“Doc, How Can You Write An Rx, When My Doc Can’t?”

Oddly enough, this question was asked of me twice this week, so I thought it should be addressed.

First of all, I’m not a lawyer, and I don’t even play one on TV. This is more of a question for a lawyer, not me. So with that said, I am going to answer the best I can with my experience in my own life which is limited to a small radius of the 15136 zip code.

This is confusing for a lot of reasons, first of all, there is NO COMMON SENSE in health care, and it revolves around MONEY, not common sense… So if anything in this blog (or any other blog for that matter) doesn’t make sense, it will just follow the money.

There are two types of eye doctors, Ophthalmologists and Optometrists. The BIG thing that separates the two is SURGERY. Almost ALL ophthalmologists do surgery (in my experience, I only know one that doesn’t). Almost ALL ophthalmologists do basically the same thing; they like to treat SICK eyes. The best ophthalmologists I know, ONLY treat SICK eyes, they have optometrists that work for them to see the “other stuff”. They do this whether they are self employed or if they work for someone or something else. (A corporate vision center).

BUT, optometrists are a funny bunch.

To become an optometrist, it takes about 8 years (VS. 12 to become an ophthalmologist). ALL optometrists are doctors who are licensed to provide primary vision care ranging from sight testing and correction to the diagnosis, treatment and management of vision changes and/or diseases. In most states this includes anything from a red eye to Glaucoma.

BUT, not all optometrists practice in a setting that allows them to practice to their full ability.

In my case, I am an independent optometrist. I am self employed, and I CHOOSE  to practice to my full ability and take very seriously the privilege to treat red eyes and Glaucoma, because I WANT to and I have the credentials (and equipment) to do so. Not all optometrists feel this way. There are a few independent optometrists that don’t want to treat red eyes (just as there are ophthalmologists that don’t want to do surgery).

Some optometrists, mostly those that work commercial (Pearle, Lenscrafters, America’s Best etc) can’t, or don’t want to treat red eyes or glaucoma, they only write Rx’s for glasses or contact lenses.  (Again, some don’t WANT to, but others CAN’T). Their employer can dictate whether they can treat a red eye, etc or not. (If you don’t have the right equipment, no matter where you practice, you can’t treat glaucoma).

To tell you the truth, this is where it gets mushy. Some commercial places have the equipment and the optometrist that has the credentials to treat a red eye, some will let them, some will not.

In my experience, most commercial doc’s (Pearle, Lenscrafters, America’s Best etc.) send out the patient that needs a medical Rx. Most commercial settings are focused on selling glasses.

Some commercial places will say they can do “everything” but only accept vision insurance which DOES NOT COVER a red eye, etc.

In summary; Most ophthalmologists do surgery (etc), most independent optometrists treat red eyes and glaucoma, (along with glasses and contact lenses), most commercial optometrists do whatever they can, (glasses, contact lenses, red eye, glaucoma) that is allowed by their employer.

So, doctors can have the same degree, but practice differently, depending on the setting they are in, or what they are comfortable with treating.


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