A needy child receives a donated exam and glasses, but
this mother’s choices spark skepticism from staff.

Forbes Optometry was a well-established optometry practice in downtown Pittsburgh, PA. The two doctor-owners, both native “yinzers,” give back to the community as much as possible. This includes donating their time, skill, and money through charity work and public outreach. Their medical practice is robust, but the unique high-end eyewear draws many new patients as well.

ILLUSTRATION BY KARLA DURANGPARANG

ABOUT REAL DEAL

Real Deal scenarios are inspired by true stories, but are changed to sharpen the dilemmas involved. The names of the characters and stores have been changed and should not be confused with real people or places.

ABOUT THE AUTHOR

NATALIE TAYLOR is an experienced optometry practice manager for Advanced Care Vision Network and a consultant with Taylor Vision. Learn more at tayloreye.com.

The practice regularly donates ‘coupons’ to school nurses in local elementary and middle schools, with the instruction to provide them to visually impaired children otherwise unable to afford eyecare. One day one of the doctors saw new patient Colin, a second grader. Colin had received a coupon for a free eye exam with basic hardware because he failed his school’s screening weeks ago. 

Colin’s mother accompanied him during the exam, eyes glued to her smartphone. The doctor found Colin was hyperopic, with an uncorrected acuity of 20/60 and escorted the pair to the optical showroom to provide Colin’s prescription to optician Richie. 

“Here are the boys frames covered by the school coupon,” said Richie, setting a tray of eight frames on the table in front of Colin and his mother. 

“This is it?” said the mother, clearly unimpressed. “Don’t you have any Ray-Ban or Nike?” 

“We do carry name brands, but the coupon covers the cost for basic frames,” explained Richie, making an effort not to look directly at her giant Gucci handbag. 

Colin began trying on frames, clearly content, but his mother fussed and complained about the choices offered. “Nothing looks good,” she sighed. “How much would I need to pay to get a good brand?”

Richie paused. “I… don’t think I’ve ever been asked that before,” he replied, struggling with his words.

“Why not?” she asked.

“These coupons are only given when a family can’t otherwise afford glasses.” He motioned to the Chanel sunglasses on top of her head and said, “Designer names aren’t cheap.”

The woman sent a shocked look at Richie. 

“I thought all the kids got this … Are you telling me,” her voice dropping an octave, “that you think I’m poor?!”

“I – I couldn’t really say,” stammered Richie, looking around the showroom for support from his coworker, who was watching the drama from a safe distance. “I know it’s our office’s intention to help needy children--” 

In a flash, Colin’s mother was on her feet, marching out of the optical. Her son scrambled to follow as she plopped her purse down on the front desk. The receptionist jumped. “I want to pay for his exam, and then I want his prescription,” she said in a nasty tone. “And his records.” 

The next morning the office was buzzing with anxiety. Colin’s mother had sent a foul email to the doctors accusing Richie of talking down to her and judging her son, and put up a similar comment on their website. 

The Big Questions
  • How should the office address this woman’s embarrassment and anger?
  • Is there anything the office can do to prevent mix-ups like this in the future?
  • Should the nurses have free license to select deserving students? What are the alternatives?

Expanded Reader Responses

Jessika A.
Asheville, NC

In our office, we work with a school nurse as well. However, it is one traveling nurse who knows the appropriate criteria for identifying those “most in need.” The key is communication; this is best achieved with a single contact person on both ends. 

Tonya V.
Beachwood, OH

It could have been handled differently. When the mother asked about brand names, Richie should’ve said, “These are the frames covered by the coupon, but we carry other frames at extra cost. The lenses would still be covered.” He should’ve directed her to those frames, letting her decide how to proceed. She was issued the coupon, so honor it and charge the difference, or the full price, for the brand frame. Issue an apology stating there was a misunderstanding, and spelling out the correct policy. Say a staff meeting was held to review coupon policies and to ensure this will not occur again.

The nurses have no way of determining who is needy. Some parents may wonder why they were not offered a coupon, and why the nurses weren’t aware of their financial situation.

Don A.
Matthews, NC

First, an immediate and sincere apology is required. A clear explanation must be provided stating that patients receiving charitable products from a selected section have the option of upgrading at additional cost. Then hold a training session to clarify the campaign for all staff.

Jonathan C.
Colorado Springs, CO

Yikes! We also send coupons to school districts for nurses to provide to kids in need. Explain that it’s at the nurse’s discretion, and apologize for any misunderstanding. 

I support giving nurses freedom to select children, as they are trained to identify those in need. An alternative would be providing coupons to charities.

Brian H.
North Hollywood, CA

It’s the nurse’s job to “screen” referred patients. The doctors, since they’re donating their time, should establish the screening criteria. The staff did nothing wrong; it was an overreaction by the parent, whose ego was insulted. We have a similar program and get parental calls for premium lenses or branded frames. Some in our practice want to limit what’s available as the program is for “needy” families. Staff tend to reject upgrade requests. If the parent insists, we give them their prescription and say they can go anywhere for their kids’ glasses. Parents want freebies too, and many believe everything should be “free.”

Robert M.
Edina, MN

The first thing they should do is to send a letter of apology to the Mom. Accept all resposibility and place no blame on the school or the nurses. Then they should set up a protocol for the administration of this community service. The free clinics I am involved with use an honor system for those seeking free services that states they have no insuraunce and are unable to afford care and product. They sign this form. They should then write up an outline of what will be provided and delivered. This will release the clinic and the school nurses from the selection process. What a wonderful service the clinic provides to their community! We should all look at this as a model for providing eyecare to the underserved!

Rick R.
Girard, PA

I think it's obvious this woman's son didn't deserve the service in the first place. I'm not so sure the office needs to make amends for someone who didn't need the service, at least financially. If you ask me, it was the nurse's fault for supplying the service to this person. She should have known who the most needy and deserving would be in the school. I don't think there are too many, if any, alternatives other than the nurse making sure she's more aware the next time.

Cindy H.
Hixson, TX

We've had a similar program in place for a long time. Our solution was to have the teacher suggest to the social worker or school nurse which students might need our help. The teachers have more knowledge of the child's home life and situations and they are generally aware of genuine visual deficiencies in the classroom setting. Hopefully these generous doctors and opticians won't stop helping the less fortunate because of this debacle. 

That being said, we've had a few that were ungrateful and demanding even in their dire circumstances. One can only do so much for those people. And we tend to say, "no good deed goes unpunished."

Lori B.
Santa Rosa, CA

This sounds like an unfortunate misunderstanding. Sound like the school nurse is the party in this scenario who "pre-judged" the little boy's financial status. Seems like when you try to do something nice, sometimes it doesn't turn out the way it is designed. I think it would be important for the school nurse to meet with a parent before handing out a "coupon" for a free eye exam and glasses. This may avoid some embarassing situations in the future.

Steve W.
Philadelphia, PA

Promotion by donation never seemed genuine to me. Who knows how much is truly donated. My father taught me to donate anonymously - to do good, not to promote oneself.

Michael D.
Eldersburg, MD

The initial problem is finding out how this family got into this program and a set protocol needs to be established. As the deed is done with this family damage control now has to take place. This lady has wildly overreacted but the rest of the community does not know it. Do not blame the nurse. (Even though it may be her fault, no good will come from that.) Make a general reply on the website to the effect that we apologize for any misunderstanding, it is not our policy to make patients feel bad, please call the office so we can clear this up, etc. When/if she does call, apologize and explain that her son was somehow but in the wrong program and steps are being taken to rectify this problem. Mea culpa, mea culpa.

Ric D.
ATLANTA, GA

The nurse set this up for failure; it was not the optician's fault. What was the prequalifier for the program?


This article originally appeared in the September 2017 edition of INVISION.

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