# Optical Forums > General Optics and Eyecare Discussion Forum >  COT's refracting and charging???

## gogetter

Im in Houston, Tx and there is a person who owns an Optical and has a "refracting" lane. he charges 25bucks for the rx and you have to get your glasses there and cannot take the rx elsewhere. surely this is still illegal right? can he be reported? apparently hes been doing it for years!! Who and where would you report this to??

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## optical24/7

I know whom you are talking about. This guy has a MD write off for him. And his exam is 25 bucks IF you buy glasses from him, not much different than some OD advertise here. I'm not a particular fan of this particular optician, but more power to him, we all need to strive for independance.

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## chip anderson

It's illegal because he is refracting (unless he has an M.D. or O.D.) on premices.
It's illegal because under Eyeglass I he must give a written Rx to the patient in his hand to take to the optician of his choice at the time of examination.  (Of course most prescribers today are guilty of this daily)

But according to some of our legislators in Mississippi who have been quoted as saying:  "It ain't illegal unless you get caught."

Chip

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## Oedema

report the MD to the medical board for not releasing the Rx .... If he's going to let someone use his license then he should be aware of the consequences.

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## braheem24

> It's illegal because he is refracting (unless he has an M.D. or O.D.) on premices.
> It's illegal because under Eyeglass I he must give a written Rx to the patient in his hand to take to the optician of his choice at the time of examination. (Of course most prescribers today are guilty of this daily)
> 
> But according to some of our legislators in Mississippi who have been quoted as saying: "It ain't illegal unless you get caught."
> 
> Chip


If it's an MD and he's only refracting and he only refracts if they buy glasses from him, there's nothin illegal about it.

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## gogetter

> I know whom you are talking about. This guy has a MD write off for him. And his exam is 25 bucks IF you buy glasses from him, not much different than some OD advertise here. I'm not a particular fan of this particular optician, but more power to him, we all need to strive for independance.


we talking the NW area right?

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## gogetter

> If it's an MD and he's only refracting and he only refracts if they buy glasses from him, there's nothin illegal about it.


Not an MD. 
He will refract you only if you buy glasses from him. 25$
And you cannot take your Rx. It stays w him.

I believe if you DO want to take your Rx he faxes it to an MD's office and u have to pick it up there.

Just wasnt sure if this was the "loop hole" or flat out illegal.

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## Jana Lewis

> Not an MD. 
> He will refract you only if you buy glasses from him. 25$
> And you cannot take your Rx. It stays w him.
> 
> I believe if you DO want to take your Rx he faxes it to an MD's office and u have to pick it up there.
> 
> Just wasnt sure if this was the "loop hole" or flat out illegal.


I believe that is illegal and I would report him to the board.  We as professional opticians cannot have someone kicking our integrity down the drain.

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## optical24/7

As I stated earlier, I'm not a fan of this optician, but my opinion is personality based, not professionally based. I've known this guy for over 30 years and he was an account of mine when I was in wholesale, with that said....

It's not illegal for him to perform a refraction, with an MD writing it off, anymore than it's not illegal for any other MD to write offf on their own staff performing a refraction. ( at least in TX.)

I also don't see how he is "kicking our integrity". There are many here at the state level that have been working hard to enable qualified, and well trained opticians to preform simple refractions.

We opticians are chained to OD's and OMD's for our livlihood. You would think we could applaud a fellow optician for raising the bar for all of us.



And now, we shall hear how terrible this is from our resident OD/OMD's. :bbg:

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## HarryChiling

> Im in Houston, Tx and there is a person who owns an Optical and has a "refracting" lane. he charges 25bucks for the rx and you have to get your glasses there and cannot take the rx elsewhere. surely this is still illegal right? can he be reported? apparently hes been doing it for years!! Who and where would you report this to??


I wouldn't report it personally.

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## rbaker

> Not an MD. 
> He will refract you only if you buy glasses from him. 25$
> And you cannot take your Rx. It stays w him.
> 
> I believe if you DO want to take your Rx he faxes it to an MD's office and u have to pick it up there.
> 
> Just wasnt sure if this was the "loop hole" or flat out illegal.



It is not illegal until a court says so. Your state/national boards of registration may only issue complaints which are resolved in the courts. The true situation here is probably found in a multitude of loopholes in a multitude of jurisdictions.

Has any patient, customer, client or mark suffered any loss or been harmed by this behavior? I mean actual harm and not innuendo. I think that the courts are leaning toward liberalizing business laws and regulations and as Bob Dylan did say "The times they are a changin."

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## gemstone

> Im in Houston, Tx and there is a person who owns an Optical and has a "refracting" lane. he charges 25bucks for the rx and you have to get your glasses there and cannot take the rx elsewhere. surely this is still illegal right? can he be reported? apparently hes been doing it for years!! Who and where would you report this to??


I don't know how much they pay this MD.  It seems to me that this MD is very foolishly hanging out a butt to be kicked very hard.  I hope they have good MP insurance.

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## tmorse

> We opticians are chained to OD's and OMD's for our livlihood. You would think we could applaud a fellow optician for raising the bar for all of us.


Hear hear!!

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## HarryChiling

> Hear hear!!





> We opticians are chained to OD's and OMD's for our livlihood. You would think we could applaud a fellow optician for raising the bar for all of us.


:cheers:




> I don't know how much they pay this MD. It seems to me that this MD is very foolishly hanging out a butt to be kicked very hard. I hope they have good MP insurance.


Just a thought, how good must this optician be to have an OMD risking his butt for him?  Can anyone else here claim to be that good?

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## OHPNTZ

How do you know he's good?  I pity the poor hyperope or latent hyperope, or binocular vision patient who sees him...

He should be reported.

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## chip anderson

It ain't no damn loophole and it doesn't exempt MD's either.  The law is very plain all _prescribers_ (defined as optometrist and ophthalmologist in the law) must give everyone a copy of thier Rx *at the time of examination* and allow them to take it to the optician of thier choice.

Chip

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## HarryChiling

> How do you know he's good? I pity the poor hyperope or latent hyperope, or binocular vision patient who sees him...
> 
> He should be reported.


I don't but how do you know he's bad?  You could pity his patients all you want but if the guy has been practiceing for 30 years as someone has mentioned his patients don't pity him.

You know the FCLCA or whatever, professionals from all sides sent in complaints about how the online vendors could be doing harm and that they should not be allowed to dispense contacts online, then the FTC actually had in a response of all the complaints NO ONE gave the FTC a solution or alternative to the system that sucks and is in place now.

Complain all you want but it would be more prudent to come up with a solution or risk sounding like the crowd.

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## HarryChiling

Maybe a similar situation concerning OD's would help put this into perspective:

-Deleted doctors advocateing prescribing beyond scope of practice-

And it goes on like this for a total of 16 posts, most OD's seem to think it is OK for their peers to practice beyond their scope, but when an optician practices beyond ours they are advocateing to lynch this guy.

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## orangezero

These aren't the same issues.  

One case involves profiting from potentially illegal activities and the other involves keeping medications on hand which are pretty much only used in emergency situations (which could lead to permanent vision loss).  Many states have very specific exemptions listed in their optometry act just for these types of medications.

When did you become an OD anyway? :)

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## braheem24

I very much respect Opometrists' abilities, but refracting is a joke that does not require 6 years of schooling to learn.

The Illegal activity in question is handing an rx to a patient while the other can cause permanent vision loss, I think Harry summed it up nicely :cheers:






PS, It's practiced in Canada without any vision loss to date :p

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## Diane

> Maybe a similar situation concerning OD's would help put this into perspective:
> 
> And it goes on like this for a total of 16 posts, most OD's seem to think it is OK for their peers to practice beyond their scope, but when an optician practices beyond ours they are advocateing to lynch this guy.


 
The original post states that it is a COT, it doesn't mention optician.

Diane

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## jediron1

> The original post states that it is a COT, it doesn't mention optician.
> 
> Diane



Part of what a COT is trained to do is to do refractions but an OD or MD must be able to sign off. Chip is also right you can't get around Eyeglass 1 by saying if you buy your glasses from me the exam will be $25 it's illegal. Now if you hand them the Rx and say we have an optical shop that has great prices you might try them out then their is nothing wrong but you must give them a choice. Chips right!

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## HarryChiling

It's wrong he's holding the script.

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## Oedema

> Maybe a similar situation concerning OD's would help put this into perspective:
> 
> And it goes on like this for a total of 16 posts, most OD's seem to think it is OK for their peers to practice beyond their scope, but when an optician practices beyond ours they are advocateing to lynch this guy.


Harry, do you realize that you are in violation of the odwire terms of agreement?

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## Oedema

> PS, It's practiced in Canada without any vision loss to date :p


http://www.optometrists.bc.ca/webupl...studies_04.pdf

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## braheem24

> http://www.optometrists.bc.ca/webupl...studies_04.pdf


Canadians are made well aware they are receiving a vision test, not an eye exam. 

The fact that a retinal detachment or diabetic retinopathy wa not caught in a vision test is like blaming your OB/GYN for not catching your cataracts.

None of those people lost vision due to a bad refraction.

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## Oedema

> Canadians are made well aware they are receiving a vision test, not an eye exam.


 Ha!  I'm sorry but did you read the link?  While there is supposed to be a very detailed informed consent done, I think it's clear that many of those people were not aware of the difference between a sight-test and a full eye exam.  In many cases these people had sigh-test despite being excluded by the criteria set by the BC college of opticians for sigh-test eligability.  And then there is this guy: http://www.collegeoptom.on.ca/curren....htm#judgement




> The fact that a retinal detachment or diabetic retinopathy wa not caught in a vision test is like blaming your OB/GYN for not catching your cataracts.


 No, it would be like blaming your OB/GYN for not catching your pelvic inflammatory disease that leaves ends up leaving you barren and infertile.




> None of those people lost vision due to a bad refraction.


You're right, they were merely inconvenienced by bad refraction/management of binocular vision disorders and lost their vision due to missed ocular pathology!

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## Dannyboy

I lived in Texas for many years and frankly I believe is not illegal. A physician may order any test to be performed by an assistant as long as a written prescription exist, it is a patient of the Ophthalmologist and there is supervision. The loophole in Texas is the following: there is nothing illegal for the assistant/contact lens fitter etc to write the name of patient in the prescription pad as authorized by the MD. The patient automatically becomes patient of the MD when he accepts the procedure to be performed and supervison is indirect. Furthermore this individual does offer two types of exams one for eyeglasses alone and one with the MD for eye health. Texas is a pro MD state and the board of optometry has very little say so in anything related to an MD. 

You can certainly "turn him in" but I would be very careful as a ruling has been previously been done in a similar case involving contact lens fitting back in the 80s. If you accuse someone of something you think it is illegal you must get the facts very well because your claim may land you in a civil suit. Otherwise why do you think he has not been turned over before? Houston is full of ODs..there is a school there you know.. but there is also an MD school full of MDs. MDs do not take very well orders.... now if this was in California that would be a different story.

Dannyboy

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## braheem24

> they were merely inconvenienced by bad refraction/management of binocular vision disorders and lost their vision due to missed ocular pathology!


Bro, they went in for a refraction that is done by an automated lane. IF they expected the phoropter to catch an eye problem they may need to see a doctor that specializes 1 inch behind the eyes.

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## Oedema

> Bro, they went in for a refraction that is done by an automated lane. IF they expected the phoropter to catch an eye problem they may need to see a doctor that specializes 1 inch behind the eyes.


And that's why those opticians in BC that do sight-testing need to start complying with their college regulations.  While you and I may be sophisticated to know the difference between a phoropter and a slit-lamp the vast majority of our patients are not.

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## LandLord

I still can't believe the force with which optometrists cling to refraction. The sooner you stop refracting, the sooner you will be perceived as real doctors. Take refracting out of optometry schools and put it in opticianry schools.

*All medical disciplines diverge into new specialties over time.* 
Technology has made refracting easier and more accurate. Optometry has shifted into health screening and disease management. Refracting specialists are a natural result of that divergence.

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## tmorse

> http://www.optometrists.bc.ca/webupl...studies_04.pdf


Just look at the refraction dates in these so-called 'case studies'. OD's in BC scaped the bottom and came up with very old news. The fact remains that, sure, there may be the odd optician sight-tested that will still break the comprehensive rules now in place, just as the odd OD and OMD still gets caught deliberately over-billing government for their services. 
The bottom line is that none of these case-study patients have taken any court action because of problems of proof. And now 30,000+ BC/Alberta residents have availed themselves of a free sight-test.. and have been entirely satisfied. :D

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## jediron1

> It's wrong he's holding the script.




I wasn't sure if you were referring to my post or not. What I said was he hands them the script and patient then has said script in his or her hand and that as far as I know satisfies Eyeglass 1 law, but again you have to give them the choice, with out choice it's a monopoly and that's illegal. And as to whether he or she is working in Texas under an MD makes no difference as Chip has pointed out it's ILLEGAL Eyeglass 1 is federal and supercedes the state. just my take  :Rolleyes:

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## gemstone

> :cheers:
> 
> 
> 
> Just a thought, how good must this optician be to have an OMD risking his butt for him? Can anyone else here claim to be that good?


Good!  Yes and having a lot of medical training as well.   He best not be missing anything. If it's malpractice for an MD to miss something, what is a good lawyer going to do with a case like this arrangement when something goes wrong?

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## Andrew Weiss

> I lived in Texas for many years and frankly I believe is not illegal. A physician may order any test to be performed by an assistant as long as a written prescription exist, it is a patient of the Ophthalmologist and there is supervision. The loophole in Texas is the following: there is nothing illegal for the assistant/contact lens fitter etc to write the name of patient in the prescription pad as authorized by the MD. The patient automatically becomes patient of the MD when he accepts the procedure to be performed and supervison is indirect. Furthermore this individual does offer two types of exams one for eyeglasses alone and one with the MD for eye health. Texas is a pro MD state and the board of optometry has very little say so in anything related to an MD. 
> 
> You can certainly "turn him in" but I would be very careful as a ruling has been previously been done in a similar case involving contact lens fitting back in the 80s. If you accuse someone of something you think it is illegal you must get the facts very well because your claim may land you in a civil suit. Otherwise why do you think he has not been turned over before? Houston is full of ODs..there is a school there you know.. but there is also an MD school full of MDs. MDs do not take very well orders.... now if this was in California that would be a different story.
> 
> Dannyboy


Thanks, Dannyboy.  It sounds like a localized Texas issue, at least in the US.  I'm a bit boggled by the "indirect" supervision of a refraction -- in most MD's offices I know of, the MD and refractionist are in the same office suite at the same time, and this guy seems to have a "supervising" MD who's off-site entirely -- but if Texas law allows it, then it isn't illegal.

I agree that we cannot assume our patients understand exactly what an eye examination covers and which instrument tests what.  Ideally, the refracting optician in this case ought to hand a slip to the patient at the end of the exam advising the patient to go to the MD for a comprehensive eye examination for health reasons.

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## HarryChiling

> I wasn't sure if you were referring to my post or not. What I said was he hands them the script and patient then has said script in his or her hand and that as far as I know satisfies Eyeglass 1 law, but again you have to give them the choice, with out choice it's a monopoly and that's illegal. And as to whether he or she is working in Texas under an MD makes no difference as Chip has pointed out it's ILLEGAL Eyeglass 1 is federal and supercedes the state. just my take


No, I was just expressing my opinion on the legality of not giving the script or making it contingent on the sale of eyewear.

I also think that MD's are more receptive to a business model that involves opticians in satelite offices and it's a win win situation for everyone.  If OD's don't learn to embrace that then they risk being left outta the loop.  Case in point was the FCLCA where their was a quote in the federal register about congress being reluctant to pass the law as is but of all the complaints there was no solution presented other than don't do it.

Opticians not refracting may or may not be an option, in Canada for instance you are seeing OD's trying to work with the opticianry college in certain areas so that they can at least come up with a solution to benefit both professions mutually.  I suggest that OD's realize that times are changing and maybe rethink how to make refracting opticians work within the eyecare model.  Keep in mind optometry isn't as legislatively strong as it was at their peak and they still face opposition from two ends.  It's not prudent to continue to stand such a firm ground and not have a contingency plan.

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## Stonegoat

I have seen several cases myself where patients who turned-out to have significant pathology were "sight-tested"...

I detect vision-threatening pathology in asymptomatic patients almost daily

Refraction is NOT a joke.....it is an evolving skill that takes years to master.

Sight-testing is a tool that opticians are using to survive in a competative optical world.  In many ways I don't blame them for it....but to say sight testing is about anything other than economics is untrue.

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## HarryChiling

> I have seen several cases myself where patients who turned-out to have significant pathology were "sight-tested"...


Anecdotal evidence is the best evidence.:bbg:




> I detect vision-threatening pathology in asymptomatic patients almost daily


I could agree with that as our OD in the office does as well.




> Refraction is NOT a joke.....it is an evolving skill that takes years to master.


Optometry school doesn't focus their entire profession on the skill of refracting, but you are still correct refracting is a skill that is intricate and requires a depth of knowledge to perform.

Optometrists in the UK hodl the equivalent of a bachelors degree and refract, their opticiasn can go back to school and further their education to become an optometrist if they choose.

I believe hong kong has a three year program that gives on the necessary credentials to refract.

Matter of fact it is a minority of countries that do have optometrists with doctoral degrees, and I'm glad to have you guys with such great knowledge but I hope it isn't at the cost of the profession.




> Sight-testing is a tool that opticians are using to survive in a competative optical world. In many ways I don't blame them for it....but to say sight testing is about anything other than economics is untrue.


Dispensing is a tool that optometrists and OMD's are using to survive in a competitive optical world.  

What I am suggesting is that if this is going to happen with or without you, why not have it be with you?

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## Stonegoat

Harry,

I live in BC, Canada.  Wal-Mart is bringing in a "sight-tester" into one of their stores in Kamloops, BC.  They are calling it a pilot project.  So now we have a massive chain that no longer employs an OD (probably couldn't get one in Kamloops..too many great private practice opportunities), and will have an optician (maybe??) performing sight-tests.

Is this a rosy picture of the future of eye care in your opinion?? 

It should be just as scary for opticians who would like to see the return of professionalism, as it is for ODs, in my opinion.

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## chip anderson

Years ago, I had a couple of good friends who were chief OMD at medical schools who on occasion ranted and raved about undiagnosed and miss-treated or untreated pathology by O.D.'s.  Of course this was in the days when O.D.'s couldn't even legally dillate, much less treat pathology.  Each doctor would claim to see patient's daily that had been under O.D. care with undiagnosed and un-treated or miss-treated pathology.

Now that O.D.'s can get referral fees and collect for surgical-follow up  visits this sort of attack on O.M.D.'s is seldom a subject for discussion.


The argument is the same just the ecconomic focus has changed to opticans.

Chip

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## Jana Lewis

> As I stated earlier, I'm not a fan of this optician, but my opinion is personality based, not professionally based. I've known this guy for over 30 years and he was an account of mine when I was in wholesale, with that said....
> 
> It's not illegal for him to perform a refraction, with an MD writing it off, anymore than it's not illegal for any other MD to write offf on their own staff performing a refraction. ( at least in TX.)
> 
> I also don't see how he is "kicking our integrity". There are many here at the state level that have been working hard to enable qualified, and well trained opticians to preform simple refractions.
> 
> We opticians are chained to OD's and OMD's for our livlihood. You would think we could applaud a fellow optician for raising the bar for all of us.
> 
> 
> ...


If it is illlegal he IS "kicking our integrity" Period. 

I am all for Opticians refracting, but I am also pro-health. It should be noted somewhere that a health exam of your eye needs to be done annually as well.

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## HarryChiling

> Harry,
> 
> I live in BC, Canada. Wal-Mart is bringing in a "sight-tester" into one of their stores in Kamloops, BC. They are calling it a pilot project. So now we have a massive chain that no longer employs an OD (probably couldn't get one in Kamloops..too many great private practice opportunities), and will have an optician (maybe??) performing sight-tests.
> 
> Is this a rosy picture of the future of eye care in your opinion?? 
> 
> It should be just as scary for opticians who would like to see the return of professionalism, as it is for ODs, in my opinion.


I have heard about that and that is the reason why I think that sight testing is here to stay. I don't know what the effect on our industry will be, but I know this, in the state I live in in the US, it's called Pennsylvania often refered to as "Penseltucky" the opposition for my proffesion has always been corporate optical and optometry. Now I practice in a state that does not consider me a professional because corporate opticals and optometry wanted it that way. Now it looks like corporate opticals are lookign to cut there largest expense, LABOR. They could pay a sight tester 1/3rd of what they pay an OD and the sight tester will likely get crappier hours, but for the sight tester this is a step up and an opportunity for my proffesion to expand our scope.

That's why I keep suggesting that instead of fighting it, Optometrists should be finding a way to make it work for their benefit. Who do you think I would rather work for an independent OD or a Walmart? That's a no brainer, but if your h*ll bent on my professions destruction then I gotta go with the mart. Sure it's like eating a bologna sandwich instead of a steak sandwhich, but when your used to eating crap sandwiches it's still a step up.

I keep bringing this up, but opticians are your insulation.  If we're in the crapper the next target up the ladder is Optomtery, the more solid opticians are as a profession the more solid your foundation.  It seems that the whole house of cards was built on sand.  We all knew that going to bed with corporate optical was like going to bed with a wh*re, now your being tested for herpes and crying foul ball.  You make your bed you lie in it.

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## Oedema

> Optometrists in the UK hodl the equivalent of a bachelors degree and refract, their opticiasn can go back to school and further their education to become an optometrist if they choose.
> 
> I believe hong kong has a three year program that gives on the necessary credentials to refract.


In the UK the entry to practice degrees for all health professions (yes, even medicine and dentistry) are bachelors degrees.  So UK physicans actually hold a Bachelor of Medicine Bachelor of Surgery (MBBS) degree.  Only by convention are physicans called "Doctor," while Surgeons go by the "Mister/Miss/Misses" to further distinguish themselves.  Confusing yes, it has to do with how medicine and surgery actually come out of two different trade guilds... medicine from the doctors and surgery from the barbers guild.

There's nothing special about a UK optometrist going back to school and becoming an optometrist.  Even you as an American optician can do it so long as you collect the pre-reequsites. 

As for hong kong their program is four years in length leading to a bachelors in optometry.[/quote]

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## Stonegoat

Harry,

You are correct.  Corporate optometry/opticianry has damaged us all.  I can't understand why any OD would of thought it a good idea to work in a corporate setting in the first place.  Just laziness I guess.  

I am glad I practice far from any corporate entities (at least for now).....I despise them and have little or no respect for the ODs that choose to work for them.

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## HarryChiling

> Harry,
> 
> You are correct. Corporate optometry/opticianry has damaged us all. I can't understand why any OD would of thought it a good idea to work in a corporate setting in the first place. Just laziness I guess. 
> 
> I am glad I practice far from any corporate entities (at least for now).....*I despise them and have little or no respect for the ODs that choose to work for them*.


Can you blame them though?  Most independent OD's pay 2/3rd what a corporate office would.  I am glad it's the opposite in opticianry , but even if it weren't I don't think I could work directly for the MAN.  I work for a Pearle right now, but it's franchised so I'm kinda on the fence when it comes to who I work for.  Even our association with the MAN seems to only get us so much good grace.




> "at least for now"


Every Jew and Armenian knows this poem and knows it well:

_They came first for the communists,_
_and I didn't speak up because I wasn't a communist._
_Then they came for the jews,_
_and I didn't speak up because I wasn't a jew._
_Then they came for the trade unionists,_
_and I didn;t speak up because I wasn't a trade unionist._
_Then they s=came for the Catholics,_
_and I didn't speak up because I was a protestant._
_Then they came for me,_
_and by that time no one was left to speak up._

-Pastor Martin Neomoller(sp?)

Anyway, it's not you now but how many OD's have you heard say things like I'll be retired before the crap hit's the fan?  I have heard opticians do the same.

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## jediron1

> Im in Houston, Tx and there is a person who owns an Optical and has a "refracting" lane. he charges 25bucks for the rx and you have to get your glasses there and cannot take the rx elsewhere. surely this is still illegal right? can he be reported? apparently hes been doing it for years!! Who and where would you report this to??




The original quote above didn't have anything to do with catching anything except the persons $25 bucks. Taken in the questions I believe should be 1:What does Texas law say about this optician. 2. Where does Eyeglass 1 fit? 3. Why hasn't he or she been turned in for all this? It doesn't matter if the MD's are powerful or not is it the law and are they breaking it? We have MD's in NY and some of them have been taken to court. You must give the patient the rx ( another words hand it to them ) It's up to them whether they stay or not. Thats law. I would go straight to the medical board and file a complaint. Chip i think we may have to find Eyeglass 1 and put it up on this board because apparently most never read it.

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## HarryChiling

> Chip i think we may have to find Eyeglass 1 and put it up on this board because apparently most never read it.


You mean the Ophthalmic Practices Rule, commonly refered to as Eyeglass 1: http://onlineopticianry.com/wordpress/?p=126

And if we're such a stickler on the rule notice it applies to OMD's and OD's, in my opinion the rule still applies in this case because technically the script is being provided by the OMD, so to argue that the optician can write the script because the OMD signs it shoudl be the same resoning as to why it shoudl be released. I think the majority here agree that the script should be released and it is unlawful to hold it.

IMO that's the only thing wrong with this scenario.  As far as him writing the scripts, that task is being delegated by the OMD that he works for and I don't think anyone here is qualified to tell him how to supervise his employees.

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## optical24/7

> If it is illlegal he IS "kicking our integrity" Period. 
> 
> I am all for Opticians refracting, but I am also pro-health. It should be noted somewhere that a health exam of your eye needs to be done annually as well.


 
It's not illegal with an OMD writing off for him. Period. With 15 OD's in any 5 mile radius in Houston, do you not think he has been investigated, numerous times? Ask Sam with ROATx, he's there in Austin and wants to do the same thing....

 I'm also pro-health, but you can't make someone go to the Dr or accept treatment. I also believe that people should be responsible for their own actions or in-actions, I don't believe in a nanny-state.

 Also on the subject of refraction; We sell OTC reader here ( as do most opticals in this neck of the woods ). Have any of you ever helped someone select the one that works best for them? ( Here, read this with these, now try these..." Am I practicing _medicine?_ 

Everyone overly concerned about simple refaction needs to all hop on a bandwagon and ride it to Washington and have OTC readers outlawed. I hate to think of all the lives lost and ruined due to OTC reader usage...Good luck on your ride! :D

:cheers:

----------


## optical24/7

One more thing I forgot to ask opinions on...

It concerns Eyeglass I and advertising. I know I've seen adds with something to the effect...." Eye Exam for $xx with the purchase of glasses". Is this illegal? In other words, regular exam is $100, with purchase of eyewear it's half that. You wanna walk with your RX, well, you don't qualify for the discount.

Not much different than 50% off frames with purchase of lenses. Don't buy the lenses, then full price for frame.

Thoughts?

----------


## Jana Lewis

> It's not illegal with an OMD writing off for him. Period. With 15 OD's in any 5 mile radius in Houston, do you not think he has been investigated, numerous times? Ask Sam with ROATx, he's there in Austin and wants to do the same thing....
> 
> I'm also pro-health, but you can't make someone go to the Dr or accept treatment. I also believe that people should be responsible for their own actions or in-actions, I don't believe in a nanny-state.
> 
> Also on the subject of refraction; We sell OTC reader here ( as do most opticals in this neck of the woods ). Have any of you ever helped someone select the one that works best for them? ( Here, read this with these, now try these..." Am I practicing _medicine?_ 
> 
> Everyone overly concerned about simple refaction needs to all hop on a bandwagon and ride it to Washington and have OTC readers outlawed. I hate to think of all the lives lost and ruined due to OTC reader usage...Good luck on your ride! :D
> 
> :cheers:


Is this fellow holding the RX? 

That is Illegal...yes?

----------


## optical24/7

> Is this fellow holding the RX? 
> 
> That is Illegal...yes?


 
I agree, very illegal if he refuses to release. We only have gogetter saying so ( I'm in no way knocking ya gg :D) What I want to know is what I asked above about advertising and exams.

  Is he allowed to offer you a reduced fee if you buy from him? For all we know he _is_ handing them thier Rx, the fee depends on whether they do business with him.

----------


## HarryChiling

> One more thing I forgot to ask opinions on...
> 
> It concerns Eyeglass I and advertising. I know I've seen adds with something to the effect...." Eye Exam for $xx with the purchase of glasses". Is this illegal? In other words, regular exam is $100, with purchase of eyewear it's half that. You wanna walk with your RX, well, you don't qualify for the discount.
> 
> Not much different than 50% off frames with purchase of lenses. Don't buy the lenses, then full price for frame.
> 
> Thoughts?





> (c) Charge the patient any fee in addition
> to the ophthalmologists or optometrists
> examination fee as a condition
> to releasing the prescription to
> the patient. Provided: An ophthalmologist
> or optometrist may charge an additional
> fee for verifying ophthalmic
> goods dispensed by another seller when
> the additional fee is imposed at the
> ...


If it is I don't see it in the Ophthalmic Practices Rule, although you cannot charge someone more money for an eye exam if they take it with them, I don't see anything about discounting the eye exam if they purchase the glasses at that location.  If there is a conflict it could just as easily be reworded to state that the discount would apply to the eyeglass purchase and not the exam and whalla well withing the law.

Maybe it would be a good idea to run all this stuff by a lawyer in the state of TX if it's an issue that's gettign people this riled up, but IMO I don't think the guy is doing anything wrong except holding the Rx which is a no no.:finger:

----------


## optical24/7

> If it is I don't see it in the Ophthalmic Practices Rule, although you cannot charge someone more money for an eye exam if they take it with them, I don't see anything about discounting the eye exam if they purchase the glasses at that location. If there is a conflict it could just as easily be reworded to state that the discount would apply to the eyeglass purchase and not the exam and whalla well withing the law.
> 
>   but IMO I don't think the guy is doing anything wrong except holding the Rx which is a no no.:finger:


 
That was my take on it too Harry, but again, we don't know that the guy is witholding an RX. gogetter, care to verify for us?

----------


## jediron1

> I agree, very illegal if he refuses to release. We only have gogetter saying so ( I'm in no way knocking ya gg :D) What I want to know is what I asked above about advertising and exams.
> 
>   Is he allowed to offer you a reduced fee if you buy from him? For all we know he _is_ handing them thier Rx, the fee depends on whether they do business with him.




Here's the real deal:

FEDERAL TRADE COMMISSION
PART 456--OPHTHALMIC PRACTICE RULES--


Sec. 456.2 Separation of examination and dispensing.

It is an unfair act or practice for an ophthalmologist or optometrist to:

(a) Fail to provide to the patient one copy of the patient's prescription immediately after the eye examination is completed.

Provided: An ophthalmologist or optometrist may refuse to give the patient a copy of the patient's prescription until the patient has paid for the eye examination, but only if that ophthalmologist or optometrist would have required immediate payment from that patient had the examination revealed that no ophthalmic goods were required;

(b) Condition the availability of an eye examination to any person on a requirement that the patient agree to purchase any ophthalmic goods from the ophthalmologist or optometrist;

(c) Charge the patient any fee in addition to the ophthalmologist's or optometrist's examination fee as a condition to releasing the prescription to the patient. Provided: An ophthalmologist or optometrist may charge an additional fee for verifying ophthalmic goods dispensed by another seller when the additional fee is imposed at the time the verification is performed; or

(d) Place on the prescription, or require the patient to sign, or deliver to the patient a form or notice waiving or disclaiming the liability or responsibility of the ophthalmologist or optometrist for the accuracy of the eye examination or the accuracy of the ophthalmic goods and services dispensed by another seller.

Revised as of January 1, 1999]
From the U.S. Government Printing Office via GPO Access
[CITE: 16CFR456.2]
[Page 453]

----------


## LandLord

FYI, it's not illegal for a sight-tester to withhold an Rx because IT'S NOT REALLY AN RX!  It's a refraction.

Only doctors write Rx's.

----------


## chip anderson

Eyeglass I addresses prescribers discounting fees on condition of eyeglass purchase.  It is specificly verboten.
463
*Federal Trade Commission § 456.5
*any provision is determined to be invalid,
it is the Commissions intention
that the remaining provisions shall
continue in effect.
*PART 456OPHTHALMIC PRACTICE
RULES (EYEGLASS RULE)
*Sec.
456.1 Definitions.
456.2 Separation of examination and dispensing.
456.3 Federal or State employees.
456.4 Declaration of Commission Intent.
456.5 Rules applicable to prescriptions for
contact lenses and related issues.
AUTHORITY: 15 U.S.C. 57a; 5 U.S.C. 552.
SOURCE: 57 FR 18822, May 1, 1992, unless
otherwise noted.
*§ 456.1 Definitions.
*(a) A _patient_ is any person who has
had an eye examination.
(b) An _eye examination_ is the process
of determining the refractive condition
of a persons eyes or the presence of
any visual anomaly by the use of objective
or subjective tests.
(c) _Ophthalmic goods_ are eyeglasses,
or any component of eyeglasses, and
contact lenses.
(d) _Ophthalmic services_ are the measuring,
fitting, and adjusting of ophthalmic
goods subsequent to an eye examination.
(e) An _ophthalmologist_ is any Doctor
of Medicine or Osteopathy who performs
eye examinations.
(f) An _optometrist_ is any Doctor of Optometry.
(g) A _prescription_ is the written specifications
for lenses for eyeglasses
which are derived from an eye examination,
including all of the information
specified by state law, if any, necessary
to obtain lenses for eyeglasses.
*§ 456.2 Separation of examination and
dispensing.
*It is an unfair act or practice for an
ophthalmologist or optometrist to:
(a) Fail to provide to the patient one
copy of the patients prescription immediately
after the eye examination is
completed. Provided: An ophthalmologist
or optometrist may refuse to give
the patient a copy of the patients prescription
until the patient has paid for
the eye examination, but only if that
ophthalmologist or optometrist would
have required immediate payment
from that patient had the examination
revealed that no ophthalmic goods
were required;
(b) Condition the availability of an
eye examination to any person on a requirement
that the patient agree to
purchase any ophthalmic goods from
the ophthalmologist or optometrist;
(c) Charge the patient any fee in addition
to the ophthalmologists or optometrists
examination fee as a condition
to releasing the prescription to
the patient. Provided: An ophthalmologist
or optometrist may charge an additional
fee for verifying ophthalmic
goods dispensed by another seller when
the additional fee is imposed at the
time the verification is performed; or
(d) Place on the prescription, or require
the patient to sign, or deliver to
the patient a form or notice waiving or
disclaiming the liability or responsibility
of the ophthalmologist or optometrist
for the accuracy of the eye examination
or the accuracy of the ophthalmic
goods and services dispensed
by another seller.
*§ 456.3 Federal or State employees.
*This rule does not apply to ophthalmologists
or optometrists employed by
any Federal, State or local government
entity.
*§ 456.4 Declaration of Commission Intent.
*In prohibiting the use of waivers and
disclaimers of liability in § 456.2(d), it is
not the Commissions intent to impose
liability on an ophthalmologist or optometrist
for the ophthalmic goods and
services dispensed by another seller
pursuant to the ophthalmologists or
optometrists prescription.
*§ 456.5 Rules applicable to prescriptions
for contact lenses and related
issues.
*Rules applicable to prescriptions for
contact lenses and related issues may
be found at 16 CFR part 315 (Contact
Lens Rule).
[69 FR 40511, July 2, 2004]

----------


## chip anderson

Landlord:  
The word Prescription means recipe not some code word for a doctor's holy inscription.

Chip

----------


## HarryChiling

> FYI, it's not illegal for a sight-tester to withhold an Rx because IT'S NOT REALLY AN RX! It's a refraction.
> 
> Only doctors write Rx's.


In the states the only way the opticians can legally write the Rx is under the OMD's wing and you better belive that it will have the docs signature on it and as such would fall under the rule of Eyeglass Rule.

If we were to argue that it was written by a sight tester then the legality of the script comes into play.

----------


## LandLord

Chip,




> It is an unfair act or practice for an
> _ophthalmologist_ or_ optometrist_ to:
> (a) Fail to provide to the patient one
> copy of the patients prescription immediately
> after the eye examination is
> completed.




Your post clearly applies to ophthalmologists and optometrists only.

I repeat, a sight tester would not be held to the same standards because:

a) sight testers are neither ophthalmologists or optometrists.

b) the results are not prescribed by anyone.  The eyeglasses would technically be unprescribed.  

Reading glasses sold at Mahmoud's Mini Mart or other retailers are *not* *prescribed*.  Mahmoud himself may test the customer with a reading card to see which power is indicated, but there is *no act of prescribing taking* *place.*  The customer who purchases a pack of Marlboro lights, a Playboy magazine and a pair of +1.50's doesn't assume they are eye-disease free because of the test and purchase.  It is the same with sight testing.  It's just a more complicated test and purchase.

----------


## HarryChiling

> Chip,
> 
> 
> 
> Your post clearly applies to ophthalmologists and optometrists only.
> 
> I repeat, a sight tester would not be held to the same standards because:
> 
> a) sight testers are neither ophthalmologists or optometrists.
> ...


Your missing the point, in TX he is not allowed to perform sight testing without an OD or OMD signng off on his/her Rx or refraction as you would like to refer to it.  Either he's breaking the law by practiceing optometry or he's breaking the law by ingnoring Eyeglass 1 but you can't have it both ways.  Technically he is not presrbing anything he is performing a procedure that the OMD he works for is using to prescribe lenses from so for all instensive purposes consider the script as comign from the OMD.

----------


## wmcdonald

> Harry,
> 
> I live in BC, Canada. Wal-Mart is bringing in a "sight-tester" into one of their stores in Kamloops, BC. They are calling it a pilot project. So now we have a massive chain that no longer employs an OD (probably couldn't get one in Kamloops..too many great private practice opportunities), and will have an optician (maybe??) performing sight-tests.
> 
> Is this a rosy picture of the future of eye care in your opinion?? 
> 
> It should be just as scary for opticians who would like to see the return of professionalism, as it is for ODs, in my opinion.


What I wish ODs would realize is that this could be a great opportunity for them to be the referral site for this sight-testing Optician. He or she will need a place to refer medical care, and it is important forus all to work together.

----------


## HarryChiling

> What I wish ODs would realize is that this could be a great opportunity for them to be the referral site for this sight-testing Optician. He or she will need a place to refer medical care, and it is important forus all to work together.


I am starting to realize that as well, it would be to our mutual benefit and by strengthening the foundations (opticianry) optometry in essence solidifies there position and insulates themselves from the eroding of the eyecare industry a bit more.

----------


## LandLord

> Either he's breaking the law by practiceing optometry or he's breaking the law by ingnoring Eyeglass 1 but you can't have it both ways.


He's breaking the law by refracting, yes.  But that's another issue, isn't it.

----------


## HarryChiling

> He's breaking the law by refracting, yes. But that's another issue, isn't it.


Not if he's doing it for his OMD as a COT.  That would be considered part of his job description as an Ophthalmic Technician.  It also means that he can't do it without his OMD, that would be illegal.  I think it's loop holes like this that opticians should be exploiting and doing it while staying professional.  He's apparently been doing it for quite some time so kudos to him.

I also think that this sort of arrangement with OD's could benefit our industry.  Come on docs think of it outside the box for a minute, satellite offices.  Lets say an optician can open up his own store under your own little psuedo franchise, each OD or OMD can have 3 to 4 opticians working in this capacity, even the technology is there to implement this type of system and is being utilized in Canada.  Why fight it, heck I know doctors that are selling eyeglasses online, one of them used to even solicit business here.  It's a great opportunity that others are exploring for instance corporate optical, ophthalmology.  The only one resisting is optometry, that doesn't look good if you ask me.

----------


## orangezero

Just one opinion.

It just feels odd there is so much disagreement and arguing about a procedure which the market has determined is essentially without value in our current society.

Does anyone think we have such a shortage of refractionists (optometrists, ophthalmologists, paraoptometric staff, ophthalmic staff, etc.) and such a shortage of access to care in north America that there is a demand for doubling or tripling the number??  Really?

I've heard people mention you could stop ODs (probably the main source of refractions) graduating for 5-10 years and there still wouldn't be a shortage of eyecare anytime in the near future.

You could drive around most towns and theoretically get 5 or 10 full eye exams within a day or two, most you could just walk in.  You may be thinking its not that way in your, but I'm sure there is one down the road or in the next town.

Most of the opticians and optometrists on here agree it is the silly lowball mentality of this industry which allows these plans to survive and prosper.  I'm certainly not implying opticians would all be lowballers (in fact I'm certain some could go boutique and charge a large amount just fine), but the reality is most new refractionists would probably be employed at places like walmart or a lux store and have no ability to set their fees or much control over how they practiced.  But it would be hard to believe fees for a refraction wouldn't enter a free fall overall.

What a dream for vision plans and commercial locations!  More patients being run through for less reimbursement, the vision plans would be more able to control the costs of materials, and eventually it would be cheap enough for every employee to have a vision plan (which most of us abhor).  I really question whether this lowered fee structure could be "made up" by additional glasses sales.

We would all be left doing more work for less pay.

I hope I did this without offending anybody.  Not the intent.  Just a thought at the market ramifications.

----------


## chip anderson

I think the real *need* here is due topractioners that hold on to thier patients and won't release the Rx.  We need to actually be able to get the patient in our office with his Rx.  Some like you actually lead the patient into thier optical department to be *sold*  while they are waiting for you to get around to actually seeing them for their *appointment* which I am sure you run at least late enough for them to be sold on some optical product.

Chip

(You can make your defence now and come and git me.)

----------


## LandLord

> I've heard people mention you could stop ODs (probably the main source of refractions) graduating for 5-10 years and there still wouldn't be a shortage of eyecare anytime in the near future.


I agree with your assessment about the ramifications of an oversupply of any service. But you're not suggesting that competitors refrain from supplying a service so that the established suppliers can keep their prices up, are you?  Isn't that a little self-serving?

----------


## orangezero

> I agree with your assessment about the ramifications of an oversupply of any service. But you're not suggesting that competitors refrain from supplying a service so that the established suppliers can keep their prices up, are you?  Isn't that a little self-serving?


Keep up their prices?  $29 for an eye exam?  Free with glasses purchase?  Are you kidding me?  To think providers of eye care are monopolistic in the least has got to be the best joke I've heard in quite a while.  I just paid $75 to have two tires put on my car, and that guy probably gets paid close to minimum wage.

Just one example.  Medicare is a rather heavily discounted insurance the vast majority of health providers are disgusted with because of low reimbursement.  Eye exams on average are anywhere from 0-75% of those fees, which should say a lot.

I'm not interested in rehashing all the legal and educational ramifications.  Been done to death.  The bottom of the barrel is already here, but there is probably room to expand the bottom.

----------


## IndianaOD

Some of the statements on this thread are laughable.  Technically we were informed that it is not legal to refract or provide any eye care unless a doctor was physically in the same building.  

The MD signing off is a moron.  He/she is legally responsible for any conditions missed.  The liability is the same as if they preformed a comprehensive eye exam.  Parents think that a nurse checking a kids eyes on an eye chart is an eye exam, you don't think this will be confusing?

As far as ODs reaching out to this illegal technician....umm I guarantee everything goes to the MD blind stamping the work.

Good technicians are worth their weight in gold, but comparing an OD with 8-9 years of post high school education to on the site training is like saying I should be able to do a kidney transplant.

----------


## IndianaOD

On further thought, what benefit would stand alone refractions by opticians serve to opticianry or the public?

Just as ODs performing LASIK doesn't benefit the profession.  Now I think if ODs want to get post-doc training to do it then fine, but there are already ophthalmologists begging people to get LASIK from them.  I probably get 3 pieces of mail, hear 20 radio ads, and 10 TV ads for LASIK in an average week.   If every OMD and OD practiced  LASIK then the price would drop until no profit could be realized...and everyone needs to eat.

If opticians refracted there would be 2-3x as many opticals out there competing until a living would be very difficult.  Speed would be necessary and patients would suffer.  Much fewer people would get eye exams routinely and would suffer preventable vision loss.   I might even speculate that your income might decrease. 

Lawyers would make millions, heck I'd be interested in getting my JD if that ever happened.

----------


## LandLord

> Keep up their prices? $29 for an eye exam? Free with glasses purchase? Are you kidding me? To think providers of eye care are monopolistic in the least has got to be the best joke I've heard in quite a while.


I'm not saying exam fees are too high and I'm not saying providers are monopolistic.  But please don't think opticians will stop refracting because you say no one needs the service.  That is, unless you are willing to close up your office because there are more than enough optometrists in business.

----------


## HarryChiling

I have worked with many a doctor who has sold eyewear for next to nothing so they could collect exam fees which were usually high.

It's almost like when you go to buy a car, you could get a low ball offer on your trade in and a great price fro the new car and a great rate on your financing.  Or any of the other numbers of combinations possible.

Insuracne companies don't allow opticians on their panels so most independent opticians charge a fair price for eyewear and have the patients submit it themselves and their is enough their to ake a living.

It was interesting that paraoptometric staff and ophthalmic staff was mentioned as refractionists.  The achilles heal with these professions is that they cannot practice independently, they must perform their duties under their doctors OD and OMD.  If opticians gained independent refraction then sure the market would have more refractionists than necessary but that's the case now and it's getting worst with new schols opening.  Many doctors offices advertise one stop shopping exam and materials, and make it difficult for an Rx to leave an office.  At the risk of offending the last federl register that discussed the issue of the ophthalmic practices rule had a fiure of greater than 30% of patients not recieving their Rx's as per the law requires.

Is it a loop hole that this guyis refracting under, YES.  Is it illegal, we won't know for sure untill someone take shte guy to court and gets ruling, but I'll tell you this:  I know the guys pratice info and I wouldn't dare share it with anyone and snitch as I have heard your profession call it on other forums on my peers.

I think it's going to happen studies that have been done that have polled OD's and OMD's think that refraction for opticians is gonna happen, it's not a matter of if it will happen but when and how it will be structured.




> If opticians refracted there would be 2-3x as many opticals out there competing until a living would be very difficult.


From your perspective, independent opticals would actually do better and thrive in that kind of enviornment.  The 2-3x more opticals would be optician owned opticals not optometrist owned opticals.  The restraints put on the trade of opticianry by optometry would be reversed so the balance would be restored not screwed up as you seem to imply.

----------


## LandLord

"Originally Posted by *IndianaOD* 
_If opticians refracted there would be 2-3x as many opticals out there competing until a living would be very difficult."_

_IndianaOD's honesty is very refreshing isn't it?  It is very, very rare that an optometrist will admit to financial concerns if opticans began refracting._

----------


## Oedema

> I also think that this sort of arrangement with OD's could benefit our industry.  Come on docs think of it outside the box for a minute, satellite offices.  Lets say an optician can open up his own store under your own little psuedo franchise, each OD or OMD can have 3 to 4 opticians working in this capacity, even the technology is there to implement this type of system and is being utilized in Canada.  Why fight it, heck I know doctors that are selling eyeglasses online, one of them used to even solicit business here.  It's a great opportunity that others are exploring for instance corporate optical, ophthalmology.  The only one resisting is optometry, that doesn't look good if you ask me.


Interesting idea Harry, but big problem here is risk assumed by the OD/MD in the relationship; malpractice risk and losing your license kind of risk.  I'm not convinced that the risk to benefit ratio offers would offer much of an incentive to participate in the model.

For one, many jurisdictions already make this type of delegation professional misconduct.  For example in Canada OD's are not supposed to be delegating offsite, and most provincial medical colleges have also come down on physicans that were rubber stamping optical Rx's for opticians (Same thing happened with the online Canadian pharmacies - US Rx is not valid so they paid Canadian physicians to write a duplicate).

Second, and most obvious is the risk of missed pathology and subsequent litigation.

----------


## chip anderson

Odd we seem to be more concerned with subsequent litigation than subsequent damage to the patient..
Does this show where our hearts really are?

Chip

----------


## Oedema

> Odd we seem to be more concerned with subsequent litigation than subsequent damage to the patient..
> Does this show where our hearts really are?
> 
> Chip


Chip, I don't think Harry suggested model had anything to do with improving patient care or compassion for the patients - my interpretation was that it was an economic appeal.

That said, I don't think we're exactly harming any patients by covering our own asses and refusing to practice at a level that does hold the potential of harming patients.  

Why should I expose myself and my patients to a system that could harm by my patient and my professional life?

----------


## wmcdonald

Specific guidelines have been developed to assure a regular health evaluation of the eye by an OD or MD. We all need to work together to benefit each other. In many ways access will be greatly enhanced with Opticians doing refraction. In an earlier thread, someone mentioned that there were too many providers already, but if that were the case, supply and demand would necessitate a reduction in fees. In most articles I read, OD income continues to rise annually, not decline. The economic engine and control are the real issues here.

----------


## Oedema

> Specific guidelines have been developed to assure a regular health evaluation of the eye by an OD or MD. We all need to work together to benefit each other. In many ways access will be greatly enhanced with Opticians doing refraction. In an earlier thread, someone mentioned that there were too many providers already, but if that were the case, supply and demand would necessitate a reduction in fees. In most articles I read, OD income continues to rise annually, not decline. The economic engine and control are the real issues here.


Guidelines?  So far the only jurisdiction that allows independent optican refraction does not have any guidelines that ensure regular oculovisual health assessments.

----------


## IndianaOD

> Specific guidelines have been developed to assure a regular health evaluation of the eye by an OD or MD. We all need to work together to benefit each other. In many ways access will be greatly enhanced with Opticians doing refraction. In an earlier thread, someone mentioned that there were too many providers already, but if that were the case, supply and demand would necessitate a reduction in fees. In most articles I read, OD income continues to rise annually, not decline. The economic engine and control are the real issues here.



How can access be any easier?  There's an OD on every corner and mega mart in this country.

OD income is flat to negative if you consider inflation.  We already are the lowest paid (on average) doctoral level medical provider out there.

Everyone must suffer through ophthalmic optics, geometric optics, physiological optics, and visual perception if they want to refract.  Well perhaps except an MD  :Eek:

----------


## chip anderson

Man you think O.D. income is flat or decreasing, you oughta be an independent optician for the last few decades.  Used to be a good reasonably lucrative business.  Now you are lucky if you aren't 90 days behind on the bills.

Chip

----------


## IndianaOD

> Man you think O.D. income is flat or decreasing, you oughta be an independent optician for the last few decades.  Used to be a good reasonably lucrative business.  Now you are lucky if you aren't 90 days behind on the bills.
> 
> Chip



I'm sure that's true, but be honest...opticians don't have 8+ years and well over $100k in student loans on average.  I have some colleagues in larger practices that pay their opticians very well (those that have been loyal and stayed around a long time).

I thought your oculist skills were buying your Mercedes?

----------


## chip anderson

Indy:
I am an ocularist (amoung other things I'm called) an oculist is another term for ophthalmologist (they can afford Bentley's if they want).
And yes it seems to be the last vestage of the optical business that is still profitable.  Now if I just had patients *with* money.

Chip

----------


## HarryChiling

I thought it was interesting in an earlier post that paraoptometric staff were mentioned as part of the too many professions as refractionists.  This profession is a baby in our field yet is already embraced.  The reason why is that it falls directly under the control of the optometrist.  An ophthamic technician is also a refractionists and again they fall under the control of the ophthalmologist.  The one thing these professions have in common is that they cannot by definition practice independently, an optician can and always has.  An optician under the control of another profession would be accepted more easily in the current system, but an optician by the title optician still has teeth.

Their is a paper in the download section from Dr Sheedy that discusses some of these issues, opticians will not be accepted by optometrists or even ophthalmologists unless we are no longer deemed a threat.  The fact that refraction is closely guarded the way it is, is a purely economic reason.  I propose that optometrists and ophthalmologists refrain from dispensing and devalueing materials, but I highly doubt tht is a real option.  I think it is a natural progression for our profession to refract and apparently so too does many other professions and the public also has learned to embrace this.  I invite all those that don't know how the process is performed to learn it.  Either through the courses offered at schools, through associations, through OJT, or any other means available to you even the online phoropters or phoropter programs available through schools and associations.  Learn the skills and upgrrade your education so when the time comes you can be one of the opticiasn that performs sight testing.

----------


## LandLord

Harry is right.  Opticians groups should lobby to HELP optometry expand their scope instead of fighting them.  If optometry's scope was wide enough, they might not need dispensing to succeed the way they do now.

----------


## chip anderson

Odd but back when OMD's were ethical (didn't dispense) Opticians and contact lens fitters were concidered they greatest allies and source of referrals.  Of course the reverse was also true.
Oh, my times they are a changing.

Chip

----------


## OHPNTZ

"The fact that refraction is closely guarded the way it is, is a purely economic reason. I propose that optometrists and ophthalmologists refrain from dispensing and devalueing materials, but I highly doubt tht is a real option. "

I don't understand how optometrists and ophthalmologists "devalue" materials.  Could you please explain?

Yet, it seems you want to devalue a service...an eye EXAM.  Of which, refraction is just one part.  What is the true benefit of an optician refraction?  Would you be able to do wet refractions?  Would you take into account AC/A ratios?  What would you do for amblyopes?  The list goes on...


"I think it is a natural progression for our profession to refract and apparently so too does many other professions and the public also has learned to embrace this. "

What other professions?  When and where does the public understand the difference between exams and refractions?  I deal with parents weekly who believe that a school screening is an eye exam...

----------


## HarryChiling

> I don't understand how optometrists and ophthalmologists "devalue" materials. Could you please explain?
> 
> What other professions? 
> 
> When and where does the public understand the difference between exams and refractions? 
> 
> I deal with parents weekly who believe that a school screening is an eye exam...


The delphi study done by a member of this board showed that a panel of ophthalmologist, optometrists, and opticiasn alike would agree that refraction is a reasonable expansion of our scope. The real issue comes down to how it will be implemented without steppin on anyones toes.

Devalue, Let's take VSP for example started by OD's for OD's. To take it the practice has to be 51% owned by an OD, every sale requires the OD disclose their wholesale cost on the frames with a stipulation that the practice cannot get more than 20% discount on the frame. The lenses are provided by the VSP lab so they have control over the cost of the lenses. In many cases the practice makes only a dispensing fee. That's devaluing.

Eyemed and the many other insurances once in a while require that you disclose your wholesale costs on certain products, the only practices that I know of that fill out those silly forms are optometrists and they don't factor into their costs labor, lease, and other costs, they just qute material costs which further lowers the reimbursements.

Opticians can't take insurances so most independent optician run shops are chargeinga fair price for glasses, contacts and other vision aids. Often times from what I have seen it is considerably lower than the insurances with more premium products when you factor in all the costs of the insurance like copays, monthly premiums, and reimbursements. So the insurance company takes a big chunk of the profit in the eyewear and the optometrists practice short changes the consumer by provideing sub par product.

The public doesn't understand the difference between an eye exam, a refraction, and a visual screening. On this you are absolutely right, if they did years ago they would have opted to skip seeing your profession and go right to the top OMD, at least in my neck of the woods they would have. Not too long ago OD's were not able to provide wet refractions, not too long ago OD's weren't able to provide treatment for various infections and conditions, it's new to you as refraction would be new to the profession of opticianry. It's foolish to argue with you ove these points as you profession overcame them so just read your history nd apply your solutions in the blanks provided.

I would like to ask you, does the public know that most OD's advocate non-licensed proffesionals to fabricate their eyewear?  Do they know that historicaly optometry has fought for non-licensed opticiasn to keep the labor low in their offices?  Then try explaining to the public what that refraction and prescription that comes from it is for.  That's how materilas have been devalued.

I was hopign to hear more about how the professions can work together, I personally think that optometry will never be ready for opticians refracting, but I belive that ophthalmology can and is in many states.  I would personally rather see our profession align with a more willign partner.  There is already a model where opticians are performing refractions under the scope of ophthalmolgy and I see that as a great avenue, I would like to see that avenue extend to optometry as well, but if it doesn't happen that's no loss for me as their only really needs to be one door opened.

----------


## pauly47

> Devalue, Let's take VSP for example started by OD's for OD's. To take it the practice has to be 51% owned by an OD,


Not true anymore.  OMDs can be a VSP provider.

----------


## OHPNTZ

Harry,

I completely agree with you regarding insurances (or third party payers).  Not only are the materials discounted, but so are the services.  Some of these insurances do not reimburse much at all.  It's a shame that they even exist...I look at it more from the reimbursement for services rendered portion.  

How do you think refracting opticians will factor in with the insurances?  I believe they will salivate at the opportunity to further cut costs...the downward spiral of our healthcare.  (Plus, don't you work as part of the luxottica empire...associated with Pearle???).

At most places I've worked (except for one), a licensed optician was part of the team.  In fact, I currently work for a predominantly optically based company.  So, unfortunately I cannot relate to the employment of non licensed staff...

----------


## HarryChiling

*How do you think refracting opticians will factor in with the insurances? I believe they will salivate at the opportunity to further cut costs...the downward spiral of our healthcare.* 

Tell me how has medical eyecare provided by OD's affecting OMD's and their practices.  No one is asking you to fall on your sword, thats why it would be best to have the three O's discuss a viable option that benefits all.  What we can't do is let the insurance companies, corporations, or one profession of the group decide how this thing is going to be played out.

If I had it my way I would be refracting with no restrictions.
If you had it your way I wouldn't be refracting.
If OMD's had it their way then I would only be refracting for them.
If the corporate goons had it there way they would have us in lanes with maybe one OD checking our work.
If insurance companies had it there way then we'd all be broke, includeing the patient.

I can't say I know the solution, I knwo I've heard about every reason why I shouldn't and why I should be allowed to refract, now I'm lokkig for solutions on how it's gonna happen.

----------


## rbaker

> Specific guidelines have been developed to assure a regular health evaluation of the eye by an OD or MD. We all need to work together to benefit each other. In many ways access will be greatly enhanced with Opticians doing refraction. In an earlier thread, someone mentioned that there were too many providers already, but if that were the case, supply and demand would necessitate a reduction in fees. In most articles I read, OD income continues to rise annually, not decline. The economic engine and control are the real issues here.


Health care in the US is not subject to the traditional free market laws of supply and demand.

----------


## chip anderson

Shoot yeah, if there are too many MD's in a field they divide the field into as many sub-specialties as required.  Then they can form a *group,* have each sub-specialist see the patient, perform different tests and bill for each doctor's time and tests.

Chip


Yes, I can give you lots of examples if you really need them.

----------


## MarcE

Back to the original question/issue. This is not new. THink PAs and LPNs. We have these prescription writing professions in every little town around here. These towns don't have an MD or DO within 20 miles. I'm not sure these "overseeing" MDs ever come to visit "their" clinics in the rural settings. Patients all the time say that they see "Dr so-and-so" who is actually a "Mr so-and-so".
This loophole is exploited frequently. Actually I'm not sure it is a loophole, I think it is illegal. But I'm not a court of law whose job it is to determine the definition of "direct oversight".
Can "direct oversight" of prescriptions be conducted from the next county? I suppose it could via fax and internet - but is it being done. Let's see, the MD sees 60 patients/day, his LPN see another 40 and his two PAs in the next county see another 40 each. Direct oversight indeed.
Why does the AMA, state medical boards, and all the other boards allow these non-physician medical professionals to have precriptive authority? Because they make money for the MD. It's always about the money.
If you want to write prescriptions or even orders for ophthalmic goods, you will need to be able to line the pockets of someone who has the prescriptive authority currently.

----------


## MarcE

New question:
COTs refract for OMD often.  It's legal and widely accepted, right?

Can COTs legally refract for ODs?  Is there a legal issue at all? If I were an OD and wanted to have my tech refract and then I come in and do a 7 minute exam and sign the Rx - are there any issues with this?

Feel free to chastize me if this requires a new thread.

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## LandLord

> New question:
> COTs refract for OMD often. It's legal and widely accepted, right?
> 
> Can COTs legally refract for ODs? Is there a legal issue at all? If I were an OD and wanted to have my tech refract and then I come in and do a 7 minute exam and sign the Rx - are there any issues with this?
> 
> Feel free to chastize me if this requires a new thread.


I don't see a problem with this system. I've done 30 minute eye exams myself and then watched the surgeon finish'er off in 30 seconds in the same lane.

----------


## MarcE

> I don't see a problem with this system. I've done 30 minute eye exams myself and then watched the surgeon finish'er off in 30 seconds in the same lane.


But that is an MD.  I know it's widely done.  What about ODs?  In the US?

----------


## Oedema

> New question:
> COTs refract for OMD often.  It's legal and widely accepted, right?
> 
> Can COTs legally refract for ODs?  Is there a legal issue at all? If I were an OD and wanted to have my tech refract and then I come in and do a 7 minute exam and sign the Rx - are there any issues with this?
> 
> Feel free to chastize me if this requires a new thread.


Anyone could legally refract for an MD or an OD - no certification needed (but I'm sure it's helpful... less in-office training needed).  It's rare, but there are OD's out there in the US that do delegate most refractions to ancillary staff.  

So in summary; MD's and OD's alike can use whoever they want to use to collect data so long as they actually look at it and use the data appropriately.

----------


## chip anderson

In our state (at the O.D.'s submission) and O.D. cannot deligate any O.D. duties, including refraction, contact lens fitting, etc.  This being done to prevent anyone but an O.D. being able to fit contacts and refract.  
This is State law, law of course, drafted, submitted, and paid for by the State Optometric Assn.

Chip

----------


## HarryChiling

> In our state (at the O.D.'s submission) and O.D. cannot deligate any O.D. duties, including refraction, contact lens fitting, etc. This being done to prevent anyone but an O.D. being able to fit contacts and refract. 
> This is State law, law of course, drafted, submitted, and paid for by the State Optometric Assn.
> 
> Chip


And if you think about it, it's assinine.  For iunstance they can't tell an OMD that they can't delegate their responsibilities, so they basically painted themselves in a corner with this law.  If opticians and OMD's were to work togather we would have less conflict.  They would never have to worry about us wanting medical privledges and we'd never have to worry abou them wanting to refract and provide eyewear, that's not something that they want to do it's somehting they're being forced to do with lower reimbursements on many of the conditions that OD's can now perform.  Optometry is chipping away at both ends of the field with little regard for the consequences, IMO.

----------


## orangezero

This mass exodus of optometry from "vision" to "medical" is not going to happen anytime soon.  There are still way too many obstacles in many states for optometrists to have access to medical panels and bill those plans successfully.  There are perhaps going to be more and more ODs working in disease specific clinics as the years go by, and even more specialization, but the vast majority will continue to be providing refractive services and wellness eye evaluations a good deal of the time in to the foreseeable future.  

I doubt there is a gap waiting to be filled, and if there is it will take forever to realistically open up.   I'm not holding my breath.

I guess there is nothing like being prepared, though.

----------


## Oedema

> it's somehting they're being forced to do with lower reimbursements on many of the conditions that OD's can now perform.  Optometry is chipping away at both ends of the field with little regard for the consequences, IMO.


Actually it's not just Ophthalmologists that have faced reimbursement cuts, it's been ALL physicians that are affected when medicare cuts it's fees.  IMHO, I think the relatively small number of OD's, and the even smaller number of those providing real medical eye care, has much of an affect on medical reimbursement.

----------


## IndianaOD

Harry,

What false name are you registered under over on ODwire?  Nice you violate the agreement and hide in the shadows.

Opticians refracting would occur until the first few multi-million dollar lawsuits went through.

If opticians can refract alone, I BET it would be a matter of months to a few years until autorefractor exams would be allowed.  Then everyone loses.  Opticianry does not have the accountability that any doctor does.

If an optician screwed up or acted unethically they would lose a license based on 1 maybe 2 years of education and maybe $6k accompanying tuition.  I would lose 9 years of significant education and over $150k of tuition.

Want to refract, go to OD school.  No 4 years of pointless non eye education like OMDs have before they actually learn useful eye training.

The eye care market is already a battleground of oversupply and overlapping expertise.  We need more?

----------


## tmorse

> Opticians refracting would occur until the first few multi-million dollar lawsuits went through.


Every licensed optician in Canada carries a mandatory $1,000,000.00 Errors & Ommisions Libility insurance policy, including those that have performed 1000's of sight-tests. Insurance actuaries assess the  potential risk to the insurance companies and determine the premiums to obtain this amount of coverage... GUESS WHAT...$80.00/yrCAD

That's right, so little risk associated with sight-test refractions by opticians that this yearly premium is little more than a file-opening charge. And the provincial/nation associations providing this group insurance also earn money from this same $80.00/yr premium. 

Might be a different story in the litigation-prone US, though. But I doubt it.  :Rolleyes:

----------


## Oedema

> Every licensed optician in Canada carries a mandatory $1,000,000.00 Errors & Ommisions Libility insurance policy, including those that have performed 1000's of sight-tests. Insurance actuaries assess the  potential risk to the insurance companies and determine the premiums to obtain this amount of coverage... GUESS WHAT...$80.00/yrCAD
> 
> That's right, so little risk associated with sight-test refractions by opticians that this yearly premium is little more than a file-opening charge. And the provincial/nation associations providing this group insurance also earn money from this same $80.00/yr premium. 
> 
> Might be a different story in the litigation-prone US, though. But I doubt it.


I wonder if insurers would cover an optician that performed sight-testing in a province where they are not authorized to do so in the event of a malpractice suit?

----------


## chip anderson

Odd:
Indiana O.D.'s arguement sounds very similar to the arguement I have heard and seen against O.D.'s diagnosing and treating medical conditions from physicians.
My, my times they are a changing.

We do all realize that if Eyeglass I were complied with opticans wouldn't care if they could refract or not.

Chip

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## HarryChiling

> Harry,
> 
> *What false name are you registered under over on ODwire? Nice you violate the agreement and hide in the shadows.*
> 
> Opticians refracting would occur until the first few multi-million dollar lawsuits went through.
> 
> If opticians can refract alone, I BET it would be a matter of months to a few years until autorefractor exams would be allowed. Then everyone loses. Opticianry does not have the accountability that any doctor does.
> 
> If an optician screwed up or acted unethically they would lose a license based on 1 maybe 2 years of education and maybe $6k accompanying tuition. I would lose 9 years of significant education and over $150k of tuition.
> ...


First of all, I am trying my best to keep this civil and I would encourage the same respect.

The ODwire.org thing, you should know that it has never been a private forum like it's intentions were and yes I do lurk there and am in disgust with most of the things I hear.  I KNOW THAT THERE ARE MANY IN YOUR PROFESSION THAT SEE THESE ISSUES FROM A FINANCIAL PERSPECTIVE EVEN THOUGH THEY CLAIM THE BENEFIT OF THE PATIENT.  So this brings me to the last highlighted text in your post if the market is a battleground why would you not suspect that I would be there lurking it's called recon.;)  Then the overlap and expertise, this has not stopped optometry as a profession from pushing forward and overlapping into the medical arena.  We do need more, opticians are the primary fabricators of the tough to fit eyewear in this country, some of us are the specialists in the eyewear arena, but that hasn't stopped many OD's and OMD's from expanding into this area of the field and I don't think it should, overall it brings the cost down for the consumer the more providers there are and the experts will always be able to survive using their skills and knowledge, so to some of us in this profession no matter which shoe is being worn Optician, OD, OMD we will always make money and have a fairly secure future, for others that have relied on legislative restriction to artificially give their businesses and practices an unfair advantage, nows the time to take your 9 years and put it to practice instead of just coast.

The line about refracting and OMD's is amazing.  If you really believe your education puts you on a higher ground than the OMD who's being naive here?  It is this arrogance that I count on to unravel your profession, nothing is owed to you for your time spent or schooling.  *Want to refract go to OD school.... Want to dispense come to my lab and go through an aprenticeship under me.*  You'll wish you were back in OD school double time.  I can take your prescription and turn it into art if I so choose, half the time it's OD's such as yourself that are creating my woes, I spend 3 hours fabricateing eyewear that you took 15 - 20 minutes to refract and my breakage is way lower than your remakes, I guarantee it.  Your profession is spending more time and resources to get away from refractions that it is creating this need so don't whine beacuse another profession sees a need that needs to be filled.

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## braheem24



----------


## HarryChiling

> 


Oh. hush you. :D

----------


## optical24/7

Although I do support optician refracting, I think there is a better way for opticians to secure their own future, one more obtainable than getting refraction part of our regular job discription....

 Outlaw doctor owned dispensaries. Just as a MD can't have a pharmacy in his office, OD's and OMD's should'nt be able to have eyewear for sale in their office. The same conflict of intertest exists for ophthalmic doctors peddling eyewear as it does for MD's and meds.


Let the stone throwing begain!! ( I've got my tin foil helmet on..:D)

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## jherman

seem refractions have been devalued in the eyes of the patient?

Who ya think is responsible for that? I see no issue with refracting opticians, if they're qualified. Apparently the MD in H-town doesn't either.

On a side note, i get a kick out reading pompous material, any more odwire.com quotes out there?

James

----------


## HarryChiling

> seem refractions have been devalued in the eyes of the patient?
> 
> Who ya think is responsible for that? I see no issue with refracting opticians, if they're qualified. Apparently the MD in H-town doesn't either.
> 
> On a side note, i get a kick out reading pompous material, any more odwire.com quotes out there?
> 
> James


Hows this one:

"Hi 
I am planning on opening a retail/optometric practice and *am wondering if I need a license optician.*
I have a good friend who has worked in the field for 20+ years without a license (he's from abroad) and *would prefer him to work for me since I don't have to pay him as much.* *Is it illegal to operate an optical without a licensed optician in NJ?* *If it is what is most cost effective way to get around it?*
I've tried contacting the state board but haven't heard back from them for a month. Any information is greatly appreciated.
Sincerely,"


Apparently the doctor has no problem asking how to get around the system and short change his patients.  These are not isolated cases, this kind of thing happens in real life all around us, every person here can find at least one example of something that devalues our professions in their own backyard.

For opticians I am asking how do we fix this?

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## LandLord

It is quotes like those above that put a fire in the bellies of struggling independent opticians.:angry:

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## IndianaOD

> First of all, I am trying my best to keep this civil and I would encourage the same respect.
> 
> The ODwire.org thing, you should know that it has never been a private forum like it's intentions were and yes I do lurk there and am in disgust with most of the things I hear.  I KNOW THAT THERE ARE MANY IN YOUR PROFESSION THAT SEE THESE ISSUES FROM A FINANCIAL PERSPECTIVE EVEN THOUGH THEY CLAIM THE BENEFIT OF THE PATIENT.  So this brings me to the last highlighted text in your post if the market is a battleground why would you not suspect that I would be there lurking it's called recon.;)  Then the overlap and expertise, this has not stopped optometry as a profession from pushing forward and overlapping into the medical arena.  We do need more, opticians are the primary fabricators of the tough to fit eyewear in this country, some of us are the specialists in the eyewear arena, but that hasn't stopped many OD's and OMD's from expanding into this area of the field and I don't think it should, overall it brings the cost down for the consumer the more providers there are and the experts will always be able to survive using their skills and knowledge, so to some of us in this profession no matter which shoe is being worn Optician, OD, OMD we will always make money and have a fairly secure future, for others that have relied on legislative restriction to artificially give their businesses and practices an unfair advantage, nows the time to take your 9 years and put it to practice instead of just coast.
> 
> The line about refracting and OMD's is amazing.  If you really believe your education puts you on a higher ground than the OMD who's being naive here?  It is this arrogance that I count on to unravel your profession, nothing is owed to you for your time spent or schooling.  *Want to refract go to OD school.... Want to dispense come to my lab and go through an aprenticeship under me.*  You'll wish you were back in OD school double time.  I can take your prescription and turn it into art if I so choose, half the time it's OD's such as yourself that are creating my woes, I spend 3 hours fabricateing eyewear that you took 15 - 20 minutes to refract and my breakage is way lower than your remakes, I guarantee it.  Your profession is spending more time and resources to get away from refractions that it is creating this need so don't whine beacuse another profession sees a need that needs to be filled.



You SERIOUSLY think that a OMD with 3 years of surgery heavy eye training is better at primary eye care than an OD with 4-5 years of eye training?

You do know that most OMDs have little to no refractice training?

The OD against optician argument is no where near the same as OD and OMD.  ODs are a DOCTORAL level profession and have been for years.  Its the AMA's money that keeps us from practicing up to our training.  

Still in many rural and urban areas there is very little access to OMDs and the OD scope was necessary.  There is no lack of eye providers at this time.  

If opticians went through 3-4 years of undergrad science and 4 years of eye training then I have no problem with them doing exactly what I do.  Just like another OD school.

----------


## IndianaOD

You also have to realize that many young ODs like myself would never have chosen OD school over med-school if the current scope of practice wasn't in place.  I wouldn't be an OD of 20 years ago, I'd be a dentist or dermatologist.

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## tmorse

> I wonder if insurers would cover an optician that performed sight-testing in a province where they are not authorized to do so in the event of a malpractice suit?


Do you really wonder that??? :hammer:

The issue is whether real harm to the public is likely, and also whether you possess risk assessment credentials superior to those of insurance acutaries. :hammer:

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## LandLord

As far as eye training is concerned, I've worked alongside both OD's and eye physicians. The OD's fresh out of school would routinely ask me for advice on refraction and pathology assessment. 

The three years of eye training they had is nothing compared to what they learn in a couple of years in the field.

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## chip anderson

How often is an O.D. sued for malpractice over the quality of his refraction?   Isn't it only when they practice medicine that they tend to get in trouble?

Ever heard of an OMD (which you claim is group of incompentents at this) being sued over a refraction?

If a refraction is perfomed and not presented as an exam for desease where is the liability?  

Chip

----------


## NC-OD

> .
> 
> The ODwire.org thing, you should know that it has never been a private forum like it's intentions were and yes I do lurk there and am in disgust with most of the things I hear.


Harry, you are admittedly a cheat and a fraud. How can anyone take anything you say seriously when you have admitted to breaking into a private website and then quoting people without their permission.

The site administrator is on to you.  You may wish to come clean.

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## LandLord

Watch out Harry.  I smell blood.

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## chip anderson

Harry and I have both been offered plaques saying we have been named to the "Hundred Best Optometrists" in the Country.  So surely we are qualified.

Chip

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## tmorse

> Harry, you are admittedly a cheat and a fraud. How can anyone take anything you say seriously when you have admitted to breaking into a private website and then quoting people without their permission.
> 
> The site administrator is on to you. You may wish to come clean.


Come clean Harry... Harry do come clean!!! HA HA  HA!!

Your caught the insiders, the back-room boys, doing their evil thing. After all, this was not for regular consumption!!
But HARRY, you are Opticianry's RAMBO!!!
Keep up the good work. 
But look out, Harry ... *the site administrator is on to you!!*  :Rolleyes:

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## HarryChiling

> Harry, you are admittedly a cheat and a fraud. How can anyone take anything you say seriously when you have admitted to breaking into a private website and then quoting people without their permission.
> 
> The site administrator is on to you. You may wish to come clean.


Yes I am and I see why the forum is private, its because the few in your profession that visit there talk about the future of the profession as if your out to destroy everything else in it other than yourselves.  I think your profession needs a wake up call, in order to continue to think you are working toward the benefit of your patients you will need to rely on the team of professionals around you and also know your place in the field, if you think any of your schooling equates you to a medical professional I dare you to place the letters MD after your name.

I'll say one more thing, NC-OD, I am very *Proactive* about my profession. ;)

----------


## IndianaOD

> As far as eye training is concerned, I've worked alongside both OD's and eye physicians. The OD's fresh out of school would routinely ask me for advice on refraction and pathology assessment. 
> 
> The three years of eye training they had is nothing compared to what they learn in a couple of years in the field.



What you say is pure hearsay, but you must be around some crappy young ODs.

----------


## IndianaOD

> Yes I am and I see why the forum is private, its because the few in your profession that visit there talk about the future of the profession as if your out to destroy everything else in it other than yourselves.  I think your profession needs a wake up call, in order to continue to think you are working toward the benefit of your patients you will need to rely on the team of professionals around you and also know your place in the field, if you think any of your schooling equates you to a medical professional I dare you to place the letters MD after your name.
> 
> I'll say one more thing, NC-OD, I am very *Proactive* about my profession. ;)



Wow, do you depend on ODs for any of your income?  Gotta go check out your little website.  Why would I want MD after my name?  Wake up, there is nothing magical about medical school, especially when it comes to the eye.  What MD pipe are you smoking?  Go worship them like they worship themselves.

I guess its a shame that ODs like me do anything they can to help out their opticians.  Their income directly comes from my work and its a responsibility I take very seriously.

I think some ODs are tired of taking crap from all sides.

----------


## braheem24



----------


## HarryChiling

> Wow, do you depend on ODs for any of your income? Gotta go check out your little website. Why would I want MD after my name? *Wake up, there is nothing magical about medical school, especially when it comes to the eye.* What MD pipe are you smoking? Go worship them like they worship themselves.
> 
> *I guess its a shame that ODs like me do anything they can to help out their opticians. Their income directly comes from my work and its a responsibility I take very seriously.*
> 
> I think some ODs are tired of taking crap from all sides.


And for only $0.39 a day you can provide a meal and place to sleep for some poor optician in Indiana. And if you act now you will get a nobel peace prize along with your optometry decoder ring.

Nothing magical about medical school except that to practice medicine you need to go to medical school or you can go to optometry school and then try and expand your profession into medicine while practiceing psuedo-medicine. You get crap from both side because you don't respect where you came from, or where your are going.

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## orangezero

> How often is an O.D. sued for malpractice over the quality of his refraction?   Isn't it only when they practice medicine that they tend to get in trouble?
> 
> Ever heard of an OMD (which you claim is group of incompentents at this) being sued over a refraction?
> 
> If a refraction is perfomed and not presented as an exam for desease where is the liability?  
> 
> Chip


ODs generally are sued and lose because of a failure to act.  Not running visual fields, not performing tonometry, not keeping good records, etc. etc.  

Are we really trying to set up a new profession which would essentially have the authority to decide when those things should be done (ie refer) but not the education to decide when it is necessary?  Providing the required education would become similar to the redundant school of redundancy (ie optometry school).  Or are you really going to claim, "I was only doing a refraction officer, I wasn't supposed to look at their pupils and see they had a brain tumor."

Hogwash, never happens.  I'm keeping this short so I can write up my letter to a specialist to rule out a malignant choroidal melanoma on an asymptomatic 35yr old male who had no complaints and just wanted glasses.:cheers:

----------


## HarryChiling

orangezero,

It's not a new profession we're talkign about setting up, it's an old profession that the others O's have done a great job emulateing in their offices, but not exactly. I am sure you know that there are a lot of opticiasn that have some skills that could never be emulated or replaced, it's not difficult to gan and attain these skills it is time consumeing and costly though, so is your education that earned you the right to refract and call yourself a doctor. I really really appreciate you being civil here and it makes it easier to see your point of view which I do. From what I hear your saying that the education needs to be there and I agree we can't just have the guy that was flippign burgers yesterday that goes by the title optician being grandfathered in or anything like that. I also feel that if an opticians were to go through optometry school that woud be overkill, todays optometry school teaches way beyond the scope of what yesterdays optometry school was teaching yet you all practice with the same title. I am askign what the minimum requirement would be to refract?

The people that paved the way fro your profession had 2 years, surely that's not enough that is the equivalent of an associates degree in opticianry. What bout a bachelors degree in refractometry? Realistically when optometrists say 8 years of education those first 4-5 years are a bachelors degree which could be in anything from liberal arts to business, surely that can't count as education towards your specific profession, so that leaves 4 years of optometry school, how much of that did you spedn learnign refraction and optical theory? How much of that is spent learning the medical side of eyecare?

Here's a model that I was thinking could be a great thing to beneft both professions Patient goes to see OD to get an exam, the OD gives and OK to refract status that is good for one year. This means that now the patient is free to get a refraction from whomever they choose. Most will more than likely stay in the same place because that's what they came for, but if they choose to coem to our location then I have the ability to provide a refraction and fit based on my numbers. Nothing would change except more choice for the patient and your profession would still be the gate keepers of the refraction but the patient will have the choice and you will still have the opportunity to catch all the medical conditions to your hearts content. That's win win for everyone.

The current model is choking opticianry as a profession and to rely on scripts that we should all be abl to agree could or coud not be released is starting to wear thin on many.

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## chip anderson

Orange:
I see patient's everyday usually with contact lens problems and some who come in with non-contact lens problems wanting me to "take a look."
Yes, I look with a slit-lamp.  If I see a problem I refer them to thier doctor.  If I see no cause for their complaint but they seem to have one, I refer them to thier doctor.   If it's due to the contact lens, or particles attached, or the fit, I fix it.
Many ask: "Why do I need to see the doctor every year when I see you?"
I always tell them that while I will damage to thier contact lenses and probably anything that is wrong with the front or the surface of your eye, I won't see or have any clue about what happens behind that."  
If I do see a problem on the surface I don't for the most part have to know what it is or what to do about it.  I just have to recognise that it is a problem and refer them to thier eye doctor.   I see no reason (and no, at this late date in life I don't want to become a refracting optician) why refraction can't be handled the same way.
If you refract, and get good results and do not visualize any problems you still advise them to see thier eye doctor yearly.  If you don't get good results or see a problem, you refer them immeadiately.  Now what's wrong with that?

Chip :Confused:

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## HarryChiling

Refraction is apparently no longer a part of a comprehensive exam through medicare so the insurance companies are no longer reiburseing squat for it.  So if the exam didn't include, but gave an "OK for refraction", just like an "OK to fit contacts" then some of the val may actually come back into the refraction, now it's easy to bill seperately for the refraction and the exam, patient pays outta pocket for the refraction and insurance pays for exam.  Patient tries to skip the doctor, they can't it doesn't work that way.  In essesnce now you haev created a new revenue stream which really isn't new.

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## nickrock

So, I have been reading, listening and collecting several thoughts over this thread for the past few days now.
Here it goes. Rant ON!!!
First of all, everyone needs to get off their high horse. ODs aren't perfect, neither are MDs, opticians, mechanics, or the corndog dipper at the mall.
The point is that there are incompetent people everywhere and very few that actually "shine" in their profession.
With that preface, I am an ABO, NCLE, COT jack of all trades. Optician, cl technician, and ophthalmic technician are just my titles and/or credentials, not my identity. So if I were an OD or MD, I wouldn't "just" be an OD or MD. I am whatever my training, education, learning, teaching, and life experiences make me.
I refract all day every day and I am damn good at it. I know I am as good as any OD around, I'm not saying that I am an OD or I have their knowledge, education, or share their scope of practice, but refracting is not quite like putting a 10-0 nylon running sutures in a corneal transplant patient with sixteen 11-0 interupted sutures, is it?
So people need to relax and meeelllloooowww out. A million dollar lawsuit from a bad refraction? HA. When is the last time you blinded or killed your patient with a bad refraction.
Oh, and your 9 years and 150k of student loans make you have a more important license or "significant" education. PLease, you're preaching to the wrong crowd here. I'm not picking on ODs, I'm picking on you! You sound like every other professional that thinks the world would not survive without your profession. I'll defend ODs cuz I've worked with them for over 9 years and MD's for almost 3. There is no better "field" or specialty better than another. One of the most intelligent and insightful comments regarding eyecare and this subject came from an OD I worked with, from ICO by the way, that said the doctors that *really* "get it" are the ones that work together in multi-specialty, multi-disciplinary practices i.e. the ODs and MDs that work together because they know that they are good at certain things but not everything and that patient's receive that best care because of it.  Maybe you didn't have the same professors?

QUOTE: _"You SERIOUSLY think that a OMD with 3 years of surgery heavy eye training is better at primary eye care than an OD with 4-5 years of eye training?

You do know that most OMDs have little to no refractice training?"_

Tisk, tisk, tisk. I work with a very talented group of ophthalmology residents and their 3 years of specialty training (that's after 4 years of medical school) in eyecare are not neccessarily "heavy" in surgical training, in fact several of their instructors are ODs.  Now, unlike you I am not making the dangerous generalization that one profession is better than another at "primary eye care," just that it is all dependent on the individual. Your comment on refractive training is ridiculous and out right untrue and ignorant.
I certainly have more to say on this but I think you get the picture. My suggestion is that you slowly remove your foot from you mouth and crawl back to ODwire.

Peace out!

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## orangezero

> Refraction is apparently no longer a part of a comprehensive exam through medicare so the insurance companies are no longer reiburseing squat for it.  So if the exam didn't include, but gave an "OK for refraction", just like an "OK to fit contacts" then some of the val may actually come back into the refraction, now it's easy to bill seperately for the refraction and the exam, patient pays outta pocket for the refraction and insurance pays for exam.  Patient tries to skip the doctor, they can't it doesn't work that way.  In essesnce now you haev created a new revenue stream which really isn't new.


I don't think most ODs like this fact.  The separation of refraction from an examination is purely a book keeping one and something that doesn't really make much sense unless you look at it financially.  It makes no sense from the standpoint of performing the exam, in my mind.  I think its a poor argument for separating refracting from health examinations.  Medicare simply doesn't want to pay for it.  They probably couldn't afford to pay for it if they wanted to, without drastic changes to the tax codes.  Others follow suite simply to save money.

However, a "wellness" examination with the code S0620 does include the refraction along with an eye health evaluation.  Medical codes (99xxx and 92xxx) are used when patients present with a medical complaint, but its slightly more complicated than that because vision plans use them improperly.  In fact, I'd probably guess including refraction in an exam is still quite common and not going away any time soon.

It is actually quite artificial how the insurance companies have been able to magically exclude eye defects (myopia, astigmatism, etc) from the rest of medical issues.  It is difficult when patients have to pay out of pocket for a procedure we do to rule out pathology.  There are many examples of when we may need to do a refraction in order to determine whether or not to refer for cataract surgery, how much armd has progressed, or any number of other cases.  This IS a medical test just like testing any of the other cranial nerves and brain function which other doctors do on a daily basis.  Determining a best visual acuity, from a medical standpoint, is quite similar to confrontation fields, pupil testing, etc.  Its one of the main things primary care physicians want to know about when I send letters dealing with diabetes and other health issues.  I see lots of problems with patients wanting to go somewhere else for a refraction.  (Not to sound flippant here, but there would be tons and tons of cases where we would have to determine a best visual acuity by doing a refraction anyway, and then you guys would complain about stealing your refractive patients!:p).

I think another point of confusion is what a refraction really is.  There will be lots of definitions that can be thrown around (and already have been if you do a search).  

As for education, I went to college knowing I would probably be an optometrist.  The optometry school I wanted to go to had rather strict guidelines as to what they would accept.  Lots of business majors had to take additional classes in physics, biology, and chemistry before entering school in order to qualify for optometry school (to be able to understand ocular anatomy, optics, visual development, etc.)  I don't think its fair to say undergraduate courses could be entirely non-medical in nature.  Most ODs today would take very similar undergrad courses to MDs, although I think the comparison is silly at best.  The point is there is quite a bit of background in the sciences required before starting optometry school.

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## fjpod

> Maybe a similar situation concerning OD's would help put this into perspective:
> 
> 
> 
> 
> 
> 
> 
> 
> ...


Harry, what's up with this post?  You lifted this text from an optometry website that requires all members to be an OD.  I am curious as to how you came upon it.  That post was started by an anonymous poster, possibly a troll who is not an OD.  Hmmm??

Sorry OP for hijacking the thread.

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## npdr

Generally, this thread has gone the way it will go, but the what is missing is the essence of refraction. What separates refraction from any other scope of practice question is the intimate relationship of refraction to the diagnosis of a medical condition. Separating the two will not help the patient and is only driven apparently by a lack of consideration of the patient's welfare. 

I know that Medicare has separated out refraction from the rest of the examination as a reimbursement issue but that does not in any way lessen the tight relationship between refraction and the health of the eye and should in no way be used as a rationale for the independent perogative for refraction.

I do believe that refraction for the purpose of following a contact lens might be appropriate but I think it would be remiss for government regulators to completely liberate refraction from a duty to examine the patient adequately. If opticians want to refract, then they must also increase their liability insurance and be liable just as optometrists for missing eye disease due to a best vision that may be used to detect disease.

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## tmorse

> If opticians want to refract, then they must also increase their liability insurance and be liable just as optometrists for missing eye disease due to a best vision that may be used to detect disease.


What are some current statistics... ie. just how ofter do optometrists miss eye disease due to a best vision refraction?

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## npdr

A best vision refraction further alerts the optometrist for occult disease. I'm particularly alerted in subacute macular edema or subretinal neovascularization that is almost invisible by slit lamp or binocular indirect ophthalmoscopy. Therefore a acuity of even 20/25 should alert an examiner of occult disease.

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## tmorse

> A best vision refraction further alerts the optometrist for occult disease. I'm particularly alerted in subacute macular edema or subretinal neovascularization that is almost invisible by slit lamp or binocular indirect ophthalmoscopy. Therefore a acuity of even 20/25 should alert an examiner of occult disease.


Well good. Since Optician sight-testers routinely refer out candidate(s) that cannot be refracted down to 20/20 there is less opportunity for of missing any pathology, right?

Now if you know, kindly answer my question re: Optometrists being successfully sued by a patient for: 
1) any reason
2) incorrect refraction.

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## orangezero

Optometrists lose lawsuits when they fail to act, which is exactly what  potential refractionists want to do for each patient they see.

There are many cases of undetected, asymptomatic eye disease in which best corrected acuity is 20/20 or better.  So even if you refract a patient to 20/15, 20/10, etc... you don't really know they are disease free until you perform a health check.  At the same time they will be left with the impression of good health regardless of any disclaimers you would have them sign or discussions you have with them.

Regardless of liability, it lowers the standard of care that patients have come to expect.  I'm not sure that is the best public relations selling point for a new profession.

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## chip anderson

NPDR:

What makes you think opticians don't have insureance?  I have carried one million per eye for 50 years and never been sued.

Chip

Of course having insureance is no guararantee  of competence, just a defense in case of lawyers.  Doesn't matter whether you have insurance or not, what does matter is that you "Do No Harm."

I happen to know an "advertising opthalmic surgeon"  who couldn't get malpractice because he had been sued so many times as a result of his refactive surgeries (His adds said he was one of the 100 best").  No problem, he kept right on practicing just put everything in his wife's name.

Chip :Eek:

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## LandLord

When a patient enters a dental practice for the sole and express purpose of obtaining a cleaning, it is the hygienist who does the work, while the dentist profits from the attached check up.

Both services are performed during the same visit. Both procedures have implications affecting the other. However, both procedures can be performed safely without the other.

Look at a brief history of the battle between the two professions. One fighting for freedom, the other fighting for control. Does it seem familiar to anyone?

-----------------------

1989: Health Professions Legislative Review (HPLR) recommends that dental hygiene be a self-governing profession, separate and independent of dentistry. 

Prior to December 31, 1993: Dental hygiene regulated by dentistry (Royal College of Dental Surgeons of Ontario - RCDSO). Dental hygiene allowed to have two non-voting observers on the RCDSO Council. 

1993: At last moment, dentistry successfully lobbies government to include provision in Dental Hygiene Act whereby dental hygienists must obtain an "order" from a dentist to perform "root planing, scaling and curettage" (i.e. teeth cleaning).

1994: The CDHO asks the Minister of Health (Ruth Grier) to amend the Dental Hygiene Act so that the "order" requirement would reflect what actually occurs in practice.

1994: "Order" requirement referred to Health Professions Regulatory Advisory Council (HPRAC) by the Minister of Health. 

In 1995 and again in 1996, HPRAC reviewed the statutory requirement for an "order" and recommended to the Minister that the requirement be removed for dental hygienists treating non-medically compromised patients.

November 1997: Minister of Health (Jim Wilson) meets with the CDHO and demurs on implementation of the HPRAC recommendations.

February 11, 1998: Minister of Health (Elizabeth Witmer) asks CDHO and RCDSO to reach an agreement on a mutually-acceptable regulation pertaining to "orders". Discussions fail to reach an agreement. 

November 1997: RCDSO unilaterally prepares regulation on "orders".

March 6, 1998: RCDSO Council approves regulation on "orders". 

December 1999: Minister of Health (Elizabeth Witmer) refers the RCSDO regulation on "orders" to Health Professions Regulatory Advisory Council (HPRAC) for a legal opinion on the validity of the regulation. 

November 19, 2001: CDHO and RCDSO meet with Minister Clement to discuss RCDSO regulation. 

December 7, 2001: Minister Clement indicates intention to approve RCDSO regulation.

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## npdr

"...*then they must also increase their liability insurance and be liable just as optometrists for missing eye disease* due to a best vision that may be used to detect disease..."

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## LandLord

> "...*then they must also increase their liability insurance and be liable just as optometrists for missing eye disease* due to a best vision that may be used to detect disease..."


That would only be true if an opticians job was to detect eye disease. What you're saying makes as much sense as trying to hold an eyebrow waxing technician responsible for missed eye disease.

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## npdr

It is also nonsensical to separate refraction from eye disease detection. That is my thesis. The two are inseparable.

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## HarryChiling

> It is also nonsensical to separate refraction from eye disease detection. That is my thesis. The two are inseparable.


Your profession up untill 30-40 years ag was based on refrctions alone, let me remind you that it was the '80's where your profession attained dilation and the beign held responsible for ocular disease is a result of education beyond your scope which was done in an effort to increase your scope.  I am amazed that many optometrists didn't stop practiceing if they really felt that they could potentially be doing harm.  Now that the profession has increased the scope beyond just refractive errors the equipment used to measure the refractive error somehow checks for disease as well?  That's odd, if that was the case we would see changes made to a phoropter, the only change that has been made to a phoropter in years is the fact that it has become less accurate from 0.12 to 0.25D.

Opticianry is not a new profession, opticianry is not new to refraction, opticianry can be an integral part of the eyecare delivery system, opticianry is directly in competition with optometry?

My question is...................how can we allow opticians to refract without being in direct competition with optometry?

There are many answers to this question, if you just can't see them then I suggest that maybe we need to loook inside to see what intentions we have for the answer not being evident or not being able to think outside of the box to solve this problem?

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## chip anderson

Hate to point it out, but didn't O.D.'s use to be opticians that became "refracting opticians", then optometrists, then  Doctors of Optometry" and now "Medical Optometrists."
Isn't there     a line in Dr. Zivago :  "We have come a long way in a short time...."

Chip

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## IndianaOD

> My question is...................how can we allow opticians to refract without being in direct competition with optometry?


As long as there is a massive oversupply of ODs, NEVER.

Again, how does the public benefit from stand alone refractions?  Eye care is the least expensive specialty and there is an ECP around every corner.

What is the benefit of ODs?  They are better at primary eye care than anyone else, PERIOD.

Do you all think Optometry schools should stop educating and certifying opticians?  If this thread is any hint, perhaps they are training our enemies.

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## orangezero

Optometry has changed partly from expansion of scope, changes in standard of care, and liability.  Its all intertwined.

Sixty years ago the detection of glaucoma was poor at best when compared to today's methods.  If it was detected often the treatment and outcomes were poor.  So, along with the increase in medical knowledge, expansion of scope, etc. etc. we also have better treatment outcomes and increased expectations.  This alone should lead those performing primary eye care (whatever that means) to have additional training and larger amounts of liability as a result.  The public expects more from an eye exam today than they did when refracting opticians were starting out.

So, in essence, a person who is doing a refraction today is completely different from a person doing a refraction 50+ years ago.  It would be an unfair comparison.  The world has changed, technology changed, medicine changed.  Many of the things optometry does (drugs we use, diagnostics, procedures we perform, etc) were not even available to anyone back when optometrists were "simply refractionists."

I guess in the end it doesn't affect my ego either way what you guys think about optometrists.  But what other profession is judged based on standards and biases from the 1950s?  I know you ALL can't be that old... :Nerd: 

Liability is an easy way to say "I'll take responsibility" or "the buck stops here."  Those wishing for refracting rights appear to want the benefits of doing refractions without any of the risks associated with primary eye care (however small you try to make it out to be).

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## LandLord

orangezero



> The public expects more from an eye exam today than they did when refracting opticians were starting out.


Not necessarily. The public's desire for an eyeglass refraction has increased more than their expectations of an eye exam. Therefore, your statement is not in its proper context. The refraction is more important to the public than the health part of the exam. The refraction is desired and demanded more than an eye health screening. Increased demand should equal increased supply. Let's face it, eye exams are a commodity. They will never be in style.



> Those wishing for refracting rights appear to want the benefits of doing refractions without any of the risks associated with primary eye care.


That's correct. We also want the benefits of being able to take seg heights and pd's without the risks associated with emergency heart bypass. The point is obvious.

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## wmcdonald

> That would only be true if an opticians job was to detect eye disease. What you're saying makes as much sense as trying to hold an eyebrow waxing technician responsible for missed eye disease.


Screening for disease is a part of what Opticians must be trained to do prior to gaining refraction. It is imperative we understand things to look for that must be referred. As to liability, the increase in scope will increase liability, so if that is a concern simply don't refract. That said, the rate of significant eye disease between 18-40 is minimal and with appropriate training and education, and established referral protocols, it can and one day will be done safely by Opticians. Why don't the ODs work with us to make certain we are well trained if economics is not the real issue? No one wants folks who have not been appropriately educated to start doing anything. Maintaining control of those patient dollars is the root issue.

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## chip anderson

Most conditions will be "clued in" by what the patient tells you.

"I'll take the history, any senior medical student can do the physical."
Dr. Chas. Mayo


Chip:cheers:

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## jediron1

> Wow, do you depend on ODs for any of your income?  Gotta go check out your little website.  Why would I want MD after my name?  Wake up, there is nothing magical about medical school, especially when it comes to the eye.  What MD pipe are you smoking?  Go worship them like they worship themselves.
> 
> I guess its a shame that ODs like me do anything they can to help out their opticians.  Their income directly comes from my work and its a responsibility I take very seriously.
> 
> I think some ODs are tired of taking crap from all sides.



Plez every OD I have worked for are cheaper then dirt. So you give your Indiana Opticians a dollar more then minimum wage and think it's a big deal. Come on get in the real world. As I have said before and will say again OD's and OMD's pay their opticians very low. They would rather hire a pretty little thing and call her a stylist so they can save the extra bucks it would cost them to hire a real optician. Don't get me started!  :Mad:

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## MarcE

> Why don't the ODs work with us to make certain we are well trained if economics is not the real issue?


Economics is always the issue.  You are threatening to take money and power from someone else.  There are only three things that ever started any war.

Money, 
Power, and 
Sex. 
And the sex part is mostly (not completely) about power.

And yes I left out religion. People will go to war for their religion, but the leaders at the top will not start a war for religious reasons.

If you could find out how to make ODs more money, they will be your best friends. The "liability" will somehow not be an issue any more.

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## jediron1

> Economics is always the issue.  You are threatening to take money and power from someone else.  There are only three things that ever started any war.
> 
> Money, 
> Power, and 
> Sex. 
> And the sex part is mostly (not completely) about power.
> 
> And yes I left out religion. People will go to war for their religion, but the leaders at the top will not start a war for religious reasons.
> 
> If you could find out how to make ODs more money, they will be your best friends. The "liability" will somehow not be an issue any more.




I guess you forgot about the crusades, leaders did go to war. It does not matter how much money you earn for an OD or OMD they are never satisfied. As much as I was making for the last OMD I worked for he turned around and said I can do this with a less expensive optician and still make money. He went through 4 opticians before he found one that could replace me. The first one he kept for a year and let him go because some how his hands got into the till ( if you know what I mean ) another words he was stealing. The other people three over the next two years could not produce like I produced. So it took that clown three years and four people to finally settle on some one and they still can't do what I did. He learned his lesson the hard way.

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## IndianaOD

> Plez every OD I have worked for are cheaper then dirt. So you give your Indiana Opticians a dollar more then minimum wage and think it's a big deal. Come on get in the real world. As I have said before and will say again OD's and OMD's pay their opticians very low. They would rather hire a pretty little thing and call her a stylist so they can save the extra bucks it would cost them to hire a real optician. Don't get me started!



Give it up, you have no idea what pay or benefits our employees get.  Full medical itself can cost $500/mo per employee.

Don't speak unless you have facts.  We have 3 with over 10 years, we must be decent employers.

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## chip anderson

There is also freedom, revenge, fear, boredom (yes, some Kings went to war just for something to do and the love of battle), political "ideals", sometimes even food,  occasionally just because someone said the wrong thing to the wrong person (political _insult) Andrew Jackson_ _once sacked and entire Canadian town for insulting the U.S. flag._  Teddy Rosevelt once told told Kaiser Whilhiem (after he bragged on the strength of his army) to : "Bring 'em on we'll whip them before breakfast."  No war ensued on this but I have no doubt Teddy would have backed it up.
Sometimes wars ensue just from mistakes (possibly the Spanish American war) several times we came close to war with the USSR from radar glitches, we almost lauched a nuclear strike because of a flight of geese.

Chip

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## eoptics

I do believe that any optician, if he or she gets simple training, can do refracting job perfectly because of the development of refined equipment and its simplicity of the operation. In the view of customer benefits, optician's practice of this job helps customers have the merits of convenience and economy.
Checking vision, that is not about desease but about abnomality of eyes, for glasses is not a difficult job any longer unlike finding eye disease that needs broad and more knowledge.
At this moment, the legal issue is only barrier.
Why do customers pay more for this? Without paying the cost, customer can get glasses economically and conveniently if the service can be provided at no charge by optican's participation. Let the law makers acknowledge these factors, first.

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## braheem24

> If you could find out how to make ODs more money, they will be your best friends. The "liability" will somehow not be an issue any more.


ODs are losing business to OMDs because of the lower reimburement rates for OMDs.  OMDs are now opening opticals and accepting vision insurance so they can maintain their 40-100 patients a day volume.

If I was an OD, I would work with opticians and lobby to have OMD exams only paid by insurance when referred from an OD, just like everything else in medicine.

We're not allowed to visit a neurosurgeon for a headache, we shouldnt need an eye surgeon for glasses.

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## jediron1

> Give it up, you have no idea what pay or benefits our employees get.  Full medical itself can cost $500/mo per employee.
> 
> Don't speak unless you have facts.  We have 3 with over 10 years, we must be decent employers.


I have enough of an idea that od's and omd's don't pay. So you give your optician a little extra big deal!

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## Stonegoat

jediron1,

If you don't like the pay...find a career that pays better and quit           b!tching :Cool:

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## jediron1

> jediron1,
> 
> If you don't like the pay...find a career that pays better and quit           b!tching




Look Goatstone :shiner: never said I wasn't paid well now. I said when I worked for cheap OD's and OMD's I wasn't paid well, get the facts straight before you stick your two cents in.  ;)

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## MarcE

> There is also freedom, revenge, fear, boredom (yes, some Kings went to war just for something to do and the love of battle), political "ideals", sometimes even food, occasionally just because someone said the wrong thing to the wrong person (political _insult) Andrew Jackson_ _once sacked and entire Canadian town for insulting the U.S. flag._ Chip


These are all great examples and I don't disagree.  I would just say that they mostly fall under power:  Freedom could be stated as power over self-determination.  When bored, kings want to be reminded of their power.
Instead of money, I should have said resources.  Such as gold, food, oil, diamonds, which are all currency in certain situations or can be exchanged for currency.

And concerning the crusades.  The leader(s), (Pope and bishops) inspired and sanctioned the war using religion as the selling point.  But it was really about expanding power for "christiandome" and therefore it's leaders.

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## Dannyboy

Optometry is in caught in the middle because there are two main groups that want them out; Ophthalmology and the optical giant corporations. 
They can whine all they want but independent optometry has its days counted. Their nearsightedness of the ODs was that instead of pushing independent opticianry out they should have actually being proactive to establish a licensing in every state for opticians forcing the corporations to play by an even level in every sense of the word. We are so afraid of the corporations today that even our licensing boards are afraid to tackle them (Optometry and Opticianry). Shame on them! 

It is too late now as close to 50% of Optometry is corporate and possibly 80% of opticians work for the big boxes. The next step for the corporations is to tackle Ophthalmology. 

Dannyboy :Confused:

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## chip anderson

Danny:  You're wrong here.  There was a time when opticianry and ophthalmology were closely allied and supported each other.  Opthalmology had lots of clout and finances when needed, opticianry was the prime source of referral for ophthalmolgists.
Now Opthalmology for all purposes is thier own optician (some may be in the pay of ophthalmolgy but it's the doctor's business and the optician is sending him nothing, just his employee.
Now that much of opthalmology no longer wants to refract or even treat desease, instead wants to be almost a surgical enterprise, the need for opticianry is greatly deminished.  While I have sent thousands of patients to opthalmologist, and even established practices for some they have learned that a meare optician is not much of a source for surgical patients.   Oh, we send the occasional cataract, a rare detached retina or so, but for them most part what we refer are healthy patients wanting refraction mostly with a routine exam.  Opthalmology doesn't even want to do this anymore.
Now O.D.'s are a source for referral of refractive surgery, cataracts, and provide follow up after these have been done, so the opthalmologist is making thousands per hour with no follow up time required.  Why should they want to be bothered with refraction and junior's conjunctivitus.
If we ever want to function and indenpendent opticians again, we in a whole heap 'o trouble.  
We will never be able to out PR the OD's and the OMD's no matter how rightous our case, they have too damn much clout, money, prestige and numbers. 
Now if you have a strategy to overpower this, for God's sake share.

Chip :cry:

----------


## IndianaOD

> I have enough of an idea that od's and omd's don't pay. So you give your optician a little extra big deal!


Ok,

This post is not beneficial for anyone, but I would like to pose a reality check.

In the midwest a high school graduate has pretty limited options.  Many choose  a factory job.  These jobs don't pay nearly as much as before and there is no job security.  Many make around $15 an hour with little to no benefits.  This is uncomfortable and mind numbing work.   You  get 30 mins for lunch non paid and maybe 2 10 minute breaks.  Others may get $8 in a service industry.  

Lets say one of our newer techs makes $10 an hour with full medical.  This makes it equivalent to $13-14 an hour.  The environment is clean and pleasant.  The work is varied and non stressful.  They get respect and get to help the patients.

Considering this comparison, how are techs / opticians getting such a bad deal?  Most are 2nd wage earners in the family.  The training is done while being paid at the office.  

A buddy is part of a large office that pays their head optician around $45k with benefits.  On par or better with teachers.

What is the problem?

----------


## Dannyboy

Chip i am not wrong! I never said that MDs never were with us...They were in the old days but those days are gone....todays mds are greedy they see optical as another source of income...They see the ODs as what we were in the past referrals. Independent opticianry is dead and independent ods are almost in the same path. Corporate opticals are here to rule wether we like it or not. ODs are their employees and nothing can be done. Why bother. Wefited contact when it was profitable...then they screwed that (I blame the Ods for this) If that Od had release the Rx maybe Starrack would have never initiated this non sense and life would have been easier...but that is too late. The Od were so focus with us as competition that they forgot about the big boxes...They are gobblling them the ods as fast as they can..and frankly they desrve that. I would not be surprise if the Optometry schools start actually reducing their schooling to less years as the big boxes only want to sell, sell. The medical training that these Ods of today receive probably will not be use to its fullest because they are doing refractions at wally....our boards are a joke as they allow these empires to get away with murders...they have no cojones....stores without opticians (and is in the licensed states) i can omnly imagine in the non licensed ones what goes on.
Dannyboy

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## jediron1

> Chip i am not wrong! I never said that MDs never were with us...They were in the old days but those days are gone....todays mds are greedy they see optical as another source of income...They see the ODs as what we were in the past referrals. Independent opticianry is dead and independent ods are almost in the same path. Corporate opticals are here to rule wether we like it or not. ODs are their employees and nothing can be done. Why bother. Wefited contact when it was profitable...then they screwed that (I blame the Ods for this) If that Od had release the Rx maybe Starrack would have never initiated this non sense and life would have been easier...but that is too late. The Od were so focus with us as competition that they forgot about the big boxes...They are gobblling them the ods as fast as they can..and frankly they desrve that. I would not be surprise if the Optometry schools start actually reducing their schooling to less years as the big boxes only want to sell, sell. The medical training that these Ods of today receive probably will not be use to its fullest because they are doing refractions at wally....our boards are a joke as they allow these empires to get away with murders...they have no cojones....stores without opticians (and is in the licensed states) i can omnly imagine in the non licensed ones what goes on.
> Dannyboy



I agree 100%. Well said Dannyboy!  :Cool:

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## optical24/7

> We will never be able to out PR the OD's and the OMD's no matter how rightous our case, they have too damn much clout, money, prestige and numbers. 
> Now if you have a strategy to overpower this, for God's sake share.
> 
> Chip


 
PM sent..;)

----------


## jediron1

> Wow, do you depend on ODs for any of your income?  Gotta go check out your little website.  Why would I want MD after my name?  Wake up, there is nothing magical about medical school, especially when it comes to the eye.  What MD pipe are you smoking?  Go worship them like they worship themselves.
> 
> I guess its a shame that ODs like me do anything they can to help out their opticians.  Their income directly comes from my work and its a responsibility I take very seriously.
> 
> I think some ODs are tired of taking crap from all sides.



There is nothing magical about MD after their name but they do hold the holy grail as far as the three O's go. Where the MD goes is where the OD's and Opticians usually go. As Chip said because of there money and power they hold the trump card and that is what MD will get you. Now on worship your right as a group OMD's have the biggest ego's and god complexes of any of the specialties.  Lastly if you wear a rain suit you won't have to worry about taking crap from all sides.  ;)

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## LandLord

I'll tell you what is magical.  Go to medical school, get an ophthalmology residency, and start making $50,000 a week doing lasik.  And that week is only 2 days long.  Make $25K on wednesday and another 25 on friday.

A lasik surgeon's pay is so far up on the scale that it makes optometrists and opticians look about the same.

----------


## Against the Rule

As a newbie I hate to get involved in a contentious discussion, but some of you people seem to be bitter about surgeons making more than OD's or even opticians!
The original post was about opticians with certain qualifications refracting--more to the point, about not releasing Rx's.  Somehow it's devolved into opticians vs. OD's vs. MD's etc.
Let me tell you something, Oh Masters of Frame Bending and Lords of the Snellen Chart...Cutting into someone's eyeball requires more skill and cojones than most here, including me, will ever have.  MD's sacrificed more to get where they are, and risk more to stay where they are (malpractice insurance), and that's why they make more money.
Many independent opticians are doing well; they are the ones who look for opportunity rather than where to place blame.  Both OD's and MD's can be great partners for opticians--I have worked with both and all of them were fair and even generous employers; they can be great partners, as well.
The pie we are all sharing is of infinite size, and opportunity abounds for all of us here who love helping people see better.  A few bad apples do not, in this case, spoil the bunch.

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## IndianaOD

> There is nothing magical about MD after their name but they do hold the holy grail as far as the three O's go. Where the MD goes is where the OD's and Opticians usually go. As Chip said because of there money and power they hold the trump card and that is what MD will get you. Now on worship your right as a group OMD's have the biggest ego's and god complexes of any of the specialties.  Lastly if you wear a rain suit you won't have to worry about taking crap from all sides.  ;)


There is always someone who thinks they are bigger and better.  General and cardio surgeons tell OMDs they aren't real surgeons.  There is always a bully with an even bigger ego.

I like being an OD because I know and can treat things that OMDs don't know exist.  Yeah they get the pay and respect, but I've had mothers come back and cry when VT rid their child of daily headaches.  

Who's to say which takes more mental fortitude.  Understanding neurology and visual processing or making similar cuts over and over again.

To each his own.

----------


## npdr

HarryChilling,

As a "manager" at a Pearle Vision in Hunt Valley,MD do you have the broad experience that you seem to convey to this board?

----------


## HarryChiling

> HarryChilling,
> 
> As a "manager" at a Pearle Vision in Hunt Valley,MD do you have the broad experience that you seem to convey to this board?


I have worked at a large scale lab in every facet from surfaceing to finishing to placing the surface saver tape on lenses to cleaning bathrooms.  I still find myself swinging a toilet brush on occasion, if tht's what your asking.  I worked for 1 year with a pediatric ophthalmologist where I assisted in 5 seperate occasions with surgical procedures, I have refracted in their office (less than a month total, ut enough to understand the process no where near ebough to master it), I ran a medium size optical for an ophthalmologist consisting of 4 different locations as the GM, I fix and update the computers in my office from installing software to replaceing faulty power supply and motherboards, I set up the network in our office as well as made a piece of furniture for the current office.  I can tech 'em rack 'em and move 'em out.

I can fabricate difficult to make eyewear often in less time than it would take many of our outside labs to get over moaning about us sending them our tough work.  You'll also find that I don't hide behind a false name and stand proudly behind my work and my statements.  I have spent the better half of this thread pleading for solutions and the net total has been every O basically contributeing the same rederick to the thread that's always spewed.  I am both tired of discussing these issue and tired of sharing the tricks I know as well.

By the way NPDR, I am not technically a manager and one of the stipulations for me workign where I do is that I cannot ever be refered to as a manager, although I do have many of the duties.  I get paid fairly decent but by no means what I am worth.  I also have a family and child which I value more than pay and benefits so for me I have found a good median between pay and time off and flexability in my job.  Our office just recently recieved a platinum award from Safilo for shrewd purchaseing and this has been part of a extensive plan set out by me and executed by our staff.  Our vendors hate us yet still value us, I bust everyones balls it's really just my personality I guess.

I have tried my best to remain neutral and to ask for any suggestions on how the profession of opticianry can see an acceptable and realistic expansion in scope.  Many of the contributors here have doen nothing but fart in the wind, what I was hoping for instead of the statements of it will never happen is more along the lines of how it would happen.

I don't want to start anything and I hope your intentions aren't a personal attack on me when you asked the question but if it is I really don't want to hear it, but if you must please slander away, Doc.

----------


## HarryChiling

> HarryChilling,
> 
> As a "manager" at a Pearle Vision in Hunt Valley,MD do you have the broad experience that you seem to convey to this board?


PS - Any of my posts if you feel that you can challenge even one of them I invite you to it.  I have pictures of many of the tougher jobs I have done as well as a few oticiasn on this board I have fabricated some toughies for.  I have images of frames I have personally made by hand as well as opticiasn on this board that have held in their hands frames I have made by hand.  I have images of lenses that I have made that would boggle most opticians (for instance a bifocal made from a SV blank without cutting and gluing two pieces together).  I enjoy making eyewear and probably spend more time readign about our indutry and participateing in it than most OD's have spent in school, sure it doesn't count for anything except to my patients.  And after all that I am still no where near the best in my field which challenges me to learn more and to devour more information.

Me to fabricateing eyewear is like you to low vision, capish. :Cool:

----------


## jediron1

> I'll tell you what is magical.  Go to medical school, get an ophthalmology residency, and start making $50,000 a week doing lasik.  And that week is only 2 days long.  Make $25K on wednesday and another 25 on friday.
> 
> A lasik surgeon's pay is so far up on the scale that it makes optometrists and opticians look about the same.



That maybe true but you never factored in that OMD's go to school on average 10 years and have huge bills to pay. Second you don't start making $50,000 you have to establish your self first get into a good practice and then after 2 or 3 years you may start making $50,000. I tell you one thing I would not want the bills of an OD or OMD from school.  :Rolleyes:

----------


## chip anderson

An OMD generally has at least 7 years of education after finishing college(pre-med).  And even those at the bottom of the class can start out at over $100K if they go to work in an established practice.  It may take a little more time if they start out with a new single shingle.  But even it they have a great many "bad habits" they don't start out at less than $50K.  In fact I wouldnt be supprised if a resident's salary isn't near that now.
I think most O.D.'s can start at around $100K now.   I am not knocking this as long as it is made honorably.   I do admit to a bit of envy.
Now if the earnings are less than honorable, i.e. forcing un-needed tests, and tests and equipment that are there to "impress the patient",  Sticking it to the insurance company just because "the code is there."  Then I have problems with this.  Doing a refraction but not presenting the result and not stating it was done because "it isn't covered by insureance" then I have a problem with this.  But another man's honor or lack of same is not my problem personally.

Chip

----------


## HarryChiling

> I have received many private messages about this lurker.
> 
> Unfortunately the individual is not listed on ODwire.org under the name he uses on Optiboard.com.
> 
> There no way to trace this individual. If someone can supply me with his e mail address, perhaps our Web master can find a way to ban him .


He he he, I'm a lurker. :D:cheers::p:p:p

----------


## jediron1

> Ok,
> 
> This post is not beneficial for anyone, but I would like to pose a reality check.
> 
> In the midwest a high school graduate has pretty limited options.  Many choose  a factory job.  These jobs don't pay nearly as much as before and there is no job security.  Many make around $15 an hour with little to no benefits.  This is uncomfortable and mind numbing work.   You  get 30 mins for lunch non paid and maybe 2 10 minute breaks.  Others may get $8 in a service industry.  
> 
> Lets say one of our newer techs makes $10 an hour with full medical.  This makes it equivalent to $13-14 an hour.  The environment is clean and pleasant.  The work is varied and non stressful.  They get respect and get to help the patients.
> 
> Considering this comparison, how are techs / opticians getting such a bad deal?  Most are 2nd wage earners in the family.  The training is done while being paid at the office.  
> ...



Ok reality check. 1. At least around NY where I m at I know of no one that is 2nd wage earners as you put it. Do you mean they don't need the money it's just for spending. Come on get real have you seen the price of gas? Most need the second income to survive. In your little economic scenario you quote: " Lets say one of our newer techs makes $10 an hour with full medical.  This makes it equivalent to $13-14 an hour" So the tech earns gross roughly $560 minus $160 benefits and $80 in taxes and your down to take home at $320 per week. I don't know of anybody that could live on that. As for your buddy, if you break it down using your above numbers they earn $45,000 minus roughly $8000 benefits minus $7381 taxes grand total take home $29,619. Very hard to have a family living on that. 2: My daughter is a teacher and when she started out she started at $37,000 and now 3 years later she is at $45,000. If she stays she will top out in 10 to 15 years at $65,000 to $75,000, far cry from what an optician makes after 20 years which is about $45,000. Now in Indiana maybe $45,000 is big money but in NY I need my wife to work to make ends meet. Gas is at $4.00 per gallon my gas and electric just shot up another $60.00 to 379.00 per month and we just went to the grocery store and everything we picked up had risen in price from 10 to 20% so your premise that your help is well paid is unfounded in NY in Indiana maybe.  Plez :bbg:

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## jediron1

> He he he, I'm a lurker. :D:cheers::p:p:p



Harry keep it up I love it! :cheers: :D  :Cool:

----------


## npdr

HarryChilling,

I'm inquiring mainly to clarify your position on optician refracting.  I accept your vast experience in the technical aspects of ophthalmic appliances but I'm having a hard time seeing how that knowledge equates familiarity with the issues surrounding a quasi medical procedure called refraction. 

What is lost on this thread is that refraction is considered by ophthalmology as part of a medical eye evaluation and although it can be separated out by the insurance company or delegated out, its importance as an independent procedure without any medical evaluation or original complaint is what bothers me the most. 

I also don't believe a traditionally trained optician has the educational background to evaluate the relevance of a particular visual acuity level. On each patient, optometrists and ophthalmologists relate the visual acuity to the presenting complaint or lack thereof. That judgment is likely to be glossed over by an optician.

In my opinion, the optician desiring refraction is simply wanting to sell glasses, while the optometrist refracting is trying to determine if there is eye disease.

Eye disease is evaluated by both structural (physical examination of the eye, imaging)  and functional changes (visual acuity, visual fields, etc) and both paradigms serve to check and balance the other. Not doing either means that there are likely things to be missed whether they are performed by any particular kind of ECP.

----------


## HarryChiling

> HarryChilling,
> 
> I'm inquiring mainly to clarify your position on optician refracting. I accept your vast experience in the technical aspects of ophthalmic appliances but I'm having a hard time seeing how that knowledge equates familiarity with the issues surrounding a quasi medical procedure called refraction. 
> 
> What is lost on this thread is that refraction is considered by ophthalmology as part of a medical eye evaluation and although it can be separated out by the insurance company or delegated out, its importance as an independent procedure without any medical evaluation or original complaint is what bothers me the most. 
> 
> I also don't believe a traditionally trained optician has the educational background to evaluate the relevance of a particular visual acuity level. On each patient, optometrists and ophthalmologists relate the visual acuity to the presenting complaint or lack thereof. That judgment is likely to be glossed over by an optician.
> 
> In my opinion, the optician desiring refraction is simply wanting to sell glasses, while the optometrist refracting is trying to determine if there is eye disease.
> ...


That's great and I am all for all of that, but lets say the patient leaves your office and then 6 months later they decide they want to have glasses made.  The need for refraction amoung opticians as I see it is solely to sell the patient glasses, but it's more than that it's a means of satisfying a patients needs.

Currently what I have to do is call the doctors office and have them fax me a script, which sometimes meets resistance although there are laws in place to prevent the prescriber from giving me any resistance, but their is a significant percentage that will ask me to fax a release to their office, because of HIPAA.  This is a misconception and even if I manage to explaint his to them and convince them that this is not the case and I can fax them the documentation of the law, then they resort to the fact that the doctor has to sign it or a technician needs to pull the file, this can often takes hours.  Then their are the occasional doctor that has sloppy hand writting and gettign confirmation from their office on the correct script will often start this whole HIPAA process and argument over again.  Then their are the few prescribers that will not release the Rx acording to a study done that was referencedd in the federal register it's somewhere in the 10% range that flat out refuse.

I have lost good patients that have always been very happy with my service to doctors offices that play hanky panky with prescriptions.  It's a real issue, now your in a unique position where you don't dispense in your office.  For you there is no financial motivation for tom foolery with the scripts and from what you have expressed in past posts your goal is to provide patients with the best visual outcome.  My original suggestions was and still is, 

"What's wrong with a refraction only within the one year period between exams?" 

I am not suggesting that opticiasn become the gate keepers of the exams, just that opticians have the ability to tweak or update the measure after a thorough exam has been performed within a specified period of time.  The customer can be better served in all aspects of the eyecare delivery system not just the exam if this were allowed.

You mentioned that a traditionally trained optician doesn't have the educational background.  I actually agree with that and this is the kind of inpt I have been trying to coax.  As the primary care providers for the health of the visual system WHO ELSE COULD I ASK A MORE RELEVENT QUESTION TO.  All my questions here have to be directed at an optometrist, you are the ones that woud have the most relevent answers and be able to provide the proper input into how something like this could work.  

Others have mentioned and I have as well that OMD's could be an alternate source of solutions, but if the OD's on this board truly believe that they are more suited for the solution that is a great opportunity to put in valid input of how to make it work instead of being left out of the loop.

I look forward to your responses.

----------


## IndianaOD

> Ok reality check. 1. At least around NY where I m at I know of no one that is 2nd wage earners as you put it. Do you mean they don't need the money it's just for spending. Come on get real have you seen the price of gas? Most need the second income to survive. In your little economic scenario you quote: " Lets say one of our newer techs makes $10 an hour with full medical. This makes it equivalent to $13-14 an hour" So the tech earns gross roughly $560 minus $160 benefits and $80 in taxes and your down to take home at $320 per week. I don't know of anybody that could live on that. As for your buddy, if you break it down using your above numbers they earn $45,000 minus roughly $8000 benefits minus $7381 taxes grand total take home $29,619. Very hard to have a family living on that. 2: My daughter is a teacher and when she started out she started at $37,000 and now 3 years later she is at $45,000. If she stays she will top out in 10 to 15 years at $65,000 to $75,000, far cry from what an optician makes after 20 years which is about $45,000. Now in Indiana maybe $45,000 is big money but in NY I need my wife to work to make ends meet. Gas is at $4.00 per gallon my gas and electric just shot up another $60.00 to 379.00 per month and we just went to the grocery store and everything we picked up had risen in price from 10 to 20% so your premise that your help is well paid is unfounded in NY in Indiana maybe. Plez :bbg:


 


That was $45k plus medical/vision/dental so the equivalent of around $55k. 

By 2nd I mean that their spouse is the primary wage earner. Automotive manuf jobs are very hard to come by these days and very unstable. New hires at Subaru Indiana get around $16.22 an hour, this goes up to around $22 or so after a couple of years. I think working in our office is much better than doing the same repetitve motion over and over again all day with no personal freedom. 

The median income for a household in the county was $43,840 (This is for our county HOUSEHOLD income)

As our office grows everyone makes more, not just the docs.

----------


## jediron1

> That was $45k plus medical/vision/dental so the equivalent of around $55k. 
> 
> By 2nd I mean that their spouse is the primary wage earner. Automotive manuf jobs are very hard to come by these days and very unstable. New hires at Subaru Indiana get around $16.22 an hour, this goes up to around $22 or so after a couple of years. I think working in our office is much better than doing the same repetitve motion over and over again all day with no personal freedom. 
> 
> The median income for a household in the county was $43,840 (This is for our county HOUSEHOLD income)
> 
> As our office grows everyone makes more, not just the docs.




My fault I thought the way you originally put it down it was the total compensation. If he or she is getting what you say then yes that is a good compensation package for that individual. Again I agree working in an office  environment is much better, but to get the compensation you quoted at least around most of NY state you have to go retail. In NY most OD's and OMD's top out their opticians at $15 to $17 per hour. I know I have worked for many OD's and OMD's and as soon as I had topped out ($16.50 at one place  ) they let me go, had nothing to do with ability or selling glasses had everything to do with how much I was making.  As I have said else ware on this site most OD's and OMD's in NY don't pay.

----------


## HarryChiling

> My fault I thought the way you originally put it down it was the total compensation. If he or she is getting what you say then yes that is a good compensation package for that individual. Again I agree working in an office environment is much better, but to get the compensation you quoted at least around most of NY state you have to go retail. In NY most OD's and OMD's top out their opticians at $15 to $17 per hour. I know I have worked for many OD's and OMD's and as soon as I had topped out ($16.50 at one place ) they let me go, had nothing to do with ability or selling glasses had everything to do with how much I was making. As I have said else ware on this site most OD's and OMD's in NY don't pay.


That's not always the doctors fault, many don't have very much business aumen so they end up relying on consultants or industry figures to gauges their business. If you look at labor it is one of the largest expenses in any practice. As a consultant the easiest way to make an imediate impact would be to cut an optician that makes 16.50 and replave with an opticians at 9.00 or round abouts, now the consultant can brag about reduceing the practices labor costs. The long term effects will not be evident immediately and if they are it's usually a steady decline. I have seen 2 models of running a successful business, treat your employees like assets, pay them well and expec t them to earn that pay and often they will exceed expectations if the correct staff is hired. What usually ends up happening is the staff makes higher wages, but the cost of goods and operational expenses come down because the staff is vested in making the employer money and making sure their best job is always there. Another method is the cheap labor method, where the cogs and operational expenses are ridiculous and the labor is short changed. Oftne the consultants have a field day with these practices, they make a few minor changes just enought o justuify their salaries and then coast untill next time. I find that the offices with educated staff seem to do well and it's easy, the other business model works well also but it always seems like the office is in a state of turmoil.

I think this is where OD's should get more educated, in teh runnign and manageing of a businesss, most are like sheep and follow the latest magazines or consultants advice blindly.  This unfotunately harms the educated and skilled optician, they almost educate themselves out of a job.  One of the greatest suggestions I have to highly qualified opticians that I myslef use is to leave stuff off your resume and cherry poick what you think that particular practice may want to hear from your resume.  Too much info and you end up with no offers, or being told your too qualified, too little experience and your pay is reduced.  I have found that my ABO, and my NCLE with two management positions and two dispensing powsitions tends to do well in the market.  Add in writing and advanced certification and I'm often told when I follow up that they're looking for someone with a little less experience.

----------


## jediron1

> That's not always the doctors fault, many don't have very much business aumen so they end up relying on consultants or industry figures to gauges their business. If you look at labor it is one of the largest expenses in any practice. As a consultant the easiest way to make an imediate impact would be to cut an optician that makes 16.50 and replave with an opticians at 9.00 or round abouts, now the consultant can brag about reduceing the practices labor costs. The long term effects will not be evident immediately and if they are it's usually a steady decline. I have seen 2 models of running a successful business, treat your employees like assets, pay them well and expec t them to earn that pay and often they will exceed expectations if the correct staff is hired. What usually ends up happening is the staff makes higher wages, but the cost of goods and operational expenses come down because the staff is vested in making the employer money and making sure their best job is always there. Another method is the cheap labor method, where the cogs and operational expenses are ridiculous and the labor is short changed. Oftne the consultants have a field day with these practices, they make a few minor changes just enought o justuify their salaries and then coast untill next time. I find that the offices with educated staff seem to do well and it's easy, the other business model works well also but it always seems like the office is in a state of turmoil.
> 
> I think this is where OD's should get more educated, in teh runnign and manageing of a businesss, most are like sheep and follow the latest magazines or consultants advice blindly.  This unfotunately harms the educated and skilled optician, they almost educate themselves out of a job.  One of the greatest suggestions I have to highly qualified opticians that I myslef use is to leave stuff off your resume and cherry poick what you think that particular practice may want to hear from your resume.  Too much info and you end up with no offers, or being told your too qualified, too little experience and your pay is reduced.  I have found that my ABO, and my NCLE with two management positions and two dispensing powsitions tends to do well in the market.  Add in writing and advanced certification and I'm often told when I follow up that they're looking for someone with a little less experience.




Good points. I have gone on many job outings only to have them say your qualifications are impressive, which is to say your too expensive and I won't pay it.Your point of putting less and getting more caught my attention and I think I will try it the next time. Your other point about business sense is very true. Most Doc's maybe great at what they do but when it comes to business and common sense it goes right out the door. Good chat!  :Rolleyes:

----------


## tmorse

> In my opinion, the optician desiring refraction is simply wanting to sell glasses, while the optometrist refracting is trying to determine if there is eye disease.


"... the optometrist refracting is trying to determine if there is eye
disease"

How VERY noble, but you forgot to add... ;)
*AND IS ALSO SIMPLY WANTING TO SELL GLASSES.*

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## LandLord

Maybe it's different in the U.S.A. where OD's are known for their gentle, caring approach, but here in Canada, the optometrists are very, very, very, very, very business, hours, compensation and eyeglass sales-minded!

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## bob_f_aboc

> By 2nd I mean that their spouse is the primary wage earner. Automotive manuf jobs are very hard to come by these days and very unstable. New hires at Subaru Indiana get around $16.22 an hour, this goes up to around $22 or so after a couple of years. I think working in our office is much better than doing the same repetitve motion over and over again all day with no personal freedom. 
> 
> The median income for a household in the county was $43,840 (This is for our county HOUSEHOLD income)
> 
> As our office grows everyone makes more, not just the docs.


I am the primary wage earner in my family. My wife makes significantly less than I do and also has insurance with her job. I am not even close to what your Subaru people make and I have been doing this for nearly 10 years. The benefits offered at my office are so poor and overpriced that it would be stupid for me to take them. Since I am the optician, lab tech, back up optometric tech, back up receptionist, back up insurance filer, and maintenance man at my office, repetitive motion is not a problem.

As our office grows, the staff grows more disheartened. Since I have been with this office (2 years), total revenue is up nearly 40%, optical sales are up over 50%. The only raise I have received as well as everyone else in the office was 3% last fall.

----------


## jediron1

> I am the primary wage earner in my family. My wife makes significantly less than I do and also has insurance with her job. I am not even close to what your Subaru people make and I have been doing this for nearly 10 years. The benefits offered at my office are so poor and overpriced that it would be stupid for me to take them. Since I am the optician, lab tech, back up optometric tech, back up receptionist, back up insurance filer, and maintenance man at my office, repetitive motion is not a problem.
> 
> As our office grows, the staff grows more disheartened. Since I have been with this office (2 years), total revenue is up nearly 40%, optical sales are up over 50%. The only raise I have received as well as everyone else in the office was 3% last fall.




As I have said about a hundred times OD's and OMD's are cheap they don't pay never have never will. I once worked for an OMD about 15 years ago who was making a seven figure income. We went to him one day ( one OD, myself and office manager ) to bring to him a proposal to increase business in the Optical shop by having his front end people refer people to us. By doing this we would offering them a bonus for every person they sent us. He said I already pay them an hourly rate ( minimum wage ) and I won't pay them more for something they should be doing anyways. We told him it was just an incentive to get more business, he said no and would not talk any further about incentives for the help because they were already get a pay check.  Once worked for an OD who called me on a Friday to let me go. On Monday I get a call from the front end person telling me the OD just pulled up in brand new Cadillac. She said I asked him where he got that. He said since we let the optician go I could afford to buy the Cadillac. Almost all the time it's not that they can't afford you but it's about what toy they next.  All true stories. Most of the time I had the business going up a nice healthy 10% every year at every place I had been. OD's are cheap and OMD's are cheaper yet! 

just my take  :Rolleyes:

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## npdr

> ''... OD's are cheap and OMD's are cheaper yet! 
> 
> just my take



I concur that 90% of ophthlamologists and optometrists are quite thrifty with salaries or bonuses.

I have been employed by both and in all cases, the salary or "day rate" was quite modest.

The question is whether an employee would be willing to go 100% commission. Would an optometrist do that? In many cases, optometrists hired by ophthalmologists are given that option of a minimum base salary with a incentive or productive element that increases the income.

I'm not saying that one way is better, but that is the landscape now. With the deluge of graduates, it isn't likely to change soon.

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## jediron1

> I concur that 90% of ophthlamologists and optometrists are quite thrifty with salaries or bonuses.
> 
> I have been employed by both and in all cases, the salary or "day rate" was quite modest.
> 
> The question is whether an employee would be willing to go 100% commission. Would an optometrist do that? In many cases, optometrists hired by ophthalmologists are given that option of a minimum base salary with a incentive or productive element that increases the income.
> 
> I'm not saying that one way is better, but that is the landscape now. With the deluge of graduates, it isn't likely to change soon.



I think you missed the point. OD's at least in NY where I am who worked with the last OMD I worked for averaged $110,000.00 per year with the head OD at each of four sites receiving a bonus if his location exceeded expectations. Now for the three and half years I was there all four locations exceeded expectations with the one OD getting a bonus of $35,000.00 and the second location OD got $30,000.00. The reason I know is I was told by the OD at my location because he was upset because his bonus was smaller, but we also had the smallest location in relation to volume. But he felt he worked his tail off and should have gotten a larger compensation.

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## npdr

I think not,

Most optometrists want to do better than that.

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## jediron1

> I think not,
> 
> Most optometrists want to do better than that.


PLEZZZZZZZZZZZZZZ
Maybe you are ok with more because you live in California where the cost of living is much higher and you need more. I have a cousin who lives in San Diego and they said my home in California would run between $300,000 and $400,000, here in NY it's $100,000. So what their making is good money no matter what you say.

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## npdr

I think you missed the point. I think it matters if the OD is from West, South, Central or wherever. 

110k +30k is not a lot of change if the business is pulling in $1MM.   It just means that the 110K outside of CA goes a lot farther.  The funny thing is that the OD pay is about the same whether in CA or anywhere else.  

I've been recruited for the Southeast with a generous salary and would have only moved if that salary wasn't at that level.

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## jediron1

> I think you missed the point. I think it matters if the OD is from West, South, Central or wherever. 
> 
> 110k +30k is not a lot of change if the business is pulling in $1MM.   It just means that the 110K outside of CA goes a lot farther.  The funny thing is that the OD pay is about the same whether in CA or anywhere else.  
> 
> I've been recruited for the Southeast with a generous salary and would have only moved if that salary wasn't at that level.



Actually if I remember right the average for each location was 1 mil a year for a total of roughly 4 mil. They employed 4 OMD's, 12 OD's, and 12 opticians with additional support staff.

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## OHPNTZ

> I think you missed the point. OD's at least in NY where I am who worked with the last OMD I worked for averaged $110,000.00 per year with the head OD at each of four sites receiving a bonus if his location exceeded expectations. Now for the three and half years I was there all four locations exceeded expectations with the one OD getting a bonus of $35,000.00 and the second location OD got $30,000.00. The reason I know is I was told by the OD at my location because he was upset because his bonus was smaller, but we also had the smallest location in relation to volume. But he felt he worked his tail off and should have gotten a larger compensation.


I work in NY state, and earn no where near that amount...as I work for an optician based company...

What is the true motivation for optician refractions???  Is it not to get more patients (customers) within your boutiques???   What is the motivation for Harry who works for Pearle????  I don't quite get it...

For example...the optician(s) I work along side do contact lens fittings.  Before I arrived, 20/20 was 20/20...no need to overrefract from their thinking.  Many were overminused.  Some had underlying conditions...ie. Fuch's Endothelial dystrophy, EXTENSIVE corneal neovasculariztion, etc...etc.  Thank God I arrived.  The opticians had no idea of the difference between corneal neo and pannus.   Mucin balls...what are those?   SPK...dont' stain...so cannot tell...  The list goes on...   

So what is the REAL motivation for refraction?  Do you analyze conditions?  What about anomolous retinal correspondance?   Where do you draw the line????

And...there are OD's who have no idea what I'm talking about...believe me...I've seen their charts...

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## jediron1

> I work in NY state, and earn no where near that amount...as I work for an optician based company...
> 
> What is the true motivation for optician refractions???  Is it not to get more patients (customers) within your boutiques???   What is the motivation for Harry who works for Pearle????  I don't quite get it...
> 
> For example...the optician(s) I work along side do contact lens fittings.  Before I arrived, 20/20 was 20/20...no need to overrefract from their thinking.  Many were overminused.  Some had underlying conditions...ie. Fuch's Endothelial dystrophy, EXTENSIVE corneal neovasculariztion, etc...etc.  Thank God I arrived.  The opticians had no idea of the difference between corneal neo and pannus.   Mucin balls...what are those?   SPK...dont' stain...so cannot tell...  The list goes on...   
> 
> So what is the REAL motivation for refraction?  Do you analyze conditions?  What about anomolous retinal correspondance?   Where do you draw the line????
> 
> And...there are OD's who have no idea what I'm talking about...believe me...I've seen their charts...



If you would have taken the time to analyze the whole picture you would have noticed that I was speaking from the opticians perspective as I am an optician. I was speaking about the Docs I had worked with. Next time please read all the posts instead of just picking and choosing certain ones for your entertainment.

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## Dannyboy

> I work in NY state, and earn no where near that amount...as I work for an optician based company...
> 
> What is the true motivation for optician refractions??? Is it not to get more patients (customers) within your boutiques??? What is the motivation for Harry who works for Pearle???? I don't quite get it...
> 
> For example...the optician(s) I work along side do contact lens fittings. Before I arrived, 20/20 was 20/20...no need to overrefract from their thinking. Many were overminused. Some had underlying conditions...ie. Fuch's Endothelial dystrophy, EXTENSIVE corneal neovasculariztion, etc...etc. Thank God I arrived. The opticians had no idea of the difference between corneal neo and pannus. Mucin balls...what are those? SPK...dont' stain...so cannot tell... The list goes on... 
> 
> So what is the REAL motivation for refraction? Do you analyze conditions? What about anomolous retinal correspondance? Where do you draw the line????
> 
> And...there are OD's who have no idea what I'm talking about...believe me...I've seen their charts...


 
Thank god you came...I would have fired them opticians that dont know **** and get some real opticians that do know their stuff. The world is a better place with you there.  :Cool: 

I believe is your duty to contact the New York Department of Education/Board of Opticianry and complain about the negligence of them Opticians... not knowing mucin ball from donut balls...what where they thinking?..Overminused..not knowing how to transpose.. You should also complain about the the ODs that do poorly in charting to the board of Optometry...lets see if you have cojones to do that an protect the public from these scums. Keep your good work.Thank you lord for having him there.

Dannyboy :Cool:

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## tmorse

> The opticians had no idea of the difference between corneal neo and pannus.


Sorry I didn't know there was a difference either.. my understanding is that OMD's refer to neovascularization as 'pannus', that same way OMD's choose to refer to hyperopia in their lexicon as hypermetropia. 

Kindly provide differential diagnosis.

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## HarryChiling

> What is the motivation for Harry who works for Pearle????


This is the second reference to where I work in this thread alone, care to explain your intentions for bringing me into your rederick?

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## HarryChiling

Deleted, hope this quiets downt he storm.

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## Dannyboy

My opinion is keep the good work and posting, you are becoming an example and I envy you for having the time and tenacity to speak your opinions openly.

Dannyboy :Cool:

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## Fezz

> Now Dr. Steven Nelson, Portland, TX I am assuming that when you said "you wanted to punch me in the face" you meant that in a docile doctorly kinda way, but don't write checks that your @ss can't cash.


I wonder if he would swing for the eye? Or, when you are an Optometrist and decide that physical violence is the way to settle differences, do you avoid punching the eye because it is sacred?

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## jediron1

> I work in NY state, and earn no where near that amount...as I work for an optician based company...
> 
> What is the true motivation for optician refractions???  Is it not to get more patients (customers) within your boutiques???   What is the motivation for Harry who works for Pearle????  I don't quite get it...
> 
> For example...the optician(s) I work along side do contact lens fittings.  Before I arrived, 20/20 was 20/20...no need to overrefract from their thinking.  Many were overminused.  Some had underlying conditions...ie. Fuch's Endothelial dystrophy, EXTENSIVE corneal neovasculariztion, etc...etc.  Thank God I arrived.  The opticians had no idea of the difference between corneal neo and pannus.   Mucin balls...what are those?   SPK...dont' stain...so cannot tell...  The list goes on...   
> 
> So what is the REAL motivation for refraction?  Do you analyze conditions?  What about anomolous retinal correspondance?   Where do you draw the line????
> 
> And...there are OD's who have no idea what I'm talking about...believe me...I've seen their charts...




WOW as Dannyboy said we are so lucky to have a distinguished individual as yourself to help us out. If you had the  cojones or integrity you would have reported those individuals to their state society for reprimand, but instead you come on here as the white knight brandishing your sword to rid all of Optometry and Opticianary of their evil deeds, but in the end all you do is talk with very little or no action. As for earning that amount, I can assure you I know of many OD's who make that amount and more. I know of 12 that work for an OMD who earn over 100,000 and I know of another practice that employs 4 OD's and they make over 100,000, so just because your pigeon holed into where you work does not speak for the vast amount of OD's who are earning that and more.  just my take  :Rolleyes:

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## jediron1

[quote=HarryChiling;245498]It seems that the OD's on this board feel that they don't have to behave professionaly behind closed doors, one of them actually called me a backstreet boy.... LOL. Even posted my picture and bio on their site and it seems they are putting together some information about me. Well here's a little something for you to research.



All because you went on their web site which whey consider sacred ground. With that much info I would go straight to the authorities and turn it all over to them. As for punching you in the face most OD's are so out of shape their lucky if they can procreate. Keep those files Harry!

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## Eyedoc71

Harry,
You go to this much trouble, including hunting me down on a classmates.com-like forum to get me involved with this over my comment?  I know you did it to keep from revealing your ODWire lurker identity.  It's hella creepy, but to put out this fire I'll interact.

OK, first of all posting my personal information on a public website could be considered harassment (actually it would be construed as assault also given the nature of the post) so feel free to turn me over to whom ever you like.  To mention my wife and child?  I recommend some serious therapy, son.  Second, I stand behind my comments.  Any reasonable person reading this comment in context (a reasonably PRIVATE discussion about your wanting to cry to the state board without exercising other options first) can clearly distinguish what I said from a threat.  This was ODs on an OD website pissing about someone that was taking delight in feeling like he got to sting someone with a higher degree.  Say what you want, but you know there is a lot of animosity between opticians and ODs...you know my personal favorite is "who put the G in front of OD".  If you haven't heard that one, feel free to use it.

I realize that you're trying very hard to be the William Wallace for opticians, but to try to throw me under the bus is childish at best.  Since it's here, anybody that would like to discuss my comments feel free.  My office number is 361-777-3400 (I don't think you mentioned that).

Oh, for what it's worth, I'm still laughing about being out of my league.   :Rolleyes: 


Quote:
Originally Posted by *Stephen McDaniel*  
_http://www.google.com/search?sourcei...yland+optician

I bet if we started calling the numbers on this list, we could locate him pretty quickly._

or we could just call those Backstreet Boys...

What makes me want to punch this guy in the face is the fact that if you read the thread he admits that the OD never rx'd the diamox and he didn't even know if he ever even USED it...he just wanted to report the guy for ordering it. This is just a case of some douche feeling he was cut out for more in life so he's going to punish someone that accomplished more.

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## Eyedoc71

[quote=jediron1;245516]


> It seems that the OD's on this board feel that they don't have to behave professionaly behind closed doors, one of them actually called me a backstreet boy.... LOL. Even posted my picture and bio on their site and it seems they are putting together some information about me. Well here's a little something for you to research.
> 
> 
> 
> All because you went on their web site which whey consider sacred ground. With that much info I would go straight to the authorities and turn it all over to them. As for punching you in the face most OD's are so out of shape their lucky if they can procreate. Keep those files Harry!


Don't worry about my shape...I'm doing just fine.  As for punching Harry in the face, the comment "the thing that makes me want to punch him in the face is the fact that..." made in a conversation is a hell of a long way from a threat.  Don't let him pump you up about my level of threat...although given the aggressive nature in which he's pursued it could elevate the legal threat.

It's not about the website being sacred, it's just private.  There's a difference.  It's not a public forum for people to just view at random.  We discuss things specific to the profession of optometry and the point of it being private is so that we can respond with a certain amount of candor.

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## jediron1

> Harry,
> You go to this much trouble, including hunting me down on a classmates.com-like forum to get me involved with this over my comment?  I know you did it to keep from revealing your ODWire lurker identity.  It's hella creepy, but to put out this fire I'll interact.
> 
> OK, first of all posting my personal information on a public website could be considered harassment (actually it would be construed as assault also given the nature of the post) so feel free to turn me over to whom ever you like.  To mention my wife and child?  I recommend some serious therapy, son.  Second, I stand behind my comments.  Any reasonable person reading this comment in context (a reasonably PRIVATE discussion about your wanting to cry to the state board without exercising other options first) can clearly distinguish what I said from a threat.  This was ODs on an OD website pissing about someone that was taking delight in feeling like he got to sting someone with a higher degree.  Say what you want, but you know there is a lot of animosity between opticians and ODs...you know my personal favorite is "who put the G in front of OD".  If you haven't heard that one, feel free to use it.
> 
> I realize that you're trying very hard to be the William Wallace for opticians, but to try to throw me under the bus is childish at best.  Since it's here, anybody that would like to discuss my comments feel free.  My office number is 361-777-3400 (I don't think you mentioned that).
> 
> Oh, for what it's worth, I'm still laughing about being out of my league.  
> 
> ...




You just proved Harry's points, when OD's are on a board with no fear of retribution  they come out with these outlandish and derogatory comments to flame the fire. Your comment about the backstreet boys was absolutely childish  and showed how immature you really are and what surprised me even more is that you real thought you knew what a douche was. Come on DOC grow up grab your cojonies and act like a man instead of some little wimp that when growing up was used to being kicked around the school yard. :hammer:

----------


## HarryChiling

Great to hear from you Steven, it's amazing how little anonimity we have on the internet, I find it easier to not hide behind a pseudo identity and clamor behind the false sense of security it provides.

It just amazed me that an OD from this board felt that the information I provided was "doing research" and it took you guys that long to find out phone numbers and other such info.  Heck I have a contat address listed in my threads and you could easily look me up in the yellow pages.

Anyway since your here and you have something to say why not share it.  I seriously am curious to hear what point of views you might have about the subject instead of these personal attacks.  Sure I may not have the book learning but I hope you won't make the mistake of thinking me a layman.  The comment about the wifey I thought was a bit much and OK I can admit it was wrong and I apoligize, but she is cute for what it's worth consider yourself a lucky man.  

Anyway, why shouldn't opticians expand there scope of practice?  Many of the excuses that have been presented were some of the very same excuses that you profession has overcome from it's opposition.  I am not saying the current optician of today with very little training, education, or knowledge be allowed to refract, but am more asking what level of training, education, or knowledge is necessary?

I hear from some "Go to optometry school", but you go to school for quite a bit of time to learn not only the refractive conditions but also the medical side of optometry.  An opticians would have very little use for the medical side of optometry.

The model I suggested was refraction between regular health checks, NOT as a replacement for or even before.  I don't think it's realistic or even fair to say opticiasn would be necessary as refractionists to screen before seeing a doctor, the idea would be a more updated refraction between health assesments when necessary to insure the patient gets the ost accurate refraction right then and there.  Of course their shoudl be guidelines in place and beign your profession sees itself as the experts please infrom the masses.

I await your thoughts.

----------


## Eyedoc71

> Great to hear from you Steven, it's amazing how little anonimity we have on the internet, I find it easier to not hide behind a pseudo identity and clamor behind the false sense of security it provides.
> 
> It just amazed me that an OD from this board felt that the information I provided was "doing research" and it took you guys that long to find out phone numbers and other such info. Heck I have a contat address listed in my threads and you could easily look me up in the yellow pages.
> 
> Anyway since your here and you have something to say why not share it. I seriously am curious to hear what point of views you might have about the subject instead of these personal attacks. Sure I may not have the book learning but I hope you won't make the mistake of thinking me a layman. The comment about the wifey I thought was a bit much and OK I can admit it was wrong and I apoligize, but she is cute for what it's worth consider yourself a lucky man. 
> 
> Anyway, why shouldn't opticians expand there scope of practice? Many of the excuses that have been presented were some of the very same excuses that you profession has overcome from it's opposition. I am not saying the current optician of today with very little training, education, or knowledge be allowed to refract, but am more asking what level of training, education, or knowledge is necessary?
> 
> I hear from some "Go to optometry school", but you go to school for quite a bit of time to learn not only the refractive conditions but also the medical side of optometry. An opticians would have very little use for the medical side of optometry.
> ...


I'll respond in detail later today to the subject at hand, but I thought it relavent to mention that I wasn't the one that posted your picture either.  I'm not hiding behind anonymity, but you have to admit that given the nature of where you took the information you found (I'm not exactly hard to find), giving out personal information randomly is not a good idea.

----------


## HarryChiling

> I'll respond in detail later today to the subject at hand, but I thought it relavent to mention that I wasn't the one that posted your picture either. I'm not hiding behind anonymity, but you have to admit that given the nature of where you took the information you found (I'm not exactly hard to find), giving out personal information randomly is not a good idea.


I would agree, especially when the intent is to cause harm.  That is why I took offense to the dosier beign compiled about me, heck between the few of you it looked liek a witch hunt being put together, what was I supposed to do.  Anyway no harm intended, I look forward to your reply.

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## HarryChiling

> who put the G in front of OD


Ok, I can't help it no I haven't heard that one and yes I will be using it, thank you. :D  Oh and welcome to optboard I'm not usually this rowdy.

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## tntborden

I think this thread is starting to drift:D

----------


## Against the Rule

Original topic: COT's refracting and charging
Morphed into: OD's and MD's are cheap
Morphed into: My mama was a ***** and I grew up on ephedrine rather than cheerios, and while I was determined enough to graduate high school, college was just too much
Which included:  Because of this, I can/could/will kick your *** because I had a tough upbringing
And led to:  Here's my office phone number, I'm a doctor and would like my business phone to be called by disgruntled opticians
I would like to say that Harry has a very good point--why can't a properly trained optician (note "properly trained") refract between medical exams?  
The OD's also have a good point--not all diseases of the eye take two or three years to manifest themselves, and a pure refractionist may miss something.
The problem with all this arguing and threatened or implied ***-kicking ability is that nothing is being done at the government level to sort this out.  Maybe Harry is an unstoppable killing machine who could quit Pearle Vision and rule the UFC as heavyweight champion, but that doesn't solve the issue of the three O's scope of practice.
I think his rational idea of trained opticians refracting in between true exams has a lot of merit, and we should discuss how to make that happen rather than who will sue who for harrassment and who's wang is bigger.

----------


## Eyedoc71

> Original topic: COT's refracting and charging
> Morphed into: OD's and MD's are cheap
> Morphed into: My mama was a ***** and I grew up on ephedrine rather than cheerios, and while I was determined enough to graduate high school, college was just too much
> Which included: Because of this, I can/could/will kick your *** because I had a tough upbringing
> And led to: Here's my office phone number, I'm a doctor and would like my business phone to be called by disgruntled opticians
> I would like to say that Harry has a very good point--why can't a properly trained optician (note "properly trained") refract between medical exams? 
> The OD's also have a good point--not all diseases of the eye take two or three years to manifest themselves, and a pure refractionist may miss something.
> The problem with all this arguing and threatened or implied ***-kicking ability is that nothing is being done at the government level to sort this out. Maybe Harry is an unstoppable killing machine who could quit Pearle Vision and rule the UFC as heavyweight champion, but that doesn't solve the issue of the three O's scope of practice.
> I think his rational idea of trained opticians refracting in between true exams has a lot of merit, and we should discuss how to make that happen rather than who will sue who for harrassment and who's wang is bigger.


Actually if you read the above posts, it wasn't me that posted most of my personal infomation. 

As far as refracting between "exams", I'll give my take on it.  To me, there is no way to separate the refractive from the medical.  When I do an eye examination, I am doing all testing necessary to address maximizing acuity and all factors that can affect it.  99% of all new glc diagnoses made are done because someone felt their rx in their glasses was off so they came in.  So from that perspective, it poses a public health risk by separating that out and making just a refraction available since MOST patients think that's all they need.  Can you determine if someone is -1.00 over their BVA last year because they have cataracts or because they're diabetic (buy don't know it)?  or +1.00 because they have a choroidal melanoma behind their macula?  There are a lot of disease factors that affect rx'ing and if you're unable to do the health assessment to augment the refraction, you're just guessing and when the stakes are sometimes blindness you can't leave it to guessing.  Obviously most patients don't pose that kind of risk, but they don't exactly carry signs around saying they're at risk.  What's next?  IOP only exams for people that are concerned about glaucoma?

On ODWire, it was suggested that a refraction isn't a doctor level endeavor.  I think this is absolutely wrong.  A doctor needs to be making those measurements and figuring out how it applies to the whole picture.  I feel no differently about ODs that try to delegate refractions to their techs (unless it's not for prescribing purposes for example post surgical cases prior to their final rx).  I wish those guys would lose their licenses or find some other profession.

I'm not saying that you can't be trained to flip dials, but there is more to a refraction than that.  I always make the analogy of nurses and doctors.  Nurses are highly qualified ancillary medical personnel.  They give injections (Hell, a lot of states won't even let ODs do that), adminster meds etc and do it with a high level of proficiency.  However, there is a huge difference between administering that med and prescribing it and that's akin to what's being suggested.  Refracting without assessing the eye health is dangerous and irresponsible.

----------


## Eyedoc71

> You just proved Harry's points, when OD's are on a board with no fear of retribution they come out with these outlandish and derogatory comments to flame the fire. Your comment about the backstreet boys was absolutely childish and showed how immature you really are and what surprised me even more is that you real thought you knew what a douche was. Come on DOC grow up grab your cojonies and act like a man instead of some little wimp that when growing up was used to being kicked around the school yard. :hammer:


Give me a break.  With the Ceasar do and the goatee, you don't see it?  Harry would make a great Backstreet Boy.  Would you have preferred that I reference 98 degrees?  I'll dumb this down for you a bit so you can keep up.  It was sarcasm.  If it was lost on you, I don't really care...it wasn't intended for you.

I didn't make that comment on this board, nor did I get a very friendly invitation.  I made a silly comment and then got flamed behind my back with comments that even had my personal information as well as references about my family (yes, I do realize they were taken off).  I know that ODs are not terribly well received here, but if you don't like my ODWire comments...feel free to attend OD school and get on the forum and tell me in the venue they were made.

After reading your comment, I can say with relative certainty what a douche is.  :D

----------


## Against the Rule

I agree with most of that, Eyedoc.  I see many patients who haven't been examined in five years or so, though, and it's because of the cost involved.  Why not let the less fortunate at least get good vision, with the requirement that say every two or three years they have a full exam?  I would add that if OD's are capable of saying "What the heck is this?  I'll refer to an MD," opticians can do the same and refer to an OD--again assuming the proper training.  The COT training and related certifications seem to be a good step in that direction.

----------


## Against the Rule

Just wanted to say I agree with some of what Eyedoc said _before_ his 98-degrees/backstreet boys post.

----------


## braheem24

> there is no way to separate the refractive from the medical.


With that logic, since every ophthalmologist does NOT refract they are missing a disease.

[Ducking for cover/]

----------


## jediron1

> Give me a break.  With the Ceasar do and the goatee, you don't see it?  Harry would make a great Backstreet Boy.  Would you have preferred that I reference 98 degrees?  I'll dumb this down for you a bit so you can keep up.  It was sarcasm.  If it was lost on you, I don't really care...it wasn't intended for you.
> 
> I didn't make that comment on this board, nor did I get a very friendly invitation.  I made a silly comment and then got flamed behind my back with comments that even had my personal information as well as references about my family (yes, I do realize they were taken off).  I know that ODs are not terribly well received here, but if you don't like my ODWire comments...feel free to attend OD school and get on the forum and tell me in the venue they were made.
> 
> After reading your comment, I can say with relative certainty what a douche is.  :D




Plez do dumb it down. 
I'll stand by my comments and you still don't know what a douche is. 

"Come on DOC grow up grab your cojonies and act like a man instead of some little wimp that when growing up was used to being kicked around the school yard. :hammer:

----------


## jediron1

> Just wanted to say I agree with some of what Eyedoc said _before_ his 98-degrees/backstreet boys post.




Well he did say he wanted to "dumb it down"

----------


## FullCircle

> It seems that the OD's on this board feel that they don't have to behave professionaly behind closed doors, one of them actually called me a backstreet boy.... LOL.


Harry...it's just because you've got the Right Stuff.  Oh oh ohohoh oh oh ohoh...

*slinking away giggling*

----------


## Eyedoc71

> With that logic, since every ophthalmologist does NOT refract they are missing a disease.
> 
> [Ducking for cover/]


I think that's not only possible, but probable.

----------


## Eyedoc71

> I agree with most of that, Eyedoc. I see many patients who haven't been examined in five years or so, though, and it's because of the cost involved. Why not let the less fortunate at least get good vision, with the requirement that say every two or three years they have a full exam? I would add that if OD's are capable of saying "What the heck is this? I'll refer to an MD," opticians can do the same and refer to an OD--again assuming the proper training. The COT training and related certifications seem to be a good step in that direction.


Without looking exactly what are you going to refer?  The difference is that with an OD, we are assessing the tissue and occassionally we run across something we don't recognize (the same is true for most general ophthalmologists).  The opticians in question would not be doing exams and so you can't really say "what the heck is this" without doing the testing to come up with the "this".

As far as the "less fotunate", we have this arguement on OD forums all the time about exam prices and I'll say the same thing here.  Very few people can't afford $100 once a year (that's well above the national average for exams).  An eye exam in my office is $85 which equates to $7 per month.  How many people do you know that really don't have $7 per month?  Besides that, the exam is rarely the cost prohibative factor in eye care.  Are you going to give them their glasses or sell them?  Let's not pretend that we're all altruistic here and at least be honest with ourselves.

I've taken medicaid in my office for many years, so I know about the resources available and I also know that for the majority of these patients, assistance programs are vehicles to allow them to afford their I-phone rather than spending their money on their healthcare.  I'm not being cold-hearted, but I don't think that you should be able to choose to have a cell phone over healthcare.  We've got some really screwed up priorities in this country.

----------


## chip anderson

Most ophtalmologists, while not billed for refraction, they or thier techs, do one at most exams.  Almost all at least have an autorefraction prior to physically examining the patient.  However without billing for same they can get an extra fee from the patient for same when asked.  
I have even encountered  a couple that do not charge when the Rx is faxed to my office on request.  However if the patient goes by and gets a written one, Rx will have a fee due at delivery?

Chip

----------


## braheem24

How about this for some harmony between the 3 Os...

Opticians remain the pharmacists of the field, without the other 2 Os, playing pharmacist.

Optometrists are the General Practitioners of the field and refer surgeries to MD and Glasses to opticians.

MD, remain the specialists and surgeons in the group and also stay out of the pharmacy.

Now, go lobby the insurance companies to bribe 'our' elected officials to pass the law.

----------


## HarryChiling

> Original topic: COT's refracting and charging
> Morphed into: OD's and MD's are cheap
> Morphed into: My mama was a ***** and I grew up on ephedrine rather than cheerios, and while I was determined enough to graduate high school, college was just too much
> Which included: Because of this, I can/could/will kick your *** because I had a tough upbringing
> And led to: Here's my office phone number, I'm a doctor and would like my business phone to be called by disgruntled opticians
> I would like to say that Harry has a very good point--why can't a properly trained optician (note "properly trained") refract between medical exams? 
> The OD's also have a good point--not all diseases of the eye take two or three years to manifest themselves, and a pure refractionist may miss something.
> The problem with all this arguing and threatened or implied ***-kicking ability is that nothing is being done at the government level to sort this out. Maybe Harry is an unstoppable killing machine who could quit Pearle Vision and rule the UFC as heavyweight champion, but that doesn't solve the issue of the three O's scope of practice.
> I think his rational idea of trained opticians refracting in between true exams has a lot of merit, and we should discuss how to make that happen rather than who will sue who for harrassment and who's wang is bigger.


That was me that deviated off topic for a bit, the thread was getting more caught up in the who rather than the what and how of the topic, so I aired out my laudry so it's now a dead issue rather than picking me apart piece by piece to kill the thread which has been a tactic in the past we can get beyond that and discuss like gentlemen.  Also I percieved a threat and it was being done behind an anonymous alias so I felt I shoudl make the person public which was wrong of them to poitn me out and wrong of me to point them out but now it's over and we can rationally discuss this issue at hand without further who's wang is bigger. :D





> I think that's not only possible, but probable.


Maybe I'm missing something but there is nothing that a refraction can do that some other check will not accomplish just as well.  If the best corrected visual acuity is lumped in with a refraction than Ok this would nessecitate refraction, but between health assesments I think this is an area that can help reduce the cost of eyewear to the public by addressing slight change between health assesments.  I know that most OD's and or OMD's would rather not deal with a recheck because the patient may have chanegd by a 0.25D between visits.  I think it can work to the mutual benefit of both professions and I think in order for it to even begin to be a pipe dream opticiasn need to address the concerns about the monetary issues involved with it.  If OD's can be convinced and the rules set so that it doesn't monetarily step on OD's or OMD's toes monetarily and maybe even come up with a system to coax more people in for an health assesment earlier than I believe this would be the ground work for making it happen, so this is where I would focus my attentions.




> As far as the "less fotunate", we have this arguement on OD forums all the time about exam prices and I'll say the same thing here. Very few people can't afford $100 once a year (that's well above the national average for exams). An eye exam in my office is $85 which equates to $7 per month. How many people do you know that really don't have $7 per month? Besides that, the exam is rarely the cost prohibative factor in eye care. Are you going to give them their glasses or sell them? Let's not pretend that we're all altruistic here and at least be honest with ourselves.


Absolutely correct it will breath new life into the profession of opticianry as the independent will truly be independent again, I also see many patients that will hold off on getting new eyewear becasue they would rather wait untill there insurance covers it, or they think it may ahve changed.  Opticiasn refracting would instill the confidence in the new eyewear purchase so it would be a great financial gain.  I also think that it would be a great financial gain for OD's as the health assesment and the exam can now finally be seperated and if billed correctly can actually increase by putting more value in your exam over mine.  I think it could work and it might even allow the axe between our profession to finally be buried.




> I've taken medicaid in my office for many years, so I know about the resources available and I also know that for the majority of these patients, assistance programs are vehicles to allow them to afford their I-phone rather than spending their money on their healthcare. I'm not being cold-hearted, but I don't think that you should be able to choose to have a cell phone over healthcare. We've got some really screwed up priorities in this country.


Can't argue with that, priorities are screwed, but that's another subject and rather than getting tongue lashed by Against the Rule again I'll just agree here whole heartedly.:D

----------


## HarryChiling

> How about this for some harmony between the 3 Os...
> 
> Opticians remain the pharmacists of the field, without the other 2 Os, playing pharmacist.
> 
> Optometrists are the General Practitioners of the field and refer surgeries to MD and Glasses to opticians.
> 
> MD, remain the specialists and surgeons in the group and also stay out of the pharmacy.
> 
> Now, go lobby the insurance companies to bribe 'our' elected officials to pass the law.


I think at one point that may have been an option but were far passed that now, even in my carrer I remember when OMD's didn't have dispensaries.  Their needs to be a change in perception on the value of Exams, Eyewear, Contacts, and Surgery.  Just recently an OD was chastising OMD's for lasik in Gaithersburg, MD at a hearing.  I am sure the OMD's would love tpo retaliate with comments about VT or other forms of optometry and the whole twisted circle continues, the only ones making out is the insurance companies.  Unless we strike some sort of accord between all the vultures will wait till we drop of exhaustion from fighting and pick our bones clean.

----------


## FullCircle

> I see many patients who haven't been examined in five years or so, though, and it's because of the cost involved. Why not let the less fortunate at least get good vision, with the requirement that say every two or three years they have a full exam?


Isn't that what the Lions Club is for? And state aid?

----------


## chip anderson

Full Circle:

The Lions Club, State Aid, and federal aid are only needed when something has priced itself beyond the ability of the public to pay.
They are only available (at least the state/federal part) when votes can be bought by getting the taxpayers to support  same.

Chip:hammer:

----------


## paradocs04

> It seems that the OD's on this board feel that they don't have to behave professionaly behind closed doors, one of them actually called me a backstreet boy.... LOL. Even posted my picture and bio on their site and it seems they are putting together some information about me. Well here's a little something for you to research.
> 
> Harry Harout Chilinguerian
> Father died at age 10 mother went crazy at age 14 me and my sister put into foster homes at age 14 and 15 respectively. Stabbed 4 times in the back in group home spent 2 months in hospital, back at group home 2 weeks retribution landed me in Victor Cullin (Juvenile Detention for the violent), 2 years later sent back to group home, went to Walt Whitman High school, Potomac, MD, at 16 amancapated lived in Laurel, MD in an apartment caught the bus to high school at 5:00am got there 8:00am left school 3:00pm caught the bus to Champions Billiards in Laurel got there 6:00pm, lied and said I was 18 so they could let me work enough hours to pay the rent 3:00am in the morning got home, downed a few Pseudoephedrine pills and Nodoze to keep me going for the next day. Did Laundry and ran errands on Saturday, crashed on Sunday. Did this for 2 years while living off $30.00 a week for groceries. 18 years old high school graduate that night we partied at a friends house, hadn't been out with friends in almost 2 years, girlfriend shows up at my apartment in the morning apparently she was raped at the party and to top it off it's one of my best friends that did it. I kick his door down and rip him a new one next day the police show up at my door and charge me with assault with attempt to maim. Since I don't have any money for a lawyer and this guys living in Potomac and father golfs with judges, so he gets off for the rape and they expunge it from his records (yes they expunged rape) I end up doing a year in county, of which I served most of it in isolation because apparently young lookign white guys tend to be picked on more and I tend to be a bit more aggressive than they're used to.
> 
> Now Dr. Steven Nelson, Portland, TX I am assuming that when you said "you wanted to punch me in the face" you meant that in a docile doctorly kinda way, but don't write checks that your @ss can't cash.
> 
> Also Doctors:
> 
> ...


I would like to know precisely what prompted you to include my name on your list... If you want to talk about cyberstalking, then I am certain your final statement there would not endear you to any jury or prosecuting attorney.

Unlike you, I have nothing to hide.

Patrick Shorter, O.D.

----------


## rmcdaniel

Patrick I don't know how you got on the list, but you are a bad bad boy.:D

Stephen McDaniel, O.D. (posting under wife's account)

----------


## IndianaOD

Wow,

This place finally started getting interesting.  First it is completely unacceptable to identify doctors personally on a public site.  This is very bad taste and a lot of patients are helped by the free-flow of ideas on ODwire.  

Harry, you should surface your ID on ODwire and allow your membership to be banned.  I wouldn't go peeping into an optician-only site if it was meant to be private.

A lot is said on private forums for humor and could be completely misrepresented if taken out of context.

My take:  I agree that good opticians are very beneficial to eye care.  However, I think the position can be properly taught in office if the person is willing to learn.   Clearly  there are currently enough licensed professionals to adequately take care of current and future needs.

----------


## paradocs04

> Patrick I don't know how you got on the list, but you are a bad bad boy.:D
> 
> Stephen McDaniel, O.D. (posting under wife's account)


Yeah, well... you know me, always looking for the next argument I didn't even know I was in.  

Takes a lot of guts to call out someone who ain't done anything to you I suppose.

----------


## HarryChiling

> I would like to know precisely what prompted you to include my name on your list... If you want to talk about cyberstalking, then I am certain your final statement there would not endear you to any jury or prosecuting attorney.
> 
> Unlike you, I have nothing to hide.
> 
> Patrick Shorter, O.D.


Look the few of you that conspired to get more infromation about me and even made a few phone calls inquireing about me did what you did with no repercusions in mind.  It was very creepy for me to see 4 doctors conspiring like you did.  I think the point was made and I would be more than willing to take down the personal names and information, please in the future be a little more respectfull of who you mess with, I would never turn it over to law enforcement chances are they would have more of a tough time finding information than I would anyway.  I would really like to hear your opinions on the subject here as obviously it touched you enough to have the few of you make rash decisions, which is OK I do that myself.  BTW welcome to optiboard great to have you.

----------


## rmcdaniel

Harry,

So you're surprised that people were offended you posted their private comments on a public forum?  You we're "creeped out"  that they wanted to know more about the stranger who aired their dirty laundry?  Do I have that right Harry?

Stephen McDaniel, O.D.

----------


## chip anderson

Anyone with any brains, even O.D.'s would have more sense than to put "private comments" on the internet.  This includes O.D.'s , Opticians, O.M.D.'s and Chilly Harry.
The last place to keep anything private is put it on the internet in any form.

"Three can keep a secret if two of them are dead."
       From the sayings of Poor Richard



Chip

----------


## jediron1

> Original topic: COT's refracting and charging
> 
> I think his rational idea of trained opticians refracting in between true exams has a lot of merit, and we should discuss how to make that happen rather than who will sue who for harrassment and who's wang is bigger.




Again your as you quote to be                  "90 degrees off axis". Conjuring up your notion of suing or wangs was ridiculous and childish but I do agree lets get back to the main point of refracting and charging.

----------


## HarryChiling

> Harry,
> 
> So you're surprised that people were offended you posted their private comments on a public forum? You we're "creeped out" that they wanted to know more about the stranger who aired their dirty laundry? Do I have that right Harry?
> 
> Stephen McDaniel, O.D.


No I wasn't suprised I have known for years what your profession is capable of.  Those passages I took from the Optometry site were in response to:




> How do you know he's good? I pity the poor hyperope or latent hyperope, or binocular vision patient who sees him...
> He should be reported.


I thought it interesting that the phrase "Don't be a snitch" came up on a professionals forum about a doctor practiceing beyond their scope, sure he knew what he was doing, but that does not excuse wrong doing this case of the COT is technically a loop hole that exists that this guy is taking advantage of and rightfully so IMO, and he's expected to do the honorable thing?  Anyway I thought leaving the names off woudl suffice as you could see I never attached anyones names to the original posts.  Let's get back on topic and I'll delete that post since I think it made it's point.

----------


## Dannyboy

I think Harry deserves an apology from these Doctors. You are so up into yourselfs....that you should be banned from this forum. Giving your opinions is one thing another is actually performing a harrasment of this nature. I think guidelines have been broken and these ODs should be banned all together. Permitting such acts such as calling him to his place of employment is deplorable. It leaves a bad after taste. When we express opinions it is our choice to be private of our names and of our personal lives. Sorry but you maybe doctors but in my book you are close to criminals. Sadly to say.


Dannyboy

----------


## HarryChiling

> I think Harry deserves an apology from these Doctors. You are so up into yourselfs....that you should be banned from this forum. Giving your opinions is one thing another is actually performing a harrasment of this nature. I think guidelines have been broken and these ODs should be banned all together. Permitting such acts such as calling him to his place of employment is deplorable. It leaves a bad after taste. When we express opinions it is our choice to be private of our names and of our personal lives. Sorry but you maybe doctors but in my book you are close to criminals. Sadly to say.
> 
> 
> Dannyboy


I am glad they are here and they have not behaved worng in any way, here.  This is a great opportunity to see how we can all get along and maybe diuscuss an issue without going our seperate ways.  I was just as wrong for retaliateing now that this is past us and all is right again in this world . . . . . why do we as professionals always go to suh extremes to make our points? are we really beyond repair?  The professions once seperated and the true sign of greatness would be a unity (not the same scope or anything don't get it twisted) but a working relationship between professions.  Right now opticians are working towards setting guidelines and they are making progress what I would like to see is OD and OMD opinions weighed into the guidelines.  And yes it's for selfish reasons I'd liek to say it was opticians that were able to take the high road.

----------


## Dannyboy

Harry our professions are not, have never been or will ever be friendly. Competion is keen. No one accepts someone "picking' your wallet for any reasons. Optometrists will not allow independent refraction because it creates a burden to them financially. If it happens it will be without their help. Rest assure of that. You may be an honorable guy and put the other cheek (sort of) but this people have exposed a very negative and frankly scary way of acting. Not only have they compromise their ethics  but certainly have exposed the owner of this forum to an unnecessary liability or at least negative publicity if you ever decided to take action agains these individuals. I stand behind my opinion. They should be banned. One thing is expressing your opnions another one is acting them up.

Dannyboy

----------


## paradocs04

> Look the few of you that conspired to get more infromation about me and even made a few phone calls inquireing about me did what you did with no repercusions in mind.  It was very creepy for me to see 4 doctors conspiring like you did.  I think the point was made and I would be more than willing to take down the personal names and information, please in the future be a little more respectfull of who you mess with, I would never turn it over to law enforcement chances are they would have more of a tough time finding information than I would anyway.  I would really like to hear your opinions on the subject here as obviously it touched you enough to have the few of you make rash decisions, which is OK I do that myself.  BTW welcome to optiboard great to have you.


You are delusional.  I don't know you from Adam, and I never made any phone calls.  So, I tell you what smart ***... Call the Feds, let's see those charges, let's have an investigation.

Here's my exact quote from ODWire:




> Quote:
>  	 	 		 			 				 					Originally Posted by *marlowbeach*  
> _That's the same article I had seen. In previous articles his bio made it sound that he was managing a lab and not an optical. Nonetheless, I would encourage members of this site, who continue to fuel arguments amongst ourselves, read this optician's comments on optiboard. While we're arguing, guys like this are mounting charges for refracting privileges._
> 
> I wonder what the AOA thinks?  Or, are they too busy patting themselves on the back for fighting the good fight against 1800?


There.  That's it. Please show me where this prompts you placing my name into a rant about your privacy and federal charges.  Please show me the error of my ways, and why I deserve your petty insignificant 'repercussions'. 

There's such a thing as defamation/libel as well, so I would tread softly.  I never mentioned your name or asked anything about you.  You crossed the line immediately bringing someone's FAMILY in on your little diatribe.  Sickening. Absolutely disgusting and inexcusable. 

Are you patently dishonest, to an extent that you cannot admit fault?  Do you not see the irony in lurking on a site anonymously (against their terms of use), and then playing victim when someone posts some info about you?

So, if you want to talk about being respectful, how about this... don't lurk where you are not welcome, don't drag people's names through the mud that have NOTHING to do with you, and leave other's family members out of your childish and putrid little rants.

----------


## rmcdaniel

> Harry our professions are not, have never been or will ever be friendly. Competion is keen. No one accepts someone "picking' your wallet for any reasons. Optometrists will not allow independent refraction because it creates a burden to them financially. If it happens it will be without their help. Rest assure of that. You may be an honorable guy and put the other cheek (sort of) but this people have exposed a very negative and frankly scary way of acting. Not only have they compromise their ethics but certainly have exposed the owner of this forum to an unnecessary liability or at least negative publicity if you ever decided to take action agains these individuals. I stand behind my opinion. They should be banned. One thing is expressing your opnions another one is acting them up.
> 
> Dannyboy


No reason to ban.  I'm out of here, this place has nothing of value to offer. 

buh bye

----------


## paradocs04

> I think Harry deserves an apology from these Doctors.


Fat chance.  What would the apology from me be for, what proof do you have of any wrong that I committed?  Yeah, the bias here is not detectable at all.




> You are so up into yourselfs....that you should be banned from this forum.


So from my one post, you have decided I am 'up on myself'?  Is your inferiority complex so deep, that you immediately judge someone based on one post?



> Giving your opinions is one thing another is actually performing a harrasment of this nature.


My opinion is you have no relevance to this discussion.



> I think guidelines have been broken and these ODs should be banned all together. Permitting such acts such as calling him to his place of employment is deplorable. It leaves a bad after taste. When we express opinions it is our choice to be private of our names and of our personal lives. Sorry but you maybe doctors but in my book you are close to criminals. Sadly to say.
> 
> 
> Dannyboy


Sadly to say you are talking out of your ***, about something you know very little about.

----------


## Dannyboy

:Confused: See what I mean! Harry wake up before it is to late...give it up close thread, edit your post before they actually commit a more serious crime!!!Hurry they are delusional that is the worse kinda.

Dannyboy

----------


## OHPNTZ

> Sorry I didn't know there was a difference either.. my understanding is that OMD's refer to neovascularization as 'pannus', that same way OMD's choose to refer to hyperopia in their lexicon as hypermetropia. 
> 
> Kindly provide differential diagnosis.


Corneal Pannus has a marked different appearance from Neo in that in has a leading demarcation line of fibrovascular tissue along with the vessels...often times seen after an inflammatory result.  Corneal Neo is a result of corneal hypoxia, with no associated fibrovascular tissue.

----------


## jediron1

> No reason to ban.  I'm out of here, this place has nothing of value to offer. 
> 
> buh bye




Nothing of value. I think the numbers of people that this site draws is testament to the fact that their is extreme value given. Your an OD who likes to put G in front of OD so you can strut around like you know anything at all. I've know OD's like yourself going around acting like semi OMD's which you strive to be. I for one I m glad your gone! Chalk one up for Harry.

----------


## Dannyboy

good bye;)

----------


## Jacqui

This may be professional suicide, but I think *trained* RN's and Nurse Practioners should be allowed to refract!! maybe even independently like the COT. 

I've seen too many times in my rounds as a nurse and as an optician where MD's and OD's have a serious case of the God complex. This not only hurts the patient (which is unforgiveable) but also hurts the profession for everyone. 

In about a year I will have my Doctorate and if someone notices that I have developed the complex, *SHOOT ME* or something.

----------


## Eyedoc71

> I think Harry deserves an apology from these Doctors. You are so up into yourselfs....that you should be banned from this forum. Giving your opinions is one thing another is actually performing a harrasment of this nature. I think guidelines have been broken and these ODs should be banned all together. Permitting such acts such as calling him to his place of employment is deplorable. It leaves a bad after taste. When we express opinions it is our choice to be private of our names and of our personal lives. Sorry but you maybe doctors but in my book you are close to criminals. Sadly to say.
> 
> 
> Dannyboy


 
Dannyboy, you may be a fabulous optician, but you're a complete idiot. We are close to criminals for responding to an optician taking information from a private forum and posting not only our private information, but posting pictures of my family??? 

If you are an example of what this board offers, being banned would actually be a compliment.

BTW, Hell will freeze over before I offer an apology for being flamed and insulted on a public forum...that would include the one I'm sure you feel you're entitled.

----------


## IndianaOD

> No reason to ban.  I'm out of here, this place has nothing of value to offer. 
> 
> buh bye



I actually thought there would be much more useful stuff on this site, I check in to see if there is once in awhile.

----------


## Eyedoc71

> I've seen too many times in my rounds as a nurse and as an optician where MD's and OD's have a serious case of the God complex. This not only hurts the patient (which is unforgiveable) but also hurts the profession for everyone.


Yeah, the lesser trained often feel this way.  As a doctor, you are the ultimate authority.  Do you really feel that you have the background to question a doctor's judgement or offer anything with regard to treatment?

Give me a break.  :hammer:

----------


## nickrock

> _Yeah, the lesser trained often feel this way_. As a doctor, you are the ultimate authority. Do you really feel that you have the background to question a doctor's judgement or offer anything with regard to treatment?
> 
> Give me a break. :hammer:





> ....I've seen too many times in my rounds as a nurse and as an optician where MD's and OD's have a serious case of the God complex. This not only hurts the patient (which is unforgiveable) but also hurts the profession for everyone.


Funny how everything comes full circle, huh?

----------


## tmorse

> Corneal Pannus has a marked different appearance from Neo in that in has a leading demarcation line of fibrovascular tissue along with the vessels...often times seen after an inflammatory result. Corneal Neo is a result of corneal hypoxia, with no associated fibrovascular tissue.


Lets see picture(s) with this fibrovascular tissue leading demarcation line, and what exactly does it indicate?

----------


## OHPNTZ

[quote=Dannyboy;245625] It leaves a bad after taste. When we express opinions it is our choice to be private of our names and of our personal lives. 

I wholehartedly agree.  I asked a question regarding the motivation of the refracting optician idea?  My question was based on if there was influence regarding a coorporate entity (ie. Pearle vision optician).  

Here's the threatening response I recieved via Harry:

"I gave NPDR the same warning I will give you. I disclose the infromation on my place of work and where I am because I think it's relevent to what I post, if you feel you have the right to use that against me I warn you I will disclose your info if your nto carefull."

NEVER was it used against the poster...nor did I ever attempt to contact your place of employment..yet I'm threatened via a PM message???

----------


## npdr

My original question was how or what kind of experience an optical manager at a corporate optical entity could have the experience that seems to pervade the speaker's posts. I was a bit surprised at the tenor and content of two private email messages.

I have tended to be even keeled about this discussion and yet I have not received equal consideration. And yet I have been linked to the other posters by affiliation only and not by my content. Thus the purpose of these posts is highly suspect.

There are some on this web forum who would banish optometrists. But if those who want to banish optometrists, why not restrain one of your ilk from "invading" the optometric forum?  I think it is rather childish to gain entry by deceit and lord over it.  We can certainly applaud the fortitude of the interloper but I'm wondering to what end is this kind of behavior? Come on, just because some one wants to let loose on an OD-only forum, that should not have any bearing on this forum. None whatsoever.

----------


## LandLord

So, what do you think about COT's refracting and charging?

----------


## OHPNTZ

> Lets see picture(s) with this fibrovascular tissue leading demarcation line, and what exactly does it indicate?


When you are fitting contact lenses, take a good look with the slit lamp.  If unsure, use a cobalt blue filter.

If you're still curious, check out some anterior seg atlases.   The point is one needs to differentiate...especially if you're doing the contact lens fits...when it comes to corneal hypoxia.

----------


## chip anderson

Damn Harry, I thought I was good at rattling O.D.'s  but you have got this to a whole new level.  By now you should have noticed that many of these O.D.'s reguard us as inferior life forms (as do far too many O.M.D.'s).   I was once having a conversation with by best friend (who was an O.M.D. and head of a UMC ophthalmology department) complimenting him on the fact that when I (or anyone else for that matter) was feeling down or incompentent, we could have a conversation with him that would let us feel that other mortals were unfit to speak to us for the next three days.  He was everyone's friend.  He replied that "I learned early on that one of the first things you do is 'take care of the little people'".     He didn't realise this, but this let me know that while he didn't reveal this he actually reguarded me, other doctors, techs, janitors, etc. as 'little people'.   Possibly a lower life form.  We remained friends but I did have a different reguard for his compliments on my skills thereafter.

These O.D.'s and most O.M.D.'s reguard us as lower life forms and there is little point attempting to have any sort of debate on how lower life forms might be able to perform any skilled action or thought that those higher up on the evolutionary scale do.  We are not capable in their eyes of even thinking on the same level.

Chip

----------


## paradocs04

> Damn Harry, I thought I was good at rattling O.D.'s  but you have got this to a whole new level.  By now you should have noticed that many of these O.D.'s reguard us as inferior life forms (as do far too many O.M.D.'s).   I was once having a conversation with by best friend (who was an O.M.D. and head of a UMC ophthalmology department) complimenting him on the fact that when I (or anyone else for that matter) was feeling down or incompentent, we could have a conversation with him that would let us feel that other mortals were unfit to speak to us for the next three days.  He was everyone's friend.  He replied that "I learned early on that one of the first things you do is 'take care of the little people'".     He didn't realise this, but this let me know that while he didn't reveal this he actually reguarded me, other doctors, techs, janitors, etc. as 'little people'.   Possibly a lower life form.  We remained friends but I did have a different reguard for his compliments on my skills thereafter.
> 
> These O.D.'s and most O.M.D.'s reguard us as lower life forms and there is little point attempting to have any sort of debate on how lower life forms might be able to perform any skilled action or thought that those higher up on the evolutionary scale do.  We are not capable in their eyes of even thinking on the same level.
> 
> Chip


My disgust with Harry has nothing to do with him being an optician, though I do feel he is a lower life form.

I feel this way because of his dishonest and slanderous comments against myself, and the fact that he pulled some school yard antics and brought in someone's family members (wife and young child) into a discussion.  That's what low life thugs do.

I have zero respect for the man because of these things.  I have yet to have an apology given for dragging my name into the situation unnecessarily.

It does seem, however, that everyone is so quick to throw me under the bus, solely because I am an OD, and despite the fact that Harry acted wildly inappropriately.  I wonder then, are some of the issues opticians are having with some ODs nothing more than a self fulfilled prophecy?

----------


## jediron1

> Dannyboy, you may be a fabulous optician, but you're a complete idiot. We are close to criminals for responding to an optician taking information from a private forum and posting not only our private information, but posting pictures of my family??? 
> 
> If you are an example of what this board offers, being banned would actually be a compliment.
> 
> BTW, Hell will freeze over before I offer an apology for being flamed and insulted on a public forum...that would include the one I'm sure you feel you're entitled.




See the OD's repertoire of the human language is so pigeon holed all they can do is call Dannyboy a " complete idiot ". So what person with a Dr. before his name runs around using school yard taunts to persuade us that this is an intelligent person wanting a meaningful conversation. The real reason is that they have no intention of having an intelligent conversation, but as Harry said when they get on these forums they can hide and act like the common criminal with no morals or integrity at all.

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## Eyedoc71

> See the OD's repertoire of the human language is so pigeon holed all they can do is call Dannyboy a " complete idiot ". So what person with a Dr. before his name runs around using school yard taunts to persuade us that this is an intelligent person wanting a meaningful conversation. The real reason is that they have no intention of having an intelligent conversation, but as Harry said when they get on these forums they can hide and act like the common criminal with no morals or integrity at all.


Hide?  You mean by not only having someone post my name, location, picture but also offering my phone number?  Yeah, I'm a cagy one...no way anyone can find me. :Rolleyes: 

You guys need to realize that the ODs that were brought on here were essentially coerced, so you'll forgive a little animosity.  I was personally insulted more than any of them (and have continued to be) even though my comments were fairly benign.  Even Harry acknowledges that he went too far and deleted his entire post.

Did I call someone an idiot for stating that the nature of the OD response (which was much milder than the posts that brought us here) was criminal?  Of course, because anyone that would make a statement like that IS an idiot.  It's not a schoolyard epithet, it's a fact.

I'm all for intelligent conversation, but only a very few so far have offered any.  They all want to defend one of their own that by his own admission was clearly in the wrong.  There are too many that are so insecure that any comment to them reflects a statement of affairs.  Do I consider an optician to have the same level of training that I do?  Hell, no..not even close and the concept that they are is laughable.  That's a lot different that considering you a "lower life form".  I very much respect what you do and I always tell my patients that the opticians I work can probably tell them more about the lenses than I can...but that doesn't make you doctors, nor does it replace 400 credit hours worth of study (that's just optometry school, I left college out).

----------


## Eyedoc71

> I have zero respect for the man because of these things. I have yet to have an apology given for dragging my name into the situation unnecessarily.


You're not going to get one because they're too busy burning their Wicker OD.

----------


## obxeyeguy



----------


## IndianaOD

> See the OD's repertoire of the human language is so pigeon holed all they can do is call Dannyboy a " complete idiot ". So what person with a Dr. before his name runs around using school yard taunts to persuade us that this is an intelligent person wanting a meaningful conversation. The real reason is that they have no intention of having an intelligent conversation, but as Harry said when they get on these forums they can hide and act like the common criminal with no morals or integrity at all.


Do you still not understand that the biggest offenses were carried out by an optician?  

BTW I don't know how much experience you guys have interacting with MDs and ODs, but you will quickly find out that ODs are probably the most grounded professionals on earth.  Head over to SDN if you want to see the MD "god" complex in action.  

Most ODs are not in it for the money.  Heck dentists have the same duration of schooling and make on average 2x as much.  It is common knowledge that ODs give away their services for far too little.  

IMO every individual deserves common respect regardless of station in life.  I will, however, go on the offensive if pure crap starts flying. 

As for the topic at hand.  No, I do not believe anyone should do stand alone refractions.  I even think an OD doing a refraction without a current ocular health exam is unwise.  The job of an optician is to educate the patient on the proper frames and lenses and dispense the product to the patient.  Some do simple data collection for the doctor as well, but determining an Rx has never been a task related to the term optician.

Its nothing against opticians in general.  I don't agree with the latitude and freedom afforded PAs and some nurses.  To me MDs are using them as cheap labor and rubber stamping all their work.  This is not the relationship that is intended.

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## Fezz

*"Can't we all just get along?"*

----------


## npdr

As someone so eloquently has done, everyone now knows who I am, but regretfully, everyone should also know that I don't dispense and that I generate over 50 prescriptions for the local LDO shop down the street. I therefore feel doubly offended by the mass hysteria associated with optometry by the optician craft on this forum.

I have only rendered opinions on low vision and other things as it relates to a realistic portrayal of eye care and yet my contributions have been besmirched by one or more other optician craftspeople here. A sorry state to say the least.

But back to the subject matter of refraction in between examinations.  When a law suit hits the fan, everyone from the original prescriber on down the line gets nailed. I don't believe the craft of optician is ready for that kind of responsibility. 

Or is it? I don't know what kind of guild training or crafts training that is involved. Is medical ethics and responsibility taught? Is the "fear of the almighty" drilled into you as it is in our education and in our CE? Please illuminate.

Thanks.

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## drk

What is it about "us vs. them" that generates so much print? :Rolleyes: 




I happen to post (too much) on both sites and know most of these people.  Many are quite talented individuals.



Ridiculous and unprofessional, but all are having fun, unfortunately.  Sporting!  Testosterone!  



"The truth" is that we should be viewing this whole scope of practice thing from the viewpoint of society, not our respective "special interest groups".  There are a few who would be able to discuss this intelligently.

----------


## jediron1

[quote=IndianaOD;245728]Do you still not understand that the biggest offenses were carried out by an optician?  

BTW I don't know how much experience you guys have interacting with MDs and ODs, but you will quickly find out that ODs are probably the most grounded professionals on earth.  Head over to SDN if you want to see the MD "god" complex in action.  



To your first question thats debatable, I did not see the afore mentioned web site so I can't comment on the facts that I have not seen or read. 

To your second question I have worked starting in 1987 with 1 OMD who definitely had the god complex. Within that group their were two other OMD's and 2 OD's. Second job in 1994 was with another god complex OMD who employed 2 other OMD's and 12 OD's and 12 opticians. Third job in 1997 was for a club store no OMD's or OD's. Fourth job in 2000 was with an OD. For the most part the OD's were easier to work with then the OMD's. At least in my situation the OD's  respected my work and told me so, where as the OMD's basically looked down at what I did.

----------


## tmorse

> I don't believe the craft of optician is ready for that kind of responsibility. Or is it? I don't know what kind of guild training or crafts training that is involved. Is medical ethics and responsibility taught? Is the "fear of the almighty" drilled into you as it is in our education and in our CE? Please illuminate. Thanks.


See regulatory College of Opticians of BC website... www.cobc.ca
for this information... that is, if you really want it.

And just when was the last doctor successfully sued for an inaccurate *refraction? Kindly provide legal citation.*

----------


## drk

Let's restart this argument pro and con with the US / Canadian citizen in mind.  Whomever makes the better case for the citizen should (and would) win.

I'll go first.

"Independent optican refracting is unneeded because there's no demand for it."

----------


## HarryChiling

> See what I mean! Harry wake up before it is to late...give it up close thread, edit your post before they actually commit a more serious crime!!!Hurry they are delusional that is the worse kinda.
> 
> Dannyboy


I know what your saying, but look at what's happening from a distance.

OD: Makes a comment on this board that opticians should do the ethical thing and report this opticians refracting.

Optician: Posts a similar case of OD prescribing beyond their scope.

OD: On another board advocate putting together information and calling opticians.

Opticians: Puts together information and exposes the ODs before he is exposed.

OD: Cry foul ball, it's not fair that's not exactly what I said.

Optician: Apoligizes for his actions explains that he tried on numerous occasions to find out the OD's intents with no responses.

OD: Asks to have offending information removed.

Optician: Complies hoping that maybe this would create some sort of neutral ground on which to discuss the issue.

OD: Goes off on a rant about he's not involved and then goe's on to posts his statement only as a way to disprove his involvement, then continues on his rant about how optician should tread lightly.

Optician: Debates whether the entire thread shoudl be moved here to humble OD once more.

It's the same scenario that plays out over and over again in our industry.  In the past I have always had a polarized view of OD's and that view has been reinforced by the few like this, but then their was the one or two that did post here that had some very interesting things to say and did offer a bit of insight into his collegues thinking on the subject.

Overall what we have seen here is a lack of ethics by a profession, followed by lack of professional behavior by that same profession.  Maybe your right this is not the profession that shoudl be the Primary Care Providers of eyecare, but unless the public sees this behavior that they display behind the scenes then how do we move forward?

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## HarryChiling

> Let's restart this argument pro and con with the US / Canadian citizen in mind. Whomever makes the better case for the citizen should (and would) win.
> 
> I'll go first.
> 
> "Independent optican refracting is unneeded because there's no demand for it."


Independent opticians refracting is needed as it will bring the cost of eyecare down.  If there is no deamnd why is there multiple optometry schools opening in the near future?

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## tmorse

> Let's restart this argument pro and con with the US / Canadian citizen in mind. Whomever makes the better case for the citizen should (and would) win. I'll go first.
> 
> "Independent optican refracting is unneeded because there's no demand for it."


That's not for you to say... let market forces determine that issue.

There are a lot of rural communities in Canada/USA that are not adequately serviced by OD's through satellite offices. Why should people have to drive 50+ miles just to get a pair of updated glasses or repairs?

Opticians could perform sight-tests in these areas and provide a much-needed service. :cheers:

----------


## drk

Ah, fresh meat! 

1.) What is the price of a routine eye examination on the free market right now? I would think that it ranges from $40-$80 in most commercial venues. How much lower "should" it be? Compared to what? Are you implying that the laws of economics are somehow suspended by two professions offering a service and not three (remember, that represents about 50K providers or more)?  Are there frightful trends in routine eye exam medical inflation to validate your concern?

(As an aside, what do you think a half hour of an optician's time is worth?)

2.) Do you believe that the educational "industry" is there to gauge demand for professions and then fill that need? Hmm. Accountants? Nuclear chemists? MBAs? ODs? You may need to think a little more deeply on that one. :)

----------


## jediron1

> Let's restart this argument pro and con with the US / Canadian citizen in mind.  Whomever makes the better case for the citizen should (and would) win.
> 
> I'll go first.
> 
> "Independent optican refracting is unneeded because there's no demand for it."




Would that not depend on what area of the country your in? Speaking only right now about the demand or need.  And how do you come to the conclusion that they is no need? I have seen no studies showing for or against the demand or need. The optician refracting I would think would only be granted after enough schooling or training to satisfy the state or federal regulatory agency  granting such permission with the stipulation that it could only be done in between the patients regular eye check up.

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## drk

Now you're talking! 

Your point is excellent; there may be non-homogeneity of supply.  Urban centers do well and rural do worse for medical services.  

In fact, that argument has been used by optometry to expand it's scope to serve populations' unmet needs, and also a (lame-o, IMHO) rationale for opening yet another OD school in Texas.

If there is undersupply of refractive needs in rural areas, then it should be addressed.

Think about this, though...what would be the smart way to go about it?  I think you'd probably find that there are all kinds of medical needs unmet in rural areas from dentistry to optical services to general medicine.  Why not simply commission regional health centers with existing professionals?  Why a new type of professional?

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## tmorse

> 2.) Do you believe that the educational "industry" is there to gauge demand for professions and then fill that need?


Absolutely YES!!:D

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## drk

Seriously?

----------


## Jacqui

> Yeah, the lesser trained often feel this way.


 Lesser trained?? I think after 40 years in optics plus training in Nursing and as a COT, I know something. Or maybe it was while helping people in New Orleans or Pakistan or Columbia, where the Dr's didn't want to go because they were afraid to get their hands dirty, that I learned something. As a Nurse, my specialties are disaster relief, free clinic work and midwifery. During disasters I see far too many eye injuries that need medical attention that only the RN's and NP's can give because we are the only ones brave enough to be there. 




> Do you really feel that you have the background to question a doctor's judgement or offer anything with regard to treatment?


*YES !!*

----------


## tmorse

> If there is undersupply of refractive needs in rural areas, then it should be addressed. 
> Think about this, though...what would be the smart way to go about it? I think you'd probably find that there are all kinds of medical needs unmet in rural areas from dentistry to optical services to general medicine. Why not simply commission regional health centers with existing professionals? Why a new type of professional?


Most if not all 'Professional' occupations automatically choose not to locate in rural areas. Health clinics in such areas have a tremendous staff turnover. But an sight-testing Optician in a small 'Mill Town' whose employees (and families) have vision benefits could benefit the whole community without appreciable risk(s). This is a new paradigm that will service mankind!!;)

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## drk

I think it is a truism that ODs in the military, or in Alaska or some other far-flung territory, or in rural settings do "higher level" stuff.

The same is true with any profession, ergo...

...an optician wishing to practice to the fullest extent of their abilities could associate with a licensed professional (even a general MD would do), refract and provide optical services.  Great idea.  Any takers?

----------


## Jacqui

> That's not for you to say... let market forces determine that issue.
> 
> There are a lot of rural communities in Canada/USA that are not adequately serviced by OD's through satellite offices. Why should people have to drive 50+ miles just to get a pair of updated glasses or repairs?
> 
> Opticians could perform sight-tests in these areas and provide a much-needed service. :cheers:



That was my thinking with using RN's and NP's that are trained. In areas such as the northern provinces and the territories where there aren't even opticians there are nurses at community clinics.

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## npdr

> Lesser trained?? I think after 40 years in optics plus training in Nursing and as a COT,



I think it is admirable that you have additional training or experience, but the question here is whether the ordinarily trained optician has sufficient training to that same kind of work here in ordinary settings.

There is no doubt that your efforts and your skill were appreciated and were well received in those special circumstances. And, on the whole, no one would probably argue that anyone who wants to step forward during those special circumstances would be well received.

But in the normal circumstance of every optician life and with only the optician education or training, I think that is a different story.

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## tmorse

> Do you believe that the educational "industry" is there to gauge demand for professions and then fill that need?


The private-education industry does it all the time... and if private schools miss-judge demand they will end up with poor enrolment, or graduates that cannot find jobs. Then market forces will prevail. The tax-payer supported public schools are a bit more immune to market forces, but they too adjust their offerings. 

Do you seriously think the 'old-boy' associations should be the ones empowered to dictate entry into occupations or professions? Or perhaps politicians? :bbg:

----------


## HarryChiling

> Hide? You mean by not only having someone post my name, location, picture but also offering my phone number? Yeah, I'm a cagy one...no way anyone can find me.
> 
> You guys need to realize that the ODs that were brought on here were essentially coerced, so you'll forgive a little animosity. I was personally insulted more than any of them (and have continued to be) even though my comments were fairly benign. Even Harry acknowledges that he went too far and deleted his entire post.
> 
> Did I call someone an idiot for stating that the nature of the OD response (which was much milder than the posts that brought us here) was criminal? Of course, because anyone that would make a statement like that IS an idiot. It's not a schoolyard epithet, it's a fact.
> 
> I'm all for intelligent conversation, but only a very few so far have offered any. They all want to defend one of their own that by his own admission was clearly in the wrong. There are too many that are so insecure that any comment to them reflects a statement of affairs. Do I consider an optician to have the same level of training that I do? Hell, no..not even close and the concept that they are is laughable. That's a lot different that considering you a "lower life form". I very much respect what you do and I always tell my patients that the opticians I work can probably tell them more about the lenses than I can...but that doesn't make you doctors, nor does it replace 400 credit hours worth of study (that's just optometry school, I left college out).


Alot of what you said is correct, if you are to use my post apologizing for my action as proof I did wrong you will also have to take it as fact that I did wrong in retaliation for being wronged.  Again 2 wrongs don't make a right.  I am not fishing for an apology just open dialog and I really do respect your opinion as a professional, I just wish that I had the honest and opne opinion.  I can't say that you are a liar 'cause I don't know you but experience has shown me in the past that the responses given are often different than the ones given to peers (I do have documentation of that from again your forums).  I took down those posts because I was asked to, it's a very starnge concept I know, but you'll be amazed at what people will do when asked.  




> Do I consider an optician to have the same level of training that I do? Hell, no..not even close and the concept that they are is laughable.


Consider this statement, you are right that is a fact, but also consider that this only applies to what you do.  What about the dispensary?  Not all ODs have the skills in the dispensary that many opticians have and this doesn't stop your profession from putting in dispensaries.  

Also some on your board seem to think that copyright infringement is a crime I committed.  If that is something you feel then please feel free to pursue that avenue, but you'll more than likely find that "fair use" would cover me to a degree, and my intentions were not slanderous or liable in any way.  The original posts left names off, the second posts with names were of those who were discussing me.  It's very simple if you posted there and discussed me, USED MY NAME, I assumed the right to use your name.  Since a few asked I removed my post, but think about it, not one post on your site with realtion to my name has been removed and there has been further discussion on that thread about me.  I don't care if it happens or not, but if I asked do you think they would remove it?  How do we get this mutual respect between us?  You don't have a class in school on how to hate opticians, what brings this about?




> You guys need to realize that the ODs that were brought on here were essentially coerced, so you'll forgive a little animosity.


I understand the animosity and it's justified you see how bad I can **** off my wife.:D  You weren't coerced though, I was being coerced at your site to post and give up my identity.  Anyway like any group you'll find the good, the bad, and the ugly.  Sorry again for the ugly at the time I thought it was necessary with the facts I had, I am sure you could see how I drew that conclusion.




> As someone so eloquently has done, everyone now knows who I am, but regretfully, everyone should also know that I don't dispense and that I generate over 50 prescriptions for the local LDO shop down the street. I therefore feel doubly offended by the mass hysteria associated with optometry by the optician craft on this forum.


I hope you don't think that my apology to your collegues extends to you, it was your viscious intent that started this.  You felt it necessary to point out information about me, I asked what your intentions were you choose not to reply, BTW you did read my message to you and you had ample time to reply.  Instead you went onto the other forum and posted again personal information about me there.  If anything the ODs that are upset at my actions shoudl be doubly offended by your actions here and there.  Your a snake, you've been a snake in the past and I have no doubt you'll be a snake in the future.




> The job of an optician is to educate the patient on the proper frames and lenses and dispense the product to the patient. Some do simple data collection for the doctor as well, but determining an Rx has never been a task related to the term optician.


1898 - American Association of Opticians
1910 - changed to American Optical Association
1919 - changed to American Optometric Association

Opticians was a reference used by both dispensing and refracting opticians before the turn of the last century, it was refracting opticians that choose to adopt the term optometrists which was coined by Landolt.  Optometrists historically resisted using the term doctor untill about 1940 -1950.  The schools at the time of 1950 required 5 years of posts high school education to confer the degree.

Maybe it's your profession that has outgrown the "Doctor of Optics" degree, maybe you shoudl have a medical degree confered, but your profession seems to focus less and less on optics and opticianry seems to embrace it more and more, maybe what opticians need is a doctorate degree for opticians?

----------


## drk

> The private-education industry does it all the time... and if private schools miss-judge demand they will end up with poor enrolment, or graduates that cannot find jobs. Then market forces will prevail. The tax-payer supported public schools are a bit more immune to market forces, but they too adjust their offerings. 
> 
> Do you seriously think the 'old-boy' associations should be the ones empowered to dictate entry into occupations or professions? Or perhaps politicians? :bbg:


No, you're pretty correct: as long as students are willing to plunk down their 50K in tuition, the schools will gladly meet that need.

Indirectly, as you state, the market will control the schools. 

In the case of optometry, there is no backlash, just yet.

In general, I agree that the free market should do it.

----------


## HarryChiling

Here is a thought:

Oculist - eyecare physicians that did not have residency training in ophthalmology.

This defination of a 100 year old extinct profession seems to describe Optometry to the tee.  

As has been told to me by many an OD.  Why would we want to practice the standard of care from 100 years ago?

----------


## tmorse

> That was my thinking with using RN's and NP's that are trained. In areas such as the northern provinces and the territories where there aren't even opticians there are nurses at community clinics.


I understand that satellite technology has progressed to the point where a rural RN can now send patient images to a specialist, who can then provide a diagnosis... it's called remote-something. So some progress is being made.

And Canadian sight-testers (ALL of whom are formally-educated and licensed Opticians) currently send their Rx findings to an OMD for interpretation and analysis before ordering eyeglasses. :cheers:

----------


## chip anderson

While it wasn't credit for sitting in the classroom.
I spent 40 hrs a week polishing bifocal buttons for four years on the night shift during my last year of junior high and the three of high school. I spent two years in contact lens manufactureing, and four years working under the supervision of a pioneer contact lens fitter at about 80 hours a week for three years (I'm sure this doesn't compare with looking at slides and looking at text) actually fitting contacts and observing patients that had been wearing contacts for 20+ years. I hand designed, hand edges, fitted them to the individual eye as well as observed, instructed, and repaired. I also owned and ran a small contact lens manufactureing company. I have taken at least 15 or so hours of "continueing education" a year for 50 years. 
I also have had many years of handholding and instruction from many of the countries finest ophthalmologist, opticians and a few optometrists.
Now I'm sure this doesn't make me the competent contact lens fitter, or ocularist, or optician even the greenest optometrists is, but it was somewhat instructive.
How many years have you followed and fitted with contact lenses for over 50 years (yes, I still have a lot of my origional patients).
I have also instructed quite a few ophthalmologist in fitting contact lenses.  You many have noticed how many of your instruction were provided by opticians working for contact lens companies (and those that were not opticians, but sales people working for same.)

Chip

----------


## drk

> Here is a thought:
> 
> Oculist - eyecare physicians that did not have residency training in ophthalmology.
> 
> This defination of a 100 year old extinct profession seems to describe Optometry to the tee. 
> 
> As has been told to me by many an OD. Why would we want to practice the standard of care from 100 years ago?


A swing and a miss...

"Residency training in ophthalmology" is just a "brand".  Who's to say ODs don't have sufficient training for their scope.  Plus, many ODs are residency trained.

Harry, I respect your desire to preserve your profession and serve society.  Here's what I think you should argue, instead:

"Since ODs and MDs are (increasingly more) uneducated in optics, well-trained and knowledgable opticians should form alliances with prescribers (instead of becoming prescribers themselves) in order to fill the niche that opticianry uniquely suits."  

What's wrong with that?

----------


## drk

> While it wasn't credit for sitting in the classroom.
> I spent 40 hrs a week polishing bifocal buttons for four years on the night shift during my last year of junior high and the three of high school. I spent two years in contact lens manufactureing, and four years working under the supervision of a pioneer contact lens fitter at about 80 hours a week for three years (I'm sure this doesn't compare with looking at slides and looking at text) actually fitting contacts and observing patients that had been wearing contacts for 20+ years. I hand designed, hand edges, fitted them to the individual eye as well as observed, instructed, and repaired. I also owned and ran a small contact lens manufactureing company. I have taken at least 15 or so hours of "continueing education" a year for 50 years. 
> I also have had many years of handholding and instruction from many of the countries finest ophthalmologist, opticians and a few optometrists.
> Now I'm sure this doesn't make me the competent contact lens fitter, or ocularist, or optician even the greenest optometrists is, but it was somewhat instructive.
> How many years have you followed and fitted with contact lenses for over 50 years (yes, I still have a lot of my origional patients).
> 
> Chip


This is a great argument on the relative value of apprenticeship-type training and didactic. I'm with you, Chip, you old coot.

----------


## drk

> And Canadian sight-testers (ALL of whom are formally-educated and licensed Opticians) currently send their Rx findings to an OMD for interpretation and analysis before ordering eyeglasses. :cheers:


That's a bureaucratically-devised waste of bandwidth, right there.

----------


## Eyedoc71

> Independent opticians refracting is needed as it will bring the cost of eyecare down. If there is no deamnd why is there multiple optometry schools opening in the near future?


Are you foolish enough to think that eyecare has anything to do with that?  It comes down to one thing.  The same thing it ALWAYS comes down to.  The optometry schools are huge revenue generators.  We don't need refracting opticians any more than we need 400 new ODs every year.

FWIW, I don't know a single optometrist or ophthalmologist that thinks that even ONE new school is needed.  Truth be told, we could probably lose one or two.

----------


## Eyedoc71

> While it wasn't credit for sitting in the classroom.
> I spent 40 hrs a week polishing bifocal buttons for four years on the night shift during my last year of junior high and the three of high school. I spent two years in contact lens manufactureing, and four years working under the supervision of a pioneer contact lens fitter at about 80 hours a week for three years (I'm sure this doesn't compare with looking at slides and looking at text) actually fitting contacts and observing patients that had been wearing contacts for 20+ years. I hand designed, hand edges, fitted them to the individual eye as well as observed, instructed, and repaired. I also owned and ran a small contact lens manufactureing company. I have taken at least 15 or so hours of "continueing education" a year for 50 years. 
> I also have had many years of handholding and instruction from many of the countries finest ophthalmologist, opticians and a few optometrists.
> Now I'm sure this doesn't make me the competent contact lens fitter, or ocularist, or optician even the greenest optometrists is, but it was somewhat instructive.
> How many years have you followed and fitted with contact lenses for over 50 years (yes, I still have a lot of my origional patients).
> I have also instructed quite a few ophthalmologist in fitting contact lenses. You many have noticed how many of your instruction were provided by opticians working for contact lens companies (and those that were not opticians, but sales people working for same.)
> 
> Chip


While I respect your background, I hardly think it compares to 4 years of college, 4 years of intensive eye specific training, hundreds of tests and several rounds of exhausting national exams before you can even START to do your job.  You have to acknowledge that you don't fit the mold for the majority of opticians out there.  Can you be an optician without a license?  Sure.  In a lot of states, they don't even recognize the necessity of a license (which I don't know how you guys haven't fixed THAT yet).  You can't discount the importance of didactic training or the testing and proficiency measurements (ie if you suck, you fail and don't become a doctor) that come with it.  I know I've worked with enough opticians in my decade practicing that I wonder how you guys don't lynch half of the folks that have the balls to use your title.

This is not about you not being good at your job...from the sound of it, those that you work for are lucky to have your level of skill at their patients disposal.  The problem is that there are those that are trying to re-define not only the job, but the very nature of your mode of health care delivery.  It would be like if all of a sudden pharmacists wanted to prescribe...but only for colds.  You really can't separate such an important part out.

----------


## npdr

> '....
> 
> I hope you don't think that my apology to your collegues extends to you, it was your viscious intent that started this.  You felt it necessary to point out information about me, I asked what your intentions were you choose not to reply, BTW you did read my message to you and you had ample time to reply.  Instead you went onto the other forum and posted again personal information about me there.  If anything the ODs that are upset at my actions shoudl be doubly offended by your actions here and there.  Your a snake, you've been a snake in the past and I have no doubt you'll be a snake in the future.
>  '...




First, I posted your affiliation on this board because it is the optiboard.You sent me two threatening notes and I don't feel I have to respond immediately just because you sent them to me. I failed to see where your note said where there was a suspense notice to reply before you escalate your verbal attacks.You may be talented but your lack of candor between your private comments and your comments on this board leads me to believe that your veracity is to be questioned in all of your public posts.If you have qualms about your affiliation, then you have a deal with that yourself lest you think that you are somehow embarrassed by your affiliation. Frankly, I'm not embarrassed by mine.

Why are you embarrassed by  yours?

----------


## tmorse

> That's a bureaucratically-devised waste of bandwidth, right there.


I agree, but it was a sop for government.;)

----------


## tmorse

> In a lot of states, they don't even recognize the necessity of a license (which I don't know how you guys haven't fixed THAT yet). You can't discount the importance of didactic training or the testing and proficiency measurements (ie if you suck, you fail and don't become a doctor) that come with it. I know I've worked with enough opticians in my decade practicing that I wonder how you guys don't lynch half of the folks that have the balls to use your title.


From what I heard about various failed US State licensing initiatives for Opticians, you are ONE OF THE VERY FEW OD's that appear to support licensing for Opticians. :cheers: 
Yet many of your OD colleagues dig deep and lobby their individual State legislature(s) to defeat all attempts by Opticianry to bring in formal training and licensure requirements in un-licensed States.

----------


## chip anderson

Eyedock71

The reason opticians are not licensed in most and especially mine is opposition from the Board Of Optometry.   You guys move out of the way, don't get politicians to add unacceptable restrictions for every bill, don't insist on most members of our boards to be O.D.'s and a lot of states will be licensed in a heartbeat.
I am too old to care at this point and if we were licensed tomarrow or outlawed entirely tomarrow I really wouldn't care.  But don't call it a problem when you are the cause of the problem.

Chip

----------


## Arohanui

If I understand (and I'm certain I do) the law in Texas is very clear.  If a patient pays for an eye exam (refraction), they are entitled to it.  However, the only way an Rx can be kept from the patient is if the patient never paid for the exam.  I know of an Optometrist who offers free eye exams, which forces the patient to buy from his optical if they don't want to pay for the exam.  However, when they decide they want to take it the patient is then hit with the price of the exam.  He is not outside of the law.  Bottom line: You pay for it - it's yours.  You don't pay for it - it's not yours.  Can it really be any simpler than that?

----------


## drk

Pure evil.




I like it.

----------


## optical24/7

> While I respect your background, I hardly think it compares to 4 years of college, 4 years of intensive eye specific training, hundreds of tests and several rounds of exhausting national exams before you can even START to do your job.


Very true doctor. Eight years of book learning never compares to experience. Would you like to have your heart transplant done by a new, out of the box surgeon, or one that has done 100's of transplants? 





> problem is that there are those that are trying to re-define not only the job, but the very nature of your mode of health care delivery. It would be like if all of a sudden pharmacists wanted to prescribe...but only for colds. You really can't separate such an important part out.


 
Now we're talking! It's only taken 10 pages of this thread to get to what I listed way back. I like the analogy of optician and pharmacist. We fill doctors Rx's. Now then, why don't MD's have pharmacies in their office? Conflict of interest, that's why. Is there not the same _exact_ conflict of interest with OD's and OMD's owning eyeglass dispensaries? ( I'm sure this will go unaddressed another 10 pages...)

Lastly, I'd like to bring up that in my state, I'm allowed to duplicate a patients RX. It doesn't matter how old it is, I can do it. ( and I do, regularly). There is absolutely, nowhere to be found, documentation that this has caused patient harm, brought law suites, or created a populous that are running around with extensive untreated path. Now then, tell me how simple refraction will create havoc where lens duplication hasn't?

----------


## braheem24

Holding an RX in TX?

Is that what this subject is about? :p

----------


## chip anderson

Arohaundi:  
 Eyeglass I specificly forbids the prescriber from discounting his fees on condition of eyeglass sales.  If the fee is nothing it is paid before it starts, he still has to hand over the Rx.  If the fee is the condition of eyeglass sale, the fine in $10,000 per incident.

Chip

----------


## Arohanui

But, Chip...he is an Optometrist...he must be right.  He paid $50K for his education.  Who am I to question?

----------


## Eyedoc71

> But, Chip...he is an Optometrist...he must be right. He paid $50K for his education. Who am I to question?


Actually if you double that, you'll be a lot closer.  I'm right because I have the training, certification and multiple verification of my knowledge and skills by a host of different local, state and national entities.  Can you say the same?

----------


## Arohanui

While I'm happy you have passed all of your boards, I was not referring to you.  I was referring to the optometrist who offers free eye exams and then charges for them if you don't purchase from him.

Also, my life didn't start, and is most definitely not defined by how many people I have surpassed in education.  I hold myself to much higher standards, and my education (in various fields) are counted as a blessing that I have the capacity to have dominated.  So, to answer your question - it really doesn't matter what I can and cannot say.  A person educated well beyond his intelligence is of no use to most - least of all to me.  So I keep myself in check.  (And just to make it clear - nothing but the first sentence was in reference to you or any other optometrist, doctor, physician, or anyone else who might get their feelings hurt.)

----------


## Eyedoc71

> Very true doctor. Eight years of book learning never compares to experience. Would you like to have your heart transplant done by a new, out of the box surgeon, or one that has done 100's of transplants? 
> 
> 
> 
> 
> 
> Now we're talking! It's only taken 10 pages of this thread to get to what I listed way back. I like the analogy of optician and pharmacist. We fill doctors Rx's. Now then, why don't MD's have pharmacies in their office? Conflict of interest, that's why. Is there not the same _exact_ conflict of interest with OD's and OMD's owning eyeglass dispensaries? ( I'm sure this will go unaddressed another 10 pages...)
> 
> Lastly, I'd like to bring up that in my state, I'm allowed to duplicate a patients RX. It doesn't matter how old it is, I can do it. ( and I do, regularly). There is absolutely, nowhere to be found, documentation that this has caused patient harm, brought law suites, or created a populous that are running around with extensive untreated path. Now then, tell me how simple refraction will create havoc where lens duplication hasn't?


I don't know...has the surgeon gone to school?  Is the old guy just someone that stayed at a Holiday Inn Express?  Personally, I would trust the new surgeon that has the credentials to back up his title than somebody that's just done a lot of them on his own essentially unsupervised.  My grandfather used to tell me "give me a young doctor and an old attorney".

I'm so glad you brought up material sales.  I don't sell materials and I closed my private practice to get out of that end of the business because I didn't like the ethical grey area, but I don't think that ODs that do are doing the wrong thing.  The purpose of Stark Laws is to protect the consumer from predatory physician practices.  This doesn't really apply because the skill of the pharmacist doesn't come into play when dispensing a medication.  If you're dispensing a pill, it's exactly the same regardless of who is dispensing it or the manner of the dispense.  The same can not be said of spectacles and whether or not opticians want to acknowledge it, there are a LOT of very unqualified folks fitting glasses which can dramatically alter the outcome.

As for duplication, I would like to horsewhip anyone that circumvents eyecare in this fashion.  I can't tell you the number of patients that come to my office because they are livid at the DPS failing them on their drivers license when they can see perfectly fine (actually 3 today).  The reality is that visual changes occur very slowly and most times the patient is unable to tell how much their vision has degraded.  It's the same as going to the pharmacy (since you like pharmacy analogies) and saying "renew my psyche and hypertension meds because I feel fine.  I don't need a visit to my doctor because I can just tell."  

I wonder how many glaucoma patients progress to the point that they can't be fixed because they circumvent the system by having some optician duplicate their prescription.  Does this cross your mind when you're doing this?  If it doesn't, it should because you're directly responsible for every patient that loses vision from undiagnosed pathology.

----------


## jediron1

> Eyedock71
> 
> The reason opticians are not licensed in most and especially mine is opposition from the Board Of Optometry.   You guys move out of the way, don't get politicians to add unacceptable restrictions for every bill, don't insist on most members of our boards to be O.D.'s and a lot of states will be licensed in a heartbeat.
> I am too old to care at this point and if we were licensed tomarrow or outlawed entirely tomarrow I really wouldn't care.  But don't call it a problem when you are the cause of the problem.
> 
> Chip



I must admit the greatest challenge we had to licensing in NY came from the big box stores and OD's.  NY went from one of the strongest state exams to that ridiculous ABO.

----------


## jediron1

> Arohaundi:  
>  Eyeglass I specificly forbids the prescriber from discounting his fees on condition of eyeglass sales.  If the fee is nothing it is paid before it starts, he still has to hand over the Rx.  If the fee is the condition of eyeglass sale, the fine in $10,000 per incident.
> 
> Chip




Chip we went over this before. Apparently no one understands Eyeglass 1 and what it's real intentions are. Unbelievable! Chip and I put on this thread the whole Eyeglass 1 regulation and still no gets it.

----------


## braheem24

> I don't know...has the surgeon gone to school?


 
Considering heart surgery is now successful due to an uneducated black man, who later in life received an honorary doctorate from Johns Hopkins because of all the surgeons he trained through the years, I would argue another example ;)

PS, his name was Vivian Thomas

----------


## Arohanui

In the first post, I was making reference to something that has been going on for many years with a certain optometrist.  I was not making reference to being for or against anything whatsoever.  It was merely mentioning someone's activities.  That's all.  As a matter of fact, the original optometrist retired after many years of practicing this way, his son took over did the same thing, and retired as well, and now a third optometrist is doing the same thing in the same location under the same business name.  It was merely an observation.

----------


## Jana Lewis

> While I respect your background, I hardly think it compares to 4 years of college, 4 years of intensive eye specific training, hundreds of tests and several rounds of exhausting national exams before you can even START to do your job. You have to acknowledge that you don't fit the mold for the majority of opticians out there. Can you be an optician without a license? Sure. In a lot of states, they don't even recognize the necessity of a license (*which I don't know how you guys haven't fixed THAT yet*). You can't discount the importance of didactic training or the testing and proficiency measurements (ie if you suck, you fail and don't become a doctor) that come with it. I know I've worked with enough opticians in my decade practicing that I wonder how you guys don't lynch half of the folks that have the balls to use your title.
> 
> This is not about you not being good at your job...from the sound of it, those that you work for are lucky to have your level of skill at their patients disposal. The problem is that there are those that are trying to re-define not only the job, but the very nature of your mode of health care delivery. It would be like if all of a sudden pharmacists wanted to prescribe...but only for colds. You really can't separate such an important part out.


I take exception to this comment. 

Opticians have been fighting for YEARS to get all states licensed! We have fought our hearts out thank you very much! 

Do ya wanna know why we don't get licensure? It's because the O.D's fight us every step of the way!! 

What I don't understand is that with licensure it would provide better care for the public... why don't O.D's want that? 

Please, don't answer... I will. You would have to pay me more. Bottom line. 

In conclusion, I ask that you don't jump to conclusions. We have fought and will continue to fight until we get licensure. And one day... we will get it!

----------


## Eyedoc71

> I take exception to this comment. 
> 
> Opticians have been fighting for YEARS to get all states licensed! We have fought our hearts out thank you very much! 
> 
> Do ya wanna know why we don't get licensure? It's because the O.D's fight us every step of the way!! 
> 
> What I don't understand is that with licensure it would provide better care for the public... why don't O.D's want that? 
> 
> Please, don't answer... I will. You would have to pay me more. Bottom line. 
> ...


Wait a minute...did you just accuse ME of jumping to conclusions????

Considering I pay the girl that answers my phone $11/hour and she's the lowest paid person in my office, I'm not sure where you're going with your post about paying opticians.  

Any time that ODs fight licensure it's about autonomy, not licenses.  Given that ODs are the recognized experts (not by your ilk of course), it only makes sense that we should be involved in the process.

----------


## Eyedoc71

> Considering heart surgery is now successful due to an uneducated black man, who later in life received an honorary doctorate from Johns Hopkins because of all the surgeons he trained through the years, I would argue another example ;)
> 
> PS, his name was Vivian Thomas


I guess I'll just have to settle for that guy with the medical degree.   :Rolleyes:

----------


## Arohanui

Doc, I have to say that I'm impressed, and I applaud you for paying your staff well.  Too many employers (not just doctors - everyone included) are too willing to pay $6 an hour and demand $11 an hour worth of work.  Bravo, Doc!

----------


## Eyedoc71

> Doc, I have to say that I'm impressed, and I applaud you for paying your staff well. Too many employers (not just doctors - everyone included) are too willing to pay $6 an hour and demand $11 an hour worth of work. Bravo, Doc!


Thanks, but it's nothing to be impressed with (unlike my trumpet playing or my winning smile).  I want quality people working for me because that's what builds a practice and you get what you pay for...period.

----------


## Arohanui

Trumpet playing?  Cool!  But I strongly agree with you.  If more employers could understand that, their turn over rate, sales, staff education level, etc. would soar!  People are happier at work and more productive when they don't have to be worried about any utilities being cut off cause they aren't making enough money just to pay the bare minimum.  Of course, the monkey must also be put on their backs to bring good reason to the table to be paid more.  The employer can't carry the entire burden.  I bet you have staff that have been with you for quite a few years.  Many don't understand, or perhaps can't see the true cost of constantly training  new employees.  What a waste of time!  You can't help it when someone slips in that shouldn't be there, but they will make their ignorance or lack of self motivation known, and they will be gone.  However, it's good to see that you take care of your staff.

----------


## Jana Lewis

> Wait a minute...did you just accuse ME of jumping to conclusions????
> 
> Considering I pay the girl that answers my phone $11/hour and she's the lowest paid person in my office, I'm not sure where you're going with your post about paying opticians. 
> 
> Any time that ODs fight licensure it's about autonomy, not licenses. Given that ODs are the recognized experts (not by your ilk of course), it only makes sense that we should be involved in the process.


Look, I have no dog in this fight. I don't care if opticians refract or not.  :Rolleyes: 

What I took exception to is the fact that you stated that opticians cannot seem to get state licensure. Your right... It's not because we bust our behinds to TRY... it's because O.D's fight us!! So, yeah.. YOU JUMPED TO CONCLUSIONS. 

And honestly, I really don't care what your office "girl" makes. The bottom line is that O.D's IN GENERAL fight state opticianry licensure! If you feel you pay your staff well, then I obviously wan't talking about YOU personally! 

Clear?

----------


## optical24/7

> I'm so glad you brought up material sales. I don't sell materials and I closed my private practice to get out of that end of the business because I didn't like the ethical grey area, but I don't think that ODs that do are doing the wrong thing. The purpose of Stark Laws is to protect the consumer from predatory physician practices. This doesn't really apply because the skill of the pharmacist doesn't come into play when dispensing a medication. If you're dispensing a pill, it's exactly the same regardless of who is dispensing it or the manner of the dispense. The same can not be said of spectacles and whether or not opticians want to acknowledge it, there are a LOT of very unqualified folks fitting glasses which can dramatically alter the outcome.


I think a lot of pharmacist would take offence at what you are saying. They are a major check and balance of drug interaction. I'm also the 1st to say we, (opticians) need a national licensure standard. With that, a patient can expect the same level of care from location to location, state to state. As far as Stark Laws, the same holds true for OD/OMD's. There are preditory optical doc's too. Don't believe me? Ask any wholesale lab owner/mamager. I was one and saw plenty of -/+ .25 Rx's from the same set of doctors...often. Or how about the studies that show 3 to 4 out of 10 patients are not given a copy of their Rx after examination. Yes, there _are_ preditory OD/Omd's....




> As for duplication, I would like to horsewhip anyone that circumvents eyecare in this fashion. I can't tell you the number of patients that come to my office because they are livid at the DPS failing them on their drivers license when they can see perfectly fine (actually 3 today). The reality is that visual changes occur very slowly and most times the patient is unable to tell how much their vision has degraded. It's the same as going to the pharmacy (since you like pharmacy analogies) and saying "renew my psyche and hypertension meds because I feel fine. I don't need a visit to my doctor because I can just tell."


So, you want to be the_ sole_ gatekeeper of Rx's. That a patient _can't_ get new glasses without your blessing. Is it just me, or does that sound like socialized medicine? Well, you might get your wish, the way we, as a country deal with medical issues here. But what say you to those whom self prescribe and medicate daily? (Allergy, anti-acid just to name 2). Are you saying I should need a Dr's Rx to buy my Tums? ( just in case that nasty reflux could turn to cancer?) I, personally believe in fredom of choice of care. With that come _personal responsibility._ 





> I wonder how many glaucoma patients progress to the point that they can't be fixed because they circumvent the system by having some optician duplicate their prescription. Does this cross your mind when you're doing this? If it doesn't, it should because you're directly responsible for every patient that loses vision from undiagnosed pathology.


Well, I'm sure you could look up how many patients with gloucoma lost vision due to lens duplication. I've been in optics over 33 years and have yet heard of a case, let a lone been involved in one. And if it eases your mind, I don't go around duplicating peoples 4,5,10 year old Rx. I'm usually duplicating something they got at their prescriber whom won't realease a valid Rx, at least in a timely manor!!!

----------


## Eyedoc71

> Look, I have no dog in this fight. I don't care if opticians refract or not. 
> 
> What I took exception to is the fact that you stated that opticians cannot seem to get state licensure. Your right... It's not because we bust our behinds to TRY... it's because O.D's fight us!! So, yeah.. YOU JUMPED TO CONCLUSIONS. 
> 
> And honestly, I really don't care what your office "girl" makes. The bottom line is that O.D's IN GENERAL fight state opticianry licensure! If you feel you pay your staff well, then I obviously wan't talking about YOU personally! 
> 
> Clear?


It's clear that you should perhaps try a decaffinated brand. I hear they're just as good as the real thing.

For someone that has no dog in this fight, I'm hearing a hell of a lot of barking from you. Lighten up, Jana.

Do you really think its the licensure that ODs fight?  If so, you should probably do a little research.

----------


## HarryChiling



----------


## Jana Lewis

> It's clear that you should perhaps try a decaffinated brand. I hear they're just as good as the real thing.
> 
> For someone that has no dog in this fight, I'm hearing a hell of a lot of barking from you. Lighten up, Jana.
> 
> Do you really think its the licensure that ODs fight? If so, you should probably do a little research.


Uhh... you need to do a little research yourself. Have you ever been to your state legislature to lobby on behalf of your state opticians ? 

Ever been to Texas to do so? 

If you answer no,then you are just blowing steam out of you backside and you have no CLUE what is really going on behind the fight for education and licensure. 

And...errr... my coffee is fine... thank you for your concern.  :Rolleyes:

----------


## Eyedoc71

> Uhh... you need to do a little research yourself. Have you ever been to your state legislature to lobby on behalf of your state opticians ? 
> 
> Ever been to Texas to do so? 
> 
> If you answer no,then you are just blowing steam out of you backside and you have no CLUE what is really going on behind the fight for education and licensure. 
> 
> And...errr... my coffee is fine... thank you for your concern.


No.  I haven't fought for opticians.  I also haven't fought for attorneys, dog catchers, used car salesmen or any number of other professions of which I'm not a member.  I HAVE fought on behalf of ODs in Texas...because I'm an OD.  :hammer:

I've got a pretty good idea what's going on legislatively both behind the scenes and in the forefront.  FWIW, ODs aren't your biggest opponent on this...and I assume you know this but it's more fun to take shots at me.  It's cool, I'm not sensitive.

I wasn't talking about your coffee.  Since you're so jacked up emotionally, I assumed you were just taking caffiene pills.

----------


## LandLord

> Let's restart this argument pro and con with the US / Canadian citizen in mind. Whomever makes the better case for the citizen should (and would) win.
> 
> I'll go first.
> 
> "Independent optican refracting is unneeded because there's no demand for it."


 There is virtually no demand for anything until it is offered.

----------


## chip anderson

Don't know where everyone comes from on this.  Eyeglass 1 is very plain and anyone other than perhaps a non-English speaking person should be able to understand it very well.
Those that claim not to understand it are merely trying to put forth thier best effort to circumvent it.

Don't be silly,


Chip:hammer:

----------


## LandLord

> If I understand (and I'm certain I do) the law in Texas is very clear. If a patient pays for an eye exam (refraction), they are entitled to it. However, the only way an Rx can be kept from the patient is if the patient never paid for the exam. I know of an Optometrist who offers free eye exams, which forces the patient to buy from his optical if they don't want to pay for the exam. However, when they decide they want to take it the patient is then hit with the price of the exam. He is not outside of the law. Bottom line: You pay for it - it's yours. You don't pay for it - it's not yours. Can it really be any simpler than that?


Makes perfect sense to me.

----------


## LandLord

This is the most rotting thread I've ever seen!

----------


## Jana Lewis

> No. I haven't fought for opticians. I also haven't fought for attorneys, dog catchers, used car salesmen or any number of other professions of which I'm not a member. I HAVE fought on behalf of ODs in Texas...because I'm an OD. :hammer:
> 
> I've got a pretty good idea what's going on legislatively both behind the scenes and in the forefront. FWIW, ODs aren't your biggest opponent on this...and I assume you know this but it's more fun to take shots at me. It's cool, I'm not sensitive.
> 
> I wasn't talking about your coffee. Since you're so jacked up emotionally, I assumed you were just taking caffiene pills.


Wow! What a nice personal swipe!!! 

Are you that sensitive that I call you out on an inaccurate post and you go all spazo, personal attack? 

Wow.. is that how you deal with your patients?

----------


## jediron1

> This is the most rotting thread I've ever seen!




You know what they say just turn the channel. ;)

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## Dannyboy

Texas is a kinda different state and if anything is going to happpen Ill bet that it will happen in Texas as far as opticians refracting. Texas Opticianry association in the early days was very disorganized but know it is probably one of the most pro education associations in the country. Just visit ther website.

Refracting Opticians are quite different than COTs and frankly very few COTs are opticians. COT/COMT are professionals that have normally trained under an ophthalmologists and have performed thousands of refractions but refractions is not the only thing they do. They perform ALL types of testing including performing invasive procedures in many parts of the planet. They have training programs in almost every major University although the grand percentage and by design of a ladder system they are trained on the JOB and educated at seminars...that is the only similiarity that exists with Opticianry. Interestingly Opticians complained about COTs doing the refractions but quite frankly most of them are pretty darn accurate. Some I would dare to say are more competent than many ODs. I asked a close friend of mine why is it that OMPs do not work for ODs and the answer is that the ODs are cheap.


Dannyboy :Cool:

----------


## jediron1

> Yet many of your OD colleagues dig deep and lobby their individual State legislature(s) to defeat all attempts by Opticianry to bring in formal training and licensure requirements in un-licensed States.





In NY that is correct along with the big box stores. The OD's fought like they were being attacked by a Texas rattle snake.

----------


## Eyedoc71

> I take exception to this comment. 
> 
> Opticians have been fighting for YEARS to get all states licensed! We have fought our hearts out thank you very much! 
> 
> Do ya wanna know why we don't get licensure? It's because the O.D's fight us every step of the way!! 
> 
> What I don't understand is that with licensure it would provide better care for the public... why don't O.D's want that? 
> 
> Please, don't answer... I will. You would have to pay me more. Bottom line. 
> ...


Yeah, I guess you're right...I attacked you.  Wait a minute...you were the one throwing the initial insults.

You just responded unfavorably to my thowing them back.  How about we play nice now?

----------


## Eyedoc71

> Texas is a kinda different state and if anything is going to happpen Ill bet that it will happen in Texas as far as opticians refracting. Texas Opticianry association in the early days was very disorganized but know it is probably one of the most pro education associations in the country. Just visit ther website.
> 
> Refracting Opticians are quite different than COTs and frankly very few COTs are opticians. COT/COMT are professionals that have normally trained under an ophthalmologists and have performed thousands of refractions but refractions is not the only thing they do. They perform ALL types of testing including performing invasive procedures in many parts of the planet. They have training programs in almost every major University although the grand percentage and by design of a ladder system they are trained on the JOB and educated at seminars...that is the only similiarity that exists with Opticianry. Interestingly Opticians complained about COTs doing the refractions but quite frankly most of them are pretty darn accurate. Some I would dare to say are more competent than many ODs. I asked a close friend of mine why is it that OMPs do not work for ODs and the answer is that the ODs are cheap.
> 
> 
> Dannyboy


Oh man.  That was good.  I'm a little unhappy about having to change pants, but when somebody makes comments so funny I pee in them I guess it's worth it.

----------


## HarryChiling

> Texas is a kinda different state and if anything is going to happpen Ill bet that it will happen in Texas as far as opticians refracting. Texas Opticianry association in the early days was very disorganized but know it is probably one of the most pro education associations in the country. Just visit ther website.
> 
> Refracting Opticians are quite different than COTs and frankly very few COTs are opticians. COT/COMT are professionals that have normally trained under an ophthalmologists and have performed thousands of refractions but refractions is not the only thing they do. They perform ALL types of testing including performing invasive procedures in many parts of the planet. They have training programs in almost every major University although the grand percentage and by design of a ladder system they are trained on the JOB and educated at seminars...that is the only similiarity that exists with Opticianry. Interestingly Opticians complained about COTs doing the refractions but quite frankly most of them are pretty darn accurate. Some I would dare to say are more competent than many ODs. I asked a close friend of mine why is it that OMPs do not work for ODs and the answer is that the ODs are cheap.
> 
> 
> Dannyboy


OMP's generally don't work under OD's because their profession was built and is maintained under OMD's.  OD's are createing a similar class of allied health personel Paraoptometrics.  They go from CPO, CPOA, CPOT.  The OMD's have the OMP's perform many procedures includeing some surgical procedures, however it is always under the supervision of the OMD.  An OMP can in no capacity practice on their own.  In this way their tied to their OMD's.  The AOA created the paraoptometric to help in a similar capacity.  For an OMP to come into an OD's office would be difficult as the duties and OMP is expected to perform are the same duties with exception of diagnosis.  In this way they would be in competition or the OMP would be performing menial work.

Previously it was mentioned that the more educated and skilled opticians should just align themselves with OD's or OMD's which is what happens now anyway, the issue here isn't would we be accepted in many offices across this country if we gave up our ability to practice independently actually Dr James Sheedy spoke to the OAA a few years back and his article is in the download section on this board.  The distilled version of his discussion and paper is tha if opticians are to have a future as a profession we will either have to make drastic changes to our education or give up the idea of being in direct competition with OD's or OMD's.  The issue of opticians refracting isn't a big deal if we do it in an OD's or OMD's office it's the independent part that scares the other professions.

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## HarryChiling

> Are there frightful trends in routine eye exam medical inflation to validate your concern?


This is a very interesting comment that actually is decieveing. 

An exam in an office in my area from 86 would run a patient $25.00, with inflation factored in (roughly 3%) an eyeexam at that same office should cost $64.38, the office charges $65.00 fro an eye exam today so I have to admit that no the cost of an eye exam is not unreasonable.

The difference is this office is now also offering eyewear. Yes they used to be non dispensing, with the additional revenues of eyewear and contact lenses the office still struggles to make it.

Now the why: This doctor is a wh@re to insurance, while their fees have gone up they give more than half of that to the insurance companies. While they now offer eyeglasses and contacts, they give additional revenue from that to the insurance companies. The scripts from this office used to support the independent opticals in the area and a few still do. Every year the reimbursements get lower from the insurance companies and every year the doctor decides longer hours is what's needed and after hireing a consultant, decides that the more seasoned opticians are paid too much, so the office creates scenarios that basically remove the more seasoned opticians in favor of newly hired we'll train them ourselves opticians, by making the workign enviornment difficult for th emore season opticians to work in they quit instead of having to be fired, consultants suggestion saves on the unemployment premiums.

This seems to be the norm where I work, I don't see this as a good enviornment for any optician. One of them worked with me and is a truly great opticians and I know that more than a few GOOD CLIENTS followed him, you know the cash pay always happy with their eyewear patients.

My point is that although the exam costs haven't gone up, time has shown that it isn't the OD that has paid the price for it. By offering eyewear in your offices for a pittance you further erode the independent optician to the point where the realization becomes if independent refraction isn't the goal I don't want it. Licensure, keep it. For me it's independent refraction or bust. The worst case scenario is that we get licensure and more educated opticians as a result.

On a side note an optician from this board posted about Canadian optometrists payign for billboards to let the public know they could go blind if they don't see an optometrist in reaction to opticians independently refracting in CA. I think that the best approach is to let the public know what their OD's think about them. Optometry has been trusted with primary eyecare, however the abuse of that power is evident by posts here and amoung themselves. These abuses shoudl be pointed out to the public in as many ways as possible.

Prescribeing drugs that are not allowed.
Behaveing unprofessionally and unethically.

I truly hope that all the crap that the few OD's here exhibit are isolated incidents, or that they at least check these attitudes at the door, but I wouldn't trust that. If anyone is interested in controversial posts from their site please contact me for copies.:p  They'll make for great PR pieces.

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## Oedema

> On a side note an optician from this board posted about Canadian optometrists payign for billboards to let the public know they could go blind if they don't see an optometrist in reaction to opticians independently refracting in CA. I think that the best approach is to let the public know what their OD's think about them. Optometry has been trusted with primary eyecare, however the abuse of that power is evident by posts here and amoung themselves. These abuses shoudl be pointed out to the public in as many ways as possible.


Sure you're not confusing Canadian OD's with Oklahoma OMD's?

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## HarryChiling

> Sure you're not confusing Canadian OD's with Oklahoma OMD's?


Nope but I'm sure the irony of it doesn't escape you.  I guess the expectation should be any expansion of scope will be meet by a backlash from the next rung up the ladder.

Do you advocate OD's performing surgical procedures?  Aren't there enough OMD's to perform this procedure?

You know all of opticianrys objections before they are made because you fight these battles with OMD's the difference is you want your scope to expand at both ends which is just ridiculous.

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## Oedema

> Nope


Sources?

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## glassynotassy

Like Jana I haven't a dog in this fight. I do have some questions or thoughts that I think should be considered.

A new optometry school in Texas - is Wal Mart funding? Their growth alone can support an entire school.

Along the same lines, will refracting opticians be more beneficial to big boxes than independent opticians?

Eye exams are very low cost relatively highly utilized touch point in the average persons health care picture.The only practicioner that has ever gotten up close and personal with my blood vessels is my optometrist/OMD. Do patients understand the value to overall health of an eye exam? 

Will growth in refractions reduce eye exams? If so, are we okay with that possibility? 

Suggestion - delete the "How I Got in to Optical" thread from this board. That type of history of our paths can not be helpful to the cause.

Optiboard represents the creme de la creme of optical professionals. This is not a representative sample of our industry, our peers. We/you, are the exception. Are there enough great ones out there to resolve refraction access issues in rural areas? Will they practice in remote areas?

Most opticians are employed by a retailer, OD, OMD. I can see how refracting could be great for some, what happens to the employed opticians?

Just a bunch of my thoughts. 


It's great to see contrasting views and debate. Please don't run off those with contrary views. Look at the contrary views as an impetus to develop arguments. Personal attacks removed, this is a very interesting and thought provoking thread.

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## Eyedoc71

> Nope but I'm sure the irony of it doesn't escape you. I guess the expectation should be any expansion of scope will be meet by a backlash from the next rung up the ladder.
> 
> Do you advocate OD's performing surgical procedures? Aren't there enough OMD's to perform this procedure?
> 
> You know all of opticianrys objections before they are made because you fight these battles with OMD's the difference is you want your scope to expand at both ends which is just ridiculous.


It's not just about the number of surgeons available. It's about professionals practicing to the level of their demonstrated education, training and skill set. ODs are well versed in minor procedures and laser surgery is just not that difficult until you hit the retina. There are considerably more ODs than OMDs and the truth is that ODs are the entry point for almost all eyecare. It doesn't make sense on ANY level to have a patient have to come to my office for an exam and then have to be shuffled off to another doctor for a straight forward procedure that I could teach my tech to do in ten minutes. Not to mention the fact that a lot of nonsurgical procedures are deemed surgery (punctal plugs are a perfect example) and that's where this whole "surgery" debacle started with ODs. No OD anywhere is advocating intraocular surgery. As far as I know, even if laser privileges were granted we have stated that it would have to come with an additional credentialling process.

How are we trying to expand at both ends?  Is there some aspect of opticianry that I'm not legally allowed to perform?

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## jediron1

> Texas is a kinda different state and if anything is going to happpen Ill bet that it will happen in Texas as far as opticians refracting. Texas Opticianry association in the early days was very disorganized but know it is probably one of the most pro education associations in the country. Just visit ther website.
> 
> Refracting Opticians are quite different than COTs and frankly very few COTs are opticians. COT/COMT are professionals that have normally trained under an ophthalmologists and have performed thousands of refractions but refractions is not the only thing they do. They perform ALL types of testing including performing invasive procedures in many parts of the planet. They have training programs in almost every major University although the grand percentage and by design of a ladder system they are trained on the JOB and educated at seminars...that is the only similiarity that exists with Opticianry. Interestingly Opticians complained about COTs doing the refractions but quite frankly most of them are pretty darn accurate. Some I would dare to say are more competent than many ODs. I asked a close friend of mine why is it that OMPs do not work for ODs and the answer is that the ODs are cheap.
> 
> 
> Dannyboy



Unless you were just concentrating on COT's the actual ladder they use is:
COA, COT and the COMT with COMT being the highest level. I know I worked for an OMD who I thought and the OD I worked under thought it would be great for me to go from COA to COT and then to COMT. I worked and studied for a month and passed the COA. The OD and I told the OMD that I had passed the COA and was getting ready to take the COT when he said "Why" I want an optician not a tech. I told him I could do both he said no. Come to find out the real reason was is that he would have to give me a raise which would have put up as the highest paid optician he ever had and he was not going to do that, in fact six months later I was gone.

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## Eyedoc71

> Unless you were just concentrating on COT's the actual ladder they use is:
> COA, COT and the COMT with COMT being the highest level. I know I worked for an OMD who I thought and the OD I worked under thought it would be great for me to go from COA to COT and then to COMT. I worked and studied for a month and passed the COA. The OD and I told the OMD that I had passed the COA and was getting ready to take the COT when he said "Why" I want an optician not a tech. I told him I could do both he said no. Come to find out the real reason was is that he would have to give me a raise which would have put up as the highest paid optician he ever had and he was not going to do that, in fact six months later I was gone.


Just to play devil's advocate, did he need another tech?  If my receptionist gets an accounting degree, do I then have to pay her six figures even if I don't require an accountant?

Sometimes our desire to expand and learn makes us no longer fit the pants we used to wear.  If you had that much training, it was probably time to move on anyway.  I have a lot of respect for what you were doing, but I'll give the hiring guys perspective.  I evaluate my needs and my budget and hire accordingly.  Just because one of the employees that I've hired for a certain position becomes too skilled for what they were hired doesn't mean they're worth the money to the practice to use those skills.  If I hired a nuclear physicist to answer my phones, I would still pay them as a receptionist because that's what I needed.

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## jediron1

> Interestingly Opticians complained about COTs doing the refractions but quite frankly most of them are pretty darn accurate. Some I would dare to say are more competent than many ODs. I asked a close friend of mine why is it that OMPs do not work for ODs and the answer is that the ODs are cheap.
> 
> 
> Dannyboy



I would say OMD's and OD's are cheap. They don't pay well never have never will. The most an OMD said he would pay was $15 per hour with no benefits.( an this was the going rate that OD's were paying ) When he was confronted on the subject that the pay was low in fact $3 to $4 less than present pay, he said thats all they could offer. At home their is a call waiting saying we have thought it over and will generously offer $15.50. They offered $.50 more, it's cost that much for gas. Needless to say I have not moved from my present job. OD's and OMD's don't pay never have never will.

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## Eyedoc71

> I would say OMD's and OD's are cheap. They don't pay well never have never will. The most an OMD said he would pay was $15 per hour with no benefits.( an this was the going rate that OD's were paying ) When he was confronted on the subject that the pay was low in fact $3 to $4 less than present pay, he said thats all they could offer. At home their is a call waiting saying we have thought it over and will generously offer $15.50. They offered $.50 more, it's cost that much for gas. Needless to say I have not moved from my present job. OD's and OMD's don't pay never have never will.


Could it be that it's the going rate for your job?  It has nothing to do with being cheap as ODs or OMDs.  What do non-medical personnel pay you guys?  I can check over at WM if you like.  I believe even the MANAGER (the highest paid person in there) makes approx $30K.  The environment (both working and financial scale) in a medical office is considerably different than a chain retail location.

I don't think that OMDs pay the ODs that work for them nearly enough, but that's what the jobs pay.  I find it highly suspect that the ODs and OMDs do similar work and the medical management by the OD is what allows the OMD to stay in the surgical suite...yet the OMD generally makes $300-$500K where the OD is lucky to squeak out $150K.  That having been said, that's what the market says that job is worth.  If the going rate for a receptionist is $7 per hour, how much are you going to deviate from that regardless if someone is great (I'm a bad example since I pay my receptionist over $10 per hour)?

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## jediron1

> Just to play devil's advocate, did he need another tech?  If my receptionist gets an accounting degree, do I then have to pay her six figures even if I don't require an accountant?
> 
> Sometimes our desire to expand and learn makes us no longer fit the pants we used to wear.  If you had that much training, it was probably time to move on anyway.  I have a lot of respect for what you were doing, but I'll give the hiring guys perspective.  I evaluate my needs and my budget and hire accordingly.  Just because one of the employees that I've hired for a certain position becomes too skilled for what they were hired doesn't mean they're worth the money to the practice to use those skills.  If I hired a nuclear physicist to answer my phones, I would still pay them as a receptionist because that's what I needed.




Your analogies between learning and pants is little strange just as your nuclear physicist to phone receptionist but I can play the game. 1. He could use another tech, because what he used to do was travel to our site and have the tech meet him there. 2. If your receptionist gets an accounting degree guaranteed she will not be working for you very long. 3. Most large corp's usually cross train so that in case someone is out they can fit another individual into his or her place with out hardly missing a  beat. Same can be said for an office if you cross train someone to the specific tasks they become more valuable not less and not less desirable.
just my take  :Rolleyes:

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## Eyedoc71

> Your analogies between learning and pants is little strange just as your nuclear physicist to phone receptionist but I can play the game. 1. He could use another tech, because what he used to do was travel to our site and have the tech meet him there. 2. If your receptionist gets an accounting degree guaranteed she will not be working for you very long. 3. Most large corp's usually cross train so that in case someone is out they can fit another individual into his or her place with out hardly missing a beat. Same can be said for an office if you cross train someone to the specific tasks they become more valuable not less and not less desirable.
> just my take


I live in Texas, we're big on "sayings" (Colloquialisms if you prefer). My point is that if he hired, needed and budgeted for an optican, your becoming a COMT and the pay that accompanied it made you no longer fit the manpower necessity in his eyes...or is it your idea that he should have fired the other tech because you trained beyond your position? Would he then have to hire another optician for the times you were unavailable doing tech work? Great for you, huge PITA for him.

I agree that from a market perspective you were worth more, but maybe not to him.

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## jediron1

> Could it be that it's the going rate for your job?  It has nothing to do with being cheap as ODs or OMDs.  What do non-medical personnel pay you guys?  I can check over at WM if you like.  I believe even the MANAGER (the highest paid person in there) makes approx $30K.  The environment (both working and financial scale) in a medical office is considerably different than a chain retail location.
> 
> I don't think that OMDs pay the ODs that work for them nearly enough, but that's what the jobs pay.  I find it highly suspect that the ODs and OMDs do similar work and the medical management by the OD is what allows the OMD to stay in the surgical suite...yet the OMD generally makes $300-$500K where the OD is lucky to squeak out $150K.  That having been said, that's what the market says that job is worth.  If the going rate for a receptionist is $7 per hour, how much are you going to deviate from that regardless if someone is great (I'm a bad example since I pay my receptionist over $10 per hour)?




With that being said around this area the going rate for opticians from OD's and OMD's ranges from a low of $13.50 to a high $17.50. With retail it ranges from $15.00 to $23.00 and in some places they are getting $25.00 from places like Wally Mart. You are right the market will bear what the market will bear, but to have a range of $13.50 to $25.00 is strange. If the OD's and OMD's were closer like $ 18 to $19 they could hire better qualified and experienced opticians instead of kids right out school. just my take

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## jediron1

> I live in Texas, we're big on "sayings" (Colloquialisms if you prefer). My point is that if he hired, needed and budgeted for an optican, your becoming a COMT and the pay that accompanied it made you no longer fit the manpower necessity in his eyes...or is it your idea that he should have fired the other tech because you trained beyond your position? Would he then have to hire another optician for the times you were unavailable doing tech work? Great for you, huge PITA for him.
> 
> I agree that from a market perspective you were worth more, but maybe not to him.



I'll give you that. Good point! The rub would have been that he could leave his tech instead of traveling 25 miles back at the main site and used me for the day and half that he needed.

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## Eyedoc71

> With that being said around this area the going rate for opticians from OD's and OMD's ranges from a low of $13.50 to a high $17.50. With retail it ranges from $15.00 to $23.00 and in some places they are getting $25.00 from places like Wally Mart. You are right the market will bear what the market will bear, but to have a range of $13.50 to $25.00 is strange. If the OD's and OMD's were closer like $ 18 to $19 they could hire better qualified and experienced opticians instead of kids right out school. just my take


I agree that hiring better folks is worth more money. You have to recognize the financial differences between working in a medical office and a high volume retail entity. In a LC for example, you directly generate several times your pay every hour so it's easier to absorb those costs. In a medical office, the doctor bears ALL of the expenses and while the optical may generate a large volume of sales, it doesn't begin to compare to the dollar amount generated by a LC or Eyemasters. I would be willing to bet that if you looked at the percentages (amount paid vs amount generated), it would be higher in a medical office.

BTW, where on earth is WM paying opticians $25 per hour?

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## HarryChiling

[quote=OHPNTZ;245682]


> It leaves a bad after taste. When we express opinions it is our choice to be private of our names and of our personal lives. 
> 
> I wholehartedly agree. I asked a question regarding the motivation of the refracting optician idea? My question was based on if there was influence regarding a coorporate entity (ie. Pearle vision optician). 
> 
> Here's the threatening response I recieved via Harry:
> 
> "I gave NPDR the same warning I will give you. I disclose the infromation on my place of work and where I am because I think it's relevent to what I post, if you feel you have the right to use that against me I warn you I will disclose your info if your nto carefull."
> 
> NEVER was it used against the poster...nor did I ever attempt to contact your place of employment..yet I'm threatened via a PM message???


I must say unless you truly are living in Mexico, your proxied access to my PM served you well. Seems all doctors aren't computer illiterate.  Ahhh Unitel.

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## Jana Lewis

> Yeah, I guess you're right...I attacked you. Wait a minute...you were the one throwing the initial insults.
> 
> You just responded unfavorably to my thowing them back. How about we play nice now?


Where is the "initial" swipe??? 

Are you that sensitive? 

Seriously.

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## Eyedoc71

> Where is the "initial" swipe??? 
> 
> Are you that sensitive? 
> 
> Seriously.


If I have to dumb it down for you, fine.  Your aggressive and insulting posture made your post an obvious offensive move to counter my point about opticians fighting for licensure.  In re-reading your post, I can visualize you jumping up and down sticking your tongue out at me.  I'm just surprised that you didn't finish it up with "so there!".  I was trying to be funny and lighten the mood a bit, but you're not going to back off.  I'm not the least bit sensitive, but reasonably easily annoyed.

In the words of Obi Wan...these are not the droids you're looking for...move along.

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## drk

> Just a bunch of my thoughts.


Who was that masked man (woman)? I like what you said.


For the record, Harry, this OD does NOT think we need surgical privileges (maybe a little loosening up on the definition of "invasive procedure" would be nice, though). We don't seem to have a surgery access issue here in the US, so the question would be "Why ODs operating?" and the answer would be "?". ODs that are so gung-ho on pointing and shooting a YAG can work within medicine and get all the jollies they want.

Harry, I get your point: _independent_ opticianry is _dependent_ on outside Rxs for customers. I say the best solution is to have the best possible optical, and affiliate with prescribers, be they in-house or out-of-house. Think about successful commercial opticals...they've brought in an OD for pennies and make a mint.

I'm telling you, your average OD likes vision care and medical care, but (strangely) dislikes optical services. There is an unmet need emerging. 

Is Opticianry as a whole going in the right direction? I say "no". The answer is NOT "refraction" privileges, but what Wm McD is trying to do: improve the educational requirements. 

I would fight to make every state licensed. The public needs to be protected against the commercialization of optical. If there needs to be a license in every venue, then opticianry will attain the statutory power it needs to survive.

Then, for economic power, opticians must create stand-alone opticals with on-site vision care services...that means affiliating with ODs, most likely. It can be done!

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## glassynotassy

> Who was that masked man (woman)? I like what you said.


I love to see more involvement from new voices. That's why this thread appealed to me so much.

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## HarryChiling

> A new optometry school in Texas - is Wal Mart funding? Their growth alone can support an entire school.


It does seem fishy that all of a sudden more schools are needed.  If it is WM that is funding think about the past legislative endevors of optometry the profession at one point was advocateing bulking up for the numbers.




> Along the same lines, will refracting opticians be more beneficial to big boxes than independent opticians?


Ahh I have mentioned this before myself, it's almost a catch 22 situation that is why it would be a great idea to iron our details with the other "O's".




> Eye exams are very low cost relatively highly utilized touch point in the average persons health care picture.The only practicioner that has ever gotten up close and personal with my blood vessels is my optometrist/OMD. Do patients understand the value to overall health of an eye exam?


NO NO NO, our biggest issue in our office is contact lens patients being so darned demanding, they think it's a joke.





> Will growth in refractions reduce eye exams? If so, are we okay with that possibility?


I don't think so persoanlly but I have no way of projecting those kind of scenarios as the whole idea is new.  Opticians in Canada maybe can shed a little light on that question.  I don't advocate it as a menas of hurting anohter profession, but if it's one profession or another being hurt my reallllllllllllllllllly realllllllllllllllllly biased opinion would be leaning towards opticians.





> Suggestion - delete the "How I Got in to Optical" thread from this board. That type of history of our paths can not be helpful to the cause.


People are who people are, their backgrounds only reflect their personalities and many of the stories are inspiring.  The creme de la creme as you refered to it seems to have deep roots in this industry.  These are the people I value opinions from, some of these folks here have family members that were pioneers in our industry.





> Optiboard represents the creme de la creme of optical professionals. This is not a representative sample of our industry, our peers. We/you, are the exception. Are there enough great ones out there to resolve refraction access issues in rural areas? Will they practice in remote areas?


This makes the poitn all the more appealing, if their are only a few that would even have the inteligence or drive to pursue refractive capabilities then how would it flood the market?  How would it lower the cost that significantly?  I don't believe it would.




> Most opticians are employed by a retailer, OD, OMD. I can see how refracting could be great for some, what happens to the employed opticians?


The employed optician can now have a fair opportunity to start their own business without the disadvantages of the past holding them back.




> Just a bunch of my thoughts.


They are thought provoking and it's the kind of post I love to read, it's the kind of post that helps to clarify a subject.




> It's great to see contrasting views and debate. Please don't run off those with contrary views. Look at the contrary views as an impetus to develop arguments. Personal attacks removed, this is a very interesting and thought provoking thread.


I agree it helps hone the mind and helps to maybe shed some light on the how the other guy feels.  It's a controversial topic and I compare it to yanking a pup from a mother wolf, there will be growlign and snarling and maybe the occasional biting.




> Who was that masked man (woman)? I like what you said.


It is nice to break up teh monotony with some inteligent dialogue. :cheers:

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## HarryChiling

> I love to see more involvement from new voices. That's why this thread appealed to me so much.


It's got drama, conspiracy, bickering, yelling, name calling.  Yet it's also covered the subject probably more extensively than most thread on teh subject.  Except the private forum threads.

----------


## Jana Lewis

> If I have to dumb it down for you, fine. Your aggressive and insulting posture made your post an obvious offensive move to counter my point about opticians fighting for licensure. In re-reading your post, I can visualize you jumping up and down sticking your tongue out at me. I'm just surprised that you didn't finish it up with "so there!". I was trying to be funny and lighten the mood a bit, but you're not going to back off. I'm not the least bit sensitive, but reasonably easily annoyed.
> 
> In the words of Obi Wan...these are not the droids you're looking for...move along.


Your not funny. 

You are an offensive jerk. 

This is exactly why we cannot seem to move forward... *sigh* oh well.. there is always a rotten apple in every bunch they say.

----------


## HarryChiling

> Your not funny. 
> 
> You are an offensive jerk. 
> 
> This is exactly why we cannot seem to move forward... *sigh* oh well.. there is always a rotten apple in every bunch they say.


If you haven't figured it out by now he's trying to get the thread either shut down or offend everyone in it.  Just ignore him and he'll fade away.

----------


## Jacqui

Have to agree Jana and Harry

----------


## jediron1

> I agree that hiring better folks is worth more money. You have to recognize the financial differences between working in a medical office and a high volume retail entity. In a LC for example, you directly generate several times your pay every hour so it's easier to absorb those costs. In a medical office, the doctor bears ALL of the expenses and while the optical may generate a large volume of sales, it doesn't begin to compare to the dollar amount generated by a LC or Eyemasters. I would be willing to bet that if you looked at the percentages (amount paid vs amount generated), it would be higher in a medical office.
> 
> BTW, where on earth is WM paying opticians $25 per hour?




I know for a fact that they were paying that in the southern part of the state around Elmira and Binghamton NY. Now I have heard that in Albany they have just ramped up the asking price because they are having a hard time getting licensed opticians. The part about the percentages I would have to agree, but again you really can't compare what the OMD gets for a procedure as to what an optician gets for glasses, but I do see your point and it's a valid point. ;)

----------


## jediron1

> If you haven't figured it out by now he's trying to get the thread either shut down or offend everyone in it.  Just ignore him and he'll fade away.




You maybe right Harry but all the postings that I have had with him have been on the up and up. I just think he things it's fun to poke at Jana to see what she will say and he gets his jollies from that.

----------


## HarryChiling

> You maybe right Harry but all the postings that I have had with him have been on the up and up. I just think he things it's fun to poke at Jana to see what she will say and he gets his jollies from that.


Well that could be right as well.  He did actually send me some very interesting points via PM and seems to be a good debater and politics well when he wants but for some reason it didn't last long.

----------


## rmcdaniel

I don't know why Eyedoc71 wastes his time on this forum. Drk is an optics geek (meant affectionately, love ya' man, in a manly way of course) so it's understandable why he sticks around.

PS. the 3 O's will never get along. It's every profession for themselves and patient care is not an issue in the turf war . Do what you must, and let the chips lye where they fall. If you can get refracting privileges more power to you. However, you opticians who like to claim the ethical high ground are pathetic. You're just like everyone else. No better no worse, so quit with the moral _rhetoric_ already.

----------


## IndianaOD

> Like Jana I haven't a dog in this fight. I do have some questions or thoughts that I think should be considered.
> 
> A new optometry school in Texas - is Wal Mart funding? Their growth alone can support an entire school.
> 
> Along the same lines, will refracting opticians be more beneficial to big boxes than independent opticians?
> 
> Eye exams are very low cost relatively highly utilized touch point in the average persons health care picture.The only practicioner that has ever gotten up close and personal with my blood vessels is my optometrist/OMD. Do patients understand the value to overall health of an eye exam? 
> 
> Will growth in refractions reduce eye exams? If so, are we okay with that possibility? 
> ...



Good points, many don't realize that an eye doctor is an allied health professional and serves to address the patient's overall health.  I check BP on every patient and have caught a lot of hypertensives either through this or a dilated fundus exam.  I have also diagnosed several diabetics that had no idea of their condition.  

The last professional to see the patient is legally responsible for their eye health, even if it was only a stand alone refraction.  

As I said before, I don't care about the history of a profession.  Surgeons started out as barbers, we came from jewelers.  What's the point?  I never would have been an OD if the medical scope wasn't already in place.

ODs and surgery is often a misleading topic.  Almost all the OD schools teach the students on injections and anterior segment procedures.  MDs always make it sound like ODs want to perform enucleations when really all most want is the ability to do injections, small exterior procedures, and laser therapy.

Now if an OD would want to spend 2 or 3 more years to preform cataract and the rest I think that is acceptable.  Don't forget residency trained ODs already have 5 years of post undergraduate training in the eye.  Your standard OMD has 3 years of specific eye training.

----------


## IndianaOD

> Who was that masked man (woman)? I like what you said.
> 
> 
> For the record, Harry, this OD does NOT think we need surgical privileges (maybe a little loosening up on the definition of "invasive procedure" would be nice, though). We don't seem to have a surgery access issue here in the US, so the question would be "Why ODs operating?" and the answer would be "?". ODs that are so gung-ho on pointing and shooting a YAG can work within medicine and get all the jollies they want.
> 
> Harry, I get your point: _independent_ opticianry is _dependent_ on outside Rxs for customers. I say the best solution is to have the best possible optical, and affiliate with prescribers, be they in-house or out-of-house. Think about successful commercial opticals...they've brought in an OD for pennies and make a mint.
> 
> I'm telling you, your average OD likes vision care and medical care, but (strangely) dislikes optical services. There is an unmet need emerging. 
> 
> ...


Well stated.

----------


## chip anderson

As a rule M.D.'s could to a lot better work in ennucleations.   Trust me I have fitted over 10,000 with prosthetic eyes.  I asked the department heads at a lot of medical schools how they could turn out such brilliant catarct surgeons and such brilliant retina people and such butchers as ennucleationists.   Was told to a man: "That's not one of the more remunerative things an ophthalmologist does with his time, so we don't spend much time on it."   Some schools said that this sort of "scut" was usually assigned to the most junior resident on staff.
Even had one ophthalmologist (journeyman) say:  "My way takes 12 minites and a good job takes 45."
Think of it the surgical result that you have to live with the rest of your life is determined by how much longer the doctor will be detained from the golf course!

Chip

----------


## Eyedoc71

> If you haven't figured it out by now he's trying to get the thread either shut down or offend everyone in it.  Just ignore him and he'll fade away.


I'm actually not trying to offend anyone...and you can thank yourself for my presence.  I'm not going away.  Outside of pissing Jana off (which she started BTW), what offensive comments have I made?

The problem is that when someone actually does engage you from the other side of the fence, the point of view is always met with anger and resentment.

----------


## HarryChiling

> However, you opticians who like to claim the ethical high ground are pathetic. You're just like everyone else. No better no worse, so quit with the moral _rhetoric_ already.


Thanks for summing it up, it's futile to try and act like their is a moral high ground.

----------


## Eyedoc71

> Well that could be right as well.  He did actually send me some very interesting points via PM and seems to be a good debater and politics well when he wants but for some reason it didn't last long.


More fun to debate in a crowd.  I guess if you're going to get in a fight, make it a bar fight.

----------


## Eyedoc71

> I don't know why Eyedoc71 wastes his time on this forum.  Drk is an optics geek (meant affectionately, love you man:)) so it's understandable why he sticks around.


Always curious what these guys have to say...and you better than ANYONE know that I love a good fight and I'm really not good at turning the other cheek.  :shiner:

----------


## HarryChiling

> I'm actually not trying to offend anyone...and you can thank yourself for my presence. I'm not going away. Outside of pissing Jana off (which she started BTW), what offensive comments have I made?
> 
> The problem is that when someone actually does engage you from the other side of the fence, the point of view is always met with anger and resentment.


I personally don't resent it I want to hear the other side.  I don't like hearing you bashing others and when the posts become nothing but that it gets tireing.  Anyway like I said you obviously have something to offer and I appreciate you offering it.

----------


## HarryChiling

> Always curious what these guys have to say...and you better than ANYONE know that I love a good fight and I'm really not good at turning the other cheek. :shiner:


That's what I'm talkign about, everyone loves a good throw down every now and again.  What other topic could produce this much drama?  It sure as h*ll ain't insurance we all hate them.:D

----------


## jeff286

I know it doesn't account for much, but many Opticians have taken this course.There is a lot  of outside MD RX's that are done by the tech's and the Doctor may just tweek it.So why not a licensed Optician who has a better understanding of the patients needs.Look at the evolution of Optometry,it seems like a natural progression for Opticians.

----------


## HarryChiling

> I know it doesn't account for much, but many Opticians have taken this course.There is a lot of outside MD RX's that are done by the tech's and the Doctor may just tweek it.So why not a licensed Optician who has a better understanding of the patients needs.Look at the evolution of Optometry,it seems like a natural progression for Opticians.


Is that still being offered?

----------


## Jana Lewis

> I'm actually not trying to offend anyone...and you can thank yourself for my presence. I'm not going away. Outside of pissing Jana off (which she started BTW), what offensive comments have I made?
> 
> The problem is that when someone actually does engage you from the other side of the fence, the point of view is always met with anger and resentment.


Hmmm let's see... how about "dumbing it down" Or "change your caffiene intake" or any other lovely "missives" you expoused??

I didn't start anything, my post was passionate. You are just too much of a jerk to see the rationale behind it. Had you tried to engage in a real life conversation you would see how passionate most opticians are about furthering their educations. 

And honestly? I really don't give a rat's behind whether or not you are an OD or a janitor... a jerk is a jerk. Period.

----------


## Eyedoc71

> Your not funny. 
> 
> You are an offensive jerk. 
> 
> This is exactly why we cannot seem to move forward... *sigh* oh well.. there is always a rotten apple in every bunch they say.


Jana, that's not fair.  I don't think you're a rotten apple, just a little misguided.  

Actually I'm not a jerk and I'm very funny..there are a few ODs on here that know me that'll back me up.  Where you and I are parting ways is that I'm also outspoken and don't respond well to being yelled at on the internet by a total stranger that took offense to a benign comment.

I have a lot of respect for you guys, but that doesn't mean that I'll agree with everything that you say or that we'll be taking long showers together.  If my demeanor offends some, just suffice to say that when I'm treated with respect I return it in kind...the same goes with being approached the other way.

----------


## Jana Lewis

> Jana, that's not fair. I don't think you're a rotten apple, just a little misguided. 
> 
> Actually I'm not a jerk and I'm very funny..there are a few ODs on here that know me that'll back me up. Where you and I are parting ways is that I'm also outspoken and don't respond well to being yelled at on the internet by a total stranger that took offense to a benign comment.
> 
> I have a lot of respect for you guys, but that doesn't mean that I'll agree with everything that you say or that we'll be taking long showers together. If my demeanor offends some, just suffice to say that when I'm treated with respect I return it in kind...the same goes with being approached the other way.


First off, I didn't yell at you. 

Had you atleast had the notion to try and understand my point of view you would see that my post was passionate. 

You can tell me you are a nice, engaging and funny all day long, all I have to go by is what you type and so far the only thing I can seem to gather from you is that you are not too terribly friendly.

----------


## jediron1

> I know it doesn't account for much, but many Opticians have taken this course.There is a lot  of outside MD RX's that are done by the tech's and the Doctor may just tweek it.So why not a licensed Optician who has a better understanding of the patients needs.Look at the evolution of Optometry,it seems like a natural progression for Opticians.



I have worked for a few OMD's in my time and I m not familiar with one that changes an rx or looks at it. Sign it and off you go.  Now I m jumping to the other side of the fence. I think if you want to refract go back to school for another two years get the basics down because whether you know it or not if your the last para health person they saw and you missed something you could be legally responsible.  just my take   ;)

----------


## Eyedoc71

> First off, I didn't yell at you. 
> 
> Had you atleast had the notion to try and understand my point of view you would see that my post was passionate. 
> 
> You can tell me you are a nice, engaging and funny all day long, all I have to go by is what you type and so far the only thing I can seem to gather from you is that you are not too terribly friendly.


I didn't doubt your passion, rude people are passionate as well.  I ****** you off and you responded.  I think you've wasted a lot of energy telling me you don't like me and I wasted a lot of time responding to it.  I get it.  You don't like me.  I've PM'd apologies so let it die.  Accept it or don't, but can we at least move on?

I do think this thread bears some discussion and I think we can all agree that Jana and I won't be attending prom together.  Now back to the matter at hand.

----------


## Eyedoc71

> Is that still being offered?


What do they teach in 100 hour refracting course (other than flipping dials)?

----------


## optical24/7

71, I want you to know I do respect you for giving up dispensing and your reasons for the same. I also want to say you're the only OD that has responded to some of my questions. I know a lot of other doctors have read this post, at least you had the guts to try to answer (some of) my questions. I'm buyin' the next rounds...

:cheers:

----------


## Laurie

Hi Harry,

The OAA 100 hour may/may not be running now...check oaa for upcoming possibilties.  (it is a great course...took it a while back...)

There are many refracting courses to choose from, many from a distance.  We offer a 3 semester sequence online, requiring you to find 'chair time' for several hours, as well as take our didactic portion online.  The online materials are custom made streaming videos with technology to capture details which allows you to see exactly how to procede, coupled with review of lens theory/design, prism, and mechanical optics.  You must fly to Tampa for hands-on/written finals at the end of each semester.

shameless plug for our program...disclosure...I teach at HCC, but do not personally profit by enrollment  *end of disclaimer*

While I have resisted this conversation in the public forum, what the heck...


Orangezero:  look what you did now! ; )
DRK:  You rock, geek-chic at its best!
Other OD's here...please continue to chime in...great discussion.
Other OMD's here...c,mon!  we know you're here!  would love your input.
Opticians here...many valid questions...am looking forward to responses...
Eyedoc71:  Would love to hear you play the trumpet, and I greatly value a beautiful smile.  However, a couple of comments you made:

WM salaries:  last meeting I attended, my recent graduate (1 year out) was earning $28.00/hr. in central Florida.  The needs for opticians in SW and North Florida are critical, and the pay is even higher.

Training for opticians refracting/college curricula:
Opticianry programs have continued to offer a broad-based curriculum including goemetric/mechanical/physiological optics, Anatomy, advanced CL fitting (would even make Chip proud), as well as classic dispensing/fabrication.  We also teach refractometry, as it is an actual job description in Florida (Refractionist), and it makes for great opticianry troubleshooting skills.

Trying to make this brief:  I attended a seminar, and later had a conversation with Irving Borish at an educational symposium.  He gave a brilliant lecture on the need for binocular refractions...anyway...during our conversation later, he talked about the days when he was involved with gaining DPA and TPA privileges (at a meeting at New York airport!).

I know...I said brief!  : )

He stated that, the intention was to go from one scope (baseline) to increase to a broader scope (one level up...).  Instead, he observed, OD's were shifting from the baseline scope --over-- to a more medical scope.  I don't want to misquote him, but I recall him saying something like, the OD curricula looks more like an MD curricla, while opticianry curricula is looking like the OD curricula of days past.  He could see that the important task of refracting was being delegated more and more by OD's and OMD's.

In addition to teaching optics/dispensing/refractometry.  (I have many friends here, and feel goofy listing credentials), however, I have had high quality dispensing experience (Lugene Opticians/Boston), a formal education, and 19 years of teaching Opticianry).  

With that said (gross!) I would like to add, that I still dispense, one night per week, and the doctor I work with is fabuous.  However, when certain scripts came up requiring VD compensation or slab-off prism, and I asked for things like refracted VD, she had the deer in the headlight eyes.  Many opticians could chime in on similar real-life experiences.  In addition, even the new OD grads are presribing a 'bumped' +0.25 Add for PALs...a dated procedure which also leads to more redos.   I value OD education, and have many OD/educator friends, however, to make room for the MD stuff, something has to give, and it appears to be advanced optics/dispensing.  The reason I mention this, is that you stated that you (OD's) are experts in dispensing, which I think is rare.

I am only suggesting, that, as OD's expand onward, it makes sense that a well-educated/well-trained optician step up, if h/she desires. 

so... my question for you:

If I have an Rx in my hand, from a doctor's office with mucho-redo rate, why can't I refract the patient, order the lenses by my numbers, and save the hassle/discomfort of redos.  Isn't the Rx in hand (within a reasonable amount of time) enough to be assured of a pathology check?  This is in the patient's best interest, and would bring redo rates down, which should keep costs reasonable, which is a benefit to the public.

: )

Laurie

----------


## Eyedoc71

> 71, I want you to know I do respect you for giving up dispensing and your reasons for the same. I also want to say you're the only OD that has responded to some of my questions. I know a lot of other doctors have read this post, at least you had the guts to try to answer (some of) my questions. I'm buyin' the next rounds...
> 
> :cheers:


What questions did I miss?

----------


## optical24/7

> What questions did I miss?


 

post 321.

----------


## HarryChiling

And Laurie still uses the old school smilies add that to your CV. ;) ; )

----------


## Laurie

what's not to love about it?

: )

----------


## HarryChiling

> what's not to love about it?
> 
> : )


I do love it, it's great. ; )

----------


## chip anderson

Harry:

Haven't had the 100 hour course but have had a bunch of shorter ones.  The ones for OPTICIANS usually are courses in true refraction.  You use a trial frame and trial lenses and a streak retinascope.  No dials.  Dials are strictly a production line devise for grinding mill refractionist who concider thier "chair time" the most valuable comodity on earth.

Chip

----------


## HarryChiling

> Dials are strictly a production line devise for grinding mill refractionist who concider thier "chair time" the most valuable comodity on earth.
> 
> Chip


And you say I know how to get a rise outta them. ;):cheers:

----------


## kws6000

> Optometry is in caught in the middle because there are two main groups that want them out; Ophthalmology and the optical giant corporations. 
> They can whine all they want but independent optometry has its days counted. Their nearsightedness of the ODs was that instead of pushing independent opticianry out they should have actually being proactive to establish a licensing in every state for opticians forcing the corporations to play by an even level in every sense of the word. We are so afraid of the corporations today that even our licensing boards are afraid to tackle them (Optometry and Opticianry). Shame on them! 
> 
> It is too late now as close to 50% of Optometry is corporate and possibly 80% of opticians work for the big boxes. The next step for the corporations is to tackle Ophthalmology. 
> 
> Dannyboy




Why should optometrists care about mandatory licensing of opticians? We have our own problems.

----------


## Eyedoc71

> Why should optometrists care about mandatory licensing of opticians? We have our own problems.


Brother, you hit the nail on the head there.

----------


## Against the Rule

A few thoughts on what's been said in this enlightening and entertaining thread (I'm paraphrasing what others have stated):
_Dentists get paid twice as much as OD's, therefore OD's are under-paid_...Or maybe a dentist can do what a dental-assistant can't, whereas as Harry pointed out an OD spends fifteen minutes with a patient performing a refraction many properly-trained opticians can do, only to leave it up to the optician to spend thirty minutes or more diagnosing the patient's actual visual needs and selecting the appropriate lens--plus making the lens in many cases.  My dentist doesn't look in my mouth, turn to his assistant, and say, "Perform a root canal...I'll be in my office surfing the 'net if you need me."  So what dentists make is irrelevant, as is time in school versus income.  Change your major if you want more money, don't whine afterwards.
_There are sleazy OD's and MD's out there_...Of course there are.  But I've worked with ten or more directly and a plethora indirectly, and have found very few.  There are sleazy opticians, too, for that matter--the ones that sell 1.67 for a -0.25 Rx.  Let's not let a few random bad examples taint a profession.
_Stalking/bizarre mentions of personal info_...Some of what's gone on in this thread is just weird.  Doctors calling a guy's workplace?  Challenges to fight?  Sorry guys, but if were bad-asses we wouldn't be opticians and OD's.  I've never met a scary optician or OD, and I'm pretty sure I never will.  
_Refracting_...Well, this is the crux of the matter.  OD's claim they're not merely refracting, but examining tissue and maybe telling the patient's fortune while they're at it.  MD's feel they're too good to refract, but they want the money for a full refraction even if they just sign off on what a 20-year-old tech found with the auto-refractor.  Opticians want to refract but we can't agree on the qualifications, we're mostly broke, and we're too busy writing up and cutting doctor's Rx changes to really focus on the issue.
They should make a "Three-O's" cereal, where two of the O's swell up in the milk and squeeze the little O until it dissolves completely.

----------


## wmcdonald

> Why should optometrists care about mandatory licensing of opticians? We have our own problems.


I have remained on the sideline in this thread for the most part, but now you have my attention. If you do not care, and that is the general feeling I hear from many of my friends in Optometry, then why, every time Opticians seek licensure, do the OD organizations lobby hard against it? Or is it more an organizational turf issue?

----------


## nickrock

As a COT, I perform way more invasive and critical measurements than refractions. Why have we not brought up the fact that COTs perfom a plethera of diagnostic and ancillary tests that are potentially harmful to patients if not properly trained?

----------


## IndianaOD

Ok, I'll bite.

What exactly is an "optician" and why do I need a licensed one?  Is an optician the gal that used to work in the produce dept at wally world and was told how to take PDs with a pupillometer?

Is an optician a person in a regional lab grinding out lenses?

How many non-hard core opticians would really want to go through a bunch of training?  It seems most happen upon the job they knew very little about going in and are trained on site.

Honestly, why would I delegate refraction to a licensed optician if I could train somebody how to use an automated system in a day?  BTW I will never delegate refraction unless I can't make a living without doing it.  Its too important.

Really, what is an optician?

Until the medical establishment and society put more value on preventative care than "procedures" we will all have to fight for the "procedures" to earn a decent living.  Why should a surgeon make as much for one procedure as an internist makes in a week?  Should a teachable technical skill like a 10 min cataract extraction pay as much as an OD makes seeing 30 patients?   There is a reason this is an unhealthy nation.

----------


## chip anderson

Indiana:  
To a degree I agree with you point.  But as long as you O.D.'s are making the point that all that wonderfull training is needed to spot problems that the patient didn't really come in for but should be saved by the fact that you found it.
Remember that the catract surgeon is also trained in medicine for the entire body.  Should the patient have a ceasure, a heart attack, or whatever while the surgery is being performed, he is trained to deal with this.  So here you have the same arguement about "he's trained" and therefore entitled to much more money than the O.D.   Just as the O.D. says "He's trained and _entittled_ to much more money than the optician or the office help.
Hell, no one has a guarantee of more moments on the earth so you could make the argument that we should all be entitled to the same amount (and not I am by no means a Marxist or even a bleeding heart liberal.)

Chip

----------


## Dannyboy

If optometry had not been so nearsighted, they would just simply stay out of they way and let opticianry fight for licensing when the time was right. If we would have been succesfull, may be the giant corporations would have been regulated to a higher level such as pharmacy and perhaps national chains wouldn't have gobble the optical field. When the big chains discover the value of the refracting optician they will challenge every one even more. Then everyone would have to reminince the good old days when OD worked as optometrists and opticians worked as opticians. 

Todays ODs have all this medical training for what...to work at wally. I believe optometry would come to realize this and start lowering their standards even more up to the point when schools will eventually reduce the amount of years or perhaps even their entrance requirememts. Doctors of optometry are the least paid doctors in the healthcare field and lack the respect that doctors with similar years of schooling have. No offense but it is a reality. An OD comes out with huge debts. Their debts are so big that many times opticians take home pay is more. Then we have ODs fighting to get this and that priviledge from ophthalmology for what..as they will never use that training to their fullest. Optometrists have a hard time getting into panels from so many insurance that it is not funny. When they work at my stores they really have a hard time practicing medical why because they are not accepted into the panels. I usually tell them to work part time for OMD groups and get their credentialing on the way and then come back but even then they bill under the OMD because they simply cannot get on board the insurance panels.. So if opticians are in trouble , optometry is behind. So who is the enemy here...not opticianry...not independent opticians. Sure opticians would need to refract to keep competiveness but I guarantee you that many independents opticians would rather have an optometrists do medical optometry and let opticians be opticians, but that time has gone and past. I for one will tell you to be content as employees or lease holders from the wallys and the crafters because that is all your next generation of graduates will accomplish. Independent optometrists were easier to get along because they simply did not have the buying power these corporations do. This is the point of view of an old independent optician but once I retire do you believe other optician will take my place or for that matter do you think an OD will actually take over...no because they are working at wally or cotco or crafters. If you are an OD planning to retire think twice of selling because your practice will not sell easily. retirement is no longer the value of the practice. 

So yes you guys have bigger fishes to fry if you are recent grads and if your independent optometrists with established practices pray that the wallys do not gobble you up. Then you have other problems that you guys are not ready like the board certification that you so much looking for.

Enjoy,

Dannyboy:o

----------


## IndianaOD

> Indiana:  
> To a degree I agree with you point.  But as long as you O.D.'s are making the point that all that wonderfull training is needed to spot problems that the patient didn't really come in for but should be saved by the fact that you found it.
> Remember that the catract surgeon is also trained in medicine for the entire body.  Should the patient have a ceasure, a heart attack, or whatever while the surgery is being performed, he is trained to deal with this.  So here you have the same arguement about "he's trained" and therefore entitled to much more money than the O.D.   Just as the O.D. says "He's trained and _entittled_ to much more money than the optician or the office help.
> Hell, no one has a guarantee of more moments on the earth so you could make the argument that we should all be entitled to the same amount (and not I am by no means a Marxist or even a bleeding heart liberal.)
> 
> 
> Chip


I don't know why topical anesthetic that I use every day would cause a seizure, but I GUARANTEE they will call 911 just like I will.

I have never been with an OMD that didn't have an anesthesiologist in the room for the completely sedated cases.

I doubt the OMD stocks clot busting drugs to be used after they run an EKG?  ;)

I agree that higher trained people should earn a little more, but an OMD with 11 years post high school should make 3x an OD with 9 years?  I'm not greedy or think I need to be rich, but the system is screwed up.

Truly I really love what I do, but to be totally honest if I knew all the fighting and problems with optometry and eye care in general I would have become a dentist or dermatologist.

----------


## Against the Rule

Indiana, you _shouldn't_ want a licensed optician.  If money is your concern, you should keep claiming that your fifteen-minute refraction is a thorough medical exam.  Let's be honest here, the guy that snips my dog's ******** is more of a "doctor" than your average OD.  
You don't get automatically paid based on how long you went to school--just ask one of the humanities P.H.D.'s serving you coffeee at Borders.  The public is figuring out what the normal OD refraction is worth, and eventually this will lead to refracting opticians and MD's only--as it was and should be.
An OD to an MD is like a nurse to a MD, or maybe even a PA to an MD.  Your profession attracts those too lazy or incompetent to become real doctors, but you want real doctor pay.  And you want opticians to solve the problems you both diagnose and create.
As it stands, OD's and MD's will continue squeezing us out, but believe me the time will come when OD's will have to be as "medical" as they claim to be--or they will be out of the picture.

----------


## IndianaOD

> Indiana, you _shouldn't_ want a licensed optician.  If money is your concern, you should keep claiming that your fifteen-minute refraction is a thorough medical exam.  Let's be honest here, the guy that snips my dog's ******** is more of a "doctor" than your average OD.  
> You don't get automatically paid based on how long you went to school--just ask one of the humanities P.H.D.'s serving you coffeee at Borders.  The public is figuring out what the normal OD refraction is worth, and eventually this will lead to refracting opticians and MD's only--as it was and should be.
> An OD to an MD is like a nurse to a MD, or maybe even a PA to an MD.  Your profession attracts those too lazy or incompetent to become real doctors, but you want real doctor pay.  And you want opticians to solve the problems you both diagnose and create.
> As it stands, OD's and MD's will continue squeezing us out, but believe me the time will come when OD's will have to be as "medical" as they claim to be--or they will be out of the picture.


There you go, you are a total goober.  That is the worst post I think I've ever seen.  I'll go take my #1 Pre-Med class GPA from a competitive ungergrad school and cry my lazy and unintelligent self to sleep.  I really hope the 4 MDs and 2 dentists that were behind me in undergrad aren't killing anyone.

You have no idea how many top notch students go to OD school.  If its so easy why haven't you done it?  Not smart enough?  Not enough work ethic?

----------


## IndianaOD

> There you go, you are a total goober.  That is the worst post I think I've ever seen.  I'll go take my #1 Pre-Med class GPA from a competitive ungergrad school and cry my lazy and unintelligent self to sleep.  I really hope the 4 MDs and 2 dentists that were behind me in undergrad aren't killing anyone.
> 
> You have no idea how many top notch students go to OD school.  If its so easy why haven't you done it?  Not smart enough?  Not enough work ethic?



I'm done with you people, you don't know the facts and can't hold a decent conversation.  Go refract yourself to glory.  I wanted to turn towards a  meaningful conversation, but its not going to happen.

----------


## Dannyboy

Od schhols have dropped their entrance requirements...so maybe your peers are not so intelligent as you are INDy.

Dannyboy :Eek:

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## tmorse

> The problem is that when someone actually does engage you from the other side of the fence, the point of view is always met with anger and resentment.


What do you expect? Your post lumped  'Opticians' into the same category as 
"...lawyers, dog-catchers and used car salesman...'" 

Good thing child-molesters, rapist and serial killers are not considered professionals .

Are you so dense (insensitive) that you can't see it?  :Rolleyes:

----------


## nickrock

Indiana, 
I would be more than happy to have a meaningful conversation with you about any topic you choose.  I understand your main points and I also understand your frustration with some previous accusatory comments made toward you or ODs in general. BUT, i think you may have a slightly skewed view of what MDs are actually trained to do. On the same breath, I think a lot of opticians view "ODs" as the ODs they work for in a private practice.  I know plenty of ODs that work in hospital settings, VAMCs, ERs, research, etc. The list goes on and on. That is what I respect about your profession. I believe you or someone else mentioned before the term, _primary eye care provider,_ which I think is an incredibly accurate description.  That is not what the majority of MDs do, which is good for all parties so that we can all work in harmony. There are enough ametropes, cataracts, and PAL wearers to go around.

----------


## chip anderson

You guys are the ones that decided  you wanted to be doctors.  You were doin' great when all you needed was a year at the University of Houston that you could get at night if you wanted to.
Now you find you painted yourselves into wanting all this education now you have to pay for it and are looking for ways to keep what you had and find ways to grab more.
I guess that's the american way.  

Chip

----------


## orangezero

ah, shucks.  I better delete a lot of this before I post.

I don't think many OD students are capable of understanding the realities of all that goes on and has gone on in this industry.  I don't think the majority of ODs have much say in where our profession came from or where it is headed.  Fewer and fewer are even able to control their own destiny.  It is interesting this seems to be blamed almost solely on commercial intervention or just plain stupidity.  Somehow this "new" profession of refracting opticians will be completely immune to all the other market pressures that are affecting ODs and the industry as a whole.

In short, it makes no sense to me why someone would want to be a (potentially less qualified) primary eye care provider with (debatable) better optical and dispensing skills but less formal education, less public awareness, less legal standing, less leadership, less ability to raise capital, less...  Does it even out?  Does this seem like something you would wish upon your child who is starting out a career?  Does a student reading this really think, "gee, I should be an optician because in 5 years we'll be able to refract and rule the world?"

You guys ever wonder how many of your refracting optician brethren just give up and join the dark side (ie go to optometry school)?  I knew a fair amount of opticians who became optometrists... how do you even figure out at what point in time you start hating their guts?:cheers:

peace, brothers.

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## Dannyboy

It is a matter of economics. OD school is simply too expensive and too long for the rewards that other careers of same lenghth offers. It is a very competive profession today and getting keener. It just makes sense that if opticianry is watered down to educate the few that want to go into opticianry schools to have refracting skills. All of the Opticianry schools with the exception of one that is under the wing an OD school offer refraction. Look at thge currriculuims of each opticianry schools...feeling uneasy? Technology is on the side of the optician. Wether is is automated or simply via telemedicine, it will come mainly because refracting can be done that way and probably not only that but the complete eye examination. 

Dannyboy :Rolleyes:

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## Eyedoc71

Man, there are some militant, ******-off opticians on this forum. So let the "Wally" doctor set you straight on just a couple of points, since I'm sure Indy is probably having a "ceasure" right now.

1) Independent refracting opticians will never be a reality in this country. Sorry, but it won't exist. Too many sight threatening (therefore lifestyle/economic) conditions show up during "routine" eye exams that can be easily demonstrated to any legislative body. It would pose too serious a public health risk and so that will never make it past committee, so let's move on.

2) Independent OD offices will never go away. Most commercial ODs are in place as a stepping stone to opening their own offices. The only reason that so many start-up offices fail is that every one insists on opening in densely populated areas which oversaturates and it's inevitable that someone is going to fail and while optometry school is really great for medical training they are seriously lacking in business courses.

3) We're getting what an eye exam is worth? There is a huge range out there. I charge $85 to walk in my door and I average roughly what my OMD actually gets paid and I'm 90% private pay. When my insurance credentialling is finalized it will be approx $140 based on my last 3 years numbers...and I'm constantly beaten up for being too low.

4) I wouldn't make such derogatory comments about how the WM ODs practice. I practice to the full extent of my license as do a lot of the guys that I know and have cutting edge equipment (actually lots of it). I routinely treat glc, corneal pathology like ulcers/injuries/foreign body removals, co-manage all surgeries and monitor my retinopathy patients. BTW, my income is about 6 times the highest pay I've seen by an employed optician (and slightly more than my dentist, but he's really good and makes more than most dentists that I know).

5) Lowering entrance standards for OD school? Where are you getting that information? I suspect it's just made up because I know that SCO hasn't. I graduated from college with a 3.8 GPA and they didn't seriously interview anyone under a 3.4. Application numbers have dropped a bit, but that cycles and there are only 100 slots anyway.

6) ODs can get on virtually any insurance panel. There are a few hold outs, but I'm on Blue Cross, Humana, United, Medicare, Medicaid, and Aetna (I've also been approached by Unicare but it's too small of a plan). Those are all the major carriers here. The only reason that we don't own eye care on this front is that there is so much infighting in our profession that we're never on the same page.
I'm a reasonable guy, but I'm reading a lot of unreasonable angry crap this morning so if I offended I'll apologize in advance.

----------


## jherman

In Texas, Optoms have to complete special training to treat Glaucoma, Glaucoma Specialist License. 
How long is that course?





> What do they teach in 100 hour refracting course (other than flipping dials)?

----------


## Eyedoc71

> In Texas, Optoms have to complete special training to treat Glaucoma, Glaucoma Specialist License. 
> How long is that course?


I have a VERY jaded opinion on that course given that it merely rehashed material that we'd not only sat through, but been tested over multiple times.  It's an excuse for the state board to extort an extra fee and an opportunity for the Univ or Houston to make an extra $900 to end up taking the same courses we spent 4 years learning the first time.

FWIW, I don't remember the number of hours but it took 4 days.

----------


## drk

Get real, James.  The course is for licensure requirements, not for education.

You get all the glaucoma you can handle in your four years and possibly residency.

----------


## Laurie

Hello Eyedoc71,




> _"Independent refracting opticians will never be a reality in this country. Sorry, but it won't exist"..."so lets move on."..._


 
With all due respect, just because _you_ don't see refracting opticians happening in this country, does not make it so.

Do you have a response to the secenario I previously described? Would love to know how a patient is in danger when I have an Rx in my hand.

: )

Laurie

----------


## jherman

were offendend by my question?





> Get real, James. The course is for licensure requirements, not for education.
> 
> You get all the glaucoma you can handle in your four years and possibly residency.

----------


## k12311997

> It's not just about the number of surgeons available. It's about professionals practicing to the level of their demonstrated education, training and skill set. ODs are well versed in minor procedures and laser surgery is just not that difficult until you hit the retina. There are considerably more ODs than OMDs and the truth is that ODs are the entry point for almost all eyecare. *It doesn't make sense on ANY level to have a patient have to come to my office for an exam and then have to be shuffled off to another doctor for a straight forward procedure that I could teach my tech to do in ten minutes.* Not to mention the fact that a lot of nonsurgical procedures are deemed surgery (punctal plugs are a perfect example) and that's where this whole "surgery" debacle started with ODs. No OD anywhere is advocating intraocular surgery. As far as I know, even if laser privileges were granted we have stated that it would have to come with an additional credentialling process.
> 
> How are we trying to expand at both ends? Is there some aspect of opticianry that I'm not legally allowed to perform?


71 does it strike you odd that seems like an argument for any expansion of scope including refracting opticians? I bet the OMD response would mirror your arguments against refracting.

----------


## npdr

> As a COT, I perform way more invasive and critical measurements than refractions. Why have we not brought up the fact that COTs perfom a plethera of diagnostic and ancillary tests that are potentially harmful to patients if not properly trained?


There is no question that COT and COMT are highly qualified and do more than what the average optician does. They perform a wide variety of medical eye and refractive procedures and even assist in surgery. I've had the pleasure of working with many.

I think optometry doesn't necessarily have any comments about this category of ophthalmic personnel. I don't.

I think I have a concern that dispensing opticians do not work under sufficient direct supervision or have significant experience to a warrant refraction scope. i know that is a generalization. I even know that some probably already do refraction such as  neutralizing glasses and holding a trial lens over the glasses to see if the vision can be improved and then fabricating the glasses that way.

COT, COMT do not customarily work or sign off on glasses Rx. What dispensing opticians want is the ability to go beyond what even the COT/COMT is doing by getting that ability. 

If Dispensing opticians were to get this scope, it would not necessarily benefit COT/COMT.

----------


## Eyedoc71

> 71 does it strike you odd that seems like an argument for any expansion of scope including refracting opticians? I bet the OMD response would mirror your arguments against refracting.


The huge glaring difference is that an OD has had years of standardized education and training (as well as didactic and practical testing) on those procedures.  Their arguement is weak.  This is not a matter of "the way they train US is better" or "we're smarter because we did a residency" because we are trained in the same areas.  A residency is impressive to the bulk of folks because they don't really understand medical school.  The average medical school graduate knows less about the eye than a 1st year OD student because they don't receive specialized training of any kind.  Medical school is just to give them general knowledge and prepare them for specialty training.  Where ODs miss the boat in their training is on the surgical end because we're not surgeons.  This is where all the fighting starts.  Is putting in a punctal plug surgery?  Of course not, but it's defined as surgery.  Is poking a cyst surgery?  No, but it's defined as surgery.  Is injecting medicine surgery?  No, but it's defined as such.

Where it breaks down for you folks is that there is no standardized training to legally call yourself an optician.  The optical manager at one of the WM in the area was the in-stock manager in the furniture dept 2 days before taking the optical job.

There is also the public health concern of taking a refraction out of the medical portion of the exam which I can't imagine any legislator thinking is a good idea.

----------


## chip anderson

I can put you in touch with a OMD that can talk for days on complications from puntal plugs and the surgical and medical proceedures required to correct the problems.
Odd how less cases of "dry eye" were diagnosed prior to there being insurance compensation for inserting them at a $450.00 fee for ten minites putting in a $10.00 piece of silicone.
I also think most of these cases would have been better  delt with castor oil drops if the doctors weren't so afraid of lawyers.


Chip

----------


## Eyedoc71

> Hi Harry,
> 
> The OAA 100 hour may/may not be running now...check oaa for upcoming possibilties. (it is a great course...took it a while back...)
> 
> There are many refracting courses to choose from, many from a distance. We offer a 3 semester sequence online, requiring you to find 'chair time' for several hours, as well as take our didactic portion online. The online materials are custom made streaming videos with technology to capture details which allows you to see exactly how to procede, coupled with review of lens theory/design, prism, and mechanical optics. You must fly to Tampa for hands-on/written finals at the end of each semester.
> 
> shameless plug for our program...disclosure...I teach at HCC, but do not personally profit by enrollment *end of disclaimer*
> 
> While I have resisted this conversation in the public forum, what the heck...
> ...


We are not shifting over. We are not trying to become anything else. We are not trying to change our job description. The problem is that we are doctors that deal with maximizing acuity and any factors that affect that. We are very well trained in all areas that affect vision and that includes pathology. What Dr. Borish was referring to is that the way we bill and structure exams from an audit perspective is more medical...but our focus is roughly the same. I find it sad that even 30 years ago, doctors did refractions only. It's because of what we've learned about the prevalence of disease and the emergence of medical treatments for what used to require surgery that our education has had to evolve.

As far as the patient scenario, no I don't think it's best for you to refract them.  If that OD is doing such a bad job, really the whole exam is suspect and they should find another doctor.  I have this happen a lot in my area because there was a really bad doctor and she missed tons of pathology as well as crappy refractions.

----------


## Laurie

Hello Again Eyedoc71,

Thanks for responding.

In most cases, it is an office where the refraction is delegated.  Generally speaking, most OD's are excellent at refracting, and most OMD's are excellent in pathology.  It is the "tech who learned it in ten minutes" that moves me to try to solve this problem.

The refraction procedure is so often delegated, I can't assume that, because the numbers are usually off, that pathology was also missed...a pretty big leap from A to B.

: )

Laurie

----------


## Eyedoc71

> I think a lot of pharmacist would take offence at what you are saying. They are a major check and balance of drug interaction. I'm also the 1st to say we, (opticians) need a national licensure standard. With that, a patient can expect the same level of care from location to location, state to state. As far as Stark Laws, the same holds true for OD/OMD's. There are preditory optical doc's too. Don't believe me? Ask any wholesale lab owner/mamager. I was one and saw plenty of -/+ .25 Rx's from the same set of doctors...often. Or how about the studies that show 3 to 4 out of 10 patients are not given a copy of their Rx after examination. Yes, there _are_ preditory OD/Omd's....
> 
> 
> 
> So, you want to be the_ sole_ gatekeeper of Rx's. That a patient _can't_ get new glasses without your blessing. Is it just me, or does that sound like socialized medicine? Well, you might get your wish, the way we, as a country deal with medical issues here. But what say you to those whom self prescribe and medicate daily? (Allergy, anti-acid just to name 2). Are you saying I should need a Dr's Rx to buy my Tums? ( just in case that nasty reflux could turn to cancer?) I, personally believe in fredom of choice of care. With that come _personal responsibility._ 
> 
> 
> 
> 
> Well, I'm sure you could look up how many patients with gloucoma lost vision due to lens duplication. I've been in optics over 33 years and have yet heard of a case, let a lone been involved in one. And if it eases your mind, I don't go around duplicating peoples 4,5,10 year old Rx. I'm usually duplicating something they got at their prescriber whom won't realease a valid Rx, at least in a timely manor!!!


There are predatory ODs and OMDs, lots of them.  How many plano with +1.00 adds have you seen with 1.67 Definity and Crizal in an Armani frame that sits on their desk when that guy that sold them knew damn well he would probably do better in OTC +1.00.  I don't defend those clowns.

As far as being the gatekeeper?  Hell, yes.  I think we should be the gatekeeper for ALL eyecare.  I don't think that even PCPs should be treating red eyes.  We are by definition the ONLY primary (and secondary) care doctors for eyes.  No other specialty fits that bill and it doesn't make sense for a patient to go to a general practitioner for eye concerns because that guy doesn't even have a slit-lamp to assess it so they're just guessing.  Seeing an OMD?  Do you go to the neurosurgeon when you have a headache?  OMDs are great and I think that every OD should own at least one, but the truth is that nowadays they are almost a subspecialty.  Exotic eye disease and surgery is their area of expertise (and bread and butter, they just don't get the reimbursements they used to so many have resorted to primary care...and also dispensing).  The reason they fight us has nothing to do with training and all about the money they no longer make performing surgery.  In the 80s the AOA (OMD side) said that any OMD that had any affiliation with an optical would be booted out of the academy and the AMA.  Fast forward to decreasing reimbursements and you'll rarely find an OMD that doesn't at least allow an optician to "rent" from them.

I'm not a big fan of self-medicating and the reason people die of things like esophageal cancer (or liver failure from too many OTC ibuprofen) is that they DO take tums rather than just having someone look at it to make sure it's just indigestion.  I believe that most doctors are honest (if they're not, find another one regardless of what type) and most will tell you if OTC will work.  I recommend OTC allergy meds all the time despite being able to prescribe them...but that's after I've verified that it IS allergies.  Truth be told, most patients don't have the slightest clue what the meds do or what quantity is safe.  They read a box and hope they're correct.  I don't mind monitored home remedies, but that's a far cry from self-medicating.

Now to the biggie...the bait and switch.  I never said that someone was going to go blind from glaucoma because you duplicated a lens.  Clever misdirection, but that's not what I meant.  Most patients are under the impression that if they're vision seems fine (notice I used the word seems - I'll get to that) that everything must be working.  So if they're coming to you to get their lenses remade and they can see acceptably, they don't see any need for an exam.  I actually had 2 end-stage glc patients last year that spent years getting their lenses duplicated at various local opticals, but I'll give one as a specific example since you asked for one.  She had come in because her vision had "just" gotten too fuzzy for her liking.  She was best corrected to 20/400 (her specs were 6 months old) from cataracts and was still driving.  Now, here's the rub...she also had end-stage undiagnosed glaucoma and cataract surgery was really just a formality.  Had she been examined at any point, it would have been caught and this lady wouldn't be blind.  She had no idea that you could get glaucoma and still retain usable vision for a long time.  Her vision loss had progressed slowly and painlessly and she had her local opticians helping her out by just duplicating her rx when her lenses were scratched or frame broken.  If you ask me, the system and the opticians that know better are directly responsible for her vision loss.

----------


## jediron1

> As a COT, I perform way more invasive and critical measurements than refractions. Why have we not brought up the fact that COTs perfom a plethera of diagnostic and ancillary tests that are potentially harmful to patients if not properly trained?




The reason your not brought up on charges is that the OMD you work for covers your behind because he or she is the OMD with the insurance to cover COT's in case they screw up.  just my take  :Rolleyes:

----------


## Eyedoc71

> I can put you in touch with a OMD that can talk for days on complications from puntal plugs and the surgical and medical proceedures required to correct the problems.
> Odd how less cases of "dry eye" were diagnosed prior to there being insurance compensation for inserting them at a $450.00 fee for ten minites putting in a $10.00 piece of silicone.
> I also think most of these cases would have been better delt with castor oil drops if the doctors weren't so afraid of lawyers.
> 
> 
> Chip


I suppose that's possible if you use intracanicular plugs, but I don't use them mainly because w/o a Jones test it's hard to tell if they're still in.  I can also put you in touch with hundreds of patients that can tell you their own story.  I always do temporary collagen plugs first and if they don't work, we move on and we only get there when topical lubrication is ineffective or inconvenient.  I don't think insurance has anything to do with it, I just think that as doctors deal with more medical eye issues it comes up.  Punctal plugs aren't a fix-all because not all dry eye is lacrimal insufficiency.  Not that I want this karma, but I've been doing plugs for almost 10 years and have never had a patient that required surgery because of their plugs (knocking wood VERY hard and repeatedly).  I've had two that had developed small granulomas over the plugs, but they neither hindered the tx or required surgery.

I have lots of patients that have had dry eye problems for years, but I was the first guy to ask them about it.  Don't confuse bad doctoring with lack of necessity.  Plugs acutally cost more like $50 and that global fee covers several visits, but that's just splitting hairs.

Castor oil?  I guess that's great if it's 1950.  :hammer:

----------


## pauly47

I think a lot of effort will have to be put forth to inform the general public that a 'refraction alone' is not an eye exam.  Neither is the DMV test or school screening.   Many "million dollar" practices employ COT/COMT to refract as part of the exam.  I know lots of COT/COMT with an optical background (used to be opticians) and they do great refractions.  I know many opticians that do great refractions.  Since the 92015 is a separate procedure, COT/COMT/opticians already get paid for it if they do them in a OD/OMD office, they just don't pocket the money themselves.  Was the original question about COT/COMT's doing refractions at their own free-standing building?  Too much other blathering to remember the whole point of this post...

----------


## Eyedoc71

> I think a lot of effort will have to be put forth to inform the general public that a 'refraction alone' is not an eye exam. Neither is the DMV test or school screening. Many "million dollar" practices employ COT/COMT to refract as part of the exam. I know lots of COT/COMT with an optical background (used to be opticians) and they do great refractions. I know many opticians that do great refractions. Since the 92015 is a separate procedure, COT/COMT/opticians already get paid for it if they do them in a OD/OMD office, they just don't pocket the money themselves. Was the original question about COT/COMT's doing refractions at their own free-standing building? Too much other blathering to remember the whole point of this post...


Never happen.  The public just floates blissfully unaware.  The only option is to take away those (dis)services.

----------


## HarryChiling

> There you go, you are a total goober. That is the worst post I think I've ever seen. I'll go take my #1 Pre-Med class GPA from a competitive ungergrad school and cry my lazy and unintelligent self to sleep. I really hope the 4 MDs and 2 dentists that were behind me in undergrad aren't killing anyone.
> 
> You have no idea how many top notch students go to OD school. If its so easy why haven't you done it? Not smart enough? Not enough work ethic?


That was a dirty bunch of remarks, I do agree though that the number of years doesn't mean squat.  It's what you do with it that people will place a value on.

I do know how many top notch students go to optometry school, but there are a few that go there becasue they couldn't get into med school.  Again these little quips and comments represent the exception rather than the rule.  Most go because they want to go, my wife sat through a speal from PCO at her school, she was pre med, before going for her post grad in micro biology.  They lied there butts off, they quoted OD's making $200K+ and they actually pointed out that their are opticals on almost every corner, they were acting like the streets were paved with gold.  They didn't mention that thes opticals on every corner were competition.

I do think tht ultimately the corporate opticals will gobble up optometry or get rid of it as a profession.  




> You guys ever wonder how many of your refracting optician brethren just give up and join the dark side (ie go to optometry school)? I knew a fair amount of opticians who became optometrists... how do you even figure out at what point in time you start hating their guts?:cheers:
> 
> peace, brothers.


Man, that's some real stuff right there, sure many do.  But how many talented individuals just leave the industry?

As far as why would any OD care about opticiasn being licensed?

We provide the after care to your patients, you can't expect that every script walkign out the door will be served by your optical.  Wouldn't you want to know that the person serving your script has some basic competency?If opticians are gone that puts you on the bottom.  Lets face it we are the O between you and zerO.It would put more value into the ophthalmic devices, and since anyone dispensing under an OD is covered byt eh OD's license, the net effect is that it will effect everyones bottom line except yours. Making you businesses more competitive and profitable.Those are just a few of the reason I have.  Hey I also think it's a great idea that you have TPA and DPA privledges it means more people to visit and treat which means more people in the optical. (I work with an OD), win-win.  It's much easier for me to work with OD's than with OMD's an OD understands optics and we can formulate a plan for eyewear making my job easier, an OMD ends up not caring about that and I don't care about surgery or medical issues so were literally speaking two different languages.  It's only logical that OD's an Opticians hash something out.

----------


## Stonegoat

Always a heated discussion when scope expansion is discussed.  Obviously there are good and bad ODs, OMDs, and opticians.  I know individuals from all the three "O"s that are stellar...I also know a few that are slimy:(.  Some ODs will try and take advantage of any situation, despite the negative impact on those around them.  I can understand the frustration of opticians who have worked for them.  I do, however, think that the motivation for stand-alone optician refractions is purely economical.  With ever-increasing competition from corporate entities, I understand that sight-testing is more about survival than greed.  

On the whole....I think the true "enemy" is the commercialization of eye care.  I have a wonderful private practice in rural Canada....I know however, that  Costco or Wal-Mart or some other big box will burst the bubble someday :cry: 

I think the three "O"s need to unite in some fasion to preserve the profession.. How I don't know.  

By the way...in BC two Wal-Mart locations have sight-testing "pilot-projects" in their opticals.  No OD or MD involvment whatsoever.  One more crumble in the eroding hill of eye care IMO.

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## gogetter

wow ....look at what i started!!....I just wandered if the person here who is not a Dr. was refracting and charging in his own place that he owns was legal or not. Doesnt give you the rx unless your getting glasses, but then again people go in there cause they need glasses or an exam! 

I got my money on HArry and Fezz

:cheers:

----------


## HarryChiling

> Always a heated discussion when scope expansion is discussed. Obviously there are good and bad ODs, OMDs, and opticians. I know individuals from all the three "O"s that are stellar...I also know a few that are slimy:(. Some ODs will try and take advantage of any situation, despite the negative impact on those around them. I can understand the frustration of opticians who have worked for them. I do, however, think that the motivation for stand-alone optician refractions is purely economical. With ever-increasing competition from corporate entities, I understand that sight-testing is more about survival than greed. 
> 
> *On the whole....I think the true "enemy" is the commercialization of eye care. I have a wonderful private practice in rural Canada....I know however, that Costco or Wal-Mart or some other big box will burst the bubble someday*
> 
> I think the three "O"s need to unite in some fasion to preserve the profession.. How I don't know. 
> 
> _By the way...in BC two Wal-Mart locations have sight-testing "pilot-projects" in their opticals. No OD or MD involvment whatsoever. One more crumble in the eroding hill of eye care IMO_.


*That's what I'm talking about.  That's not even thinking outside of the box, that's just opening eyes.*

That would be another great heated debate and would hope that thread gets just as many comments as this one and a diverse combination like this one.  I think more good came from this thread than bad and sure I behaved badly, but would you expect anything less of me.;)

_Are saying that their is no OD or OMD on premise?  Or they're using hte eyelogic system that gets interpreted off premises?  Either way I think it's going to be a reality and I doubt it will be something opticians or optometrists get a say in ulsee we premptively create the rules for such a beast.  The winner is the group that decides how this thing gets hashed out, the losers are the ones who fight to ingnore the progress or lack of progress depending on your view point.  If anything maybe it's an excercise in diplomacy that comes of it._

----------


## Fezz

> I got my money on HArry and Fezz
> 
> :cheers:


 

:cheers:

----------


## Stonegoat

Harry,  

Maybe there is an off-premises MD who "interprets" the refractive results. That's meaningless anyway.  

We can bicker all day long, while the mega-beasts gobble-up more and more of our autonomy.

I have never practiced opticianry, but I imagine the dream of most opticians is to work in a professional environment, were they are respected and compensated for their level of skill.  I imagine many, if not most, opticians would like their own store, and the opportunity to generate a great income and establish long-term relationships with their clients, who view them as skilled professionals.  

This dream becomes increasingly difficult to optain with the increasing presence of big-box dispensaries.  Independant opticians likely fold and join the borg, or try and compete with $99 PALs...."get a free cowboy hat and whistle with each pair of SV glasses".......not the dream I'm sure.

This trend is likely unavoidable...but that makes it no less a shame.  ODs are as much to blame as anybody.....no offense, but working for Wally World degrades the profession, whether the OD is the best or the worst.

I see the future, and it isn't too rosey for eyecare....unless of course we lose our fear and greed and unite....pretty damn unlikely :Cool:

----------


## HarryChiling

> Harry, 
> 
> Maybe there is an off-premises MD who "interprets" the refractive results. That's meaningless anyway. 
> 
> We can bicker all day long, while the mega-beasts gobble-up more and more of our autonomy.
> 
> I have never practiced opticianry, but I imagine the dream of most opticians is to work in a professional environment, were they are respected and compensated for their level of skill. I imagine many, if not most, opticians would like their own store, and the opportunity to generate a great income and establish long-term relationships with their clients, who view them as skilled professionals. 
> 
> This dream becomes increasingly difficult to optain with the increasing presence of big-box dispensaries. Independant opticians likely fold and join the borg, or try and compete with $99 PALs...."get a free cowboy hat and whistle with each pair of SV glasses".......not the dream I'm sure.
> ...


I am pat of the borg in a way and so is the doctor I work for it is a franchise but your right the corporate optical is a problem. Opticians years ago decided to try and get licensure to at least assure a minimum level of competency amoung those that practice our profession. Wheather you not it or not you practice opticianry with the scripts that are generated through you. Some one's got to turn them into glasses and that someone should be a skilled and competent individual. Optometry and big box prevented opticians being licensed and I don't really understand why it benefits you the most. No one can tell you you have to hire an optician, but it would insure that the chains wold have too.

Again that ship has passed and even if optometry and opticianry were to work together at this point does either profession still have enough teeth to bite the big one? Under the current administration I am suprised we all didn't sucumb to big business OMD, OD, Opticians and any other profession in our country alike. With the new election comes new hope a new set of leaders with a new set of ideas, it's time to cash in together if you ask me, or at least hold the door while I make a run for it. :D

----------


## chip anderson

Speaking of the new administration.  Night before last I finally found out what Obama means by *change!*   It's what we gonna have left after he gets his people in place and his programs in place.


Chip :Rolleyes:

----------


## jediron1

> Specific guidelines have been developed to assure a regular health evaluation of the eye by an OD or MD. We all need to work together to benefit each other. In many ways access will be greatly enhanced with Opticians doing refraction. In an earlier thread, someone mentioned that there were too many providers already, but if that were the case, supply and demand would necessitate a reduction in fees. In most articles I read, OD income continues to rise annually, not decline. The economic engine and control are the real issues here.





It's always been about money. OD's have for years at least in NY tried to keep the optician under their thumb and by doing this has stunted the industry as a whole. The only time the optician has say is when said OD is employed by the optician and the only time that happens is when they need each other. If it wasn't for the fact most OD's can't dispense worth a dime we opticians would be out on the streets instead in offices. OD's look down on opticians as OMD's look down at OD's,. It's a rude awakening but then again so is a dog returning to it's own vomit.

----------


## LandLord

> It's always been about money. OD's have for years at least in NY tried to keep the optician under their thumb and by doing this has stunted the industry as a whole. The only time the optician has say is when said OD is employed by the optician and the only time that happens is when they need each other. If it wasn't for the fact most OD's can't dispense worth a dime we opticians would be out on the streets instead in offices. OD's look down on opticians as OMD's look down at OD's,. It's a rude awakening but then again so is a dog returning to it's own vomit.


 It sounds terrible in New York!  It's not quite that bad in Ontario.

----------


## opticalwoman

He doesn't let you take the script because that would be illegal.  He technically isn't "giving" you a script.  There was a guy doing that in Little Elm about 4-5 years ago.  He was reported, closed up shop, left owing Hoya labs tens of thousands of dollars, and had about 40 patients that were left without their glasses/contacts that were paid for but not yet dispensed to them.

----------


## jediron1

> It sounds terrible in New York!  It's not quite that bad in Ontario.





It's not quite that bad. The problem is OD's like to lord it over you like your some vermin they have to put up with and as WMcDonald has already said it's always the OD's that are trying to keep opticians in lock step every which way they turn. If it's not wages it's legislation to reduce our role in the three O's to that of dog catcher and if you've seen animal tv even they have brought their status up more than we have because of OD's and the Big box stores.  

 just my take, take it or leave it

----------


## Eyedoc71

> It's not quite that bad. The problem is OD's like to lord it over you like your some vermin they have to put up with and as WMcDonald has already said it's always the OD's that are trying to keep opticians in lock step every which way they turn. If it's not wages it's legislation to reduce our role in the three O's to that of dog catcher and if you've seen animal tv even they have brought their status up more than we have because of OD's and the Big box stores. 
> 
> just my take, take it or leave it


I also used attorneys in that example.

----------


## rmcdaniel

I think I'm going to start a profession.  This fledgling profession will supply contacts and premade glasses.  They will be placed in a box for people to come and try on.  They will be charged by the amount of time it takes to find a pair of glasses or Contact Lenses and the cost of the goods.  There will be no acuity chart or slit lamp, just tell 'em to "put 'em on and walk around a little bit, see how they feel".  I think I'll see if I can lease space in Walmart next to the KY Jelly display, because they'll likely need a little lube by the time I'm finished with them.

Anyhow, not sure what to call my new profession.  Some ideas:

-McDaniel's Pick a Pair
-No see no pay
-ODs a No-Go
-U Don't need no Stinkin' Eye Exam
-Even Opticians are OverPriced
-Your head might be a Achin', but think of the money you be a Savin'
-Glaucoma Depot

Anyhow, please help me with naming my new profession.   As you can see, it is totally consumer friendly, and if any of you disagree with me on that, well....you're just a bunch of greedy *******s with a God complex.

----------


## Ory

> Anyhow, please help me with naming my new profession.


 WalMart Pharmacy:  Whether it burns when you see or burns when you pee, we've got you covered.:drop:

----------


## jediron1

> I also used attorneys in that example.



I know you used attorneys but attorneys are not our main concern OD's and their tight fisted control is our concern not whether Alan Dershowitz can get someone else off. As the Chicago White Sox coach said: PLEZZZZZZZZZZZZZ!

----------


## jediron1

> I think I'm going to start a profession.  This fledgling profession will supply contacts and premade glasses.  They will be placed in a box for people to come and try on.  They will be charged by the amount of time it takes to find a pair of glasses or Contact Lenses and the cost of the goods.  There will be no acuity chart or slit lamp, just tell 'em to "put 'em on and walk around a little bit, see how they feel".  I think I'll see if I can lease space in Walmart next to the KY Jelly display, because they'll likely need a little lube by the time I'm finished with them.
> 
> Anyhow, not sure what to call my new profession.  Some ideas:
> 
> -McDaniel's Pick a Pair
> -No see no pay
> -ODs a No-Go
> -U Don't need no Stinkin' Eye Exam
> -Even Opticians are OverPriced
> ...





Does anyone know what the heck this rambling is all about? It looks like the ramblings of an institutionalized person ( no knock on institutionalized people ). :hammer:

----------


## HarryChiling

> walmart Pharmacy: Whether It Burns When You See Or Burns When You Pee, We've Got You Covered.:drop:


:D That's a good slogan.




> Does anyone know what the heck this rambling is all about? It looks like the ramblings of an institutionalized person ( no knock on institutionalized people ).


They're never gonna take it seriously, they don't want change why would they the pecking order suits them well.  Now just a little more chipping away at the top and they're done.

How about we just get rid of OMD's and Opticiasn since we're juts useless and then the world will be perfect.  Or even better why not come up with a new insurance plan, pay the OD's nothing but tell them that if they do a whole lotta exams that's a whole lotta nothing and for the few that figuire it out I'm sure a doggy bone outta suffice.

We all got jokes, my favorite was the burning when you pee'd.

Why not come up with a solution that benefits one of the other sides?  The realization must have sunk in by now that OD's are not the right avenue to pursue if our profession is to get anywhere, so we pack up and move to what's higher in the food chain.  Model our profession to benefit the next higher "O" and reap the benefits, look at Canada.  They have sight testing, maybe their schools or their associations can work with our countries organizations and schools in createing a game plan.  The eyelogic system is devised by an OMD and is a publicly traded company, $2.00 a share last time I checked, how many here got a few bucks they could spend on share of Eyelogic.  How sweet is that eyelogic big business and ophthalmology, that's two birds with one stone.

----------


## jediron1

> :D That's a good slogan.
> 
> 
> 
> They're never gonna take it seriously, they don't want change why would they the pecking order suits them well.  Now just a little more chipping away at the top and they're done.
> 
> How about we just get rid of OMD's and Opticiasn since we're juts useless and then the world will be perfect.  Or even better why not come up with a new insurance plan, pay the OD's nothing but tell them that if they do a whole lotta exams that's a whole lotta nothing and for the few that figuire it out I'm sure a doggy bone outta suffice.
> 
> We all got jokes, my favorite was the burning when you pee'd.
> ...



Harry I think you make some valid points. In NY you might know this but we do have sight testing that we can do for people who want to renew their auto license but even there the OD's stuck there nose in and demanded that an OD or OMD had to sign off. So the merry go round goes round and round and round and where will the OD get off? Who cares just get off!

----------


## HarryChiling

> Harry I think you make some valid points. In NY you might know this but we do have sight testing that we can do for people who want to renew their auto license but even there the OD's stuck there nose in and demanded that an OD or OMD had to sign off. So the merry go round goes round and round and round and where will the OD get off? Who cares just get off!


I didn't know that.  Do you perform sight tests?  What additional education is required?  How's it working out?  Is your state board or organization keeping records of the results for future legislation?

----------


## jediron1

> Harry,  
> 
> Maybe there is an off-premises MD who "interprets" the refractive results. That's meaningless anyway.  
> 
> We can bicker all day long, while the mega-beasts gobble-up more and more of our autonomy.
> 
> I have never practiced opticianry, but I imagine the dream of most opticians is to work in a professional environment, were they are respected and compensated for their level of skill.  I imagine many, if not most, opticians would like their own store, and the opportunity to generate a great income and establish long-term relationships with their clients, who view them as skilled professionals.  
> 
> This dream becomes increasingly difficult to optain with the increasing presence of big-box dispensaries.  Independant opticians likely fold and join the borg, or try and compete with $99 PALs...."get a free cowboy hat and whistle with each pair of SV glasses".......not the dream I'm sure.
> ...




So is a "pound of flesh" . 1. At least in the states the OMD or OD according to the laws written must on be on premise for it to be legal but I suppose they have ways around that.  2. The mega beasts are taking more, do you think Wally world is going to be content on being number 2 behind LUX? Not a chance in hades. 3. At least with the Borg your in a collective one for all and all for one. But with optical it's all against the optician and it's mostly done by OD's. 4. Pretty damn unlikely because of OD's not opticians we would welcome collaboration on this and many other points but OD's look down at opticians as OMD's look down at OD's. It's a dog eat dog world  and each one of the three O's wants to be top dog.

----------


## jediron1

> I didn't know that.  Do you perform sight tests?  What additional education is required?  How's it working out?  Is your state board or organization keeping records of the results for future legislation?




They actually passed that quite awhile ago but it never took off because of opposition and I will let you guess from where. But it is still on the books. No I don't. I don't believe it needed additional education since anyone at your local DMV does it with little or no training. As far as I know they have kept no records. Again blame OD's for that because they scared everyone into believing that only they could do that test. 


PS Harry if you go to:www.*ny*dmv.*state*.*ny*.us/forms/mv619.pdf 

you will find test can be done by an optician.

----------


## rmcdaniel

> Does anyone know what the heck this rambling is all about? It looks like the ramblings of an institutionalized person ( no knock on institutionalized people ). :hammer:


Over your head sparky?  I think intelligent people here understand the analogy.

Stephen McDaniel, O.D. and his God complex

----------


## jediron1

> Over your head sparky?  I think intelligent people here understand the analogy.
> 
> Stephen McDaniel, O.D. and his God complex




I m sorry your highness I didn't realize I was talking to royalty, I will scurry on back to my hole and not bother you. UNBELIEVABLE A_s.

----------


## HarryChiling

> Over your head sparky? I think intelligent people here understand the analogy.
> 
> Stephen McDaniel, O.D. and his God complex


Is it correct to say praise McDaniel do we pray to a VA chart or what, starnge religion.:D

----------


## jediron1

> Is it correct to say praise McDaniel do we pray to a VA chart or what, starnge religion.:D




Harry look at post #448. When you go there it's under instructions #2 it's it can be done by an optician. Yes you must kiss his ring and bow to the VA chart.

----------


## rmcdaniel

Look I've always defended opticians and their right to refract if they can get the legal status to do so.  I've even been trashed on Optometry forums by saying so.  My belief has been opticians should be in commercial venues not Optometrists.  However, this thread has been a real eye opener.  Lots of scary ignorant freaky folks in your profession, now I've got to go back and apologize to the ODs I've argued with in the past.

Stephen McDaniel, O.D.  
New Lifetime fighter against optician privileges.

----------


## Framebender

or a Dispensing Optician?  I got your joke, but am confused as to why you would list yourself as an Optician.

Just curious!

:cheers:

----------


## HarryChiling

> Harry look at post #448. When you go there it's under instructions #2 it's it can be done by an optician. Yes you must kiss his ring and bow to the VA chart.


Oh, that's a Godfather complex not a God complex, my bad. :D




> Look I've always defended opticians and their right to refract if they can get the legal status to do so. I've even been trashed on Optometry forums by saying so. My belief has been opticians should be in commercial venues not Optometrists.


That's not what I've read from you previous posts, but I'll go back and take another look.




> However, this thread has been a real eye opener.


I agree.




> Lots of scary ignorant freaky folks in your profession, now I've got to go back and apologize to the ODs I've argued with in the past.


Look at the pot calling the kettle black.  Make it a good apology I'll be there a little later.:D




> New Lifetime fighter against optician privileges.


Lighten up Godfather.:D

----------


## jediron1

> Look I've always defended opticians and their right to refract if they can get the legal status to do so.  I've even been trashed on Optometry forums by saying so.  My belief has been opticians should be in commercial venues not Optometrists.  However, this thread has been a real eye opener.  Lots of scary ignorant freaky folks in your profession, now I've got to go back and apologize to the ODs I've argued with in the past.
> 
> Stephen McDaniel, O.D.  
> New Lifetime fighter against optician privileges.



PLEZZZZZZZZZ I've better things to do then argue with an OD who things he should have a G in front of it. The only freaky scary people are the OD's who won't give an inch but want a mile. You won't get anywhere calling people ignorant which probable is why you had a lot of fights on your OD board. Oh by the way I did get your little ramblings and it still seems it came from an institutionalized individual.

----------


## rmcdaniel

> or a Dispensing Optician? I got your joke, but am confused as to why you would list yourself as an Optician.
> 
> Just curious!
> 
> :cheers:


Sorry.  I'm an OD posting on my wife's account who is an optician.  Too lazy to open my own acocunt, and I won't be around for long.

----------


## rmcdaniel

Harry, I challenge you to find one negative thing I've ever said about opticians before this thread on any site(we all know you have access to places you shouldn't be).  In fact, I'm so sure you won't find anything (and I've got a BIG mouth on forums)  I'm willing to place a sizeable wager on it.  Thousand bucks....?  Put your money where your mouth is Killuh'.

Specifically, I'm talking before today and before this thread, because moving forward I don't feel the same about opticians in general, so all bets are off.

----------


## HarryChiling

> I think I'm going to start a profession. This fledgling profession will supply contacts and premade glasses. They will be placed in a box for people to come and try on. They will be charged by the amount of time it takes to find a pair of glasses or Contact Lenses and the cost of the goods. There will be no acuity chart or slit lamp, just tell 'em to "put 'em on and walk around a little bit, see how they feel". I think I'll see if I can lease space in Walmart next to the KY Jelly display, because they'll likely need a little lube by the time I'm finished with them.
> 
> Anyhow, not sure what to call my new profession. Some ideas:
> 
> -McDaniel's Pick a Pair
> -No see no pay
> -ODs a No-Go
> -U Don't need no Stinkin' Eye Exam
> -Even Opticians are OverPriced
> ...


That one should count as it was before the you said you were through with being nice, anyway since it's a technicality I'll accept half the thousand $500.00 you shoudl know where to send it. :D

I actually enjoyed your posts and PM's and you made your intentions pretty clear, I don't mind a little picking and actually found it quite funny. Anyway get over your sensitivities, yank the g-string out, pick your wedgie whatever necessary, I actually might take you up on that drink you promised and around here we don't take that lightly.:cheers:

Your wife's an optician? What's her opinion? PM me if your having a hard time on this thread.

PS - That $1000.00 wasn't a pot shot at us broke opticians.  Duck and cover. :D

----------


## kws6000

> Harry, I challenge you to find one negative thing I've ever said about opticians before this thread on any site(we all know you have access to places you shouldn't be).  In fact, I'm so sure you won't find anything (and I've got a BIG mouth on forums)  I'm willing to place a sizeable wager on it.  Thousand bucks....?  Put your money where your mouth is Killuh'.
> 
> Specifically, I'm talking before today and before this thread, because moving forward I don't feel the same about opticians in general, so all bets are off.



Im also finding this thread to be a major eyeopener .I feel like the only man in a womans study course. 

I used to feel sympathetic towards opticians and have never badmouthed them or have actually heard any of my optometric colleagues say anything bad about them.

However,over the years Ive heard the occasional nasty thing from opticians against ods.

This thread just reinforces how a lot of opticians really feel about us.

Needless to say,Im re-evaluating my position.

----------


## HarryChiling

> Im also finding this thread to be a major eyeopener .I feel like the only man in a womans study course. 
> 
> I used to feel sympathetic towards opticians and have never badmouthed them or have actually heard any of my optometric colleagues say anything bad about them.
> 
> However,over the years Ive heard the occasional nasty thing from opticians against ods.
> 
> This thread just reinforces how a lot of opticians really feel about us.
> 
> Needless to say,Im re-evaluating my position.


Oh please, here's an example of your sympathy:

http://www.optiboard.com/forums/show...8&postcount=45

Double talk, that's the kind of crap that starts the heat, why not just keep the lies to yourself instead of spreading it like your trying to get corn to grow.

----------


## rmcdaniel

> That one should count as it was before the you said you were through with being nice, anyway since it's a technicality I'll accept half the thousand $500.00 you shoudl know where to send it. :D
> 
> I actually enjoyed your posts and PM's and you made your intentions pretty clear, I don't mind a little picking and actually found it quite funny. Anyway get over your sensitivities, yank the g-string out, pick your wedgie whatever necessary, I actually might take you up on that drink you promised and around here we don't take that lightly.:cheers:
> 
> Your wife's an optician? What's her opinion? PM me if your having a hard time on this thread.
> 
> PS - That $1000.00 wasn't a pot shot at us broke opticians. Duck and cover. :D


 
I got to get off this site, my wife's email in box is blowing up and she's giving me an ear full because I keep forgetting to unsubscribe to this thread.:D   Good luck, I certainly wish success, wealth, and happiness for you all.  I'm all about a strong economy, and the more of us making a good living the better.

Also, some of you need a mental health assessment (we all know who you are) so I hope you get it real soon.:p

Peace and love to all you mofo's.  Happy hour here I come....in about 2 hours.:(

----------


## jediron1

> I got to get off this site, my wife's email in box is blowing up and she's giving me an ear full because I keep forgetting to unsubscribe to this thread.:D   Good luck, I certainly wish success, wealth, and happiness for you all.  I'm all about a strong economy, and the more of us making a good living the better.
> 
> Also, some of you need a mental health assessment (we all know who you are) so I hope you get it real soon.:p
> 
> Peace and love to all you mofo's.  Happy hour here I come....in about 2 hours.:(



To quote the manager for the Chicago White Sox: PLEZZZZZZZZZZZZZZZZZZZZZ!

----------


## Eyedoc71

> To quote the manager for the Chicago White Sox: PLEZZZZZZZZZZZZZZZZZZZZZ!


Yeah, seriously...don't you know it's 5:00 somewhere?

----------


## jediron1

> Yeah, seriously...don't you know it's 5:00 somewhere?




REALLY! :cheers:

----------


## HarryChiling

> Yeah, seriously...don't you know it's 5:00 somewhere?


Happy Hour, universal agreement.

I wonder if OD's drink domestic or import, probably imports with their snobby butts. :cheers:









































(I almost peed myself writing that, and if Fezz found out I'm trying to instigate a BREWhaha, he'd kill me.)

----------


## Fezz

> (I almost peed myself writing that, and if Fezz found out I'm trying to instigate a BREWhaha, he'd kill me.)



Did somebody say BrewHaHa?

I'll drink to that!

:D:cheers::D:cheers::D

----------


## jediron1

> Happy Hour, universal agreement.
> 
> I wonder if OD's drink domestic or import, probably imports with their snobby butts. :cheers:
> 
> (I almost peed myself writing that, and if Fezz found out I'm trying to instigate a BREWhaha, he'd kill me.)



I like that! It is 5:00 somewhere! :cheers: Harry did you get back to the NY posts?

----------


## LandLord

> Happy Hour, universal agreement.
> 
> I wonder if OD's drink domestic or import, probably imports with their snobby butts. :cheers: 
> (I almost peed myself writing that, and if Fezz found out I'm trying to instigate a BREWhaha, he'd kill me.)


They probably drink Heineken and pretend they like the taste of it !!!

----------


## Ory

> I wonder if OD's drink domestic or import, probably imports with their snobby butts. :cheers:


 I drink Canadian beer, but then I'm in Canada.  I'm still trying to figure out how I'd drink it with my snobby butt; perhaps a straw?:o

----------


## LandLord

> I drink Canadian beer, but then I'm in Canada. I'm still trying to figure out how I'd drink it with my snobby butt; perhaps a straw?:o


If you're an optometrist, you'll fully extend your pinky finger away from the bottle of Labatt's Blue.  An optician would simply use a chilled glass.

----------


## HarryChiling

> I drink Canadian beer, but then I'm in Canada. I'm still trying to figure out how I'd drink it with my snobby butt; perhaps a straw?:o


LOL, I'll buy the drinks you buy the straws. :D:cheers:

----------


## kws6000

> Oh please, here's an example of your sympathy:
> 
> http://www.optiboard.com/forums/show...8&postcount=45
> 
> Double talk, that's the kind of crap that starts the heat, why not just keep the lies to yourself instead of spreading it like your trying to get corn to grow.


Actually,in the context of that thread ,that is being sympathetic. Ive seen how some opticians treat other opticians who try to get patient information,specifically cl info ,and lets say there isnt any cooperation there.
ODs tend to be more cooperative with opticians compared to how opticians treat their competitor opticians from what Ive seen.  

If opticians want to start a turf war why dont they just come right out and do it,rather than sniping behind optometrists backs.

Most established optometric practices have enough income to be able to squash independent opticians based on price should they choose.  

As for sight testing,Ive seen how the opticians do it around here.They tend to wear white lab coats  and try to convey the impression that they are performing a complete eye exam,taking advantage of the publics confusion about the differences between optometrists and opticians.

They generally only admit to who they are when pressed by the patient.

The provincial opticians were actually trying to get government approval to perform  all parts of a complete eye exam with the exception of the internal health assessment.Thankfully,that got shot down.

As for opticians doing refractions in between proper eye exams as a convenience to the patient,who is spreading the crap here ,Harry?

 It is strictly about getting the persons money before they potentially go elsewhere.

Face it Harry,opticians attempting to do eye exams is strictly about the money.

If you want to be able to provide the complete service,do what I did and get the appropriate training instead of trying to  sneak in through the back door.

I see enough  cl related pathology due to contact lens fitting opticians fitting anybody with an rx and some money to make me cringe at the thought of unregulated,unqualified opticians passing them selves off as vision experts doing sight testing.

Its just going to be a matter of time before somebody with missed pathology sues the *** of a sight testing optician.

----------


## kws6000

> If you're an optometrist, you'll fully extend your pinky finger away from the bottle of Labatt's Blue.  An optician would simply use a chilled glass.


Gee landlord,just a bit of envy there?

----------


## HarryChiling

> As for opticians doing refractions in between proper eye exams as a convenience to the patient,who is spreading the crap here ,Harry?


It's about the few bum OD's that write bum scripts and yes it's about the money it's the money that it costs the fabricator to cover your craptastic script while you play doctor. You could always pony up and pay for your few mistakes or just keep spreading the manure doesn't matter to me much either way.




> Most established optometric practices have enough income to be able to squash independent opticians based on price should they choose.


That's the unniest thing I have heard, I wish you or your peers would try that, you wouldn't be competeing with opticians you would be competeing with Walmart and by the looks of it they might have the advantage on both price and skills.

Try this on for size most established opticianry practices can squash independent optometrists based on skills.




> As for sight testing,Ive seen how the opticians do it around here.They tend to wear white lab coats and try to convey the impression that they are performing a complete eye exam,taking advantage of the publics confusion about the differences between optometrists and opticians.


What's good for the goose is good for the gander, it reminds me of another profession. Care to guess?




> It is strictly about getting the persons money before they potentially go elsewhere.


You make it seem like business is somehow a dirty thing, what do you work for smiles and lolipops? Do you know what capture rate means?




> Face it Harry,opticians attempting to do eye exams is strictly about the money.


Are you even reading any of the previous posts? How dull are you.




> If you want to be able to provide the complete service,do what I did and get the appropriate training instead of trying to sneak in through the back door.


Again sounds like another profession, you don't get to decide what my profession can or cannot do. You can oppose it, you can shout it from the roof tops, but you can't tell anyone what to do. That's for lawmakers to decide.




> I see enough cl related pathology due to contact lens fitting opticians fitting anybody with an rx and some money to make me cringe at the thought of unregulated,unqualified opticians passing them selves off as vision experts doing sight testing.
> 
> Its just going to be a matter of time before somebody with missed pathology sues the *** of a sight testing optician.


Anecdotal. Typical.

You can face the reality that it's gonna happen, heck for you it's already happened. Think about it your on a thread where people are discussing the posibility of sight testign opticians and your acting like it will never happen and they're practiceing in your neighborhood. Talk about dense, that's short bus mentality you exhibit.  It's like the signs say don't feed the animals.

----------


## LandLord

> Gee landlord,just a bit of envy there?


 I was joking!  Why, do you extend your pinky when you drink beer?

----------


## obxeyeguy

> I see enough cl related pathology due to contact lens fitting opticians fitting anybody with an rx and some money to make me cringe at the thought of unregulated,unqualified opticians


And yet we have about 32 unlicensed states, due in a large part to OD opposition. I'm confused! What would most OD's prefer?? Properly trained and educated opticians, or cheap off the street help? 

Not a cheap shot, just a legitimate question.

----------


## Ory

> If you're an optometrist, you'll fully extend your pinky finger away from the bottle of Labatt's Blue. An optician would simply use a chilled glass.


 Labatt's Blue?  I'm sorry, I thought we were talking about _real_ beer.

----------


## Eyedoc71

> And yet we have about 32 unlicensed states, due in a large part to OD opposition. I'm confused! What would most OD's prefer?? Properly trained and educated opticians, or cheap off the street help? 
> 
> Not a cheap shot, just a legitimate question.


I think where the problems come up is that there are so many opticians that want to turn the profession into mini-doctors completely without training.  There have been a few that have made the correlation with optometry and ophthalmology, but that couldn't be more different.  ODs go to school for 4 years learning about the eye and it's relation to systemic conditions...4 years.  That's a long time and during that time we're tested by every entity known to man including some state tests that were designed in part with physician "assistance".  It's not a matter of whether or not we're qualified, that can't really be disputed by any reasonable person.  

There is also the problem with necessity.  There is just no demand that would require the revamping of your entire industry to create yet another type of eyecare provider.  The waters are muddy enough as it is (ESPECIALLY in Texas - with the 3 levels of optometrist which I find completely misleading to the public).  The public ALREADY thinks that the refraction is the meat of an eye exam and the rest is just annoying despite the pathology found and treated.  The education, cost, legislation and most importantly REGULATION to make this viable and NOT a public health hazard is just staggering when it's just not needed for anybody but the opticians.

----------


## optical24/7

71, I don't think you answered obx's question. Even dog groomers in some states have to have a licence. Do you think the public is well served by having absolutely no qualification ( in some states) to be an optician? In
Texas, as an example, there is no barrier from being a burger flipper Monday and calling yourself an optician Tuesday. 

"Optician" is a broad generalization. Opticians can be dispensing opticians, fabricating opticians, instructor opticians even frame stylist call themselves opticians. Each has their own level of importance and skill sets. Just as there are differing levels of OD's, there are differing levels of opticianry. Some of us have A.S. degrees, some have demostrated and achived Master Optician status ( and thats not just given to you, I would be willing to bet you the majority of all practicing OD's could not achieve that status with out much more study than given in OD school).

----------


## Eyedoc71

> 71, I don't think you answered obx's question. Even dog groomers in some states have to have a licence. Do you think the public is well served by having absolutely no qualification ( in some states) to be an optician? In
> Texas, as an example, there is no barrier from being a burger flipper Monday and calling yourself an optician Tuesday. 
> 
> "Optician" is a broad generalization. Opticians can be dispensing opticians, fabricating opticians, instructor opticians even frame stylist call themselves opticians. Each has their own level of importance and skill sets. Just as there are differing levels of OD's, there are differing levels of opticianry. Some of us have A.S. degrees, some have demostrated and achived Master Optician status ( and thats not just given to you, I would be willing to bet you the majority of all practicing OD's could not achieve that status with out much more study than given in OD school).


A "license" in that sense is not what you're talking about.  A dog groomer applies with the state and requires no background education to achieve it.  In no way does the public equate dog grooming with a veterinary examination so there is no public confusion there.  This is completely different than refracting or licensed opticians.  ODs are the recognized experts in optics (whether or not it's valid is debatable, I'll agree with you there), yet when it comes up opticians want to be completely independent.  Why?  Because they say so.  THIS is what most ODs are against.

----------


## optical24/7

> A "license" in that sense is not what you're talking about. A dog groomer applies with the state and requires no background education to achieve it. In no way does the public equate dog grooming with a veterinary examination so there is no public confusion there. This is completely different than refracting or licensed opticians. ODs are the recognized experts in optics (whether or not it's valid is debatable, I'll agree with you there), yet when it comes up opticians want to be completely independent. Why? Because they say so. THIS is what most ODs are against.


 
You're still evading the question....

Should an optician be required to have demostrated at least basic optical ability to practice opticianry?

----------


## Framebender

that I am in the last 10 year window for retirement. That's not a window that's going to change what I do or how I'm compensated. Despite the mud slinging there are 2 groups very passionate about what it is they do. That in itself is very gratifiying to me. It means that the profession I love is in good hands.

It was never the anatomy and physiology that excited me. For me it was the excitement of fabrication. Being able to hold an Rx in one hand, a frame in the other, being able to accurately envision the finished product and then making that vision come true. That coupled with the desire to control cost of goods and always increase profitability has led me through my career. That being said, I will contribute both time and money for Opticians right to refract. Education is the key. One of the things I truly love about this business is that it is ever evolving. Nothing remains the same. There's always new products, new procedures and just when you think it can't get any better, it does! I don't expect our roles not to change as well.

I am proud to be an Optician. I am proud of the energy so many of you are expending. We need to learn from the OD's about organization. The AOA sends out an email and thousands call their congressman or write checks or volunteer to promote something. They have strong state and national organizations. If the state and national organizatins agree about something, you can bet that every OD worth their salt is going to close ranks and move forward, regardless of whether they personally agree with it. They have a sense of betterment of their slice of the optical pie and they have done well for themselves.

Living in Texas is very gratifying because we have a strong state association. I believe they have my best interest at heart, so whether I agree with them or not I will close ranks and move forward. We are very diverse in our opinions, but why pick everything to death? We do control our own destiny which is a very cool thing to realize. I can see where Opticians are already moving from the molotov tossing stage to real action. There are leaders and educators on the national level that are starting to make real gains.

Thank you to those of you who are trying to make a difference. You know who you are. This rounds for you!!

:cheers::cheers::cheers:

----------


## Eyedoc71

> You're still evading the question....
> 
> Should an optician be required to have demostrated at least basic optical ability to practice opticianry?


I'm not evading the question, I'm practicing conflict avoidance.  Your analogy of a dog grooming license is flawed because you're not talking about a license to practice business, you're talking about a certificate of competency.

I'll answer your question with a question.  To whom?

I agree that opticians should have to demonstrate competency, but where all of the problems arise is that there is no agreement as to whom should that competency be demonstrated AND that competency shouldn't be a spring board to changing from a dispensing/fabricating profession to a prescribing profession.  

You guys think that it's all about money for us, but the truth is that a very good optician can more than generate the extra $6-10 per hour difference in revenue.

----------


## chip anderson

Eyedoc71:

Generating it is one thing.  Being allowed to keep it instead of the prescriber keeping it is another.

Chip

----------


## optical24/7

> I'm not evading the question, I'm practicing conflict avoidance. Your analogy of a dog grooming license is flawed because you're not talking about a license to practice business, you're talking about a certificate of competency.
> 
> I'll answer your question with a question. To whom?
> 
> I agree that opticians should have to demonstrate competency, but where all of the problems arise is that there is no agreement as to whom should that competency be demonstrated AND that competency shouldn't be a spring board to changing from a dispensing/fabricating profession to a prescribing profession. 
> 
> You guys think that it's all about money for us, but the truth is that a very good optician can more than generate the extra $6-10 per hour difference in revenue.


 
Alright, you feel opticians should have to demonstrate competency. So you wouldn't oppose opticians to be required in Texas to pass certification tests, both writen and practical like in Florida and a few other states? In other words, you wouldn't fight required lisensure for opticians?

Or are you going to tote the line that it's not needed?

----------


## Eyedoc71

> Alright, you feel opticians should have to demonstrate competency. So you wouldn't oppose opticians to be required in Texas to pass certification tests, both writen and practical like in Florida and a few other states? In other words, you wouldn't fight required lisensure for opticians?
> 
> Or are you going to tote the line that it's not needed?


You're trying to pigeonhole me counselor. There are a lot of factors that would determine my support or opposition. I would need to read the law proposed before I will just throw out blanket support for "licensure". Often times, there is considerably more in those propositions than just "taking tests". Who will be the licensing authority? Who will administer the tests? What broader issues does the law open up with the wording? It's always the autonomy and expansion that creates the largest points of opposition. One of my questions is what percentage of dispensing opticians are currently licensed? Is this a small minority standing on a soap box? I certainly think that I'm qualified to determine if an optician (licensed or not) is competent enough to work in my office without the necessity of a licensing board.

Would the opticians be willing to be under the authority of the optometry board in exchange for such licensing?

----------


## Judy Canty

Would Optometry be willing to be under the authority of a board of medicine in exchange for hospital priviledges? MD supervise MD's, OD's supervise OD's and Opticians supervise Opticians. We perform different and necessary functions in the field of eye care.  This is still nothing more than a turf battle.  This discussion has not improved the relationship between the professions, nor is it likely to.  We still adamantly refuse to grant respect to each other for our respective bodies of knowledge and until that happens, we will continue to rage against each other.

----------


## chip anderson

Simple :  
Set up a board and have them approve licensing guidlines, prepares such tests as needed.  Board should consist of 5 journeymen opticians of at least 10 years experience, 1 board certified ophthalmologists, and 1 board certified optometrist.  Yes, you do see a pattern here, the opticians *would be in charge of thier own board and licensing* but would have input from both bodies of prescribers.  

Now, what's the problem with this?  I'm sure you feel O.D.'s should be in charge of the board.   Which would fine if Opticians were in charge of the optometry board (after all there have been opticians a lot longer than there have been O.D.'s, right? So the opticians must be the better trained and more knowledgable according to O.D. logic.)  I mean after all contact lenses were first made, fitted, designed and manufactured by opticians not O.D.'s so why should you be the ones to fit them now?

Seriously, the problem is so simple when you take the power struggles out of it that it could be done in a week-end.  

As long as one branch wants authority over the other, the fight is lost by both sides.  And of course O.D.'s and O.M.D.'s will never agree to having thier own help licensed and regulated by opticians, even if the  help is called an "optician."    Big boxes will throw thier conciderable weight and finances to oppose this.   

Chip

----------


## Eyedoc71

> Would Optometry be willing to be under the authority of a board of medicine in exchange for hospital priviledges? MD supervise MD's, OD's supervise OD's and Opticians supervise Opticians. We perform different and necessary functions in the field of eye care. This is still nothing more than a turf battle. This discussion has not improved the relationship between the professions, nor is it likely to. We still adamantly refuse to grant respect to each other for our respective bodies of knowledge and until that happens, we will continue to rage against each other.


ODs would have to submit to the authority of MDs in a hospital setting, but that's because they would be dealing with medical boards and surgery which is the OMD area of expertise.  This isn't a turf battle, this is professions acknowledging their place in the strata.  OMDs are primarily surgeons whose area of specialty and training is surgery and exotic eye disease.  ODs are primary and secondary care providers specializing in optics, vision correcting devices and medical management of eye disease.  Opticians are professional dispensers and fabricators that take a doctors work to fruition.  It only makes sense that ODs that are involved in surgery should be under medical authority just as OPs should be under ODs/OMDs as the prescribers.  It has nothing to do with respect for your knowledge.

----------


## HarryChiling

> ODs are the recognized experts in optics (whether or not it's valid is debatable, I'll agree with you there), yet when it comes up opticians want to be completely independent. Why? Because they say so. THIS is what most ODs are against.


Opticians have always been independent.  Also in the previous post you stated that no one can dey the education that an OD recieves and I agree with that whole heartedly I do, but as you profession starts to expand your scope and certain things get condensed it creates a need for ancilliary staff to pick up those areas an maybe even specialize in those areas.  I know a lot of OD's that could smoke the competition in optics but that seems to be changing.  Also righ tnow the guy down the road that just got hired yesterday and threw on a lab coat is refered to as an optician, I have spent almost 10 years in this industry with OJT, I just finished a course, I am in the process of attaining the highest certifications in our industry and liek obxeyeguy stated it's not quick or easy but yet I am still grouped into the same occupation as the guy downt he road swinging his PD stick.

Ultimately the patient does suffer, how many news pieces have been done just this year on shoody eyeglasses?  People not recieveing the products that they paid for?  People getting bum eyewear online?  That's gotta get to you too.  I see refraction in the future, but I see everything you and your peers mentioned as being potential roadblocks and although I would like to say that the opposition recieved on refraction is unwarranted at this point in time it's not.  First we as opticians need to clean house, if you don't have an education get it, if you don't have licensure, get it, if you don't have a way to differentiate between a frame stylist and optician create it.  Lot's of things we as profession need to do before we expand anything, these things should be things you surely agree with, right?

----------


## Eyedoc71

> Simple : 
> Set up a board and have them approve licensing guidlines, prepares such tests as needed. Board should consist of 5 journeymen opticians of at least 10 years experience, 1 board certified ophthalmologists, and 1 board certified optometrist. Yes, you do see a pattern here, the opticians *would be in charge of thier own board and licensing* but would have input from both bodies of prescribers. 
> 
> Now, what's the problem with this? I'm sure you feel O.D.'s should be in charge of the board. Which would fine if Opticians were in charge of the optometry board (after all there have been opticians a lot longer than there have been O.D.'s, right? So the opticians must be the better trained and more knowledgable according to O.D. logic.) I mean after all contact lenses were first made, fitted, designed and manufactured by opticians not O.D.'s so why should you be the ones to fit them now?
> 
> Seriously, the problem is so simple when you take the power struggles out of it that it could be done in a week-end. 
> 
> As long as one branch wants authority over the other, the fight is lost by both sides. And of course O.D.'s and O.M.D.'s will never agree to having thier own help licensed and regulated by opticians, even if the help is called an "optician." Big boxes will throw thier conciderable weight and finances to oppose this. 
> 
> Chip


This could possibly be the dumbest post I've read.  Opticians should be in charge of the optometry board based on time existed?   :Confused:   Please tell me that's the point you're trying to make (I realize it was an example, but it's so silly that it's impossible to read it with a straight face).  There is that tiny little hiccup of the complete lack of training and education on your part.  :hammer:

If the OD and OMD have no authority only input, why even bother putting them there?  I would be willing to endorse having equal ODs and OPs (I really don't see the need for OMDs to be involved given their lack of optical training), but as figureheads?  I hate to throw a monkey wrench in your week-end plan, but give me a break.   :Rolleyes:

----------


## Judy Canty

> It has nothing to do with respect for your knowledge.


MD's fought tooth and nail to prevent TPA education and legislation for OD's. 

What then, if not lack of respect or loss of turf, is driving this great fear of a college-educated and regulated Optician?

I'm not trying to be combative here, but I am trying to understand why organized Optometry is so opposed to organized, educated and regulated Opticianry. Expanding the scope of Opticianry is really not an issue until college-level education and state-wide regulations are in place. These are the same battles that Optometry fought and won more than 100 years ago. If it was worth the fight then, it's worth the fight now.

----------


## HarryChiling

> MD's fought tooth and nail to prevent TPA education and legislation for OD's. 
> 
> What then, if not lack of respect or loss of turf, is driving this great fear of a college-educated and regulated Optician?


And why the h*ll are some opticians fighting it?:angry:

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## Judy Canty

Probably, fear of change in the status quo.

----------


## chip anderson

I thought this would be obvious even to O.D.'s that since we were thier fathers, they should not have authority over us.  Trying to point out that there is no reason that O.D.'s or O.M.D.'s should have authority over us over that of making sure thier Rx's are properly filled (which they already have, or at least used to before WM and mail order), and the ability to make non-economicly motiviated recommendations (as they do with drug stores).
Now why should they be on the board at all if they don't "control" it?  Simple: To have input and advise (smart as us journeymen opticians is we don't know everything, and don't see everything from the prescribers (those that are not econmicly motivated that is) point of view.  Do not O.D.'s have a few OMD members on thier "ruling bodies?"  Don't O.M.D.'s have nurses and administrators that are not physicians on thier oversight committes?  
In fact it might not even hurt to have a few non optical people on the board.  But if it is to establish what opticians should be, it should be a majority of *opticians.*
Obviously O.D.'s, O.M.D.'s, and various groups of opticians have differing views of ethics (those that still understand the word), competence and honor are.  O.D.'s appearently set thier standards (not O.M.D.'s)  Physicians and O.M.D.'s  set thier standards for these things, why should not Opticians do the same?
It would (and sometimes is the case, and often opposed for this reason) be very easy for an O.D. controlled board, or even one with a majority of
O.D.'s and Merchant OMD's to regulate everything that was profitable as being beyond the scope of independent opticians.  In fact I am sure this is what you would submit as the basis of such boards.

Chip

----------


## 35oldguy

Funny. Approximately in the early 1950's or 60's, OPTOMETRISTS WERE GRANDFATHERED IN. My local OD was working at a funeral home. He had no formal education in the field. He started out with an antigue set of trial lenses that he adapted to a persons eyes. Before him was the optician who at that time were the experts in the field. Now over 50 years later the OD wants all the gravy. OD's are not experts in the field of opticianry. They should do every thing in their power to educate all opticians,, get them licensed and start working together to help people who need eyecare. The funny part of it is always about money! When eyeglasses were selling for $29.95 a pair the doctor did not care. Now with all the advanced products and the charges that the consumer have to pay it really is getting ridiculous!

My brother and his wife just paid $1200 for 2 pair of progressives. The Rx on his was OD Pl OS Pl +2.00 Add in policarbonate. Hers OD -2.00 OS -250 with a +200 add in the same. He bought them from his OD friend who he said gave him a big discount. I wonder what he would have paid at Sears or an independent optician if the doctor would have gave him his RX to shop around for the best price and materials? It is all about money is it not?






> A "license" in that sense is not what you're talking about. A dog groomer applies with the state and requires no background education to achieve it. In no way does the public equate dog grooming with a veterinary examination so there is no public confusion there. This is completely different than refracting or licensed opticians. ODs are the recognized experts in optics (whether or not it's valid is debatable, I'll agree with you there), yet when it comes up opticians want to be completely independent. Why? Because they say so. THIS is what most ODs are against.

----------


## kws6000

> I was joking!  Why, do you extend your pinky when you drink beer?



My apologies,for taking this the wrong way. And no .I dont extend my pinky and I usually drink from the beer bottle.

----------


## kws6000

> And yet we have about 32 unlicensed states, due in a large part to OD opposition. I'm confused! What would most OD's prefer?? Properly trained and educated opticians, or cheap off the street help? 
> 
> Not a cheap shot, just a legitimate question.


Things are obviously different in the usa.Up here we havent as a group tried to interfere with optician licensing .I would prefer properly trained opticians.

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## optical24/7

> You're trying to pigeonhole me counselor. There are a lot of factors that would determine my support or opposition. I would need to read the law proposed before I will just throw out blanket support for "licensure". Often times, there is considerably more in those propositions than just "taking tests". Who will be the licensing authority? Who will administer the tests? What broader issues does the law open up with the wording? It's always the autonomy and expansion that creates the largest points of opposition. One of my questions is what percentage of dispensing opticians are currently licensed? Is this a small minority standing on a soap box? I certainly think that I'm qualified to determine if an optician (licensed or not) is competent enough to work in my office without the necessity of a licensing board.
> 
> Would the opticians be willing to be under the authority of the optometry board in exchange for such licensing?


 
71, you *gotta* be the spokesman for TOAPAC. and if you aren't, you should be!





( for those wondering...Texas Optometric Association Political Action Committee)

----------


## Eyedoc71

> 71, you *gotta* be the spokesman for TOAPAC. and if you aren't, you should be!
> 
> 
> 
> 
> 
> ( for those wondering...Texas Optometric Association Political Action Committee)


lol...with my mouth?

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## optical24/7

> lol...with my mouth?


 
71, you tote the line impecably! I will nominate you to all my OD buddies..

:D

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## LandLord

> I see enough cl related pathology due to contact lens fitting opticians..


Ha!  That's a joke!  Contact lens pathology because the prescription was filled by an optician?!  Exactly what pathology are the opticians in Calgary causing??

----------


## LandLord

> Labatt's Blue? I'm sorry, I thought we were talking about _real_ beer.


Real beer, as in Kilkenny?  Or do you mean "real" optometry-style beer like Heineken?

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## optical24/7

Imagine there's no surgeries,
except by M.D.'s...
No refraction,
Except by OD's....
Imagine all prescriptions,
filled by opticianry, ooh, ooh, oohoo....

You may say, I'm a dreamer,
but, opticians have their place.
We can over come this,
With legistation from the populist...

We, opticians, are fighting the wrong fight (imho) for refractiion  or any other scope outside of opticianry. We need to be fighting for the_ independance_ of opticianry from the OD/OMD mode of operation that exists now. A doctor _should not_ be allowed to own a dispensary_. Period._ Just like an MD can't have a pharmacy. It's a direct conflict of interest. There is absolutely no difference in Dr. owned opticals than MD owned pharmacies. It's an absolute conflict of interest._ Period_!  And the great thing is that there is presidence on this! The vote of the people can out wieght the money of an interest group. I've seen it too often on local issues. Politicians want votes for them more than cash from an interest group.

 We, #1 need to get lisensure to go forward. _This is why_ optometry opposes our continued efforts to move towards licensure. They feel threatened by any advancement into their "turf". And the funny thing is, most Dr's have no idea how to trouble shoot Rx's. They ask their optician "why"....

In a perfect world, doctors prescribe, optician figure out best solutions to visual needs based on Rx and lifestyle. Doctors aren't "eyewear peddlers". They are prescribers. Why do OD's resist this? Oh yea......$$$$ Sorry docs, but you aren't *doctors*  if you are eyewear peddlers...A real Dr. has _best patient interest_ in mind, and has _no conflict of interest!!_
But that's not reality. You _know_ your bread and butter comes from your dispensary. Why not charge and make a living off of your medical expertise? That's your training, right? Well mine is in finding best solutions for patients. There is a pletora of options now a days. And you think you know about these, and are on the front line of patient adaption issues?  I would beg you to look at your training and experience compared to a well trained and experienced optician. 

If we truely are looking to advance our status and importance in this field, and in the publics mind,  we need to differenciate. Doc's....I'll give you refraction, and the medical side of optics, but I'm way better at eyewear solutions than you...

----------


## obxeyeguy

Ha!  Leave for about 8 hours, and what a debate over a simple question.
I do believe eyedoc has some very valid points.  We see the OD's pushing up the food chain into the OMD's territory, and feel we can move up a step.  Never will happen until we can institute a national regulatory type organization to regulate the credentialing.  He##, we can't even get 30 states licensed.

I personally don't care to refract.  I make more than a lot of OD's for dispensing and fabricating eye wear.  At 53, I'm looking for the end of the line, soon.  Down the road.  Yes I can see opticians refracting independently, if there are any left:angry:

----------


## jediron1

> Ha!  Leave for about 8 hours, and what a debate over a simple question.
> I do believe eyedoc has some very valid points.  We see the OD's pushing up the food chain into the OMD's territory, and feel we can move up a step.  Never will happen until we can institute a national regulatory type organization to regulate the credentialing.  He##, we can't even get 30 states licensed.
> 
> I personally don't care to refract.  I make more than a lot of OD's for dispensing and fabricating eye wear.  At 53, I'm looking for the end of the line, soon.  Down the road.  Yes I can see opticians refracting independently, if there are any left:angry:




Thats my point if there are any left. With Wally world trying to get away from OD's next it will be the optician. I won't be around to see that.  :Mad:

----------


## LandLord

optical24/7:

I wish what you're saying would happen.  But it's kind of like trying to put the toothpaste back in the tube.  After it's out, it's too late.  The government will never stop OD's from dispensing.

Why do you think OD's are so afraid, and fight so hard to prevent opticians from refracting?  Once we start refracting successfully, there will be no going back.  It will be the end of the road for OD's.  They will be stuck in the middle between two specialties.

----------


## IndianaOD

Last week.  Two patients came in for safety glasses Rx.  Both refracted to 20/20.  Both had moderate/severe undiagnosed glaucoma. Both were in mid to late 40's, plenty of time for lights out if not diagnosed and treated.

----------


## jediron1

> optical24/7:
> 
> I wish what you're saying would happen.  But it's kind of like trying to put the toothpaste back in the tube.  After it's out, it's too late.  The government will never stop OD's from dispensing.
> 
> Why do you think OD's are so afraid, and fight so hard to prevent opticians from refracting?  Once we start refracting successfully, there will be no going back.  It will be the end of the road for OD's.  They will be stuck in the middle between two specialties.




The problem when OD's dispensing is that they will never or almost never hire a qualified optician to do the work. What or who they hire is usually a pretty little thing tell them to show a little cleavage and sell that frame for $400 nice little profit of $300 now with lenses he or she will make another $300 so why bothering with a qualified optician? Oh and when they come back for the fitting they can show them the famous OD head hugger trick of the temples. Now when they come back with a problem it's more cleavage and please bend over a little and all those problems that men have suddenly go away. And you only have to her pay her slightly above minimum. So why bother hiring a qualified optician, maybe morals or as Chip likes to point out integrity.

----------


## Laurie

Hi Indiana OD,

There is no doubt that, when a patient comes in for a seemingly simple objective, latent sight-threatening pathology is uncovered.

We ARE NOT talking about independent refractions w/o proof of pathology check...

The optical redo rate is off the charts...due to poor refractions.  I'm quite sure the wholesale labs could chime in here.

And, when I am dispensing eyewear for $1,000.00 - $3,000.00 per pair, redo-rate is crucial...mostly in regard to customer satisfaction.  It is a pain in the b*** for opticians, patients, and labs to take time/costs to fix this problem.

We (opticians) are talking about refracting within a reasonable amount of time, in-between exams by OD's and OMD's...this is in the best interest of everyone...


Why the resistance?

: )

Laurie

----------


## Oedema

> We (opticians) are talking about refracting within a reasonable amount of time, in-between exams by OD's and OMD's...this is in the best interest of everyone...


That may be so, but it is not the paradigm set by refracting opticians in British Columbia.

----------


## LandLord

If OD's are really concerned about people's eye health, they will start working on a system that will ensure EVERYONE receives an eye health exam, once opticians start refracting.

The current system only ensures *those needing glasses* receive an oculovisual.

How many 40-year-olds do you see coming in for an eye exam for the first time in 20 years?

*It's time to replace eyeglasses with something else as the trigger for an eye health exam.*

For example, before you can renew your license plate sticker.

----------


## kws6000

> Ha!  That's a joke!  Contact lens pathology because the prescription was filled by an optician?!  Exactly what pathology are the opticians in Calgary causing??



Lets see :how about untreated infiltrates,corneal ulcers,excessive neovascularization,corneal warpage,severe dry eye.

Opticians are clueless in ocular pathology and are unable to treat the same.

I frequently see people who have corneal health issues who should have never been fit by the optician.I personally know of opticals that will sell anyone contacts as long as the customer has an rx and the money.

Opticians attempting to do stand alone eye exams is a joke  and is just being fueled by greed. 

Opticians are not vision experts and never will be.

----------


## kws6000

> Hi Indiana OD,
> 
> There is no doubt that, when a patient comes in for a seemingly simple objective, latent sight-threatening pathology is uncovered.
> 
> We ARE NOT talking about independent refractions w/o proof of pathology check...
> 
> The optical redo rate is off the charts...due to poor refractions.  I'm quite sure the wholesale labs could chime in here.
> 
> And, when I am dispensing eyewear for $1,000.00 - $3,000.00 per pair, redo-rate is crucial...mostly in regard to customer satisfaction.  It is a pain in the b*** for opticians, patients, and labs to take time/costs to fix this problem.
> ...



Why the resistance? Have you not being reading the rest of the thread?

How is it in the best interest of anyone except opticians for unqualified people to pretend to do eye exams?

----------


## kws6000

> That may be so, but it is not the paradigm set by refracting opticians in British Columbia.


Same in alberta.Here opticians pretending to do eye exams dress in white lab coats and downplay that they arent optometrists.

----------


## kws6000

> Last week.  Two patients came in for safety glasses Rx.  Both refracted to 20/20.  Both had moderate/severe undiagnosed glaucoma. Both were in mid to late 40's, plenty of time for lights out if not diagnosed and treated.


But what does that have to do with opticians pretending to do eye exams?The optician doesnt care as long as they get to sell the glasses.

----------


## kws6000

> Hi Indiana OD,
> 
> There is no doubt that, when a patient comes in for a seemingly simple objective, latent sight-threatening pathology is uncovered.
> 
> We ARE NOT talking about independent refractions w/o proof of pathology check...
> 
> The optical redo rate is off the charts...due to poor refractions.  I'm quite sure the wholesale labs could chime in here.
> 
> And, when I am dispensing eyewear for $1,000.00 - $3,000.00 per pair, redo-rate is crucial...mostly in regard to customer satisfaction.  It is a pain in the b*** for opticians, patients, and labs to take time/costs to fix this problem.
> ...



How are you going to have proof of a pathology check? Opticians dont know how to check for it.

----------


## kws6000

> optical24/7:
> 
> I wish what you're saying would happen.  But it's kind of like trying to put the toothpaste back in the tube.  After it's out, it's too late.  The government will never stop OD's from dispensing.
> 
> Why do you think OD's are so afraid, and fight so hard to prevent opticians from refracting?  Once we start refracting successfully, there will be no going back.  It will be the end of the road for OD's.  They will be stuck in the middle between two specialties.


Why would optometrists condone an unqualified group trying to muscle in on the profession? If you want to be able to do my job,then become an optometrist ,if you have the ability.

Its bad enough having unqualified technicians fitting contact lenses and pretending to do follow care on the unsuspecting public.Its too late to put that genie back in the bottle.

Opticians dont have the crediblity,organization,or money to pull this off.

----------


## chip anderson

Opticians can use a slit-lamp, they can do flourciene checks. They can actually listen to the patient.  They can evert a lid (which many O.D.'s and O.M.D.'s neglect to do).  They don't have to know how to treat anything the just have to be able to recognise it's there and refer to a doctor.  They can also check corneal curavature, and irregularities so this argument is invalid.  
The only times that they cannot perform these things is when optometry manages to block thier doing it in the legislature.  Or I have encountered some opticians that had somehow been intimidated by O.D.'s that they really  did feel that they would be breaking the law to do same even when no such law exists.

Chip

----------


## kws6000

> Alright, you feel opticians should have to demonstrate competency. So you wouldn't oppose opticians to be required in Texas to pass certification tests, both writen and practical like in Florida and a few other states? In other words, you wouldn't fight required lisensure for opticians?
> 
> Or are you going to tote the line that it's not needed?


Actually,in reflecting upon the threads in this post, its not to the benefit of the optometric profession to help opticians gain legitimacy or organization.

If opticians want to get this foothold,they will have to earn it on their own. 


This thread also reinforces why its to the benefit of optometrists to train their own techs instead of hiring the enemy.Why help their group get stronger.

This thread has  opened my eyes and changed my position regarding opticians towards  a much more adversarial one.

----------


## kws6000

> Opticians can use a slit-lamp, they can do flourciene checks. They can actually listen to the patient.  They can evert a lid (which many O.D.'s and O.M.D.'s neglect to do).  They don't have to know how to treat anything the just have to be able to recognise it's there and refer to a doctor.  They can also check corneal curavature, and irregularities so this argument is invalid.  
> The only times that they cannot perform these things is when optometry manages to block thier doing it in the legislature.  Or I have encountered some opticians that had somehow been intimidated by O.D.'s that they really  did feel that they would be breaking the law to do same even when no such law exists.
> 
> Chip



The people that Ive seen werent told by their optician to seek further care.

----------


## jediron1

> But what does that have to do with opticians pretending to do eye exams?The optician doesnt care as long as they get to sell the glasses.



Oh Plezzzzzzzz! By this inaccurate assessment it just goes to prove you have not been reading the posts or you would have known what the back and forth was really all about. You come on read a couple of posts and think I can add my two cents. Plez get the facts straight before you leap to your conclusions.

----------


## LandLord

kws6000

Your 8 posts above suggest a very personal hostility towards opticianry. You give anecdotal examples of patients suffering every ocular pathology under the sun at the hands of greedy opticians playing doctor. Yet the reality is that opticians are trained, licensed and government-regulated professionals. If they were so incompetent as you suggest, there would be a public backlash or at least a number of malpractice lawsuits. Neither of which has happened.

I'm going to take a stab at your real motivation and suggest that if you are not making the money or commanding the respect you feel you should be, don't take it out on opticians. Instead, get into real estate as I have. I make more in rental income than I do in the glasses business.

----------


## jediron1

> Opticians can use a slit-lamp, they can do flourciene checks. They can actually listen to the patient.
> 
> Chip





I actually have had three people that I talked to and referred them to the local OMD who was astonished that an optician actually referred three patients over and one ended having to have emergency surgery because of a retinal tear. Talk does work. Right on Chip.

----------


## chip anderson

Over the last 50 years I may have recognised or suspected pathology (ranging from, dendritic keratitus, to ulcers, to detached retinas, to I don't remember, to occasional I just suspected something and nothing was wrong). This is what the OMD's that refer to me expect me to do.
I refer every one back to the prescriber unless it seems urgent and then I send them to the first available.   Even though nowdays this sometimes means hours on the phone getting past the wall of women employees that insulate the OMD.

I have seen and all the OMD's I have seen have complained about OD's fitting people that should never have been fitted (as those with dentritic keratitus ). Don't hear as much not as OD's are a source for refractive surgery and catarct referrals, which for the most part opticians are not.

However this does not indicate that OD's have improved, just means that now that they are a resource instead of compeditor, the attitude has changed.

Chip

----------


## Dannyboy

The only reason ODs do not let opticians refract independently is that they depend on the income that their prescriptions generate in "their" optical. They cannot stand on their own when it comes to practicing medical and routinely are denied participation in medical plans. Just say it the way it is an stop giving a million pathology related reasons why refraction should be part of their eye exam. ODs are really refracting Opticians with some medical training. They are not specialists and is a joke that they are seeking board certification. They are just Optometrists regardless of their optometric physician title that they use trying to confuse the public or the insurance companies....

Dannyboy :Eek:

----------


## kws6000

> kws6000
> 
> Your 8 posts above suggest a very personal hostility towards opticianry. You give anecdotal examples of patients suffering every ocular pathology under the sun at the hands of greedy opticians playing doctor. Yet the reality is that opticians are trained, licensed and government-regulated professionals. If they were so incompetent as you suggest, there would be a public backlash or at least a number of malpractice lawsuits. Neither of which has happened.
> 
> I'm going to take a stab at your real motivation and suggest that if you are not making the money or commanding the respect you feel you should be, don't take it out on opticians. Instead, get into real estate as I have. I make more in rental income than I do in the glasses business.


Gee,and there is no outright hostility towards optometrists in this forum?

Im tired of playing nice to all the cheap shots from opticians.This forum shows  me how widespread this is in your group.Ive heard the same thing from optician staff members going to optician conventions.

If the opticians fitting the cls were as competent as you claim,I wouldnt have seen these cases.

Of course these cases are anecdotal.Do you expect me to reveal patient names?

Who is the patient going to complain to? Lawsuits are only viable if there is proof of permanent vision loss.

If i were as hostile,at the time, towards opticians as you claim,I could have stirred things up  big time by revealing to these patients how inept their care was.

May be I should do that in the future ,and encourage my colleagues to do the same,so that these people will be more vocal and start complaining to the provincial health minister.

This would definitely help in any potential government action regarding opticians trying to do  pretend eye exams.

I definitely dont have any warm and fuzzy feelings towards opticians after reading this thread  and my views towards opticians  in general have significantly hardened. I have no intention of doing anything to help their group.

As for my income,Im doing quite well and dont mind my place in life,unlike some of the opticians posting here who blame all their career woes on optometrists.

A lot of optometrists arent aware of the hostility towards them from opticians .If they were.,they have the organization and the money to torpedo opticians and might just be inclined to do so.

----------


## Laurie

Hello kws6000,

Yes, I have read the threads...have you read them all as well? In my responses, I indicated that, when there is a written Rx in hand by an OD or OMD, within a reasonable amount of time, it is expected that the doctor who wrote the Rx did a pathology check...

It does not appear to be beneficial to debate this here, and I won't engage in a fight...I am just curious, why the big resistance, if we have an Rx in hand? 



: )

Laurie

----------


## kws6000

> Over the last 50 years I may have recognised or suspected pathology (ranging from, dendritic keratitus, to ulcers, to detached retinas, to I don't remember, to occasional I just suspected something and nothing was wrong). This is what the OMD's that refer to me expect me to do.
> I refer every one back to the prescriber unless it seems urgent and then I send them to the first available.   Even though nowdays this sometimes means hours on the phone getting past the wall of women employees that insulate the OMD.
> 
> I have seen and all the OMD's I have seen have complained about OD's fitting people that should never have been fitted (as those with dentritic keratitus ). Don't hear as much not as OD's are a source for refractive surgery and catarct referrals, which for the most part opticians are not.
> 
> However this does not indicate that OD's have improved, just means that now that they are a resource instead of compeditor, the attitude has changed.
> 
> Chip


Since ODs are so stupid regarding pathology.you should show us how it is done.

Most opticians wouldnt know  what  dendritic keratitis was if it reached out and slapped them in the face.

----------


## Dannyboy

who are you kidding...your so call organization plainly does that every time there is an opticianry bill....we have learned that  the only thing in between opticians getting licensure is the Optometric groups. Do not come and give your grandeur pathology sermon as we have heard that. Opticians are not stupid you know..we can also refer to specialists when we see something wrong.

Dannyboy :Eek:

----------


## kws6000

> Hello kws6000,
> 
> Yes, I have read the threads...have you read them all as well? In my responses, I indicated that, when there is a written Rx in hand by an OD or OMD, within a reasonable amount of time, it is expected that the doctor who wrote the Rx did a pathology check...
> 
> It does not appear to be beneficial to debate this here, and I won't engage in a fight...I am just curious, why the big resistance, if we have an Rx in hand? 
> 
> 
> 
> : )
> ...


If there already is a written rx in hand from a qualified provider,why is there  a need for another pseudo exam?

----------


## Dannyboy

man are you dense..She is saying that if the OD or OMD screwed the refraction it should be simply redone at the time of the problem so the patient does not waste his/her time going back to the doctor...

Dannyboy :Confused:

----------


## IndianaOD

Becoming an optician has no risk.  Can be trained on site without a high school diploma.  No money or time realistically invested in the career.  Nothing lost if things go south.

OD: Most all have 4 year undergrad degree.  It can't be a gen-ed degree either.  Look at the pre-reqs including biology, organic chem, microbiology, calculus, physics etc.  That is 4 years invested and probably at least $50k.

Then 4 years of OD school.  Not a cakewalk for most at around 22 credit hours a semester.  That's another 4 years and on average well over $$100K extra in debt.  

Becoming more popular is a 5th year of optometric residency paid at a VERY low rate.  At least MD residents make around $50k + a year during residency.

Now if an optician, who we will say is licensed after passing a couple tests, is found guilty of malpractice or unethical behavior they lose a job at which they had nothing invested.  If an OD screws up.  Boom 8 years + and usually over $150k.  That is motivation to take care of your patients.

Soon less than half of ODs will make any money at all off of material sales as commercial gains more footing.

You all do realize with the increasing competition and internet sales there will be next to no profits in eye wear, regardless if opticians or others refract.

----------


## kws6000

> who are you kidding...your so call organization plainly does that every time there is an opticianry bill....we have learned that  the only thing in between opticians getting licensure is the Optometric groups. Do not come and give your grandeur pathology sermon as we have heard that. Opticians are not stupid you know..we can also refer to specialists when we see something wrong.
> 
> Dannyboy


I dont blame the american ODs  for blocking the opticians.We should have done the same here ,except we were too complacent and played nice.

Now we have increasing militancy from unqualified people trying to practice optometry.

Why would I give a pathology sermon? You wouldnt understand.

You dont have the qualifications to know when something is wrong.

To the best of my knowledge, in Canada,most ophthalmologists wont take  referrals  from  technicians.

----------


## kws6000

> Becoming an optician has no risk.  Can be trained on site without a high school diploma.  No money or time realistically invested in the career.  Nothing lost if things go south.
> 
> OD: Most all have 4 year undergrad degree.  It can't be a gen-ed degree either.  Look at the pre-reqs including biology, organic chem, microbiology, calculus, physics etc.  That is 4 years invested and probably at least $50k.
> 
> Then 4 years of OD school.  Not a cakewalk for most at around 22 credit hours a semester.  That's another 4 years and on average well over $$100K extra in debt.  
> 
> Becoming more popular is a 5th year of optometric residency paid at a VERY low rate.  At least MD residents make around $50k + a year during residency.
> 
> Now if an optician, who we will say is licensed after passing a couple tests, is found guilty of malpractice or unethical behavior they lose a job at which they had nothing invested.  If an OD screws up.  Boom 8 years + and usually over $150k.  That is motivation to take care of your patients.
> ...


Indy,dont bother.some of this group isnt intelligent enough to recognize what they dont know.

They are like 3 yr olds who only care about what they want.

They just want to be wanna be optometrists without the training,costs, and responsibility.

----------


## Laurie

> If there already is a written rx in hand from a qualified provider,why is there a need for another pseudo exam?


Hi kws6000,

By calling a refraction a pseudo-exam, you confuse the issue further.

I am not sure if you are aware that redo rates are out the window, and that it is sometimes very difficult for an optician or a patient to retain their spectacle Rx when they want to purchase eyewear outside their prescibing doctors office. I see no risk of the optician in this scenario refracting/making spectacles based on their numbers, when the patient has been seen by a doctor within a reasonable amount of time.

There is a need for a qualified opticians (formally educated from accredited colleges) to be able to troubleshoot...refracting is part of optical troubleshooting.

: )

Laurie

----------


## kws6000

> Hi kws6000,
> 
> By calling a refraction a pseudo-exam, you confuse the issue further.
> 
> I am not sure if you are aware that redo rates are out the window, and that it is sometimes very difficult for an optician or a patient to retain their spectacle Rx when they want to purchase eyewear outside their prescibing doctors office. I see no risk of the optician in this scenario refracting/making spectacles based on their numbers, when the patient has been seen by a doctor within a reasonable amount of time.
> 
> There is a need for a qualified opticians (formally educated from accredited colleges) to be able to troubleshoot...refracting is part of optical troubleshooting.
> 
> : )
> ...


I have no problem with redos.My rate  is about two per year based on changing my initial rx.

I do have an issue with unqualified people trying to do pseudo exams.

First it starts off as you say,then it progresses to opticians doing these assessments without restrictions,and then it progresses to opticians attempting to do all parts of the  eye exam except for the internal health assessment and would likely progress to attempting to include that by doing telemedicine with a qualified practitioner.

The provincial opticians here tried to get approval for doing "simple sight tests" that consisted of virtually all of the eye exam except for ophthalmoscopy.

This is a slippery slope that only benefits opticians and their ability to merchandise eyeglasses and contact lenses.

----------


## kws6000

> The problem when OD's dispensing is that they will never or almost never hire a qualified optician to do the work. What or who they hire is usually a pretty little thing tell them to show a little cleavage and sell that frame for $400 nice little profit of $300 now with lenses he or she will make another $300 so why bothering with a qualified optician? Oh and when they come back for the fitting they can show them the famous OD head hugger trick of the temples. Now when they come back with a problem it's more cleavage and please bend over a little and all those problems that men have suddenly go away. And you only have to her pay her slightly above minimum. So why bother hiring a qualified optician, maybe morals or as Chip likes to point out integrity.


Ive hired and currently have opticians working in our offices.After reading this thread and other threads on this board Ive revised my position on this.I dont intend to hire any more if I can train assistants to do their tasks.Ill pay them the same as the opticians,so its not about money.

Why would I help strengthen a group which is determined to become wanna be optometrists.?


My eyes are now open.

----------


## OHPNTZ

Kws...

Let the thread die.  This debate occurs not only on this thread, but just about any thread you begin to write on...

This site is VERY anti-optometry.  No matter what is said, you will be accused of hating opticians...and looking down on them...even if you do not.  It is a perception of "Every OD hates every optician!!!".  You will hear this over, and over again...

----------


## kws6000

> Kws...
> 
> Let the thread die.  This debate occurs not only on this thread, but just about any thread you begin to write on...
> 
> This site is VERY anti-optometry.  No matter what is said, you will be accused of hating opticians...and looking down on them...even if you do not.  It is a perception of "Every OD hates every optician!!!".  You will hear this over, and over again...


I think this attitude is widespread throughout opticianry.Up until recently I just tended to ignore it and live and let live,but my attitude has changed a lot in the last few days.

----------


## OHPNTZ

Your attitude will change by reading these posts...almost as if you're brainwashed into believing this hatred.

Actually, tomorrow morning maybe I'll begin to hate the optician I work with...because I'm supposed to...then I'll call up all of my OD friends, and make sure they're haters too.

----------


## tmorse

> Lets see :how about untreated infiltrates,corneal ulcers,excessive neovascularization,corneal warpage,severe dry eye.
> 
> I frequently see people who have corneal health issues who should have never been fit by the optician.I personally know of opticals that will sell anyone contacts as long as the customer has an rx and the money.


Strange that you cast blame on the Optician Contact Lens Fitter for all these types of corneal health issues when you KNOW that at least 70% of ALL Contact Lens patients (including YOURS) FAIL to follow their prescribed wearing schedules, hygiene, follow-up visits, lens replacement schedules, etc, etc. 
And these patients know it, too... that is why there are no successful lawsuits against Opticians, even though ALL of Canadian Opticiasn carry a mandatroy minimum $1,000,000.00 Errors & Omissions liability insurance, and obtain it for a paltry $80.00 annual fee.   :Rolleyes:

----------


## optical24/7

> This thread also reinforces why its to the benefit of optometrists to train their own techs instead of hiring the enemy.Why help their group get stronger.


Oh please, please, if there is a God in heaven, give this OD his wish. There is nothing more a well seasoned and trained optician could want. It will finally give us an oprotunity for independance. There are pleanty of OD trained frame stylist out there that drive patients from their doctors practice with their lack of skill.

 Over the past three decades I've hire optometry students to work for me. Be it lab or dispensing. To the man, (and ladies) each one has told me how much more they learned from me than at college. Just curious, whom taught you your few hours in opticianry? Maybe...an optician?

Maybe I need to rethink whom I'm teaching.....

----------


## IndianaOD

> Oh please, please, if there is a God in heaven, give this OD his wish. There is nothing more a well seasoned and trained optician could want. It will finally give us an oprotunity for independance. There are pleanty of OD trained frame stylist out there that drive patients from their doctors practice with their lack of skill.
> 
> Over the past three decades I've hire optometry students to work for me. Be it lab or dispensing. To the man, (and ladies) each one has told me how much more they learned from me than at college. Just curious, whom taught you your few hours in opticianry? Maybe...an optician?
> 
> Maybe I need to rethink whom I'm teaching.....


 
I was taught by the OD who wrote the book on ophthalmic optics, thank you.

----------


## Judy Canty

Ladies and Gentlemen, this thread is spiraling out of control.  I've asked my fellow moderators to review the past few days posts and decide on it's future.  You all have the choice of dialing back the rhetoric or just allowing the thread to end.  If you can't, then the moderators will make the decision for you.

----------


## jediron1

> Ladies and Gentlemen, this thread is spiraling out of control.  I've asked my fellow moderators to review the past few days posts and decide on it's future.  You all have the choice of dialing back the rhetoric or just allowing the thread to end.  If you can't, then the moderators will make the decision for you.





What is the big deal if it does a little spiraling? Sometimes a lot can be accomplished in times of spiraling.    :Rolleyes:

----------


## jediron1

> Gee,and there is no outright hostility towards optometrists in this forum?
> 
> Im tired of playing nice to all the cheap shots from opticians.This forum shows  me how widespread this is in your group.Ive heard the same thing from optician staff members going to optician conventions.
> 
> If the opticians fitting the cls were as competent as you claim,I wouldnt have seen these cases.
> 
> Of course these cases are anecdotal.Do you expect me to reveal patient names?
> 
> Who is the patient going to complain to? Lawsuits are only viable if there is proof of permanent vision loss.
> ...



Gee,and there is no outright hostility towards opticians from OD's on this forum is their? If the contact fitters were that bad you should have reported them. Now what if what really happened is they never failed to following instructions? Case in point. Patient comes in gets fitted by an OD for contacts and is instructed in everything they should do. Comes back a month later ( He has worn contacts before ) and has corneal edema from over wearing, who's to blame the OD or patient who did not follow instructions? Just as we don't know both sides in this case we can't judge who is right or wrong, but if your a doctor then it was your duty to turn those people in IF it was their fault, but how can you prove it. The thing I'm saying is their are two sides to every story and yours sounds awful one sided.  just my take  :Rolleyes:

----------


## HarryChiling

> I was taught by the OD who wrote the book on ophthalmic optics, thank you.


How'd you do in his class.  I heard he's a tough cookie and monotone when he lectures, not a great combo as I tend to tune out monotone people.

----------


## jediron1

> I was taught by the OD who wrote the book on ophthalmic optics, thank you.


 
 Over the past three decades I've hire optometry students to work for me. Be it lab or dispensing. To the man, (and ladies) each one has told me how much more they learned from me than at college. Just curious, whom taught you your few hours in opticianry? Maybe...an optician?

Maybe I need to rethink whom I'm teaching.....


 What he asked was who taught you optical skills as an optician not who taught ophthalmic optics. Ophthalmic optics when I was in school was a physics course 2 semesters long which included thick lens theory along with the complex systems for setting up of microscopes and the gauss system for telescopes and much more. But what did you learn to be competent in the optical side or another words how did you learn to dispense glasses.

----------


## HarryChiling

> Over the past three decades I've hire optometry students to work for me. Be it lab or dispensing. To the man, (and ladies) each one has told me how much more they learned from me than at college. Just curious, whom taught you your few hours in opticianry? Maybe...an optician?
> 
> Maybe I need to rethink whom I'm teaching.....
> 
> 
> What he asked was who taught you optical skills as an optician not who taught ophthalmic optics. Ophthalmic optics when I was in school was a physics course 2 semesters long which included thick lens theory along with the complex systems for setting up of microscopes and the gauss system for telescopes and much more. But what did you learn to be competent in the optical side or another words how did you learn to dispense glasses.


Hire 'em, your getting the shaft bro. We bring them on as interns. After their first year they need to do 160 hours, 120 ophthalmic dispensing, and 40 clinical. Our office gets a few especially since we have an in store lab and various equipment than many offices don't have it gives us the edge in getting the interns. Many just don't like the ophthalmic optics part, I have a student now who is very competent, but her focus is medical and that's great this new bread of OD is goind to soon replace the OD of yesteryear and before you know it they will be done with optics.

I think also that IndianaOD was refering to Brooks, all the doctors that I have worked with that were taught by him alwasy had respect for opticians and I would dare any of the so called doctros that learned under him to mention their disdain for opticians.  Most that have worked under him have takne the same ophthalmic optics course that he teaches opticians in the same school.  I have heard from all the doctors that have had his courses that he is very strict, but a great teacher.  A while back I contacted the school for a book that is OOP that he wrote and was sellign for crazy dollars on all the internet sites.  After a breaif chat with him he had a copy printed and spiral bound sent to me and it cost me next to nothing.  Great man great doctor, a very respectable person.

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## jediron1

> Hire 'em, your getting the shaft bro. We bring them on as interns. After their first year they need to do 160 hours, 120 ophthalmic dispensing, and 40 clinical. Our office gets a few especially since we have an in store lab and various equipment than many offices don't have it gives us the edge in getting the interns. Many just don't like the ophthalmic optics part, I have a student now who is very competent, but her focus is medical and that's great this new bread of OD is goind to soon replace the OD of yesteryear and before you know it they will be done with optics.
> 
> I think also that IndianaOD was refering to Brooks, all the doctors that I have worked with that were taught by him alwasy had respect for opticians and I would dare any of the so called doctros that learned under him to mention their disdain for opticians.  Most that have worked under him have takne the same ophthalmic optics course that he teaches opticians in the same school.  I have heard from all the doctors that have had his courses that he is very strict, but a great teacher.  A while back I contacted the school for a book that is OOP that he wrote and was sellign for crazy dollars on all the internet sites.  After a breaif chat with him he had a copy printed and spiral bound sent to me and it cost me next to nothing.  Great man great doctor, a very respectable person.



Good points. I m a little older but I believe I have heard of Brooks the ones I m more familiar with are Russel Stimson, Ralph Drew icons of the optical world. One thing Russell Stimson knew was his optics even wrote a book on it which I did have until we had a flood and it got damaged.  :Cool:

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## hcjilson

If any of you have a mind to, you could restart this under a different title- It will be allowed to stand as long as posting guidelines are kept in mind (and in posts).

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