This Owner Requires Staff to Sell Products Against the Patient’s Best Interests. How Would You React If You Were on Her Team?

“HEY TERRY, I just pulled this tray down to dispense the order — I initially worked with this patient and remember the encounter, and this is not the frame they chose.” Sam added, “It looks similar but it’s a different brand.”

Terry responded, “That’s strange… Did the patient narrow it down to a few that were similar and maybe the wrong one was sent to the lab?”

“Absolutely not. The final three frames were nothing alike — which is why I remember the frame that was selected.” Sam continued, “I could go grab it off the floor right now…”

“Ugh,” Terry sighed. “I think I know what happened — is the frame in the tray a brand that Heather is a rep for?”

“It is!” Sam added, “Wait, how did you know that… and why would you ask that?”

Terry responded disheartened, “Long story short — Jackie looks through the orders before they go to the lab and if she sees a frame that’s similar to one of Heather’s, she makes an executive ‘I’m the owner’ decision and swaps the frame out.”

“That makes zero sense.” Confused, Sam asked, “Why?”

“If I may be frank… Heather is her friend and she pushes Jackie perks from the frame company she works for.” Terry added, “The more frames of Heather’s that our office sells, the more Visa gift cards that Jackie gets.”

“Well, that pisses me off — she has no right to mess with my order that my patient chose,” Sam vented. While dispensing the order, the patient didn’t seem to notice that the frame was different, so she decided to let this one slide.

A few days passed and Jackie approached Sam and Terry, “I have a friend who is our Account Manager at the lab we use. We’ve been negotiating some ways to save money and they locked us in with some amazing prices!”

“Oh wow, that’s great — good work,” Sam replied.

“So, to get these prices the requirement is that 90% of the lenses we order from them need to have their in-house AR.” Jackie continued, “And 90% of our materials ordered need to be poly.”

“AR or poly or both?” Sam questioned.

“90% of all of our orders need to be both poly and have the specific AR,” Jackie answered.

Sam and Terry looked at each other in astonishment. Sam was at a loss for words, so Terry responded, “What about the patients who are poly non-adapts… or need higher index than poly… or request a specific AR?”

Jackie interrupted Terry, “To the patient, poly is thinner and lighter and AR is AR.”

Terry replied, “What about when a patient doesn’t want to pay for AR or poly?!”

“Listen…” Jackie insisted, “You have 10% of wiggle room — and are going to need to figure out a way to take those specifics and keep them within that margin. We only use this one lab and it’s simple math — just make sure that 90% of your orders meet the requirements.”

Neither Sam nor Terry could muster up any words. Jackie gave them a quick “thumbs up” and walked away.

Samantha S.
Phoenixville, PA

I can understand why the owner may want to sell more a of a certain brand due to certain incentives. BUT you can’t sneak it in the backdoor like that. Integrity in business matters, it brings customers back to you rather than the competition. Highlight that brand in the office with a nice display and discuss certain selling points. If the patient had noticed it wasn’t the frame they picked out, that could create a new headache for the staff and cost the office money due to potential remakes and wasted time. As for the 90% policy, the 90% goal would only be achievable if the office already uses poly for the majority of jobs. For the AR, I would want a sample of it and get the staff a pair of glasses with this AR to try for themselves. If the AR is as good as any other that patients are currently purchasing, then I don’t see a problem with switching to the house brand for a majority of jobs.

Kelsey B.
Winston Salem, NC

Changing a patient’s frame would be crazy behavior and the reason given seems very unethical. Patients have a right to understand what they are paying for and should be getting exactly that which was discussed, nothing more and nothing less. If I were this staff member, I would find a different place to work ASAP. Poly is appropriate for most patients but not all, certainly not 90%! While I do think AR is important on all lenses, the reality is that not everyone can afford that. If it’s between a patient having nothing or having uncoated CR39 lenses they can function with, I’m choosing the second option every time.

Deborah T.
Austin, TX

Oh no! I would let the owner know that what she is doing is immoral. I would explain to her that if a patient has chosen a specific frame, it’s because she liked it the best. The owner has no right to put herself, and her handouts from the rep, ahead of her patients. As far as the lab pricing, she can try to sell more poly and AR but if it doesn’t happen, she can’t get upset over it. As opticians, we have the duty to recommend to our patients what they NEED for their best visual needs. I would never put a high-power prescription in a poly lens. I want to make sure I give my patients the opportunity to obtain their best vision. If I was the optician, I’d start looking for another job.

Jeff G.
Spring Valley

I have a hard enough time with patients who claim the frame they ordered is NOT the frame they ordered. I wouldn’t work for a Jackie no matter how much you offered. You never go through other people’s jobs and switch out frames. Seems like Jackie is the only one that benefits from all the kickbacks and she’s willing to compromise quality with crap. Been an optician over 30 years now and I’d rather keep my morals and give people what they paid for, not what someone else wants to do to save a dollar.

Caitlin N.
Montrose, CO

I think that perks are a great way to help the business grow and should be used to do so. I don’t think they should necessarily be used for personal gain. If they are being used for the correct purpose it makes more sense to have an incentive. I don’t think just because there is an incentive a product should be used. We truly believe in the products we use and we do end up with some perks from those products, however we also stand behind our products and tell the patients what value they are getting with each AR coating and higher quality lens purchase. A specific percentage of sales with these coatings or lens designs seems like it would be less possible without having the confidence behind the value.

Pablo M.
Atlanta, GA

I am all about saving as much money as we possibly can. Having said that, being in a licensed state puts fiduciary responsibilities on us Licensed Dispensing Opticians. We are obligated by law to put the welfare of the patient first and foremost, and we can face civil and criminal penalties for taking actions detrimental to the patient. I have resigned from corporate optical places for much less than that. MY. LICENSE. IS. NOT. FOR. SALE. It is incumbent on managers/owners to find ways that make financial sense for the practice, but ensure the patient receives the best possible combination of products and services in all price brackets. Jackie could get herself in a lot of trouble if her bait-and-switch is discovered… the word of mouth alone could be crushing.

Chris D.
Florida

I would definitely have to sit down with that owner to have a discussion on ethics. Swapping a similar frame style if there was a real necessity is not a problem but if it’s solely to reap personal gain that’s a behavior that’s not acceptable by anybody in the practice. As far as that lab deal goes, she is adamant to shortchange patients to get superior lens options that they can and would be willing to pay for, so to save a few dollars on one part of her lab bill she’s shooting herself in the foot for greater profits on better materials and qualities of anti-reflective treatment. I cannot support unethical behaviors by anyone in a company from the top down. And ultimately patients are going to become wise to this and rebel and insist on refunds or refuse to shop there in the future.

Ben T.
Miami, FL

Whenever there is a customer complaint about “That’s not the frame I picked,” I would take it right to the owner without trying to mitigate the situation myself.

If the products provide what is best for the patient, then there shouldn’t be an issue. The staff should have the freedom to always provide solutions that will best fit the patient’s needs. I would also renegotiate that 90% with the lab because that is way too high of a commitment.

Everything you sell should be priced appropriately to protect your margins.

Rick R.
Girard, PA

Okay, this is the owner you’re talking about. That’s a worst-case scenario. The fact the owner would insist on such unsavory practices towards patients/customers, especially for kickbacks or perks, is tantamount to bad business.

There is no possible way to stay within those specs unless you’re lying your butt off by NOT telling your patients/customers what they are paying for. I worked for chains where that was a standard practice to lie and cheat the customer to keep up sales numbers.

It absolutely does not make sense in the long run because eventually that is going to come back to haunt you, as an employee, and as a business that cannot be trusted. Losing business is not a good way to run a business.