Legal to say "prescribing" certain lenses?

[luvely]

Hi all, just had a question as a new optometrist.

I'm currently employed at an optical and my boss talked to me after returning from Vision Expo West that we should be saying in the exam room and when we hand off patients to the optical that we are "prescribing anti glare, blue light blocking lens, ect."

To me that doesn't sound very legal..? I talked to her again and asked her to consult with the other doctor that works here first because I discussed with my friends and they don't think it sounds very legal.

I don't mind educating patients on the benefits of such products, which I already do in the exam room, but I don't feel comfortable saying I am prescribing so and so, when it's not a medical thing.

I also don't want to clash with my boss.

Any advice would be appreciated. Especially if you've had any similar experience to this.

Thanks very much!

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[catzeye523]

I'm not sure if making that statement is "legal"...but I would agree with you in terms of feeling uncomfortable with using that word, "prescribe". I was in a very similar situation as yourself 3 years ago. I was on a conference call with other managing ODs and our regional, and she said "I don't want to hear the word, 'recommend', ONLY 'prescribe'!" That's the day I realized I couldn't be employed anymore and actually found a position where I could be considered an "independent OD". I hated the idea of someone else (who by the way did NOT go through optometry school to learn about patients' true needs) telling me what to do, and especially telling me what to prescribe! "Prescribe" is a strong word. If you feel that uncomfortable, seriously consider either having that conversation with your boss or looking for work elsewhere. Personally I felt that it was unethical, so that's the reason why I left. Good luck with whatever you decide!

 

[luvely]

I'm not sure if making that statement is "legal"...but I would agree with you in terms of feeling uncomfortable with using that word, "prescribe". I was in a very similar situation as yourself 3 years ago. I was on a conference call with other managing ODs and our regional, and she said "I don't want to hear the word, 'recommend', ONLY 'prescribe'!" That's the day I realized I couldn't be employed anymore and actually found a position where I could be considered an "independent OD". I hated the idea of someone else (who by the way did NOT go through optometry school to learn about patients' true needs) telling me what to do, and especially telling me what to prescribe! "Prescribe" is a strong word. If you feel that uncomfortable, seriously consider either having that conversation with your boss or looking for work elsewhere. Personally I felt that it was unethical, so that's the reason why I left. Good luck with whatever you decide!

Thank you for your reply

I actually did tell my boss just that, that I was fine with talking to patients about the benefits of such products but I didn't feel comfortable saying I was prescribing them.

I had it in mind to go along with it since she displayed some pushback to my comments but when I came out to hand off I couldn't bring myself to say it and just said I recommended it.

She didn't say anything because I have stated talking about products more to patients before judging if they can afford it or not so just a compromise there.

For sure if she had penalized me for not saying I prescribed such and such I don't think I'd be able to stay long out of resentment and unease

 

[KHE]

There's nothing wrong with using the word "prescribe" in those scenarios. Patients come to you to have their problems solved. A "recommendation" will be interpreted by the patient as "meh......I can do this or not."

Also, never, EVER take it upon yourself to judge whether a patient can afford something.

 

[PBEA]

Legal? yes

ethical? mostly no (IMO, there are few exceptions)

The problem becomes when the pt thinks that the "prescription" is a requirement, etc. Lens type is a suggestion. A valid suggestion, but a suggestion nonetheless.
The op's boss (like so many others) is trying to use the authoritative sounding "prescription" to generate higher ticket sales....nothing more.

 

[Commando303]

Hi all, just had a question as a new optometrist.

I'm currently employed at an optical and my boss talked to me after returning from Vision Expo West that we should be saying in the exam room and when we hand off patients to the optical that we are "prescribing anti glare, blue light blocking lens, ect."

To me that doesn't sound very legal..? I talked to her again and asked her to consult with the other doctor that works here first because I discussed with my friends and they don't think it sounds very legal.

I don't mind educating patients on the benefits of such products, which I already do in the exam room, but I don't feel comfortable saying I am prescribing so and so, when it's not a medical thing.

I also don't want to clash with my boss.

Any advice would be appreciated. Especially if you've had any similar experience to this.

Thanks very much!

I feel you are asking about the legality of something because you intuitively are aware the behavior is unethical. And, yes, I'd say it is unethical to "prescribe" the coatings you're mentioning — you may recommend it, but you don't "prescribe" A.R. coating to your patient.

In my view, you may be employed by whomever you are, but the wishes of your boss do not get to supersede your ethical conduct as a provider of clinical care.