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Industry must protect doctor-patient relationship in pursuit of convenience
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by Deanna Alexander, OD, FAAO
The online marketplace has given rise to an industry that offers subscription-based delivery for a wide variety of goods. With a touch of a button, we no longer have to remember to pick up razors or toothbrushes at the store. Instead, they’ll be delivered on a regular schedule to our doorstep.
The convenience of subscription model deliveries is in high demand, but in the space of medical devices, like contact lenses, patient health and safety through corporate responsibility must be prioritized over cyber subscription sales.
Recently, it was announced that Colgate-Palmolive Co. was in negotiations (Copeland et al.) to purchase a minority stake in Hubble, an online startup contact lens retailer with a history of mailing contact lenses to made-up patients with made-up prescriptions (Griswold. The move by Colgate-Palmolive raised eyebrows amongst analysts, physicians and business observers, as the legacy brand seemed to offer legitimacy to a startup with a checkered past on safety and whose contact lens manufacturer has been served with warning letters from safety regulators (FDA).
The move also brought to light a potentially dangerous market development: The validation of startup companies that may put profit ahead of patient safety by partnering with reputable legacy brand companies. Contact lenses are a medical device that must be used under a doctors’ care and not packaged, marketed and sold like soap or toothpaste.
A strong doctor-patient relationship remains the foundation of a healthy patient. An ideal practice, as described by “The ideal medical practice model” (Moore et al.) is one where modern technology meets an excellent physician-patient relationship. The authors indicate this approach would, “enhance doctor-patient relationships, increase face-to-face time between doctors and patients, reduce physician workloads, instill patients with a sense of responsibility for their health and cut wasted dollars from the entire system.”
Contact lenses are regularly sold by online subscription services like Hubble without true verification of the validity of a patient’s prescription. This action erodes the foundation of patient care by working around the doctor-patient relationship. Patient health is jeopardized when these services bypass a strong doctor-patient relationship. In this case, the product being mailed isn’t a toiletry. Extended-wear contact lenses, for example, have the highest medical device classification by the FDA, which puts it in the same classification category as a pacemaker.
A study published by the BMJ (Morjaria) showed the danger and damage that can occur when a patient chooses an online subscription and doesn’t receive appropriate professional care. A patient had been complaining of pain ahead of a vision procedure. Doctors were stunned to find more than two dozen contact lenses lodged in the woman’s eye. According to an article in USA Today, the patient had put off regular optometrist appointments (Hafner).
In the quest to provide convenience through subscription model delivery of contact lenses, corporate responsibility should include prioritizing professional care to ensure the long-term health and safety for the patient. The important step of comprehensive eye examinations and new, valid contact lens prescriptions, could have prevented the dangerous medical event examined by the BMJ.
Fortunately, there are some subscription models, like Sightbox and LensFerry, that are fostering both the convenience of subscription-based services with appropriate professional care. These two services work with the patient and their doctor to ensure a comprehensive eye exam is conducted, a proper contact lens evaluation is delivered, the patient’s prescription is valid and verified by the seller, and the correct prescribed lenses are sent to the patient.
Embracing technological advances while preserving the doctor-patient relationship is a win-win. Patients will achieve better access and health outcomes while enjoying the convenience of an online marketplace. Doctors are able to minimize adverse events related to contact lens wear, which ultimately reduces the burden on the health care system by promoting prevention over the associated high costs of managing eye health complications. This not only leads to lower health care costs for the patient but reduces the risk of permanent vision loss that can occur when problems are not identified early.
Patients are best-served when corporate responsibility that ensures a strong doctor-patient relationship works in unison with the convenience and economic advantages of having medical products, like contact lenses, delivered right to the patient’s doorstep.
References:
Copeland R, Terlep S. A toothpaste club? Colgate to invest in online startup. The Wall Street Journal. July 2, 2018.
FDA warning letter to St. Shine Optical Co. Ltd. August 26, 2013.
Griswold A. Contact lens startup Hubble sold lenses with a fake prescription from a made-up doctor. Quartz. December 14, 2017.
Hafner J. Doctors find 27 contact lenses lodged in woman's eye, journal reports. USA Today. July 17, 2017.
Moore LG, Wasson JH. Fam Pract Manag. 2007 Sep;14(8):20-24.
Morjaria R. Br Med J. 2017;doi.org/10.1136/bmj.j2783 .
For more information:
Deanna Alexander, OD, FAAO, practices in Fort Collins, Colo. She is the chairwoman of the Health Care Alliance for Patient Safety. She can be reached at: Deealex1@aol.com. For more information on the Health Care Alliance for Patient Safety, go to www.patientsafetytoday.com.
Disclosure: Alexander reported no relevant financial disclosures.