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Since October 16, 2020 I have had to take an extra step at the end of the exam to explain to patients they they need to sign a statement saying that they received a copy of their contacts lens Rx. Firstly, some people get a bit apprehensive when asked to sign any kind of legalese- as they should. Second, the question “why?” pops up when they’ve been wearing contacts for years and never had to do this rigmarole before.

So, obviously, the Contact Lens Rule was created to punish all optometrists for the sins of a few. No doubt that online retailers were behind this. You would think the proper way to handle a complaint that your optometrist didn’t give you a finalized prescription would be to tell your state optometry board and let them correct the issue as their rules dictate. But that wasn’t good enough for the Feds, so now we live in a county where the FTC has requirements for optometrists- although the punishment for not complying isn’t spelled out clearly.

So if we’re going to take away power from the states regarding their administration of licensed professions, then let’s just be consistent and have a national optometry license and tell the states that they can take their boards and throw them in the septic tank where they also think all the optometrists belong.

Tags: 1-800, Comics, contacts, doctors, Government, patients

In an e-mail today to Walmart affiliated optometrists from Dr. Chad Overman, director of professional relations, he announced in relationship to Walmart and 1800Contacts that:

“Given future diverging business interests, a decision has been made to end our relationship effective December 31, 2012”

This isn’t 1800Contacts’ first divorce. As I explained before, 1800Contacts shacked up with a regional optical in Utah, Standard Optical, a few years before their civil union with Walmart in 2008.

Dr. Overman continues:

“Even before our alliance with 1-800 Contacts, our patients have counted on us to provide them a broad assortment of contact lenses at affordable prices, and our pledge to them and you is that we will continue to do so. In the event your patients have questions, thank them for their continued trust and patronage and provide them assurance of our continuance of this commitment…
Why are we ending our relationship?
Our customers trust us to provide a broad assortment of products at everyday low prices, and we approach every business decision through this lens.”

The last few years I did enjoy how we typically get contact lens orders to patients in just two days. That’s great customer service, but I’ll bet it’s more cost expense than Walmart is willing to pay in hopes of keeping prices low. I guess we’ll go back to saying “about a week?”

Tags: 1-800, contacts, Wal-Mart, WalMart

The Utah Optometric Association is very worried about H.B. 408 which is being introduced for the 2012 legislative session. I know they must be worried because a volunteer optometrist from the association called me, and I’m not even a member of the UOA.

It turns out they are rightfully worried because while the title, “Use of Optical Scan Machines,” might seem innocuous, what is really behind the curtain is pernicious.

While there is currently no text on the le.utah.gov website for H.B. 408, sources say that the bill’s sponsor, Greg Hughes, from Draper, UT (home of 1800Contacts) intends to allow the current prescription law to be changed to allow a person to buy glasses based on the reading of an autorefractor.

Apparently, the plan is for a company, like 1800Contacts, to set up a Glasses Kiosk in a popular store, like Walmart. (By the way, 1800Contacts has been selling glasses for a while.) The person puts their head in the machine, the autorefractor spits out some glasses numbers, a pupilometer measures a p.d., the person selects their frame and lens options, then they slide their credit card and wait for their glasses to arrive in the mail. (Maybe a nicer kiosk would measure the Rx in your current glasses and have you look at an eye chart, and factor those measurements into the numbers the kiosk “prescribes” you.)

If allowed, I predict an unintended consequence will be that no optical will adjust your glasses for free, like they currently do. You will have to show a receipt just to get your glasses adjusted, so everyone buying glasses from kiosks or internet sites will walk around looking like goobers and in pain from poorly adjusted glasses.

Other obvious consequences will be that people will walk around with headaches and blurry vision since autorefractors are notoriously inaccurate and will usually over-estimate nearsightedness and underestimate farsightedness. And say nothing of the fact that many people need prism to see straight/avoid headaches.

But here is the biggest reason to forsake this bill: People need eye exams to ensure good eye health. A refraction is only one piece of a complete eye exam. I’ve already written about the woman who only wanted more contacts, but because she had an eye exam, I saw some worrisome findings and referred her for more specialty care which discovered a brain tumor.

That’s just one patient. I’ve actually done that a couple times with brain tumors. Other times I’ve had patients whom I’ve diagnosed leukemia, diabetes, pituitary adenoma, increased cerebral spinal fluid pressure, glaucoma, macular degeneration, eye infections, allergy eyes, and more all just from a “routine eye exam.” None of these people thought there was something wrong- they just wanted new glasses or more contacts.

We can’t ignore that an eye exam is more than just looking at an eye chart and getting a refractive prescription.

But let’s say you wanted to. Let’s say you are simply a consumer advocate who wants to help people buy glasses. Your idea is to waste everyone’s time and money by making a law to separate the refraction from an eye exam. The consumer who values their eye health will simply also get an eye exam in addition to buying a glasses Rx and purchasing spectacles from a kiosk.

Okay, Utah Legislature, why are you stopping there? What if I’m a business that wants to sell antibiotics cheaper, to more people, than the present system of physicians and pharmacies? I want to set up kiosks that take your temperature. If you have a high temperature, you get vended an antibiotic. Sounds great for consumers, right? Why should eye care providers and opticals be the only ones to suffer? Make physicians and pharmacies suffer as well!

If you want to change the system, change it fairly for everyone. Let’s be just like third world countries which don’t require doctor prescriptions at pharmacies or optical shops. If it’s about consumer advocacy, what could be better, right?

Of course, you will essentially be forcing a large portion of health care providers to change professions. And don’t even mention how news reports will be full of people self treating, taking the wrong medicine for the wrong diagnosis, and dying. It’s a small price to pay for consumer choice, but since I have some libertarian leanings, I wouldn’t mind trying it out as long as every medical profession participates and not just optometrists.

However, if you don’t think that all roads should be toll roads and marijuana should be legal, then let’s continue to require prescriptions for medicines and medical devices, like glasses and contacts.

Choose one, Utah Legislature. Just be consistent across all professions to make the playing field level.

If you have an opinion on 2012’s H.B. 408, then contact your Utah lawmaker.

On a side note, I hope the sponsor of H.B. 408, Greg Hughes, is happy with himself. The UOA is burning tens of thousands of dollars (that it can’t afford) on lobbyists that only work for six weeks to fight H.B. 408. Even if HB408 is defeated this year, who knows if it will come up again next year and they’ll have to spend more money again! Mr Hughes, I’m not sure how you can sleep at night. You are causing poor optometrists to spend tons of money fighting legislation that you introduced only because a big business told you to. Even if you said you were sorry and withdraw the bill, you can’t un-burn the cash you’ve caused to be burned.
Please, lawmakers, try to think outside your wallet when making decisions about bills to consider during legislative sessions. I propose we only allow you to meet every two years in order to provide more stability for us business owners.

Tags: 1-800, doctors, economy, Government, optometrist, Organized Optometry, patients, politics

Trufocals have arrived! Now all you have to do is adjust a slider to focus from near to intermediate to distance.

Sphere powers are from +6 to -11, cyl up to -3.50, any axis, up to 3 p.d. prism horizontal and vertical per lens, add up to +3.00, and p.d. from 50 to 70 mm.

Patients can upload a scan of their Rx to the TruFocal folks. That is awesome! (My bank has been accepting scans of checks for deposits since 2006. How come contact lens retailers aren’t doing this?!?!)

As soon as I have a spare $900 I’ll have to get me a pair.

(H/T to Maino’s Memos)

Tags: 1-800, frames, ophthalmic tech, spectacle lenses

So apparently people have caught on about the negative verification and con the system to get contacts without actually getting an eye exam.

This patient from Dr. Bazan’s office shares her experience.

It really does help to see the doctor to get the best contacts for your eyes. Not only contacts, but info about contact lens solutions. I can’t tell you how many people love ClearCare yet they had never heard of it before I explained it.

I wish people would value the doctor.

BUT, should the law should punish people who buy contacts without a real prescription?

The libertarian in me says no. I should be able to buy antibiotics at the pharmacy without a prescription if I want. The only thing bringing some people in for an eye exam is getting that piece of paper, but it turns out some people don’t even bother with the Rx paper and just game the mail-order system.

The solution? Teach people to value the doctor. We can foster that value every time the patient has an evaluation by explaining how glad we are that they came in. We must be sure to educate how great it is that they had an eye exam whenever:

1. their Rx changes
2. we change their contacts to a better lens for comfort and eye health
3. we recommend a better, more compatible, care system for their eyes and contact lenses
4. we educate them on the latest and greatest options for them, even if they don’t want or require a change in lens or care system
5. they have a medical condition related to their eyes

And I don’t hold the prescription over their heads. The Utah law is that I make the expiration date for two years if their eyes are healthy; however, I frequently mention that it is best to have a yearly eye exam, especially if they note even a subtle change in their vision.

Tags: 1-800, Acuvue, Check Yearly, contacts, optometrist, patients

You may not realize it, but I know the web page you visited just before coming to my site. So for example, if you went to Google and did a search for “optometry blog,” I see in my logs that you just came from the site “http://www.google.com/search?hl=en&fkt=1859&fsdt=5568&q=optometry+blog&btnG=Google+Search”
(By the way, I’m number one on the list today. You could be if you bothered to blog.)

It’s really interesting to see what search terms get people to my site. I think it would be even more interesting to analyze and respond to questions implied by people’s search keywords. As a public service, I will now respond to actual search terms and attempt to answer any implied questions. Seriously, I am not making these up. It is not a comprehensive list, but these particular ones make good blogging fodder.

1. “career switch from optometry” – I hear ya’, brother, but do you really want to throw away four extra years of school and over $150K? Is optometry really that bad?
2. “do optometrists make lots of money?” – Yes, they put a question mark in their search. No, we don’t is the short answer, but more on specifics down the list.
3. “why become an optometrist” – Only because you love it, but that begs the question: How do you know if you would love it unless you already became an optometrist?
4. “easiest optometry school to get into” – Okay, first of all, this person hopefully won’t get into optometry school, but I think it’s safe to say that the answer to the quesiton is Pacific University because, hey, they took me. (That was a joke.)
5. “walmart optometrist average salaries” – There are only a few optometrists in the country actually employed by Walmart. In many states that scenario is illegal (stupid government interference.) Walmart optometrists working on a contracted lease only make what they get from exam fees, so it’s not a salary because you aren’t guaranteed an income. The Optometric Business Academy publishes a yearly survey of Walmart and Sam’s Club affiliated optometrists and the median gross fee income is: $161K for 2007 and $167,473 for 2008. Keep in mind your net will be at least 20% less.
6. “optometry debt” – I don’t have any statistics, but most of my class was around $100-150K and that was 2003. Now a days it’s becoming debatable whether the loan debt is worth your potential income. The actual numbers for indebtedness for 2005 averaged for all schools is $125685 (from ASCO under data and surveys).
7. “AOA optometry dues too high” – Yes, I agree. Next question.
8. “average number of new patients seen for start up optometric practice” – Um, try zero.
9. “how to become an optometrist” – First, get good grades in high school. Then get good grades at college (state universities are just fine). Schmooze influential faculty members your first two years of college to get a good recommendation letter for your optometry school application. Take the OAT and get a good score. Then apply for optometry school your third year of college. Get an interview and do really well. Get accepted to optometry school. Take out $150K in student loans. Get good grades in optometry school. Take the NBEO and pass all sections. Graduate. Get a state license when your NBEO passing scores are released. Do temp work from May to July of your graduation year (I made frozen dinners). Start practicing around July of your graduation year. Wow, you know, for all the same work you could have entered a career field that pays better or entered a field that pays just as much but requires less time and loan money.
10. “what should you know about optometry” – well, for starters see the previous question. You should also know that you are paid according to how many exams you do. You can only do so many exams, and people will only be willing to pay so much for an exam, so already you are limiting yourself. If you want to make some real money you need to consider a career field that allows you to sell an infinite amount of widgets to anyone, anywhere in the world.
11. “How to make optometrist buy from you.” – As I’ve said before, that shouldn’t be too hard. He or she chose to became an optometrist so they are easier to fool.
12. “what pays better, a pharmacist or optometrist” – They pay the same, but the pharmacist doesn’t have $150K in student loan debt. People point out that pharmacists have to work late hours and weekends, but optometry is quickly heading in that direction.
13. “when did eye exams become so expensive?” – Ever since the optometrist hired a practice consultant. (Again, what is the deal with putting a question mark in a web search?)
14. “optometry school worth it” – Only if you want to be an optometrist. A better question would be which optometry school makes it the most worth it.
15. “how much school does an optomitrist have” – Bad spelling aside, the short answer is eight years post high school.
16. “laws against 1800 contacts” – Yah, there should be a law that says someone else can’t take my business away from me without my permission. The government needs to fix all my problems. Where’s my binky?
17. “are prompt pay discounts for medical exams legal” – The previous billing expert I listened to said yes. The one before him said up to a reasonable amount like 10%. The true answer should be I should be able to charge whatever I want to whoever I want, but thanks to the government and insurance contracts that is not possible.
18. “what to take in high school to become an optometrist?” – Take whatever the heck you want. Who cares about high school? College is the new high school. By the way, why take the extra effort to type in a question mark in a search box?
19. “what retinoscope looks like” – Shh! It’s a secret.
20. “optometrist jokes” – I would refer you to some excellent, witty cartoons sketched on a mouse pad by a charming optometrist.

Well, that concludes the first edition of Answers to Your Search Questions. I’ll release more later, so stay tuned.

Tags: 1-800, Answers, optometrist, Wal-Mart

For those of you who remember Link Gate on my practice website, you’ll remember that my response to criticism of linking to Wal-Mart.com was, “Why link for free when I can sign up to earn ad revenue from 1-800 CONTACTS link referrals?”

Some outfit called Commission Junction handles the details for 1-800’s referral program, and I got this email from them today:

You are receiving this email because we are concerned that your Commission Junction publisher account has not generated any valid commissions (from payable transactions) recently. We encourage you to begin earning commissions as quickly as possible. Otherwise, your publisher account is at risk of deactivation due to dormancy…

So for the one guy who started Link Gate, let me assure you that no one cares that I link to 1-800 or Wal-Mart since apparently no one follows the links anyway.

Tags: 1-800, LinkGate, Wal-Mart

I always wanted to do a podcast, but I’ve never gotten around to it because who wants to hear me ramble? I can say things more succinctly by writing them. I think a podcast is interesting when it’s a small group discussion or an interview with interesting people. I’ve never gotten around to recording either scenario, so I never published a podcast…until now.

In a previous post I linked to a YouTube snippet of the CEO of 1-800 CONTACTS, Jonathan Coon, giving a speech to Wal-Mart optometrists. Posting the entire video from the DVD would take too much bandwidth, but I managed to scrape the audio to share with you. So it’s not really my podcast, but it is a step in the right direction.

Again, if I get a legal letter from 1-800 or Wal-Mart demanding that I remove the content, I will of course comply; however, they did send this DVD to every Wal-Mart optometrist, and some of those optometrists also work in private practice settings. Also, this presentation defends 1-800 CONTACTS and Wal-Mart’s partnership better than anything I’ve heard. So, I think you will agree that every optometrist who is interested should listen to this talk (or watch it if you can borrow it from your nearest Wal-Mart Vision Center).

Enjoy. (Click the player below or download manually or subscribe to it in iTunes or subscribe to Optoblog’s site feed or podcast feed to automatically get it in your favorite podcatcher.)

Tags: 1-800, Wal-Mart

It is interesting that some private practice docs can’t seem to tell the difference between Kleenex and Puffs- I mean 1-800Contacts and other retailers of soft contact lenses. This article was written in October 2006, but certain items are worth repeating in 2008:

…optometrist Wiley Curtis, of Arlington, Texas, represented the AOA’s position, tempered by his own experience. “Over the course of this year, I have tracked 18 contact lens orders placed with 1-800 Contacts,” he says. “I am saddened to report that the first 17 orders were all filled by the company without any verification contact with my office, in apparent violation of the FCLCA.”

After the hearing, 1-800 Contacts looked into this accusation. “Our records from the last 12 months to this doctor’s office show 192 phone calls, three faxes and eight total hours on the phone with his staff,” says Kevin McCallum, 1-800 Contacts’ senior vice president of marketing and operations. “We received 117 orders from this doctor’s patients. All 117 orders received a successful verification request.”

This actually happened while the congress was hearing testimony about the FCLCA. Apparent AOA stooge, Dr. Curtis, alleged that 1800Contacts broke the law, so the 1-800Contacts team stayed up all night to research, and the next day at the hearings they provided evidence to the contrary.

I only first heard about this event when I listened to Jonathan C. Coon, CEO of 1-800 CONTACTS, speak to all the Wal-Mart Optometrists on April 27th at our all-travel-and-expenses-paid meeting in Nashville, TN. He had given pretty much the same speech on a DVD sent to all Wal-Mart vision centers earlier this year after the announcement of Wal-Mart and 1-800’s alliance. Here is a significant clip. Please watch.

I wish everyone could see the entire half hour speech, but the above video clip combined with the aove AOA-is-stupid story show why optometrists blindly dislike 1-800 Contacts. I hated 1-800 blindly because that is what the organized optometrist establishment taught me to do. After learning the facts, there is no reason for any optometrist to dislike 1-800, unless that optometrist also hates all their other competitors. I don’t because I’m friends with most of the other optometrists in town and 1-800 is making my life easier now.

For these reasons, I would like to officially and publicly retract the negative comments I made about 1-800 Contacts in this previous post. It was a knee jerk response conditioned by organized optometry, for which I am ashamed.

I admire Mr. Coon and his core team for everything they’ve done to become a very successful business. I think that private practice optometrists, like the above Dr. Curtis, are just jealous. Incidentally, Mr. Coon in his speech said that after presenting the facts about Dr. Curtis’s patient orders to 1-800 Contacts, 1-800 asked him and the AOA to stop making wrongful [slanderous, defaming] accusations or privide their evidence. He has yet to bring evidence or retract his statements.

Don’t be blinded, everybody. Go to your nearest Wal-Mart Vision Center and ask to watch the 1-800 Contacts DVD.

Tags: 1-800, AOA, Organized Optometry, Wal-Mart

So I found out that I didn’t have to apply with 1800’s referral network, ProNet, for my practice located inside a Wal-Mart vision center because I’m already in the system because of the alliance between 1800Contacts and Wal-Mart. You won’t believe how awesome this is. First of all, no more telephone calls. It’s all fax now. Huge time saver for the opticians who need to keep busy helping my patients get checked out so they can pay my every-day-low-price exam fee.

And then today, 1800Contacts had a customer on the phone whose prescription expired, so they called my Wal-Mart vision center, and the customer was patched through to talk to an optician. The patient scheduled an exam for Saturday. How sweet is that?!!

Tags: 1-800, patients, Wal-Mart