“As your Doctor sir, I’d like to assure that your
lenses are made to my exacting specifications, and the shop
out front is the only one I would trust with your Rx!”
“Well Helen, of course you can take your Rx anywhere;
however, we won’t be responsible for the accuracy of the
lenses….”
“Mrs. Smith is a client of XYZ Optical up the street,
would you quote her the (wink, wink), special price for
their customers.”
Ad infinitum, ad nauseum, so the battle goes on between
the dispensing MDs and the independent eyeglass shops that
fed them the referrals that helped get them started.
A recent article by “The Ethicist” Randy Cohen in the
NYT mentions a specialist who recommended a CT scan for a
patient at a lab that he had an undisclosed financial
interest in. Randy’s take essentially was, “…. That’s
why a physician should not send patients to facilities in
which he has a financial interest. It is neither prudent
health policy nor good medical ethics to put a doctor or a
patient in such a position,” and he follows, “worse
still, apparently the physician was cagey about owning a
piece of the action”
Not for nothing do doctors own pharmacies, imaging labs,
blood labs, and surgical facilities of all types. Why not
eyeglass shops?
The Federal Anti-Kickback Law prohibits the offer,
solicitation, payment or receipt of anything of value
(direct or indirect, overt or covert, in cash or in kind)
that is intended to induce the referral of a patient for an
item or service that is reimbursed by a federal health care
program, including Medicare or Medicaid. …. As a result,
virtually any financial relationship in which a health care
provider is a referral source, as is the case here, has
potential anti-kickback implications. To the extent that
ophthalmologists may profit from referrals of patients to
optical shops in which the ophthalmologists have a financial
interest, theoretically the Federal Anti-Kickback Law may be
triggered.
In practice; selling eyewear by doctors has been glossed
over, (well under the radar) perhaps it is too hard to
police and establish how a given consumer could be harmed.
“There will be a charge for a redo on glasses not
purchased here – even if the Rx needs to be, er … refined.”
“We really have to dispense glasses because of
insurance requirements…”
“We are not liable for a do-over if this Rx isn’t
filled in our shop.”
I guess it just grinds when I hear clients telling me
what their Doctor said while attempting to hold on to the
eyeglass sale after the exam is over. (Especially with all
the interesting fees that get tacked on to the insurance tab
for “diagnostic tests.”)
Anyhow, have a great Summer. Get some golf or fishing in,
then join your state society and get active - it could help.
