Tuesday, September 12, 2006

Optometrists behaving badly

Time to stop picking on attorneys and their rent-seeking ways. Let's pick on optometrists instead.

From Division of Labor:

The other day I headed off to LensVisionDOC to get a new pair of eyeglasses being sure to take along my last prescription. I'm having no trouble with my eyesight; I just need new glasses since I stepped on this pair a couple months ago and one of the lenses keeps popping out.

I get there, pick out a nice new set of frames, sit down, wait, wait, wait, and finally someone comes by to do the transaction. But nooooooo!!!! My presciption is more than two years old and has "expired." They can't do it they say. I say, "My eyes are fine with this prescription." They say it "doesn't matter--it's the law" Of course, they have an optician right there on sight site who can do an eye exam. I left. GRRR. Libertarian blood pressure rising. Take...deep...breath.

Ok here's the question for all you students of political economy. Which of the following two statements is most accurate.

1. It is important for people to get regular eye exams and therefore prescriptions should expire after a time. Without this requirement, people would wear prescriptions too long and would jeopardize public safety and their own health.

2. The Opticians lobby Optometrists lobby wants more business for its clients and knows that requiring current prescriptions will increase the incomes of opticians.

If you think (1) is most accurate, can you tell me why eye exams aren't mandatory for all people every two years and why it is not against the law to wear eyeglasses for more than two years? If you think (2) give yourself an A in my class.


Anonymous Anonymous said...

Perhaps the person who spoke to you regarding the eye examination did not explain the situation clearly. All people should have their eyes checked every two years. A refraction is only part of a complete visual assessment. Changes to ocular health and vision can be subtle and asymptomatic. In addition, making spectacles involves time, labor and materials. It is better to ensure the prescription is correct with an up-to-date prescription rather than have to change it afterwards.

9:31 AM  
Blogger a singapore economist said...

Yes, maybe you are right, but, personally, I don't want the government to tell me when I need a new prescription.

Optometrists have also fought hard to prevent online sales of contact lenses. What other reason could there be to do so except that online sales costs them $$$?

BTW, this story isn't mine.

10:01 AM  
Anonymous Anonymous said...

The story isn't yours? I see. But it is a common misconception so it's good that you brought it up. There are 2 sides to the online contact lens sales story. If a person has a valid up-to-date prescription, then ordering online should not be a problem but the contact lens wearer should ensure that they still see their eye care practitioner. Contact lenses are a medical device and are not without risks. They prevent oxygen from reaching the eye, carbon dioxide from leaving the eye and are associated with corneal ulcers. Contact lens wearers need to be assessed more often (6 monthly is probably the minimum) because of the higher risks to eye health. Prevention is better than cure, because during healing, the eye can scar. Scarring on other skin surfaces is not as big a problem as it is in the eye - a scar in the cornea will stop light from getting into the eye and cause vision loss. All medicine and health care involves a risk to benefit analysis. The riskier the prescription, then follow up assessments should occur more frequently. Other guidelines are: blood pressure (yearly), professional breast examination (yearly if 40 years and older), cholesterol test (every 3-5 years), diabetes (every 3 years if over 40), glaucoma (every 1 to 2 years if over 40 years), physical (yearly), dental (yearly). If an optometrist wants to work to best practice and not get sued for negligence, they will work to recommended guidelines (internationally accepted standards).

4:38 PM  
Blogger a singapore economist said...

If an optometrist wants to work to best practice and not get sued for negligence, they will work to recommended guidelines (internationally accepted standards).

Why would an optometrist be liable if he/she warned the patient of the risks? Car manufacturers aren't liable if a person not wearing a seatbelt dies in a car accident. Why shouldn't it be up to the patient to decide what risk he/she is willing to accept? And, after all, we allow people to partake in risky behaviour all the time: smoking, drinking, eating unhealthy foods.

1:22 AM  
Anonymous Anonymous said...

It has to do with selling items that are fit for their purpose - intended to protect consumers (if there is a law for that in your conutry), whether the country follows the medical model or the retail model for optometry. In Australia, health care practitioners can be reprimanded for overservicing too so there is protection for the patient (medical model), purchaser (retail model).

6:39 AM  
Blogger a singapore economist said...

I think how we differ is in the belief that the market punishes firms that don't protect the consumer's health, with no need for government intervention. In other words, a business that harms consumers is one that will have a short life span.

8:07 AM  
Anonymous Anonymous said...

While it might be true that the market does punish firms that do not take care of their customers(witness the case of Bausch and Lomb,incidentally contact lens manufacturers, and the fungi incident leading to a fall in their sales earlier this year), however, isn't there always a concern with how fast the market punishes them in cases such as this? Shouldn't government intervention be allowed to try to limit this problem even if it cannot totally prevent it?

7:07 PM  
Blogger a singapore economist said...

I don't believe the driving force behind the making of safe products is a firm's concern with complying with regulations. Bausch and Lomb and most firms well know how product safety directly affects its bottom line. They work very hard to prevent such ruinous events. Firms have too much to lose if customers lose faith in their brands.

Of course, if the government can increase public safety, then I am all for it. I'm critical of seemingly self-serving regulations that are passed off as preserving public safety.

8:17 AM  
Blogger Horny Goat Breaks Wind said...

Optometrists in Singapore tend to be a rather self-serving bunch with an eye on retail rather than professional responsibility (which is why no one expects any professionalism from them in the first place). I should know this having graduated from the Dip Optom course in SP. Im now doing the degree version in Australia and frankly, its not much better... it just pays better.
However, even my lecturers agree that (health issues aside) unless u r under 22 or over 45, it is really unnecessary to regularly check the eyesight of your patient unless he is complaining about blindness and all that.
There really is no law that says one has to check your eyes every so often, its just a guideline. The point is, optometrists in singapore are just glorified salesmen, they have the capability to do better but flogging eyeglasses is much more profitable than lobbying the government for changes that will really benefit the public (and place more liability on themselves).

4:05 PM  
Blogger Clear View Eye Care said...

I think the reason for regular eye exams is more medical than optical. There are medical problems that can occur from wearing a prescription past its time. For instance, eye strain, excess convergence etc. There is a risk too when a prescription changes slowly. Someone may not be legal to drive and say "my glasses are fine." I've seen it. Still, more than just the spectacles it is important to be checked for medical problems on a regular basis. Glaucoma, diabetic retinopathy and others can occur without any symptoms and may lead to blindness if not diagnoses in a timely manner. Clear View Eye Care believes in doing yearly eye exams to prevent these medical conditions regardless of how well the glasses are performing.

2:59 AM  
Anonymous Opticians Eye Test said...

Taking proper care of our eyes is one of the most essential elements of being healthy. Regular opticians eye test thus have to be a necessary part of our medical routine. Most people tend to be slightly put off at the various procedures opticians use to determine vision problems, but that is really quite unjustified. People who smoke or take certain medications should ask their doctor if they are more likely to have eye diseases because of family background. These little measures can help our eyes healthy and keep all the emotional, physical, and financial problems that come with eye problems away.

8:11 PM  

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