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Consider Going Paperless

If you aren't going to enforce policies, why document them with forms?

GARY GERBER, O.D.

A long-time patient asks you to repair an old frame he bought elsewhere. The frame repair is what you'd classify as "high risk" — meaning, it may break if you try to fix it. Would you refuse to fix it, or would you fix it, though have the patient sign a waiver first?

If you do attempt to fix it and it does break, how would you proceed? Getting to the heart of this matter: If you did have the patient sign a waiver, in advance, acknowledging you weren't responsible, would you still take responsibility and make sure the patient leaves happy — with either a discounted pair of glasses, a free frame or some other concession?

Let the patient leave happy

When posing this scenario to doctors, nearly all say: "Whether the patient signed something or not, I'd want them to leave happy and would make sure they left with another frame." Most say they would offer a frame at a discounted price, and a few say they would offer a frame at no charge. Personally, I agree with these solutions because having patients leave unhappy — when avoidable — is bad for business. So, if most of us would want the patient to leave happy, it begs the question: "Why have any sort of waiver form in the first place?" In fact, if you're not going to enforce an office policy, why have the policy in the first place?

Forms and policies like this are often put in place to ward off potential problems and in this case, most likely to stimulate the sale of a new pair of glasses and save the patient problems down the line. That's all admirable. The question, however, is why the need for documentation? Few of us would flaunt the piece of paper in the patient's face and say, "Hey, I warned you they'd break, so no soup (glasses) for you!"

What we should do is confidently and carefully explain why the patient shouldn't attempt to repair his frame. Instead of warning of a potential problem, we should recommend he purchase a new frame. We should make the discussion positive by saying something like: "I'm glad we took a careful look at your frame so we can let you know that if we attempt to repair it, it will likely break. So you're better off keeping it as is, for either spare parts, or — if wearable — for an emergency pair. Now let me show you a new frame."

What of progressive lenses?

The same sentiment can be said for progressive lenses. In an attempt to stave off a potential refund, some practitioners have a patient sign a document asserting that if patient adaptation isn't possible, the practitioner will not refund the patient, or he will provide a partial refund of the difference in price to a lesser-priced lens. In this case, the incidence of non-adaptation is so miniscule that no valid reason exists for such a policy, let alone a written one that you're likely not to enforce.

Additionally, from a sales perspective, discussing non-adaptation in one sentence and following that with a sentence that attempts to explain the benefits of a new technology lens sends a significant mixed message to the patient. Regardless of what you might say or have the patient sign, what they'll hear and read is: "The lenses are great and you'll see great. But if you don't, you're not getting your money back. Too bad, so sad."

Eliminate any unnecessary forms that you're not going to enforce anyway. Doing so makes doing business with you easier. OM