"Beware of bargains in heart surgery, parachutes and contact lenses," warns Dr. Stephen Glasser, president of the D.C. Optometric Society.
Glasser may be right about forgetting the cost when it comes to coronary bypasses or rip cords, but when choosing between soft contact lenses--ranging from $75 to $300--the decision gets a bit blurry.
Splashy storefront posters and blitz advertising by commercial eye establishments have turned soft contact lenses into a competitive and big business. Manufacturers' sales have more than doubled: from $99.6 million in 1977 to $229 million in 1981. It's no secret that commercial establishments have taken a chunk out of the sales of private practitioners who, although their prices are higher, claim they provide more comprehensive care.
Many area independent doctors feel that some of their storefront counterparts don't stress personal attention, nor give patients sufficient time.
"Some of them are like a gas 'n' go," claims Dr. Michael Obremsky, a past president of the Virginia Optometric Association who runs a private practice in Annandale.
Commercial establishments disagree. Care is sufficient, they say. "We don't fit 'em and forget 'em," says Bill Cole, president of Kinsman Optical.
Other private practitioners feel some commercial establishments have turned shopping for contact lenses into just that: shopping. The public is bombarded by commercial-establishment ads that make them think contact lenses are a product, not a service, says Dr. Harold E. Davis, secretary of the contact lens section of the American Optometric Association and a private practitioner in Illinois.
"Doctors should be answerable to patients, not stockholders," says Dr. John Greenwood, past president of the District's Board of Examiners who practices privately in Georgetown.
"The basic service is the same, the product is the same. The public wouldn't be coming if they weren't pleased," says Randy Gershen, regional manager of Maryland and Virginia's Pearle Vision Stores.
Says Dr. Joyce Chatlin of Designer Optical: "Cheaper lenses give more people an opportunity to have contact lenses, not only the lawyers and accountants, but the secretaries."
Contact lenses from a private practitioner in the D.C. metropolitan area cost (for lenses, exam and follow-up care) about $200 to $300. At six major commercial establishments surveyed, costs range from $75 to $145 (for lenses, exam and follow-up). Thoroughness of exam and number of follow-up visits vary among both private and commercial establishments.
Good and bad experiences--with both private and commercial establishments--have been reported. Wherever you decide to go, here are some reminders:
* Ask why a particular lens was chosen for you. As with designer jeans, not everyone can wear the same make.
Lenses differ in their water content. Since the amount of water can vary from 38 to 70 percent, proper-fitting lenses must take into account the amount of tears produced by your eyes. Also, lenses are made differently to fit various eye curvatures or may be thinner or thicker depending on the weight and cover of your eyelid.
All of the 20 or so FDA-approved manufacturers of soft lenses are not alike and the size and diversity of stock varies in different establishments. At Sterling Optical, for instance, 98 percent of the stock is Bausch & Lomb; Atlantic Optical carries three manufacturers; Kinsman, seven; the Contact Lens Clinic, 15. Dr. Obremsky estimates that most private practitioners stock about seven or eight brands.
* Ask about all charges and add-ons. The prices quoted on storefront posters may include only the cost of the lenses. Get prices for examination, chemicals, heater and follow-up visits before you make a commitment. Make sure the price of the lenses covers all manufacturers; some makes may be more expensive.
* Be sure you understand the establishment's follow-up visit policy and be sure you follow up.
"The initial visit is important," says Dr. Harold E. Davis, secretary of the contact lens section of the American Optometric Association, " but after-care is of paramount importance."
Most of the area's commercial establishments include scheduled return visits as part of the deal: maybe two or three return appointments.
When the establishment advertises "follow-up care for one year," that frequently means the patient--not the doctor--initiates the return visit. But, maintains Glasser, scheduled appointments are essential because many patients may not realize they're having problems.
* If the establishment has a refund policy (many do), make sure you understand the details.
At the Contact Lens Clinic, you get back $104 of the $139 outlay if you're not satisfied after six weeks. Designer Optical's policy entitles a patient to a refund for the full cost of the lenses within two months, and the patient must have returned at least twice for follow-up visits within that time. And according to Designer Optical optometrist Chatlin, patients are required to sign a contract, which agrees that they will return within that time.
According to the Better Business Bureau of Metropolitan Washington, complaints against commercial establishments have been filed primarily because consumers did not understand a refund policy.
"The most common complaint is 'I want my money back,' " says Dr. Charles Cooperswaithe, past secretary of the District of Columbia Board of Optometry, who heard complaints at the board's monthly meetings.
The patient may have thought the refund policy included a full money-back guarantee, says Cooperswaithe, when it didn't. Reasons for the returns, he says, have ranged from dissatisfaction with the fit, to the inability of some people to wear contact lenses.
* Make sure you see eye-to-eye with your doctor. Hedge your decision--whether it is for a private or commercial practitioner--on referrals from friends and family.