What Part Of Know Don't You Understand?

Whether your patient's purchasing decisions are based on price, selection, emotions or what fits inside their insurance bubble, ECPs are required to think quick on their feet while following their gut. 

To buy or not to buy-that is the question. The answer lies somewhere between what the doctor prescribes, how the ECP conveys that and what the patient expects.  I was presented with a patient last week that after further review, I know I should have never allowed the situation to get so out of hand. I messed up when I ignored my ECP gut full of moral obligations to the patient and the practice. I've only been in the optical industry for 20 years so I'm still learning.

Here are the cliff notes from my ongoing patient encounter with Mr. Noears and his wife that may end up being a bad novel.

Mr. Noear's old Rx	Mr. Noear's new Rx
OD -8.50 -0.25 x 090	OD -8.50 -0.75 x 090
OS -10.25-0.25 x 120	OS -10.25-0.75 x 115
+2.00 add OU	+2.25 add OU
PD=60
Progressive lens wearer

Mr. Noears chose a metal frame with clip-ons (size 58-18-150) during a handoff with minimal communication. The shape and color looked nice on him, the size looked ridiculous. I discussed his lens options and he definitely liked the idea of having a polarized clip-on. I reminded him that he wears his glasses all of the time and the larger the frames the thicker and heavier his lenses would be. I was matter of fact about the frame being too large on him and not a wise decision at all for his RX. He had no problems with his current pair and he would keep those for back up. I checked to see if we could get that exact frame (51-18-140) and they were discontinued (imagine that) with no warehouse leftovers. I strongly recommended that we order a few smaller frames for him to come back and try on. I would make sure the ones I ordered were comparable to his current pair. 

After several minutes of working with him his wife spoke up. I should have followed my gut feeling that this was not going to be good. She told me not to worry about ordering any frames because she liked the larger frames on him and she didn't think the lenses would be that thick. I could immediately tell she was the one that wore the glasses in that family. With his nose pressed up against the mirror (as our office eagerly awaits a mack daddy fitting system) he agreed with her that the frame size looked good. 

At this point it didn't matter what I recommended since their minds were made up. Mrs. Noears said her husband has to wear the glashez (glasses) and these are the ones we want. Alrighty then. If I owned the practice I would have politely refused to make the eyeglasses on the spot. In this case I was with another patient when the (fill in) doctor walked the Noears into the dispensary and happened to choose this particular frame to demonstrate the clip-ons. I explained to Mr. Noears as privately as possible in the midst of a crowded dispensary that the doctor was not showing him the frame in regards to it being the best size for him. He said he realized that and proceeded nudge his wife to get the checkbook out.

I took the measurements I needed and put his tray aside. I had to call him later that day with some information regarding his vision insurance and asked him about canceling the order telling him it was not too late. No thanks. Guess what? He hated the finished product when I presented it to him. He wanted to know why the darn lenses were so thick? I calmly explained (thanks to Bikram Yoga) the reasons for the thickness and revisited our conversation and the notes from the day he placed the order. I asked him if he wanted me to help him now. I told him that I too was disappointed and I'm willing to make it right as long as he agrees to completely trust me this time. 

I said I would order the smaller frames for him to try on and call him when they came in. I explained in detail that it would take 7-10 business days to make the new lenses after we decide on a frame. Without hesitation he agreed. Mrs. Noears called back five minutes after he left and wanted to know what happened. She asked if they would be getting any money back. I bet you can guess the answer to that one. 

The smaller frames arrived and I called to let Mr. Noears know. Mrs. Noears answered and said that no one told Mr. Noears that he would have to come back to just try on frames. They told him he would be picking up his new prescription eyeglasses. I told her that the triangle communication between the three of us was not working out real well. I said that he was well aware of what he and I discussed and asked her to please have him call me. It will be next week before he can come in to try the frames on. I hate to leave you hanging however the final results are still up in the air. 

Morals of the story:

• The patient is the patient is the patient 

• Always follow your gut

• Never lose control of the agenda 

• Think quick on your feet 

• Actions speak louder than words

• Politely refuse

If you know your morals as an ECP and ever find yourself in a situation that compromises them; remember that even though the patient may not understand you don't need to prove it to them.