System Failures?
Could someone clarify the legal position with regard to the current CET points system? Firstly, many CET articles do not actually teach anything but simply go over old ground.
Secondly, there is nothing to say that the answers to questions have to be filled in by the person named in the response sheet, or tapped into the computer by the named person. We are not obliged to stay awake during a CET lecture or show anywhere that we have learned anything.
As we are simply required to be awarded CET points in order to comply with the law, is it not possible for an arrangement to be entered into with, say, Tesco, for us to be awarded CET points in proportion to the size of our shopping bill, for a small fee, of course. Alternatively, would it be legal for someone to set up a CET points website and supply the answers to all current free CET articles as they are published for the benefit of all those professionals who know all they are supposed to know, but are too busy to read the articles?
W P Curran
London
Whatever Next?
Well, we thought it likely - now the giant of mail order, Next, is selling prescription spectacles. Although some better news for practices with Next starting at £43.49 lowest complete delivered charge, increasingly up to £183.49 for rimless, all with a limited single vision range.
This, after a rather convoluted thought process to see if you meet all its ordering criteria. Mrs N failed to reach 'Go!'
Next's proposed solution to ask customers to use the printed frame measurements off their existing spectacle to establish the nearest fit, together with the use of 'average PDs' has huge scope for potential errors in ordering. I guess most optical practices can compete at these prices providing their spectacle charges are not already carrying a huge subsidy for an under-priced eye examination.
It would be interesting if practitioners could collect and report anecdotal evidence of the experiences of those patients who use the internet or direct mail supply to purchase Rx spectacles. One cannot believe it will be that simple for the general public to specify their own Rx order correctly! No doubt, we shall have to just wait and see.
Frank Norville
Gloucester
Be advised
Mr Snelgrove (optician, July 22) asks a number of interesting questions, all of which can be answered by looking at the law of negligence.
Without boring your readers with too much detail, in order to be liable in this tort, the claimant (patient) has to establish three basic elements. If a patient suffered eye damage some time after an examination was refused by an optometrist, he would have to show that that optometrist owed him a duty of care, that he breached that duty and that the breach caused the actual loss. Once those elements have been established, it is necessary to show the extent the damage can be attributed to the optometrist's act/omission and whether he has any defence.
Clearly the individual facts would determine liability, but I would suggest that the optometrist would have no defence to argue that he did not examine the patient because he anticipated he would be unable to claim the appropriate fee. There may be other factors that make a test at that time inconvenient to perform, but if a patient presents themselves with symptoms that raise concerns for their ocular health, then an optometrist is immediately under a duty of care to this patient. This duty does not mean that the optometrist must examine them immediately, but whatever they decide to do, in the event of a claim the optometrist will be measured against the standard of care that a reasonably competent optometrist would give.
Given the fact that an examination would only determine whether a referral of any sort was necessary, I would argue that a reasonably competent optometrist, unable to perform an eye test, but presented with such symptoms, would and should simply refer that patient there and then - problem solved.
Indeed, this matter raises the interesting point that I have made before, but maybe needs reinforcing. Optometrists should be very wary of performing additional tests which are not part of a routine eye examination, as the moment he performs additional tests he is under a duty of care to act upon the result of those tests. If he inadvertently misses something that should have been picked up during that additional test, he will be found liable whereas no liability would have arisen had he not performed that additional test in the first place!
In fact looking at the level of optometrists' fees, I can only think that few or possibly none of them realise the burden and duty of care they do automatically assume performing even the most rudimentary eye examination.
David Levy
Radlett, Herts
Cost analysis
I cannot let pass Nigel Burnett Hodd's letter (optician July 15), which reads like an advertisement for Johnson & Johnson. Though not intentional, it is inappropriate to promote Johnson & Johnson in this manner as, with my other clients and colleagues, I have a different experience.
Referring specifically to the prices mentioned in the letter, I urge practitioners to watch out for Johnson & Johnson adding the surcharge, which would in total change the cost of the lenses. I could only suspect that they must be spoiling Mr Burnett Hodd more then CIBA Vision, for he is at the forefront of the contact lens field.
And finally, while it may not be the case, but it sounds as if Mr Burnett Hodd is implying that he is influenced by the product cost in prescribing contact lenses! OopsÉis he playing into the hands of Mr J M Wells, Tesco and others?
Yogesh Patel
Morden, Surrey
The Editor Writes
The Editor would like to remind letter writers that while readers' views are welcomed they must be expressed in an appropriate manner. The Editor insists that all references to companies or individuals should be factual.
Comments about individuals should not be defamatory and prices quoted should not be the subject of confidentiality agreements signed between practices and suppliers. optician has a long tradition of freedom of speech and is often the only magazine willing to publish controversial letters. We welcome strong views but urge writers to express them in a reasonable and legal fashion. The Editor retains the right to edit or not publish letters as he sees fit.