For Practicing Docs: What are your biggest peeves?

[DILLIGAF]

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I thought this would be a fun question to ask, as diversion from the usual 3 meal staple here on SDN (100% simpleton angst, comparison to other professions, am I wasting money). My question to the docs out there, in any field (trolls welcome!) is this: What drives you crazy that OTHER doctors do that you end up having to clean up for? I do not want PATIENT peeves. (this would be very repetitive and have no readership value). So, I guess I will go first.In no particular order....

1) Getting a referral for photopsia, with no adjacent retinal imagery or follow-up of any kind. As in pt came to them, said "I see lights in places where there are no lights", doctor freaks out, sends them to the VA or to my office. And this is NOT just an OD thing....had an OMD "anterior seg specialist" send me a detachment alongside a lattice on a MONOCULAR (!!!!!) patient last month. I saw the pt 2 weeks later after this. Nuff said.

2) Optomaps....God save us from optomaps. A doc sending me a (really blurry and green from lid reflection) photo of something potentially serious.

3) No scleral depression docs; you know who you are. If the idea of putting a little Alcaine on and depressing to see if something flaps around like a ship flag into the vitreous makes you uncomfortable, please go tech somewhere. Makes me crazy.

4) Not checking in the slightest for severe BV issues...I.E. Your pt has convergence insufficiency, is a hyperope, and somehow your +5.00 with +2.00 adds make them vomit into a trash can. (OMD's, this ones a little more on you. My OD colleagues are terrible on #2 and 3) Do a little phoria testing please. Takes 3 minutes. (As an aside, do they TEACH BV in med school? I swear some of the OMD's of my age, 40's and older, are clueless about all of this.)

5) Crown glass. Please stop rx'ing this garbage. I don't care if the patient loves it. They won't love it when it shatters and Seidel signs them. Plus it is heavy and ugly.

6) Last one....and I swear my head starts to explode when I get this (happens at the VA all the time w our older pt base) ok, here goes...PLEASE PLEASE stop sending me everything that has blood somewhere as "proliferative diabetic ret". Half the time it is Eales, IJRT, or one of the million other things. (my favorite was an OD/OMD joint practice that sent me a low grade vitreous heme as proliferative DR. That is like saying "you have a brain tumor" vs "you have a headache") Anyone, from anywhere, of any training level, that sends me a DR diag without doing a glucose test should be sent away to a labor camp. Just awful...

So, I want to know these kinds of peeves that other docs have, so that I make sure I don't do them. Tell me yours. I want to make a good list and put it on my door.

 

[Commando303]

5) Crown glass. Please stop rx'ing this garbage. I don't care if the patient loves it. They won't love it when it shatters and Seidel signs them. Plus it is heavy and ugly.

!

 

[200UL]

1. Can you explain your point for item 1 in more detail.
2. What is with Optomaps? I have never seen/heard of these being used in an OMD office? Why is this form of retinal photography more popular in optometric circles?
6. Not sure of the point here... I think I may agree with you but approximately 60% of the time a vitreous heme is caused by proliferative diabetic retinopathy - therefore it is the safest guess if you know nothing else going on. If the patient actually has diabetes, over 90% of the time there is a vitreous heme, it is a result of proliferative diabetic retinopathy. Again, a nice guess if you know nothing else going on.

Eales disease is very infrequent. JXT RARLEY causes vitreous heme. These would not be even included in my differential of a vitreous heme until an exam is completed and something does not add up. Diabetes is diagnosed based on blood glucose levels (random/possibly HAIC) and not retina findings. Diabetic retinopathy is diagnosed based on retinal findings in a patient with a history of diabetes.

 

[DILLIGAF]

To 200UL

1) I was basically referring to the fact that I have seen many times whereupon a pt is sent to me, complaining of something that is an obvious red flag (flashes, recent onset of large floaters, etc) and the doc that saw the person did NOTHING to investigate. Thus I end up with a pt at the VA with no "urgent" tag, getting a standard 2-3 week wait for a workup, all that may have something that we MIGHT have been able to do something about surgically. This is not really on me as much as it is the OMD's that I am the traffic cop for. I hate to constantly have their frustrations vented to me about the "no idea what that is, here you go" docs that many times make our job harder.

2) I must be clear....the Optomap is a 100% OD thing, and it makes me crazy. Now, it DOES have a purpose; that being as a much quicker more pt friendly fundus view for pt's without any history, perhaps at intervals between actual dilated exams. With this said, it is NOT a very high quality image. All I know is that I saw a pt last Thursday with what was suspected to be a macular hole. I got an Optomap that was garbage and EMR "fundus view" notes that were worthless.(it said, "Lam hole susp" and that was it) No OCT, no real photos, no etiology (pt was 52), and then waited for almost a month to see us. That can't happen....and yes, the OMD's are a million times better about being much more explanatory and giving the right tests. Many times the OD's are used to referring to a certain few people, and we are the backup to the backup, thus we get coded stuff we can't understand.

6) In reading my post, can see where I was ambiguous.....what I mean is that I get a lot of referrals that simply say "PDR", and nothing else has really been done to verify. Many times, these pt's are BOOKED to see an OMD, but the OMD's are constantly bumping them to the OD's to basically say "This diag is probably garbage. Get us something we can use." The retina guys we have there are usually overwhelmed by the "saw blood, must be DR" referrals to the point that we are needed to sift through the laziness. That is why it is probably my #1 peeve. And yes, Eales was just something that came to mind (seen it twice ever, once last winter, and it was sent as PDR even though the pt had a BRVO and hemi-field loss. The OMD that wanted a diag had never seen it, and he is almost 60!) A lot of times we get a default DR diagnosis simply because the patient is older, overweight, and has blood somewhere. This one is pretty equal, no matter who is referring to us.

I would add one more, and it is actually kind of a question for 200UL....

--- Assuming you are a retinal OMD, what do you do if something really nasty on the ant seg side is sent to you? Do you take that still? Do you refer out to a "Ant seg doc"? I say this because I get it from the main OMD I work with daily, that we get OMD referrals from OTHER MD's simply bc it is a recalcitrant case or not in their "tunnel vision". As a disclaimer, I must add that almost ALL of my disease contact throughout my career has taken place in the Veterans' Admin....does it commonly work this way in private hospitals/networks? I would really like to know...Thank you for your comments, and I will try to be more clear.

 

[KHE]

I thought this would be a fun question to ask, as diversion from the usual 3 meal staple here on SDN (100% simpleton angst, comparison to other professions, am I wasting money). My question to the docs out there, in any field (trolls welcome!) is this: What drives you crazy that OTHER doctors do that you end up having to clean up for? I do not want PATIENT peeves. (this would be very repetitive and have no readership value). So, I guess I will go first.In no particular order....

1) Getting a referral for photopsia, with no adjacent retinal imagery or follow-up of any kind. As in pt came to them, said "I see lights in places where there are no lights", doctor freaks out, sends them to the VA or to my office. And this is NOT just an OD thing....had an OMD "anterior seg specialist" send me a detachment alongside a lattice on a MONOCULAR (!!!!!) patient last month. I saw the pt 2 weeks later after this. Nuff said.

2) Optomaps....God save us from optomaps. A doc sending me a (really blurry and green from lid reflection) photo of something potentially serious.

3) No scleral depression docs; you know who you are. If the idea of putting a little Alcaine on and depressing to see if something flaps around like a ship flag into the vitreous makes you uncomfortable, please go tech somewhere. Makes me crazy.

4) Not checking in the slightest for severe BV issues...I.E. Your pt has convergence insufficiency, is a hyperope, and somehow your +5.00 with +2.00 adds make them vomit into a trash can. (OMD's, this ones a little more on you. My OD colleagues are terrible on #2 and 3) Do a little phoria testing please. Takes 3 minutes. (As an aside, do they TEACH BV in med school? I swear some of the OMD's of my age, 40's and older, are clueless about all of this.)

5) Crown glass. Please stop rx'ing this garbage. I don't care if the patient loves it. They won't love it when it shatters and Seidel signs them. Plus it is heavy and ugly.

6) Last one....and I swear my head starts to explode when I get this (happens at the VA all the time w our older pt base) ok, here goes...PLEASE PLEASE stop sending me everything that has blood somewhere as "proliferative diabetic ret". Half the time it is Eales, IJRT, or one of the million other things. (my favorite was an OD/OMD joint practice that sent me a low grade vitreous heme as proliferative DR. That is like saying "you have a brain tumor" vs "you have a headache") Anyone, from anywhere, of any training level, that sends me a DR diag without doing a glucose test should be sent away to a labor camp. Just awful...

So, I want to know these kinds of peeves that other docs have, so that I make sure I don't do them. Tell me yours. I want to make a good list and put it on my door.

My pet peeves......

Arrogant doctors.

 

[DILLIGAF]

Whoa....I have no idea how it is that asking "What things that other docs do drive you crazy?" is automatically arrogant. If there is ONE thing in the entire world that I know for certain I am not, it is arrogant. I just thought it would be kind of fun, not some kind of referendum on everyone's incompetence. Yes, it is a little unnerving to get diags without a BASIC workup to support it. Yes, still seeing crown glass kind of urks me with how far lenses have come since I was a kid. I am not a bomb thrower in the least, and I am certainly not the best doctor I know or probably even close. I mean, is ANY problem that ANY doc has with a general practice among their colleagues arrogance 100% of the time? Am I a self-absorbed jerk because I find it a little disappointing to see pt's that get sub-standard care because of the pressure their original docs were under for time, under-equipped, sometimes worrying about a lease getting pulled? I don't blame the doc near as much as I blame the circumstances they are forced to work under. 99% of anyone called "doctor" out there is a very sharp person that cares very much for their pt's....This is a given....So, am I not allowed to get frustrated about their circumstances and the results it necessitates? Can I not put something funny on my door to make people laugh at some of the bone-headed stuff even "us mighty docs" do?

Either way, the last thing SDN needs is more personal attacks. That was a little heir-trigger....sorry.Jeez, can't even get docs on here to not hatchet job one another....lighten up.

 

[imemily]

What about dealing with customers who refuse to have their rx filled by your optical?

 

[Commando303]

What about dealing with customers who refuse to have their rx filled by your optical?

Why should that be a pet peeve? Doesn't a patient have the right to fill his or her prescription wherever he or she wishes?

 

[nc2tarheels]

Why should that be a pet peeve? Doesn't a patient have the right to fill his or her prescription wherever he or she wishes?

lol, yes, but 99% of docs get pissed to hear someone say "can u make a copy of my rx so i can take it with me". lol

 

[Commando303]

lol, yes, but 99% of docs get pissed to hear someone say "can u make a copy of my rx so i can take it with me". lol

They shouldn't.

 

[KHE]

Whoa....I have no idea how it is that asking "What things that other docs do drive you crazy?" is automatically arrogant. If there is ONE thing in the entire world that I know for certain I am not, it is arrogant. I just thought it would be kind of fun, not some kind of referendum on everyone's incompetence. Either way, the last thing SDN needs is more personal attacks. That was a little heir-trigger....sorry.Jeez, can't even get docs on here to not hatchet job one another....lighten up.

Try re-reading your original posting and see if it comes accross to you as "a little fun" or more like "a referendum on everyone's incomptence."

 

[KHE]

What about dealing with customers who refuse to have their rx filled by your optical?

Here's the thing about that.....

In my office, we don't sell cheap frames. We don't sell cheap lenses. We don't sell low end A/R or progressives.

Now....in the exam room, professional ethics dictate that you treat everyone the same regardless of their income or their insurance plan or whatever. In essence, we almost have to be all things to all people..

But in the optical, you can't do that. You simply can't be all things to all people. So some people will walk out. Would I prefer that every single person got something from me? Probably. But the reality of the situation is that that isn't going to happen and really, it can't happen.

When people want to walk out, we ask where they normally get their glasses or contact lenses from. Most times, we're less expensive than where they want to go.

But certainly there are times where we are not. IN that case, we simply try to take 30 seconds to explain the difference in products. The most common analogy we use is that you can buy a $20 disposable camera at CVS or you can buy a $1000 Nikon camera. We have the Nikon. Sometimes that works, sometimes people only care about price and that's their perogative.

So the moral of the story is, understand that you can't be all things to all people in the optical.

 

[mclem222]

I dont think that post was arrogant at all..this forum should allow us to "keep it real".
My pet peeve are patients who are completely irresponsible with their contacts. Then they come back with an ulcer and tell another doc "Dr Smith never told me not to sleep in them..really I am supposed to replace them after two weeks?...he never said that"

 

[nc2tarheels]

They shouldn't.

That doesn't discount the fact that 99.9% of the time, it happens.

 

[Visionary]

I see KHE's point about calling out other docs, but I thought I'd comment on your specific examples.

1) Getting a referral for photopsia, with no adjacent retinal imagery or follow-up of any kind. As in pt came to them, said "I see lights in places where there are no lights", doctor freaks out, sends them to the VA or to my office. And this is NOT just an OD thing....had an OMD "anterior seg specialist" send me a detachment alongside a lattice on a MONOCULAR (!!!!!) patient last month. I saw the pt 2 weeks later after this. Nuff said.

I see a lot of this, but it's not a pet peeve. Of course, I'm a retina doc.

2) Optomaps....God save us from optomaps. A doc sending me a (really blurry and green from lid reflection) photo of something potentially serious.

Great device, when used correctly. In fellowship, we only used Optos for widefield imaging, including angiography, on dilated patients. Undilated Optos photos are less than worthless.

3) No scleral depression docs; you know who you are. If the idea of putting a little Alcaine on and depressing to see if something flaps around like a ship flag into the vitreous makes you uncomfortable, please go tech somewhere. Makes me crazy.

I see this from ophthalmologists, as well. Part of it is comfort level. If you're primarily an anterior segment doc, you aren't going to treat a retinal tear anyway. Might as well save the time of scleral depression and send to a retina doc. I'm fine with that.

4) Not checking in the slightest for severe BV issues...I.E. Your pt has convergence insufficiency, is a hyperope, and somehow your +5.00 with +2.00 adds make them vomit into a trash can. (OMD's, this ones a little more on you. My OD colleagues are terrible on #2 and 3) Do a little phoria testing please. Takes 3 minutes. (As an aside, do they TEACH BV in med school? I swear some of the OMD's of my age, 40's and older, are clueless about all of this.)

What's BV?

5) Crown glass. Please stop rx'ing this garbage. I don't care if the patient loves it. They won't love it when it shatters and Seidel signs them. Plus it is heavy and ugly.

That would suck.

6) Last one....and I swear my head starts to explode when I get this (happens at the VA all the time w our older pt base) ok, here goes...PLEASE PLEASE stop sending me everything that has blood somewhere as "proliferative diabetic ret". Half the time it is Eales, IJRT, or one of the million other things. (my favorite was an OD/OMD joint practice that sent me a low grade vitreous heme as proliferative DR. That is like saying "you have a brain tumor" vs "you have a headache") Anyone, from anywhere, of any training level, that sends me a DR diag without doing a glucose test should be sent away to a labor camp. Just awful...

Most of the VH I see now is actually PVD-related (no breaks, just hemorrhagic PVDs). My diabetic population is fairly well-controlled (much more mild-moderate NPDR than PDR), so that biases my sample. In residency and fellowship, most VH was PDR-related.

 

[Visionary]

My pet peeve are patients who are completely irresponsible with their contacts. Then they come back with an ulcer and tell another doc "Dr Smith never told me not to sleep in them..really I am supposed to replace them after two weeks?...he never said that"

Is anyone responsible with their contacts? 😀

 

[Visionary]

Here's the thing about that.....

In my office, we don't sell cheap frames. We don't sell cheap lenses. We don't sell low end A/R or progressives.

Now....in the exam room, professional ethics dictate that you treat everyone the same regardless of their income or their insurance plan or whatever. In essence, we almost have to be all things to all people..

But in the optical, you can't do that. You simply can't be all things to all people. So some people will walk out. Would I prefer that every single person got something from me? Probably. But the reality of the situation is that that isn't going to happen and really, it can't happen.

When people want to walk out, we ask where they normally get their glasses or contact lenses from. Most times, we're less expensive than where they want to go.

But certainly there are times where we are not. IN that case, we simply try to take 30 seconds to explain the difference in products. The most common analogy we use is that you can buy a $20 disposable camera at CVS or you can buy a $1000 Nikon camera. We have the Nikon. Sometimes that works, sometimes people only care about price and that's their perogative.

So the moral of the story is, understand that you can't be all things to all people in the optical.

True. How about this as a pet peeve: glasses being improperly made (e.g., change in base curve, optical centers off, BF segments too low or high) at the outside optical, leading the patient to return and gripe to you? Until you explain it to them, that is.

 

[4Eyes]

The Optomap thing can really fire me up, too. It can be awesome as an educational tool for patients. (Though other cameras are equally or more awesome for that purpose.) But I once observed an OD who used it undilated instead of actually looking in the eye. With anything. That really bothered me. Also bugged me that it was advertised as being able to see more into the periphery than a dilated eye exam (maybe if you didn't have the patient look anywhere). Same OD had made his own EMR system that had values for pupils, cover test, EOMs and whatnot automatically entered. Though he never actually tested any of these things. This OD was reallllly great at contacts, but gosh it was irritating to see some other things.

This was a busy private practice OD who I observed as a student for quite some time. Interestingly, in the couple months or so I observed him, he NEVER had a single patient complain of flashes or floaters. I'm not nearly as busy as he was/is, but I have at least one of those a week.

Until a few years ago, my town had a couple of unethical ODs who would Rx small amounts of prism just so Rxs received elsewhere would feel wrong.

There's another OD in my town who tells all his patients that no spec Rx (from anyone) EVER expires.

 

[DILLIGAF]

I do apologize if I did not make my intention for the post clear to begin with. The last thing I want on this forum, in any discussion, is to pit people, especially colleagues, against one another. To any outsider, that is the frustrating part about the forum and why so many write a few posts and leave; sniping at people for no apparent reason, usually out of a knee-jerk reaction. If I ever start one of those, I will never come on here again....

So....here is what I mean: I know that I probably do a lot of things that drive the other docs I work with crazy, and them for me. For example:

1) My office staff probably do a little too much of the record keeping. I get little complaints (often from people I have very good working relationships with) that such and such my office manager wrote made no sense, a base curve that doesn't exist was written, conversion to and out of plus cyl was wrong, etc.

2) Probably my biggest doc to doc complaint: as I remember from school....I see zebras, not horses, a lot of the time. I spent far too much of my time either in corporate (very little disease, refract all day) or at a VA that served as the eye problem fall-back for a very large area (in Dover. Saw some disease that I now realize was EXTREMELY rare on a regular basis. I.E. Pick a syndrome, dystrophy. I once saw 3 full on lacquer cracks degenerative myopes in a week. Because of this, I am now a little alarmist in my private practice seeing a normal patient base. I would imagine my main OMD guy gets tired of seeing "syndrome" at the end of his dry AMD pt's. 😀

3) I use polycarb....on everyone....ok not really, but unless they are going to really be hurt by the dispersion, it's poly for you baby!

This is the kind of stuff I wanted to know from other docs, and why I asked. Also, the observation about the optical being the one place where "you can't be everything to everyone" was very sharp. I had never really looked at it that way...

As for pt's doing asinine stuff, that could fill up several volumes. (my fav so far in my entire career was a guy that took the lenses out of a hand magnifying glass, somehow, and then proceeded to solder a frame together from parts of a tractor. Came in after 2 weeks of this and said "I just walk into stuff all the time, and I think the sun is really hurting my picture film back there.") This is what happens in "rural optometry" in Canada....

Anyway, tell me what makes you want to . I want a list to put on my door next to the "I would have gotten done faster, but I had help" sticker. My partner has a top ten "reasons NOT to come to my office to tell me" and I want to beat him, plus I think it would be fun to see how much of that stuff that I do myself!

 

[imemily]

Here's the thing about that.....

In my office, we don't sell cheap frames. We don't sell cheap lenses. We don't sell low end A/R or progressives.

Now....in the exam room, professional ethics dictate that you treat everyone the same regardless of their income or their insurance plan or whatever. In essence, we almost have to be all things to all people..

But in the optical, you can't do that. You simply can't be all things to all people. So some people will walk out. Would I prefer that every single person got something from me? Probably. But the reality of the situation is that that isn't going to happen and really, it can't happen.

When people want to walk out, we ask where they normally get their glasses or contact lenses from. Most times, we're less expensive than where they want to go.

But certainly there are times where we are not. IN that case, we simply try to take 30 seconds to explain the difference in products. The most common analogy we use is that you can buy a $20 disposable camera at CVS or you can buy a $1000 Nikon camera. We have the Nikon. Sometimes that works, sometimes people only care about price and that's their perogative.

So the moral of the story is, understand that you can't be all things to all people in the optical.

Just curious, but why don't you sell cheap frames/glasses?

Why not have the best of both worlds, i.e. high end and lower end glasses/frames? I would guess that you would sell more glasses that way, since your optical would appeal to more patients who , were at first, reluctant to purchase high end frames.

Do you recommend a new grad to start selling lower end frames, than gradually move up to higher end frames? The only problem I see with this is that previous patients would eventually notice it and switch to another OD.

I really don't understand how some corporate companies like sams club can offer free glasses for 2 years or $19.99 glasses, and still make some profit.

 

[admiralbean]

Just curious, but why don't you sell cheap frames/glasses?

Why not have the best of both worlds, i.e. high end and lower end glasses/frames? I would guess that you would sell more glasses that way, since your optical would appeal to more patients who , were at first, reluctant to purchase high end frames.

Do you recommend a new grad to start selling lower end frames, than gradually move up to higher end frames? The only problem I see with this is that previous patients would eventually notice it and switch to another OD.

I really don't understand how some corporate companies like sams club can offer free glasses for 2 years or $19.99 glasses, and still make some profit.

I'm not a practicing optometrist yet but I think that as the doc, you should sell the patient a quality product that you believe in. I don't want my patients walking around town with duct tape holding their glasses together telling other potential patients that they got them at my office! Many people take their spec purchase seriously and are willing to shell out a little extra for higher quality materials. It is important to educate them on their options. If they prefer to save a little money and get their Rx filled somewhere else, that's fine too!

 

[admiralbean]

I really don't understand how some corporate companies like sams club can offer free glasses for 2 years or $19.99 glasses, and still make some profit.

They probably buy those frames for a couple of bucks. The lenses are most likely CR-39 which are less than a dollar per lens for single vision (correct me if I'm wrong...I think that's what they told us in school).

 

[Shnurek]

Yes, KHE mentioned this before that if you try to compete with the cheap optical chains, you will probably lose. His clients are ones that focus on quality of service and quality of product.

 

[imemily]

Yes, KHE mentioned this before that if you try to compete with the cheap optical chains, you will probably lose. His clients are ones that focus on quality of service and quality of product.

But, I think it would be hard to find these types of patients. The majority of the population is cheap!

 

[Shnurek]

But, I think it would be hard to find these types of patients. The majority of the population is cheap!

Yes, indeed.

 

[Veritas23]

But, I think it would be hard to find these types of patients. The majority of the population is cheap!

So the goal then would be to find a place where people have the money to pay for that extra quality service/material (i.e. Nikon vs. Canon disposable) and open a Private Practice there.

I'm sure that's exactly what KHE has done and why he is able to dictate to his patient-base the "camera comparison" analogy.

On the whole I agree with you imemily.

 

[KHE]

Just curious, but why don't you sell cheap frames/glasses?

Because cheap glasses=too many hassles and problems than they're worth and it takes away time and energy from dealing with higher end products and patients.

Why not have the best of both worlds, i.e. high end and lower end glasses/frames? I would guess that you would sell more glasses that way, since your optical would appeal to more patients who , were at first, reluctant to purchase high end frames.

You can't. Do they sell Ford Tauruses at the Mercedes dealership? Why not? Why not have the best of all words? Do they sell Big Macs at Le Cirque? Why not?

Do you recommend a new grad to start selling lower end frames, than gradually move up to higher end frames? The only problem I see with this is that previous patients would eventually notice it and switch to another OD.

That's right. If you build a client base who's cost conscious and then try to switch, you're going to lose that patient base.

I really don't understand how some corporate companies like sams club can offer free glasses for 2 years or $19.99 glasses, and still make some profit.

Razor thin margins and high volume. In some cases, a loss leader to get people into the store.

 

[KHE]

But, I think it would be hard to find these types of patients. The majority of the population is cheap!

That's not really true. These same people who are "cheap" are just DYING to wait on line for hours on end to get the latest iPhone 4 when their iPhone 3 works just fine.

These same people are just DYING to have a Coach bag. Or UGG Boots. Or an Aeropostale shirt. Or whatever other "hot" item is out there. And they'll pay huge money for it. Why? UGG boots, aeorpostale shirts are all just made in China stuff. Why do people want to buy those things?

The key is you have to set up to make them WANT to buy your product. And I'm not talking about any sort of bait and switch or any of that crap. We don't do that garbage.

It's true that often times, glasses are what's referred to as a "grudge" purchase. People buy them grudingly. Their vision is finally so poor that they have to buy them. Or their 8 year old frame finally snapped in two so they have to buy them. Or their lenses are so horribly scratched that they have to buy them.

Overcoming that mentality can be difficult but it can be done. When they walk into your office, they have to think to themselves "oh man.....I'VE just GOT to have this set of lenses. I WANT this." (Not I need this.) I WANT this.

How do you do that? How do you market to those people? How do you make them WANT your stuff?

Think about that.......that's probably a topic for another thread.

 

[DILLIGAF]

KHE is exactly right....a CostCo that I worked at years ago operated at a loss, and the ownership was totally fine with that. You were rated based on having as little LOSS as possible, as the numbers that it required to make money in a given month were not sustainable over a full year.

As for the way it is now, I do sell a few cheaper frames, but I overprice them as to make the jump to much better frame very small. I.E. Most businesspeople in optical are fine with a smaller margin on really expensive frame/lens combo, but using the same margin on a cheap plastic frame is never worth the time or hassle. I tend to take a pretty firm hand into optical sales, and generally sell these cheaper glasses to pt's that need a plus at near, are an occupational fit, etc. I never recommend a garbage frame for a child or for someone that will need to be wearing them all the time. I tell the pt's that the extra money is well worth it in their situation, and they understand my logic on that 99% of the time.

It is really trying to find a balance between serving the pt's that are super cost conscious vs those that couldn't care less what it costs, so long as it helps them and looks good. It is tough to make it easy for the former without taking away the business and professional (the latter tend to talk a little more about their experience) opportunity of the latter. You do kind of have to decide to whom you are going to build around.

I guess that counts as a peeve: the whole "these frames are busted and I think the lens is wrong.", to which I have to say, "they were 20 dollars. You can't buy a cab ride for 20 dollars."

Especially bc in my experience, in glasses, you do a lot of times getting what you pay for. (within reason. $800 drill mounts don't give you Xray vision or anything)🙂

 

[mclem222]

It comes down to valuing something. Some people don't value the glasses for appearance or vision. Others do. The ones who don't want the cheapest thing possible. Similar to the moms who bring in kids and don't want to hear any explanation or chat I have for vision problems and are ready to take them out of the office."so is he good to go??" ..just like dropping the car off at the mechanic.

 

[Hoffy]

Yep, "if I buy my glasses here do I get the exam for free?" Said while texting on their blackberry or iphone. Drives me nuts! Just shows where the value is placed and where people's minds are. But we do have that attitude in the U.S. sadly. Even a non flashy pretty basic progressive lens set of glasses can cost you an arm and a leg!