doc recommendations vs. rx

[Joann Raytar]

varmint said:
I think the lens type should be the patients informed choice. Sometimes depending on the circumstance the prescribing Dr may need to be called. I always like the same BC recommendation. With todays new aspherics and technologies, I think sometimes its in the Pt's best interest to disregard that recommendation. I agree with Judy's response to this issue.

Good point! For example, a high myope comes in with an Rx for their first progressive and a specific brand is written on the Rx. There isn't much change in the distance Rx. They previously wore 1.67 Index lenses which aren't available in the specified progressive brand. To match the recommended brand would result in a different index, a thicker lens and a bad first impression of progessives before the patient even puts them on.

[JennyP]

aaron said:
1) The expiration date. This is up to the doctor as long as it is at least one year. :shiner: ad

I have one doc office near me that specifies a date 6 months from the exam date! I suspect that this is so the patient will get the rx filled soon after the exam, and any problems can be addressed before the patient's health changes. At least I think this is the reason!

[aaron]

I know that 6 months is OK for CTL Rx's, but the doctor according to Federal regulations cannot have the spec Rx expire before 1 years time.

[Pete Hanlin]

I am very anxious to see some feedback on this issue. First of all, let me say that I have NOT specifically researched this, but over the years I was taught by industry professionals that prescription drugs are controlled substances -- spectacle lenses are not.
You are correct. Spectacle lenses are not considered controlled substances. In fact, even though they are considered "medical devices," they are not considered to be at the same level of- say- a contact lens (which is why contact lenses must gain approval from the FDA for each new design and material and spectacle lenses do not).

In Florida, a neutralization (or an Rx) is required to have the prescriber's name, the patient's name, address, date of Rx, sphere, cylinder, axis, add, and prescribed prism. Since the law does not specify that a prescription must contain a lens type, I would conclude that lens type is not part of the Rx (any more than frame type should be).

Now, if an informed prescriber has taken the time and trouble to research a design that s/he feels comfortable with and recommends it via the Rx- don't be surprised if the prescriber is more than a bit miffed if that recommendation is ignored! However, it would be my personal opinion that such a recommendation is just that- a suggestion that is based upon professional experience.

[harry a saake]

My thoughts, first for those of you who work with a doc, it depends on the working relationship you have. I worked with stopper, who posts on here frequently for over four years. We had a lot of discussions if not one every day, and believe me it was good for all concerned.
.....Normally speaking, if an outside rx comes in with a specific brand, especially varilux, i probably wont pay it too much attention. First reason is varilux over the years has had a misguided attitude towards certain opticians,mainly chain ones, and has refused to be of any help.
.....What i will do is sit down with the patient, and do an assesment of thier needs. With over 150 different progresives on the market place, there is plenty of choice. This is no different then docs who use private label brand contacts, and while there is no choice there, there is with the glasses. I have even seen rx,s with a note on them, patient needs a size 9. Whats next, patient has to have ralph lauren?

[Stopper]

Harry,
I sure do miss those daily talks. Hope you are doing well.

I feel that prescribing a specific lens is more of a recommendation. Just like recommending AR or polarized sunlenses. I leave it up to the optician and the patient to decided what is best. On a rare occassion I have recommended a specific lens type or material if the patient is having trouble adapting.( like a patient who has been wearing cr39 forever and is now trying poly but noticing chromatic abberations)And if I do this I try to let the optician know my reasoning and it usually isn't a problem. Keep the patients best interest inmind and you will rarely have a problem.

[chip anderson]

Harry:

Is size 9 a dress size? I am really courious what Varilux's uncorrected attitude is?

Stopper:
Very good answer.

Chip

[harry a saake]

The size thing is a lenscrafters gimmick where they put on the potential patient, what looks like an over sized boley guage, and if i remember right you get a reading between 6 to 13, the patient is then told to go look for those size frames. The frames have labels on them saying what size they are.
.....Varilux, the wrong attitude is they will not help anybody who works for a chain. They will NOT send in a rep to tell you about the latest, or how to measure for them or anything else. As far as i,m concerned thats wrong and it is highly stupid. But i can live without varilux as there are plenty of superior lenses on the market.

[Pete Hanlin]

Harry,

Sorry to hear about your negative experiences with Varilux. All I can offer is in the past month I've traveled to two chain facilities to offer technical assistance and training on processing and measuring of all lenses. I'm headed to another chain facility this week.

Still, I've worked for chains myself and can appreciate what you are saying. Coincidentally, there are retail account managers who work specifically with Essilor's retail customers. Have you tried contacting one of them for information?

[Susan Henault]

I understand that today doctors might specify a brand on the rx for different reasons than they did years ago, but I think it is worth while to consider how the practice got started in the first place ...

... "Varilux", when there actually was a company by that name, had its sales professionals train the independent doctors to specify the Varilux brand on the prescription in an attempt to influence the consumer to purchase Varilux brand lenses from the private practitioner. At the time, this strategy had a little more impact because the chains did not have the access to Varilux brand lenses that they have today. Even so, chain store professionals would talk to patients about other options, rendering the habit ineffective overall. You know what they say, "Old habits never die" (just like bumping the add a quarter if the patient wants a progressive instead of a bifocal - but that's another thread :)).

QUALIFIER: I am not implying that Essilor of America sells Varilux brand lens blanks directly to chains. But considering that some chain stores now have Varilux/Crizal brand products on their retail price list, they must also have consistent, hassle free suppliers of these products.

[harry a saake]

Susan, yes most of the chains have it available, but you have to aparently pay more for it, since it has to come from another lab, an approved lab i believe the terminlogy is, thus we have to sell them at a very high price.
.....Pete, all i can tell you is that every time i called, i got the same answer.

[Pete Hanlin]

Next time you need an answer, please feel free to email me at the address provided in my signature. I will try my best to get you what you require. Sorry you've had trouble getting answers in the past.

I've also done a bit of research into Brand Consultants and chain locations. Several chains have expressly requested that we not send representatives into the stores, since purchasing decisions are made corporately.

(Speaking of which, I am still trying to ascertain Crizal-ability of Shamir products, Susan- I haven't forgotten!)

[Susan Henault]

Pete:

I'm really glad that you mentioned the issue of retail chain relations with manufacturer's reps. I thought about bringing it up, but didn't want to raise an issue that might only apply to one or two chains. My understanding is that in an effort to get the lowest possible price, some chains actually negotiate with venders to keep reps away. The point being, if the chain can commit to effectively reduce the vender's cost of doing business with them, then the vender can afford to drop their price even more. I know this is along somewhat different lines than you mentioned. The truth is, there are as many factors involved as there are venders and potential customers out there.