editor's perspective

Should Contact Lens Prescriptions Mimic Medical Prescriptions?

BY JOSEPH T. BARR, OD, MS, EDITOR
December 2000

I've written numerous times that I'm not sure how we justify selling glasses and contact lenses after we prescribe them when in most situations, ODs and MDs are not supposed to sell medicines they prescribe or perform lab tests they order. This usually sets off a very emotional reaction to rationalize what is usual and customary. In the old days, there was a quality control aspect to eye doctors and opticians monitoring the devices that labs made for them. That is certainly less true today. Now I know that the majority of you who have made it this far into this editorial would like to verbally or otherwise injure me for saying these things, and you can quote numerous examples of how I am wrong. So before I need to call my bodyguards, let me assure you that I support your right to sell glasses and contact lenses after you prescribe them, right up there with your right to free speech and assembly. No one could be more qualified to sell these devices than you.

New Jersey Assembly Bill A2244 would prohibit optometrists from dispensing eyeglasses and contact lenses to their patients. This legislation is supported by "major optical chains." The proposed law alleges that sending your Rx with your patient to another person to buy the eyewear/contact lenses would prevent doctors' "significant financial interest" from influencing patient decisions. The law would encourage choices, supporters contend. Optometrists, of course, worry about the impact of such a law on their income. And rightly so, because logic does not always prevail in legislatures.

The problem here is not optometric income. The problem is that the good people of New Jersey, the eyecare consumers of New Jersey, didn't come up with this idea. If they would have, then the issues would have been the following:

• We are being soaked by overprescribing optometrists.
• We want to always go shop elsewhere for our eyewear/contact lenses.
• We are not getting good service.
• We are having many complications with our devices which the optometrists overprescribed in their best interest, not ours.

These risks have not been pointed out by the citizens of New Jersey because such situations rarely occurred. If New Jerseyites were asked, they would say, "I prefer to get my devices from my doctor because:

• That's why I went to see him or her."
• I haven't had a problem with the current system."
• What you propose is a big hassle."
• I don't feel unsafe as it is."
• Leave me alone."