We may call it by different names, but all optometrists deal with eyeglass rechecks, Rx problems, refractive troubleshooting or just the simple redo. I’m pretty sure most of us hate seeing these on our schedules, but let’s take a closer look at them and why you should learn to love them.
Why is the visit no charge?
It just is. That has become the norm in our industry for decades and we have to just accept it. ODs love to use the analogy that when a physician prescribes a medication that does not work and the patient returns, another exam fee is usually charged. It makes sense in theory that we should be compensated for our work, but the market prevails and very few optometrists charge for a recheck due to a complaint about new glasses. It is not uncommon for a mistake to be made at some point in the process of making new glasses and we owe it to our patient (customer) to troubleshoot the problem.
If we fix the problem at no charge, it is usually not necessary to determine and reveal exactly who was at fault. If we charge the patient additional fees, it would be necessary to explain why.
Why not just tell staff to handle it?
Opticians can and do play a major role in troubleshooting eyeglass complaints. The level of involvement depends on the skill and knowledge of the optician. I encourage you to train your staff on how to listen to the complaint and ask the right follow-up questions. A protocol should be followed to carefully verify that the lens prescription and all the optical measurements are within tolerance compared to what was ordered. Once all the measurements are confirmed to be as ordered, the optician can double check that some measurements like the PD and seg height were taken properly and visual acuity at far and near point can be measured. Additional factors like lens material, base curve, and progressive lens design should be noted. When all this data is considered along with the patient’s complaint, the problem may be discovered; or maybe not.
If the problem has been correctly diagnosed, the glasses should just be remade to fix the error. Most eyeglass problems do not ever need to reach the optometrist. But big trouble can occur if there is an attempt to fix a problem and that attempt fails. The problem remains. The cost of the remake is going up. If that happens, the patient will lose confidence very quickly and the time spent waiting for the correct glasses can become intolerable. A refund may be requested. The patient may write a negative review on social media.
This is why the optometrist may want to become involved earlier, rather than later. The optometrist may be able to help with the troubleshooting. If there is a possibility that the lens prescription is wrong, it may be easier and more certain to just recheck the refraction. That usually requires the optometrist. ODs are also very good at listening to visual complaints and understanding what the cause is, that can help your office to pinpoint the problem.
Better to see them than not see them
As you see patients back for eyeglass issues, don’t take it personally. Eyeglass problems will occur and your practice will be judged on how well you handle them. Fix it right the first time and patients will actually be glad they came to you. They may be glad they did not go to some cheap place or order online, where it may be harder to find a resolution.
This is why we should love Rx rechecks, if you did not see them, I would be worried that the patients were not getting the best care and may not be completely satisfied with their services and products.
Don’t send a bad message to staff
I think it is best to encourage staff members who do the initial troubleshooting on glasses to let the patient see you if they have any doubt about the cause of the problem. This goes beyond just telling staff that is OK to put these patients in your schedule. If you act annoyed or complain behind the scenes about seeing these patients, staff get the message. Welcoming Rx trouble might get you a few false positives in your exam chair (patients who did not actually need to see you), but that is better than false negatives (patients who should have seen you but the staff tried remaking the job due to some imagined reason).
Remember that these patients spent a lot of money in your office and they are having a bad experience. Your office most likely had something to do with that. It may have been an error by your lab or your staff or maybe even you. Get these patients in to see you quickly. Make room in your schedule. Remember also that Rx problems are almost never as bad as you think they will be. Just greet the patient with a positive attitude and a smile and reassure him that you will resolve the problem.
I think I am a true expert at Rx problems. It must be all the practice I’ve had with it.
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.