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A colleague emailed me to ask how I would handle a situation that recently
occurred in his office. He thought it might make a good topic for a Tip of the
Week article and I agree. Here is his story:
A patient who had left my care secondary to “insurance changes” came back to
my office after two and a half years. She asked for an adjustment on a pair of
glasses which were over a year old and not purchased from us. Additionally, the
glasses were a drill mount with progressive lenses and very badly damaged from
the patient “rolling over on them”. So, because we are nice, my office manager
tried to adjust them and of course the lens broke. Then, of course, it was our
fault; the patient was mad and claimed no responsibility. You can imagine the
We have probably all had similar situations occur in our offices at some time.
Cases like this provide valuable opportunities for staff training. We can look
at this situation in two ways: how to prevent it and how to handle it when
How to prevent it
In my view, when we accept a pair of glasses for adjustment or when we agree to
make new lenses to fit an older frame, there is an implied responsibility that
we will return the patient’s property in the same or better condition as when we
accept it. In cases when your office can’t or won’t accept that responsibility,
the burden is on your office staff to explain that to the patient in advance and
determine if the patient wants you to proceed with the work even when no
guarantee is provided.
There are many legitimate reasons to use a disclaimer and inform the patient
that your office will exercise great care, but that breakage is possible and
that you can’t guarantee the outcome. The disclaimer can be in writing or
verbal. I use a written form that the patient signs whenever we accept a
patient’s old frame for new lenses. The form and more details are available in
If I were accepting a pair of glasses for adjustment or repair, I would make the
determination of responsibility on the spot. The important thing is to inspect
the frame and lenses in front of the patient and point out any defects before
taking it out of the patient’s sight.
If the glasses were covered under our practice warranty or if the adjustment
were simple, I would proceed with no disclaimer. I like to have optical policies
that are patient friendly. We want to be easy to do business with. I don’t want
to have a disclaimer for every little task. If the adjustment was tricky or if I
felt the frame could not be replaced easily, I would verbally warn the patient
that it could break. I would let the patient know that if the frame is out of
warranty, our office will not be responsible for replacement. I would also
mention the likelihood that the frame may be discontinued and that the lenses
will not fit into another frame. If I got the patient’s verbal agreement on that
point, I would proceed.
How to handle it
Even though we can all look back and see that this unfortunate situation could
have been avoided, let’s accept that these things still happen. Deciding when to
offer a disclaimer is a judgment call and therefore, we may occasionally judge
wrong. Well-meaning technicians may not anticipate a breakage. Breakage could be
so rare that we let our guard down. We may have staff turnover and a new
optician is not trained in these scenarios yet. No office is perfect.
Outstanding practices are staffed with people who are eager to please and who
try to earn patient loyalty with excellent service. Maybe even win back a
patient who left over insurance coverage. I applaud the effort.
In my philosophy of the patient-centric practice, customer service is king.
Seeing everything from the patient’s point of view and letting the patient win,
even if there is a cost to the practice, are cornerstones of excellent service.
Patient-friendly policies result in high levels of satisfaction and loyalty.
Those factors are extremely valuable and produce far more revenue, indirectly
and invisibly, than the immediate expense. Patients are consumers and they know
that things occasionally go wrong, but they watch closely to see how any
business will respond when mistakes happen.
Here are the important steps to take when the patient perceives that frames or
lenses were damaged by your office, assuming no disclaimers were given.
Always be forthright in admitting that you damaged a frame or lens.
Nothing is more important than honesty. Never hope a patient will not
discover a defect that you caused. Once you bring the matter up, it usually
goes quite well! Teach all staff this principle.
Owners and managers should not breed a culture where staff members are
afraid to be honest by expecting perfection or by getting angry over a
mistake. Obviously, if mistakes happen often, retraining or reassignment
must occur, but there is no need to ever become angry.
Apologize to the patient. Unfortunately, many staff members and doctors
never use the words “I’m sorry”. It is really all the patient wants to hear.
Take the blame.
Definitely absorb the costs to make the situation right. Replace the
frame at no charge. If that frame is not available anymore, help the patient
choose a new one and have new lenses made for it at no charge. The good side
of this is that the patient understands that he has chosen a practice with
If the patient thinks you scratched his lens while adjusting or
repairing the glasses, but you know that is not true, replace it at no
charge anyway. Apologize and order the replacement with a smile. Remember,
this would have been avoided if you had inspected the lenses in front of the
patient before taking the glasses away to the lab.
Don’t worry when you suspect that a person is trying to take advantage
of your practice. It’s so rare that it is really not a problem. Some people
simply require much more care than others and our effort is to satisfy
Don’t lose any sleep over these situations and don’t let them ruin your
day. These problems are only stressful if you allow them to be. It’s all
small stuff and it’s part of owning a business. Smile and move on. You win
in the end by building a practice that’s in great demand.
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.