By William T. Reynolds, O.D. , American Optometric Association President, Family Doctor of Optometry in Lexington, KY
Each year, from the moment I became a doctor of optometry, I recommit myself to the optometric oath. The first line in that oath states our north start very simply: “I affirm that the health of my patient will be my first consideration.” I live that mantra every day which is why it is inconceivable that the federal government would enact a law that makes it more difficult for me, and the 44,000 doctors of optometry, to deliver that care to patients.
Despite protest from tens of thousands of doctors, patients and consumer advocates, along with more than 150 bipartisan House and Senate leaders, this October the Federal Trade Commission (FTC) finalized Contact Lens Rule changes that deprioritize patient health and safety. This action and the burdens the new rule places on the patient care system are particularly egregious at a time when the nation’s health care is facing incredible strain from the unprecedented crisis created by COVID-19.
First, the rule largely ignores serious patient health and safety concerns stemming from the increasing use of disruptive and unreliable contact lens prescription verification robocalls, which too often leads to patients receiving different contact lenses – Class II and Class III medical devices – than what was fitted and prescribed by their eye doctor. The FTC itself acknowledges the patient safety risks here noting “The Commission is concerned about the misuse of passive verification to substitute a different brand and manufacturer of lenses.” However, the Commission chose not to take decisive action to stop this concerning practice.
The rule also put forth a burdensome requirement that drives a strong wedge in the doctor-patient relationship, requiring eye doctors to comply with unnecessary and costly contact lens paperwork and record-keeping requirements. Specifically, the rule mandates that eye doctors obtain a signed form from their contact lens patients verifying that the patient received a copy of the prescription following completion of the fitting and prescribing process. This requirement has negatively impacted my relationship with my patients and created an administrative headache at a time, during this noxious pandemic, when any extra burden threatens the very viability of our practices.
Simply put, this new rule is a raw deal for eye doctors and the more than 45 million contact lens wearing patients in America. Fortunately, forward-looking Senators understand that this rule needs to be changed and have put forth a solution with (S. 4613), the Contact Lens Rule Modernization Act. This act, at its heart, is bipartisan legislation that would fix the FTC’s flawed rule changes.
The bill does two things, both of which are beneficial to contact lens-wearing patients and their eye doctors. First, the bill prevents the use of robocalls to verify patient contact lens prescriptions. If S. 4613 is passed, to keep patients safe, sellers of contact lenses would be required to verify prescriptions using other forms of electronic communication (e.g., fax, email, etc.), not automated robocalls. These robocalls are often sent via computer at all hours of the day and night, in many cases are so muddled we can't even understand the patient's name let alone their prescription and there is no call back number to correct errors, all of which make it challenging for doctors and staff to properly verify contact lens prescriptions.
Second and most importantly to me and my patients, the bill addresses the signed verification requirement of the new rule that went into effect last month. My contact lens patients are asking why they need to sign even more paperwork, what the signed verification form is for, and why the U.S. government thought this was a good idea in the first place.
The most serious side effect is that patients are skeptical and confused about the signed verification form and wonder what "doctors" have done to make the government require this new paperwork. It either makes people distrust their eye doctor – a terrible byproduct of this unnecessary rule – or question the federal government and in many instances, it does both.
This is why the Contact Lens Modernization Act is so important. The bill doesn’t do away with any requirements dealing with patient rights, it simply necessitates doctors to post a clear and conspicuous sign in their offices that notifies patients of the right to their contact lens prescription at the completion of the contact lens fitting. As the National Consumers League recently noted: “This type of posted signage is already mandatory in California, seems to be working well there, and we think it should be emulated at the federal level.”
In a climate where every primary eye health care provider is going above and beyond to deliver safe care to their patients, we need clear and efficient solutions. Not more paperwork or requirements that sow doubt and confusion and, ultimately, put patient health in jeopardy.
It is critical that legislators support the Contact Lens Modernization Act today for improved eye health and vision care tomorrow.