How do such terrible RX's happen?

[Taven7755]

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Hello everyone,
I am a current optometry student that has had a lot of eye problems in the past. By this, I mean that I have had 7 surgeries on one eye, including a macular hole repair...my question is this:

I recently went to a local doctor's office, one that was close to my home and had an appointment the following day (I was leaving town, and the first 4 places I called were booked for at least 2 days out). I went there, and I recieved an Rx for a new pair of glasses...The problem is I can't see out of them at all...I was given a +150 -250 (!!!!!) x180 for the right eye (that has had a lot of knife time, and has no astig at all) and I was wondering how this happened..until I realized this: I was NEVER seen by a doctor...😱

The person that wrote the Rx was an optician, and I was basically just put into an auto-refractor, had a very shotty Mono refraction, and I was out the door in 15 minutes...it was very cheap (I think $25, but the glasses were more expensive) I have the frames, but I will be going to the school clinic to get another Rx for them...

So....what I want to know is whether that is legal? I assumed that only a doctor can write an Rx? Is this incorrect? How does someone make that kind of mistake is the Rx?

The scariest part...they probably gave out a bunch of other terrible Rx's today!!!

Thanks for the input!!!

 

[mr cricket]

wow for a serious condition like that I would go to an ophthalmologist. I don't really trust optometrists (some of them are very dodgy) so I go to the ophthal once every 2 years to see how my eye is progressing and get an Rx from him. Cost a fortune but I don't want to lose my precious eye because of a dodgy optom. However I still visit an optom once a year

 

[KHE]

wow for a serious condition like that I would go to an ophthalmologist. I don't really trust optometrists (some of them are very dodgy) so I go to the ophthal once every 2 years to see how my eye is progressing and get an Rx from him. Cost a fortune but I don't want to lose my precious eye because of a dodgy optom. However I still visit an optom once a year

Ummm....you are aware that this is the forum for optometry students right?

 

[OD4eyes]

thats soo awful!!!! Why didn't you go to your school's clinic? Wouldn't it be free since you are a student?
I hate to say this but you get what you paid for. $25.00 for an exam is suspiciously low. That should be illegal and hopefully it is.

 

[blysssful]

Did you tell them that you are a current optometry student?

Don't take this the wrong way, but as an optometry student, weren't you also paying attention to what was going on during the exam? Were the glasses ordered without you seeing the Rx? Is it at all possible that your Rx was mixed up with someone else's?

In the past semester, I've been refracted about a million times and if someone (anyone... a student, optician, ophthalmologist or OD) tried to tell me that I have 1.50D more cyl than I previously thought, MAJOR red flags would fly up.

I'm definitely not saying that it is your fault that the office is incompetent (and possibly running things illegally), but any patient should be discerning in those circumstances.

 

[mr cricket]

either way it is the responsibility of the optometry practice to ensure that a suitably qualified practitioner does a proper Rx.

Otherwise go to an ophthalmologist. They do things perfectly.

 

[blysssful]

either way it is the responsibility of the optometry practice to ensure that a suitably qualified practitioner does a proper Rx.

Otherwise go to an ophthalmologist. They do things perfectly.

HAHAHA I really hope you're joking.

 

[Taven7755]

Thank you to all that have replied...

For one, I have no idea as to how the one respondent took my experience, in which I was questioning whether it is legal to get an Rx by an optician (i.e. I didn't see a Dr at all) as grounds to say that OD's cannot be trusted...that is called hearing what you want to hear and his opinion was grossly misinformed...

As for the visit, I would have gone to the school clinic, but it was a thursday and they were booked on fri, and we have been told repeatedly not to make appts on weekends...I had just gotten my glasses destroyed (by a dog, long story), and am pretty much blind w/o them and it would have been a VERY bad idea to drive as far as I was uncorrected....

As for the optician, I was under the impression that they were a doctor the entire time. It was not until later that I realized that the person who signed the Rx (a male Dr), with his name checked in the box, was not who did the exam (a woman, and none of the dr's in the practice were)...

I have since gotten the problem fixed, and I got a great new pair at my clinic (you get one free exam a year, after that it is just discounted)....

My question is more straightforward: Can a non dr perscribe in the US? I am now very curious

Thanks!👍

 

[blysssful]

My question is more straightforward: Can a non dr perscribe in the US?

No. An optician can only dispense glasses from a prescription written by an OD or an MD. Without a written prescription from an OD or MD, the optician can use a patient's existing glasses to duplicate the spectacles. They cannot legally do the refraction without OD or MD supervision, nor can they make changes to the existing prescription (unless it has to do with how the glasses were made, such as the improper pupilary distance or something like that). They are also allowed to look up your previous prescription from your chart, provided they had access to that information.

Some offices have opticians do the refraction then have the supervising doctor come in to verify everything... but if the doctor didn't even SEE you, that is certainly not legal, as far as my understanding goes.

 

[OD4eyes]

No.The optician can use a patient's existing glasses to duplicate the spectacles.


I think they should make that illegal. Some patients make duplicate of the same RX for years and never have their eyes check and just assume that it will made correctly. Besides 1800 contacts, this is one thing I dislike about the profession.

 

[blysssful]

I think they should make that illegal. Some patients make duplicate of the same RX for years and never have their eyes check and just assume that it will made correctly. Besides 1800 contacts, this is one thing I dislike about the profession.

Agreed. I think with new contacts you have to get a new Rx? Someone verify this?

 

[OD4eyes]

Agreed. I think with new contacts you have to get a new Rx? Someone verify this?

You have 8 hours to verify the RX for contacts once they sent you the recording over the phone or fax. However, sometimes the RX may somehow go through or patients over 2-3 year supply of contacts right before the RX is going to expire. We try our best to control the system and verify everything but their will be a few you will miss regardless. RX for glasses should not be duplicated but this is still done. Some patients don't mind spending $700 for glasses but they do mind paying for an eye exam. It does not make sense to me but it happens. I love optometry because of the patient interaction. Thats is why it is important for the optometrist and the staff to educate patients on the importance of an annual exam and proper care of contact lens systems. Yes, you do need a new RX to order new contacts but you also need a new RX to order contacts after date of expiration.

 

[jefguth]

Some offices have opticians do the refraction then have the supervising doctor come in to verify everything... but if the doctor didn't even SEE you, that is certainly not legal, as far as my understanding goes.

Maybe they took fundus photos and the doctor interpreted those??? At the very least I hope they have a C/D ratio recorded in the file, b/c to my understanding Florida's board has a hefty penalty for inadequate documentation.

Maybe they had an optometry intern do your exam? I know when I was on externship one of my preceptors routinely did not check some of my patients (mostly IOP checks though), just discussed the case with me and we sent the patient on their way without seeing the doctor.

Another possibility is that there isn't even a doctor there on site! Wouldn't be the first time it's happened, especially in Florida.

 

[JMU07]

You have 8 hours to verify the RX for contacts once they sent you the recording over the phone or fax.

The experience our office always had with 1-800-contacts was that you had however many hrs to verify but that if it WASN'T verified it would automatically fill. What the hell kind of sense does that make?

 

[KHE]

The experience our office always had with 1-800-contacts was that you had however many hrs to verify but that if it WASN'T verified it would automatically fill. What the hell kind of sense does that make?

Losing sleep over things like that is a lost cause. 99% of the times the lenses ship out right away anyways whether you verify them or not.

I've even started to have a few patients who enter their Rx information but when they are asked for their fax number, they are entering their OWN fax number and just verifying the Rx themselves.

People will likely be incredulous over that but the reality of it is is that the authorities can't control the flow of narcotics, illegal drugs and child prostitues over the internet for God's sake. Does anyone honestly think they're going to throw any man power behind hunting down people illegally obtaining Acuvues?

 

[JMU07]

Losing sleep over things like that is a lost cause. 99% of the times the lenses ship out right away anyways whether you verify them or not.

I've even started to have a few patients who enter their Rx information but when they are asked for their fax number, they are entering their OWN fax number and just verifying the Rx themselves.

People will likely be incredulous over that but the reality of it is is that the authorities can't control the flow of narcotics, illegal drugs and child prostitues over the internet for God's sake. Does anyone honestly think they're going to throw any man power behind hunting down people illegally obtaining Acuvues?

Yeah, you're right. We didn't worry about it, because there was nothing we could do you know? Just doesn't make sense.

 

[OD4eyes]

Yeah, you're right. We didn't worry about it, because there was nothing we could do you know? Just doesn't make sense.

It is mostly harassment! It is really annoying when your work has to be interrupted due toBradscott trying to confirm a contact lens prescription. They sometimes call back to back on mutiple lines. It is riduculous! Thats is why we try to stock our most popular lens but hey its capitalism. The doctor that I work for hates 1-800 contacts and offers us a small bonus everytime we sell a year supply, which is great incentative for the staff and another way to avoid Bradscott calling me during my pre-examination.
1-800 contacts you can suck it!!!!

 

[JMU07]

It is mostly harassment! It is really annoying when your work has to be interrupted due toBradscott trying to confirm a contact lens prescription. They sometimes call back to back on mutiple lines. It is riduculous! Thats is why we try to stock our most popular lens but hey its capitalism. The doctor that I work for hates 1-800 contacts and offers us a small bonus everytime we sell a year supply, which is great incentative for the staff and another way to avoid Bradscott calling me during my pre-examination.
1-800 contacts you can suck it!!!!

LOL. Brad Scott sucks, he really is a nuisance.

 

[KHE]

It is mostly harassment! It is really annoying when your work has to be interrupted due toBradscott trying to confirm a contact lens prescription. They sometimes call back to back on mutiple lines. It is riduculous! Thats is why we try to stock our most popular lens but hey its capitalism. The doctor that I work for hates 1-800 contacts and offers us a small bonus everytime we sell a year supply, which is great incentative for the staff and another way to avoid Bradscott calling me during my pre-examination.
1-800 contacts you can suck it!!!!

Let's all play the practice management game for a second....

Pretend for a second that you've all graduated and are owning your own practice:

How do you feel about the concept of incentivising employees for things like a years supply of contact lenses?

Is that a good thing or bad thing? Do you think that providing some sort of incentive helps the staff sell more "years supplies?"

Or, the counter argument is that if we all agree that a years supply of lenses is ideal for the patient to have to ensure compliance with wearing schedules, then should an incentive be required? Should that not simply be part of the staff's job description?

 

[RTM]

either way it is the responsibility of the optometry practice to ensure that a suitably qualified practitioner does a proper Rx.

Otherwise go to an ophthalmologist. They do things perfectly.

Wow!! That comment is amazing. Perfectly?

Why should people in this forum have to read cricket's posts if he is banned?

 

[OD4eyes]

Is that a good thing or bad thing? Do you think that providing some sort of incentive helps the staff sell more "years supplies?"

Or, the counter argument is that if we all agree that a years supply of lenses is ideal for the patient to have to ensure compliance with wearing schedules, then should an incentive be required? Should that not simply be part of the staff's job description?

Well, it depends on the type of patient. I would not offer a year supply to an patient that uses contacts occasionally. However, if the patient is strictly a contact lens user, I would promote the year supply to ensure that they will keep their replacement schedule. For me, I would probably sell the same amount of year supplies but I know other co-workers that are really driven to sell more year supplies because of the incentive. In the beginning it was difficult for me to sell and promote a year supply but as I became more familiar with rebates and prices, I became more confident. I do feel that it is a positive because the staff will make an effort to become familiar with contact lens brands, prices, and patients' need. It also, helps us from getting sooo many contact lens verifications. It is and should be apart of our job description but it encourages the staff to be more productive. I know some offices that do not offer any bonuses without meeting a certain quota or none at all. It really depends on your office politics.

 

[OD4eyes]

Is that a good thing or bad thing? Do you think that providing some sort of incentive helps the staff sell more "years supplies?"

Or, the counter argument is that if we all agree that a years supply of lenses is ideal for the patient to have to ensure compliance with wearing schedules, then should an incentive be required? Should that not simply be part of the staff's job description?

Well, it depends on the type of patient. I would not offer a year supply to an patient that uses contacts occasionally. However, if the patient is strictly a contact lens user, I would promote the year supply to ensure that they will keep their replacement schedule. For me, I would probably sell the same amount of year supplies but I know other co-workers that are really driven to sell more year supplies because of the incentive. In the beginning it was difficult for me to sell and promote a year supply but as I became more familiar with rebates and prices, I became more confident. I do feel that it is a positive because the staff will make an effort to become familiar with contact lens brands, prices, and patients' need. It also, helps us from getting sooo many contact lens verifications. It is and should be apart of our job description but it encourages the staff to be more productive. I know some offices that do not offer any bonuses without meeting a certain quota or none at all. It really depends on the office politics.

 

[KHE]

Well, it depends on the type of patient. I would not offer a year supply to an patient that uses contacts occasionally.

That's perfectly reasonable.

However, if the patient is strictly a contact lens user, I would promote the year supply to ensure that they will keep their replacement schedule. For me, I would probably sell the same amount of year supplies but I know other co-workers that are really driven to sell more year supplies because of the incentive.

Ok, so let's play Devil's advocate for a second there. Is that a good thing? Should employees in that type of situation need a financial incentive to do that or should the provision of a year's supply of lenses for most patients not be part of their job description?

In the beginning it was difficult for me to sell and promote a year supply but as I became more familiar with rebates and prices, I became more confident.

Why was it difficult for you?

I do feel that it is a positive because the staff will make an effort to become familiar with contact lens brands, prices, and patients' need. It also, helps us from getting sooo many contact lens verifications. It is and should be apart of our job description but it encourages the staff to be more productive.

Well again, I would point out that an incentive is supposed to be for something that is above and beyond the call of duty. Should people be given or expect incentives for doing what is essnitally their job? Isn't that what a salary is for?

I know some offices that do not offer any bonuses without meeting a certain quota or none at all. It really depends on your office politics.

So what do you all think is the best way of doing things? That's the whole point of my posting. To try to stimulate discussion or thoughts on these issues.

 

[OD4eyes]

That's perfectly reasonable.

Ok, so let's play Devil's advocate for a second there. Is that a good thing? Should employees in that type of situation need a financial incentive to do that or should the provision of a year's supply of lenses for most patients not be part of their job description?


Well, everyone working for the doctor are part-time hourly employees. We were all trained by the doctor and initially our knowledge of contact lenses was very minor. The doctor encourages us to sell year supplies and does not mind giving us a very small credit. Yes, it is and should be apart of job description but whats wrong with giving your employees a pat of the back when they do a good job. I was never good at sales because I did not want to projective to patients that I was after their money. Even in my past corporate optical job, I helped patients with the choosing of their frame and lens but never did any direct sales transactions.
Year supplies are hard to sell because it is asking patients for alot of $ at once and prices from our competitors (1800-contact, vision direct)... do not make it any easier. Some will be hasten because they want to look for a better deal, may be worried of losing boxes or prescription changing.However, now I realize that I am only looking out for the best interest of the patient when selling contacts or performing any task in my job. I am the only pre-optometry student at job and the benefits of the incentive is that your staff will be more capable to sell contacts and patients will come more annually instead very of 3 years. I pretty certain that my knowledge of contacts is quite extensive due to this (I mean not just Acuvue but I know all Cooper, Ciba & B&L lenses). I probably would give my employees some type of incentive because I have done the job and I know it is not easy, especially in this economy.