carefully (when it is called for) and they see a difference, what am I to do?
    a. Give them the exact power they see best with?
    b. Decide "well, this patient may walk. And that darn cost of goods for Warby Parker...Let me overminus or overplus a teensy, just in case"?


    My point is that I don't want idiots calling my office asking me to change my prescription to fit their limitations. Not my problem, and they can't make it my problem. Grow a pair, Warby et al.

  15. #15
    What's up? drk's Avatar
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    Thanks Robert S.

    I think I'll just say (and it applies to CL onliners and increasingly, retail pharmacies and mail-order pharmacies and their frenemies, the health insurances) "Please fill the Rx as written. No substitutions. Thank you."

    Do you know how time-wasting it is to clean up everyone else's mess? I have my own mess to deal with.

  16. #16
    What's up? drk's Avatar
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    Quote Originally Posted by Lab Insight View Post
    And I'm sure he's one of those that regularly prescribes quarter cyls in 0.12D and says the patient notices the difference.
    And I'm sure your dopey lab is one of those that touts the accuracy of their house brand progressive...and how my patients will see the difference...

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    Quote Originally Posted by drk View Post
    Thanks Robert S.

    I think I'll just say (and it applies to CL onliners and increasingly, retail pharmacies and mail-order pharmacies and their frenemies, the health insurances) "Please fill the Rx as written. No substitutions. Thank you."

    Do you know how time-wasting it is to clean up everyone else's mess? I have my own mess to deal with.
    A script for answering these queries would save you the time.

  18. #18
    Master OptiBoarder OptiBoard Silver Supporter lensmanmd's Avatar
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    Quote Originally Posted by drk View Post
    Boo hoo.

    I'm NOT saying that 1/8 of a diopter matters very much, typically.

    In fact, few can see the difference.

    My point is that I don't want idiots calling my office asking me to change my prescription to fit their limitations. Not my problem, and they can't make it my problem. Grow a pair, Warby et al.
    Every. Single. LMS. Has the ability to calc 1/8D. Every. Single. One.

    How to confuse Mcticians: Provide the refracted VD and have them calculate the as worn RX based on fitting VD.

    BTW, I will sub 1/4D increments for 1/8D RXs when FSV can be used. Why? B/C I know how.

    Just tell me that you won’t prescribe a Plano -.12! I can name a few ODs.
    I bend light. That is what I do.

  19. #19
    One eye sees, the other feels. OptiBoard Gold Supporter
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    Quote Originally Posted by rbaker View Post
    From one Dick to another, how about notating PD's in furlongs and frame sizes in fathoms.That would really frost their pumpkin.
    Eighths and a little base in or out prism to sink their apprentice teeth into, when appropriate.

    Quote Originally Posted by optical24/7 View Post
    Man doc, I wish I owned the pharmacy you use, they must be getting rich refilling your BP meds!

    1. 90% retention rate? Celebrate! Roll a fatty! Break open a bottle of Ripple! Heck, go all in and get a case of Busch beer and share with staff! That’s really good compared to what I see in many offices. You’re doing something right, congrats!

    2. You personally answer these random dumb calls?.....Why?.......Don’t you have staff more than capable to answer these simple questions? “ Well hi Mr. Warby! Oh, the doctor only prescribes in 1/8ths. He suggests that locations that can’t fill an Rx as prescribe should refuse to fill...”

    3. Do you slap puppies if they have an accident indoors? (Ah..don’t answer that. Never incriminate yourself on a public forum ). All doctors, in all fields, have patients that don’t take their doctors advice. And yes, they return to these same doctors with the same complaints or new issues because they did not follow the doctors order. That 2nd visit is your opportunity to let them know they “ didn’t follow my plan of treatment”. .... They are your “puppies “. Don’t swat ‘em on the nose, educate them. ( I’ve read peeing a little on the newspaper gives puppies a smell and incentive to do the same...oh, sorry to going off topic...j
    +1, including the case of beer and fatty.
    Roberts Optical Ltd.
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    www.roberts-optical.com
    ~~~~~~~~~~~~~~~~~~
    Science is a way of trying not to fool yourself. - Richard P. Feynman

  20. #20
    What's up? drk's Avatar
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    Lensman, that's all I'm askin'. Keep me out of it.

  21. #21
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    Quote Originally Posted by drk View Post
    Or maybe I am a dick.

    If I get one more call from Costco or Warby because their McTicians can't fill my Rxs, I'm going to go nuclear, yet again.

    Nth case in point:
    I get a call from a patient (a physician, no less) because Warby "can't fill your Rx because you prescribed in increments that they can't use. They use 'quarters'. I was wondering if you can (insert some stupid euphemism for change which I don't remember) YOUR Rx."

    So I call Warby Brick and Mortar Inc.:
    "No we can only fill 1/4D."
    "Do you not have licensed opticians on staff?"
    "We do."
    "Is this not within ansi tolerances, anyway?"
    "We only fill 1/4D steps".
    "Well, then, I only write in 1/8D steps, and I'm not 'adjusting' the prescription so you can fill it to your randomly-chosen, dumbed-down standards."


    I'm sure cheap-o Warby is going to sell the patient some lame lens, but what if they tout some stupid digital design with 0.1 D accuracy on surfacing? POINTLESS. What if Warby or Costco or WalMart decide they only like 1/2D steps? Then what?

    What if the online CL suppliers "only supply the 8.4 Acuvue Oasys"? Then am I supposed to deal with that crap, too?

    Fill...my...damn...prescriptions...and...quit...calling...my ...office.

    Or,

    Choose...whether...you...want...your...vision...care...from. ..your...optometrist...or...a...website.


    (And don't get me started about the "we don't make computer glasses from prescriptions...call your doctor to write one"!)
    I can fill your .12D all day at Costco....why the hate?

  22. #22
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    Quote Originally Posted by lensmanmd View Post
    Every. Single. LMS. Has the ability to calc 1/8D. Every. Single. One.

    How to confuse Mcticians: Provide the refracted VD and have them calculate the as worn RX based on fitting VD.

    BTW, I will sub 1/4D increments for 1/8D RXs when FSV can be used. Why? B/C I know how.

    Just tell me that you won’t prescribe a Plano -.12! I can name a few ODs.
    Ill grab my vistometer and measure +/- from the standard 12mm all day if need be. Let me get my McABO hat on....

  23. #23
    What's up? drk's Avatar
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    I hate Costco because they're a cult. I have patients that are members of Cultco, and they take their contact and glasses Rxs to their Temple to fill.

    Doesn't matter if they go out of network to do so.
    Doesn't matter if my stuff is better.
    Doesn't matter if my stuff is priced similarly.
    Doesn't matter if they just looooovee me (and don't seem too impressed with the OD Wizard at the Temple) but I'm not going to be here for them, at this rate.

    Then, the Priests and Priestesses of the Altar of Optical call my office, and want me to make a Sacrifice of my prescribing accuracy, or make an Offering of a free computer lens design for them, because it's obviously against their Religion to be independent thinkers.

    Hey, I get it. Tom Cruise and John Travolta worship at Costco. They're famous, and it's glamorous to rub elbows in the mega-Cheetos aisle.

    You've succumbed. But leave me out.

  24. #24
    Master OptiBoarder optical24/7's Avatar
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    Doc, Doc,...You “ Didn’t follow my plan of treatment “...I’m glad you’re back for a second visit..... Remember : 90% capture rate. (Yea!) Independence! Getting to say, “Told ya so!” To pagan purchasing patients...

    Now then, fill the Rx I prescribed, roll a fatty and spring for a 30 pack of Busch Lite. Sit back and know, life is good..

  25. #25
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    "I hate Costco because they're a cult. I have patients that are members of Cultco, and they take their contact and glasses Rxs to their Temple to fill."

    Haha, that's funny. I'm a devout Costcoan. I attend 11am grocery mass every Sunday and then stop for a poutine at Resto. But at least here in Ontario, the opticians are as qualified as anywhere else. Any RO here would never bother to call you. I'd just fill to the nearest quarter. And I'd probably round down in 90% of cases. BUT I respect any 8th measured Rx and when I did my final inspection, I'd take it into consideration when deciding whether to pass the order or not. To hell with those unlicensed online retailers. Don't change, drk. (I don't work at Costco)
    Last edited by Warrior; 10-01-2019 at 08:57 PM.

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