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If you ask optometrists all over the U.S. and Canada about their policies for releasing a contact lens Rx, you would find many different ideas. Opinions vary widely on how and if the Rx should be released, and I respect each doctor's right to decide on his or her policy, within the limits of state law. But I encourage doctors to look closely at their policies - and to do so from the patient's point of view.
I'm surprised that doctors often don't see how some policies make their practice look in the eyes of patients. Many contact lens Rx policies in common use today actually make the doctor look either desperate or sneaky. I'm sure neither is a quality that any doctor wants to project, and usually the policy was honestly developed with the idea of protecting the patient, or the doctor's liability.
My goal when a patient is seeking lens replacement outside of my office is to retain him (and his family) for the professional eye care services they will need in the future. I know the most common reason people seek alternative sellers of contacts is they want to avoid the cost of the eye exam that would be required if they purchased lenses from me. That doesn't mean they don't ever want to have an eye exam again. It's actually pretty easy to keep the patient, if we don't create any ill will during this attempt to purchase contacts. Let's face it; we don't make that much profit on the sale of materials anyway - so why cause a confrontation or even hidden resentment.
This is an area that requires us to look at our policies from the patient's point of view. Patients are smarter than we think and they can easily spot a tactic that was designed to prevent a sale from a competitor. Here are a few policies that I think look suspicious:
Only prescribing private label lenses and writing the Rx out in the private label name, when a more common label would be easier to fill. I don't think this really stops anyone from buying lenses elsewhere, since all contact lens retailers know very well how to convert the private label brand to the common brand. The strategy can backfire because it invariably invites a comment that infers that the prescribing OD is using a brand just because it's hard to get outside of his office. Even if the hard-to-get approach is successful in stopping the purchase this time, I think patients feel deceived and tricked, and may not return.
The following four strategies seem like just that... strategies. Patients see them that way too.
Not releasing the Rx but offering to send the entire record to another practitioner
Requiring the patient to sign a written release form before releasing the CL Rx to someone else
Only giving the CL Rx in writing to the patient - refusing to call it in or verify the Rx when contacted
Releasing a form that says the data is for information purposes only and is not an actual Rx to be filled
Here are a few polices that might make your practice look desperate to make a sale:
Offering to match the price
Asking why the patient wants the Rx, before making it clear that you will release it.
Asking where the patient intends to get their contacts and advising him that you will only release it if you approve of the patient's choice.
So how do I handle the request? First, I truly believe that patients have the right to their CL Rx if it's valid. We all know when the Rx is valid and when it isn't. It's just like a drug Rx. If a patient asks for the CL Rx and it's valid, or if his retailer of choice asks, I simply release it. No hassles, no questions, no problems. If the Rx is expired due to the patient not returning for regular exams, we politely indicate that the Rx has expired and the patient needs an exam to renew it - and we offer a convenient quick appointment. Refusal to release a CL Rx because it's expired is, in my view, a legitimate reason. It passes the "would I do this if it were a drug" test.
It's pretty simple in the end; I want patients to buy their contact lenses from my office because they want to - not because they have to. I make them "want to" by having lenses in stock, offering legendary customer service and setting lens prices competitively.
Best wishes for continued success,
Neil B. Gailmard, OD, MBA, FAAO
Editor, Optometric Management Tip of the Week
Dr. Gailmard's new book, Practice Management in Optometry: A Blueprint for Success Based on the Optometric Management Tip of the Week, is now available on Amazon.