glasses and drugs are they the same?

04/09/2010 at 5:55 AM 1 comment

Yesterday I went to buy regular lenses for my sunglasses. These are really cool (and cheap) sunglasses that have a lens carrier behind the dark lenses so that people like me that can’t see more than ten feet can still look cool in the summer.  As an aside, my daughters agree that there is nothing in the world I could do to ever approach looking cool.

These are simple, easy to make lenses that are a single prescription, no bifocal or transition lenses. Should be  a piece of cake. I went to Lenscrafters because they can do them in an hour and they were the last to examine my eyes. Sure enough they had my prescription but it was ‘expired’ . What do you mean expired, I ask. I am still here, I am still wearing my regular glasses made from that prescription? Nope they said, they could not in good faith allow me to use that prescription and as it turns out they have an appointment coming up in a few minutes.

As I thought about it I asked the nice lady what the cost of the lenses would be. $185 she says. This from the people that advertise on their web site of  $145 glasses, lenses and frames. I left and went to my favorite optician. He cannot turn out the lenses in an hour but his products are so much better. For the last 7 years I have been able to see better than ever thanks to his efforts. ( I should have come her first) He is very pricey though, but for my regular set of transition glasses it is worth while, and they last forever. He had no problem using the old prescription, clearly I was seeing quite well with it, plus his price for the upgrade lenses was $60 total! Tax included.

But it had me thinking. One thing our office does that drives patients crazy is a requirement to be seen for a refill if it has been a year since the last visit. I have always felt it was more than reasonable. The industry standard is somewhere between 6 mo and a year. In practice I find that a year is a bit too long, but it is too hard to expect my staff to calculate nine months consistently.

So are we behaving like Lenscrafters? demanding a visit when the patient feels fine with his current prescription?

After much reflection I came up with several distinctions that allowed me to comfortably answer no.

1. Medicines interact with other medicines, lenses don’t

2. The consequences of an old prescription in a medicine is potentially much higher than for lenses that don’t let you see ‘quite right’.

3. With lenses and seeing, the patient is actually much better than the doctor at evaluating how well they are working. With medicine the opposite is true, the patient may not realize that the medicine is not doing the job, as in hypertension, diabetes etc.

So I feel much better that we are not being so glaringly ridiculous with out rules and I get new lenses for $60!


Entry filed under: Doctor Musings. Tags: , .

conundrum of teaching Punk’ed

1 Comment Add your own

  • 1. Linda  |  04/09/2010 at 7:10 AM

    About a year ago I saw a guy who was really peeved about having to come in just to get a refill on his BP meds (it had been well over a year.) But, as he was getting ready to leave, he said the classic line, “By the way, doc…” and it turned out that he was having trouble swallowing. The workup showed an esophageal cancer and he needed major surgery, radiation, chemo, but he is still alive today and doing reasonably well. I wonder how things would have gone if he had waited until he absolutedly couldn’t tolerate the swallowing thing any more. Maybe not any different, but sometimes you do pick up serious things when you “make” a person come in to be seen.


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