Article Date: 2/1/2007

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BY WALTER D. WEST, O.D., F.A.A.O.
Chief Optometric Editor

Going Above and Beyond the Sale of Spectacles and CLs
Why we must be wary of any model of practicing optometry that doesn't put our patients' health first.

Recently, concerns regarding some optometrists being employed by retail optical companies have taken on a new twist. It seems that, in at least a few instances, retail optical companies, store managers or corporate guidelines are telling the optometrists how they should practice by the .

Following the money

It would seem that these optical retailers are so concerned about their retail profitability, that the optometrists are told to forgo providing medically related care to patients. The medically related care provided by the optometrist doesn't put a spectacle prescription in the patient's hand and, therefore, the retail optical looses an opportunity to sell a pair of glasses.

Now, is this really a surprise to anyone? Really, is it? The optical retailer's existence depends on the sale of spectacle frames and lenses, plano sunglasses, prescription sunglasses, contact lenses and the accessories that go along with them.

Can you believe that the delivery of clinical care to patients, the diagnosis and management of conditions, such as glaucoma, allergy and ocular surface disease, are passed over by optometrists in a retail setting in exchange for refractions and spectacle prescriptions so that the retailer can sell a pair of glasses and increase profits?

We all must focus our efforts on creating and supporting state laws that promote the clinical performance of optometrists, so that optometry isn't reduced to a function of profit from the sale of spectacles and contact lenses.

Before you cast a stone

But wait! I almost forgot to share an important step in this crusade. Before optometrists in every state get all fired-up and indignant about how profit from the sale of spectacles and contact lenses is shaping the clini- cal care delivered to patients by optometrists in retail optical chains, they need to take a look at themselves.

Individual private practitioners depend on the sale of spectacles and contact lenses for 65% or more of their overall income. Patients regularly visit individual private practices where their medically related eyecare needs remain undiagnosed and unmanaged, even after they've had their eye exam and purchased their new spectacles.

While it may be true that the independent optometrist who practices in this fashion does so of his own free will, rather than having been directed to do so by the manager or corporate guidelines from an optical retailer, the end result is, unfortunately, the same: The patient's need for medically related eye care and education goes undelivered.

Full scope care in every setting

Don't get me wrong, I'm all for protecting the rights of the optometrists in a retail setting. They should be able to practice unencumbered, full-scope care without the misdirected demands of a store manager or corporate guidelines.

But, perhaps we need to encourage many of our private practice, self-directed colleagues to move in the same direction.



Optometric Management, Issue: February 2007