In order to explain what a professional dispensing fee is, you first need to understand what a professional is. The term “professional” is one that gets bandied about and misused with alarming regularity. In general terms, a professional is someone who has skills and/or knowledge that someone else is willing to pay for. There is no product involved, only fee for service. Lawyers, doctors, engineers are all good examples of professionals. A dispensing fee is simply a certain type of fee charged by a certain type of professional.
When a product is being sold for profit, it is known as retail sales. When the GST was instituted, it recognized the dichotomy between “goods” and “services”. Traditionally, the retail sales area is given much more leeway by government. Marketing ploys are widespread and occasionally misleading. In retail sales the law says “Let the buyer beware”, meaning that if you are unhappy with a retail transaction, you have limited recourse. Professional services are much more tightly regulated, and generally professionals are responsible legally for the services they provide. An obvious exception to this rule is professional athletes who get paid large sums of money due to their exceptional skill sets, but a long-suffering Maple Leafs ticket buyer has no recourse when the team falls flat in yet another season!
So a retail merchant makes a profit from selling a product, and a professional charges a fee for providing a service. So far, so good. For an Optometrist things get a little more murky. An Optometrist charges a fee for doing an examination, which is clear enough. The examination determines the physical health of your eyes, the muscle function, binocular coordination, sensory ability, and refractive status, resulting in a prescription for glasses, if needed.
The difficult part arises when an Optometrist provides a patient with contact lenses or spectacles, because now there is a product involved. Optometrists believe they are best suited to fill your prescription because they have the training and education to see the big picture necessary to translate your needs into a suitable solution. To avoid a possible conflict of interest, it was decided long ago that an Optometrist could not profit from the sale of a product, and is required to provide all materials at cost. However, because the Optometrist is also providing skill and knowledge in the provision of the product, a dispensing fee applies. This causes much confusion for people who want to compare cost, quality and service to a retail optical store.
In a retail store, product is sold for profit. A typical $50 frame might be marked up to $120, and a typical pair of lenses might go from $50 to $100, for a total of $220. An Optometrist is required to supply those frames and lenses at cost, but adds a fee of $120, for the same total. The important difference is that markup increases as a percentage of the cost of the product, whereas the fee is constant and independent of the cost of the materials. An Optometrist has no incentive to talk you into a more expensive frame, or to add optional coatings to lenses, unless he/she feels that it is really of benefit to you, because there is no additional profit. The fee stays the same whether you buy the least or most expensive materials. At the upper end of the cost scale, an Optometrist will almost always be less expensive, and at the low end the retail merchant will usually be less expensive. Marketing ploys come into play, and hopefully by now everyone understands that in a 2 for 1 deal, you’re not really getting a free pair!
What do you get for that dispensing fee? There is so much more that goes into making a pair of glasses for you than simply choosing a stylish frame and making lenses from a printed prescription. The first part is frame fit. Does the bridge of the frame suit the shape of your nose? Does the lens size suit your face? Are the temples (arms) a suitable length? Are they adjustable? Does the frame suit the type of lens that you need? What if your eyes aren’t level? Or your ears? What if your nose isn’t exactly centred? Can the frame be adjusted to compensate? These are all considerations in addition to whether you like the style and colour.
The second part is lens design. Are the lenses a single focus? Bifocal, trifocal, multifocal (progressive)? What range of distances are the lenses meant to be used for? Specific task, or general purpose? Should they have anti-scratch, anti-reflection, adjustable tint? What about a UV filter? Are they digital or traditional? What quality/cost level should be chosen for progressive lenses? To maximize your comfort and ease of use, and the usefulness of the spectacles, it’s much more complicated than you might initially imagine.
The final part of the fee involves counselling and adjustment. When you pick up the specs, the frame needs to be adjusted to fit your head. The tilt, the wrap, the temple length, the nose pads (if present), levelling, all need attention. Heads come in all shapes and sizes, and few are symmetrical, and your comfort depends on good adjustments. You should also receive knowledgable advice before and after getting the glasses, on all of these factors, as well as warnings about when to use the specs, what adaptation problems might arise, and what can or can’t be done about it. Don’t forget to ask about future adjustments, repairs, warranties.
To make matters even more confusing, some Optometrists have lobbied to be allowed to price products like retail outlets do, to make comparisons and competition easier and better for the public. This has recently been approved, so some Optometrists will show a dispensing fee on a bill, while others won’t.
What’s the bottom line? Deal with people you know and trust. When you are buying a product pre-made in a box, such as a toaster or television set, shop for price. When you’re shopping for a professional service, such as that involved in buying a pair of spectacles, or having contact lenses fit, then you want to know and trust the person doing it. You want someone who cares about you, has the knowledge and skills to take care of your needs, and is legally responsible for doing it right. You want a professional.