optoblog.com

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.

I just was contacted by Review of Optometry. Apparently, they didn’t want any comment from me, but they were hoping that I knew the name of an optometrist in Utah that is vocal about 1-800 type stuff (apparently not me, just any other Utah O.D.). So, Utah ODs if you want to comment on the whole 1800/Wal-Mart story, let me know so that l can pass on your information to Review of Optometry.

But I thought that if by some miracle R.Opt. makes a link to my site, I’d better update more about what I’ve discussed with others about the whole partnership with 1-800 and Wal-Mart since my original post. Of course, this has been a hot topic at Wal-MartOD.com and at other sites like the highly secretive society of ODwire (which I don’t read anymore because, hey, it’s a secret).

So in my last post, you read the e-mail that I immediately sent back to Wal-Mart HQ the moment I heard about the news. The next day I went to work, and to my utter amazement, my vision center manager thought the partnership was pretty cool. Why? Apparently, Wal-Mart currently buys their contacts directly from each company, so this partnership is supposed to make the process faster for the patient. It is also supposed to help lower costs since 1-800 and Wal-Mart can combine their buying power to ask for a deeper discount from the individual contact lens manufacturers.

Then the district manager called and expressed the same opinions, but also added that Wal-Mart would save money by transferring the expensive maintaining of walmart.com’s online contact lens sales to 1-800’s website. She also said that 1800 has a huge brand recognition. If you walk-up to someone on the street and ask them where one could go to buy contacts, something like 40% will say 1-800-Contacts.

So this tells me that Wal-Mart is using 1-800 as their sort of high recognition buying group. In my practice, I order most lenses through a buying group like Lensco, but then some lenses I just purchase through the manufacturer, and hard lenses I get through Valley Contax ( I know Lensco does hard lenses also, but Valley has the I-Kone and my alumni’s C.A.D. design.)

So is it a sin for Wal-Mart to get itself a buying group? Of course not, unless that buying group happens to belong to the Spawn of Satan. Okay, all kidding aside, I wrote the following follow-up e-mail to Dr. Patel:

…I would gladly be willing to recant anything I’ve said about 1800 CONTACTS if they would join the Vision Council of America, prominently display the “Check Yearly. See Clearly.” logo (checkyearly.com), erase from their site any directions for consumers to subvert doctor recommended expiration dates, and withdraw their lobbying efforts for government mandates on 2-year expiration dates.

You should include that as part of your bargain with them.

So, just because 1800 sells contacts online doesn’t make them my enemy. It’s their coaching of consumers to badger doctors about prescription expiration dates and worse, their lobbying for laws to mandate to doctors a minimum 2-year expiration date (which succeeded into become a Utah state law).

Wal-Mart recently announced in a letter that they are “excited to announce a long term alliance between Wal-Mart/Sam’s Club and 1-800 CONTACTS..”

May Heaven help us, because 1-800 sure isn’t going to. I promptly wrote the following E-mail to Dr. Patel, Wal-Mart’s Director of Professional Relations:

Dr. Patel,
I would advise against any kind of alliance with 1-800 CONTACTS. You’re not the first one to try. Standard Optical, a Utah-based optical chain, aligned with this Utah-based contact lens reseller for a while, and it didn’t last long. You should talk with those in the know about why it didn’t work out.

1-800 is also militant about teaching the general public to force the doctor to make decisions not in their best interest. Everyone inside our industry acknowledges that yearly eye exams are important, but 1800’s own website indoctrinates consumers to mandate to their doctor that prescriptions should expire at the two year mark OR LATER. (see: http://www.1800contacts.com/docAndRx/DocRx-release-1.shtml ). As a Utah eye doctor, I already suffer with practicing in the only state in the nation with a minimum 2-year contact lens expiration date- thanks to 1800’s lobbying power in our Utah legislature.

I had a patient last year, whom if her prescription hadn’t expired, she wouldn’t have come back in to see me for her yearly exam. If she wouldn’t have had her yearly exam, I wouldn’t have noticed an FDT screening visual field defect and reduced vision in one eye that wasn’t there the previous 2 yearly exams. If I wouldn’t have seen her, I couldn’t have referred her to the ophthalmologist who referred her for imaging which found the diagnosis of a brain tumor. A yearly eye exam saved her life, and under 1800’s reign, we are sure to miss these kinds of cases in the future.

If your only goal is to cut costs related to online sales at walmart.com, why not use 1800 as a nameless, behind the scenes
subcontractor? Giving them the limelight is the wrong move for Wal-Mart. An alliance with 1800 disgraces our reputation.

Also, I’ll quote from your FAQ (http://www.walmartod.com/clients/1814/docs/FAQ_Alliance.pdf): “Consumers in that same survey specifically cited cost and “purchasing them is inconvenient” as reasons for over-wearing their lenses.” Wal-Mart boasts about how something like 50% of a town’s population visit their store in any given week. How is stopping by the vision center on their bi-weekly pilgrimage inconvenient? What they meant to say is expensive or don’t have enough money. They expect to buy a box per eye and stretch it as long as possible. The real problem is that people expect a year supply of contacts to be less expensive than glasses just because you throw them away, and most also expect them to be a replacement for, not in addition to, glasses. Change those two perceptions, and you’ll increase your contact lens sales without help from the enemy of 1800 CONTACTS.

Please see my previous blog posts about 1800:
https://optoblog.com/2007/10/09/check-yearly-live-another-year/
https://optoblog.com/2007/07/30/patients-say-the-funniest-things/
https://optoblog.com/2007/03/19/1-800-eat-crap-and-die/

Sincerely,
David Langford, O.D.

Here’s another example of why everyone should consider getting a yearly eye exam despite what Canadian studies say. A college student came in for a routine eye exam to get more contacts since the last doctor made her contact prescription expire only after a year. Everything seemed normal except that this year she didn’t pass the FDT screening field with one eye and that same eye had 20/30 vision. The ONH looked a little pale and both were elevated.

If I was still in Indian Health Service, I could have handled this myself- ordering all kinds of fun tests. But what I’ve learned out in the private sector is that insurance companies HATE it when optometrists order tests. Patients get denial letters on labs. Forget about imaging. Besides, I was having a train wreck day, so I just punted to the ophthalmologist.

Turns out that an MRI ordered by the OMD diagnosed a brain tumor that would have killed her if allowed to fester. I know that because she stopped by last week on a day that I wasn’t there to say thank you. When I heard that, I felt ashamed. I should have been the one to piece together the information and order the scans and have the burden to tell her the bad news.

But regardless of my personal shame, the patient is now okay. She is yet another shining example of why Utah state law should not mandate to me that I have to make prescriptions good for two years. I saw her chart from previous years. No VF defects, 20/20 vision in both eyes- no indication that the next year she would be diagnosed with brain cancer.

Hey 1-800 and your lobbiests! Who knows how many people you will kill or blind because you force by law that every eye doctor in the state of Utah has to make their Rx’s for 2 years.

So everyone: check yearly, see clearly, live longer.