# Optical Forums > General Optics and Eyecare Discussion Forum >  TN Licensing Board Declaratory Order

## Roy R. Ferguson

Hi All:

On 29 Oct the Tennessee Board of Dispensing Opticians heard a Petition For Declaratory Order. I thought the members of this group might be interested in discussing the particulars. For your information, the Board found the answer to 1,2,and 4 to be NO and 3 to be YES. What are your thoughts?

4. Provide a statement of the facts that led to the filing of this petition.

The Petitioner asserts that large retail optical chains within Tennessee are placing untrained, non-licensed employees into optical sales, supervisory and management positions that are required by Tennessee state law to be filled by licensed opticians. The Petitioner asserts that non-licensed managers have no accountability to the state licensing board and that non-licensed managers are unfamiliar with state optician and licensing laws.

5. Provide a summary of the relief the Petitioner is requesting, including the specific nature of the requested order and the conclusions the Petitioner would like the agency to reach at the conclusion of the declaratory process.

The Petitioner is asking the Board to answer the following questions:

(1) Can a person who is not a licensed optician or an apprentice optician in Tennessee sell or take orders for prescription contact lenses, or perform any of the duties related to dispensing opticians, which include but are not limited to frame and lens selection for glasses, prescription interpretation and entry, pupillary distance and segment measurements, rx neutralization, fitting and adjusting prescription eyewear, and dispensing prescription eyewear, including plano contact lenses?

(2) Can an apprentice optician perform optician duties described in Question 1 above without the direct supervision of the sponsoring optician?

(3) Must store managers, district managers, regional managers, territorial managers, and other supervisors, officers, and managers of optical chains and dispensaries within Tennessee be licensed opticians?

(4) Can optical employees go into the public sector and solicit business for optometrists by means of verbal communication, business cards, and/or vision screenings?

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## HarryChiling

Doc,

The choices made were good ones.  I would think No to 1, 2, 4 and Yes to 3 as well.  I could see how 3 could be argued that the running of a business could have nothing to do with opticianry, but IMO if the supervisor or higher up does not hold a license then they would try and coerce the employees that do or are aprentices into doing things that may not be in the patients interest.  Great topic thanks for bringing it to our attention.

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## Johns

Of course, I agree as well, but what's the Board's next step?

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## Jubilee

Very interesting. I agree that the answers were the "correct" ones.

I imagine there is going to be some legal wrangling in the state of Tennessee as Luxottica, Walmart and many other chains will be crying fowl over this ruling and the additional cost it will place on conducting business in the state.

While I have met some really good managers that came from non optical backgrounds, I believe that all should have to receive their license/certification in a set period of time in order to demonstrate their knowledge of the optics and have adequate understanding of some of the issues that may come up.

I believe this is more important in the store management level than necessarily the regional. 

I know at one point LC was "encouraging" and in some cases mandating that all members of management obtain at least ABO certification...

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## RT

Do all TN hospitals require all managers, supervisors, and officers to be doctors or nurses?

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## HarryChiling

> Do all TN hospitals require all managers, supervisors, and officers to be doctors or nurses?


 That's a good point RT, but often times management will make decisions based on business alone, where as an optician must coinsider the good for the patient.  I am kinda split on this one, I can see both sides but at the same time I know that where there is a loop hole the large chains will capitalize on it which is why I would tend to go with YES to #3.

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## hcjilson

> Do all TN hospitals require all managers, supervisors, and officers to be doctors or nurses?


They do when they practice medicine! Although it may be a rarity, you can find most competent managers on the selling floor. Would you have us believe they are just window dressing?  hj

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## AdmiralKnight

I agree with about 90&#37; of that. Like Harry, I'm a bit torn on managers, especially once you've passed the store level. A good manager will rely on the people under them, including their opticians to give them opinions etc. And I'm a bit iffy on part of number 1 as well. Personally, I have no problem with the idea of 'Frame Stylists' or whatever title you want to give them. With the understanding that the optician has the final say on fit/appropriate for the rx. It doesn't take a degree to tell someone if a frame looks good on them.

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## Roy R. Ferguson

Hi All:

Read #1 very carefully.  It appears the Opticianry program in our state may no longer be able to operate the on-campus dispensary or send students out for internships with licensed opticians since they are not registered apprentices.  

Roy

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## HarryChiling

> Hi All:
> 
> Read #1 very carefully. It appears the Opticianry program in our state may no longer be able to operate the on-campus dispensary or send students out for internships with licensed opticians since they are not registered apprentices. 
> 
> Roy


That's gotta be an exception to the rule.  If it isn't then maybe an exception of this nature should be included.

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## AdmiralKnight

Things like that were part of my problem with (1). It groups a LOT of things into a simple yes or no answer. There are a lot of grey areas in there that should be looked at per-case basis.

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## HarryChiling

> Things like that were part of my problem with (1). It groups a LOT of things into a simple yes or no answer. There are a lot of grey areas in there that should be looked at per-case basis.


Well then good foresight on that one, it caught me right in the keister as I imagine it would to many.  Is the intention to stop those that are not supposed to be dispensing from dispensing, or is it to stop students from learning?  I guess I would need a little more background to these question, like what were they meant to address?

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## Roy R. Ferguson

(2)                 Can an apprentice optician perform optician duties described in Question 1 above without the direct supervision of the sponsoring optician?

In Tennessee a licensed optician may only supervise two apprentices.  If the sponsoring optician is sick or on vacation, how do the two apprentices legally perform work activities?

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## obxeyeguy

> Must store managers, district managers, regional managers, territorial managers, and other supervisors, officers, and managers of optical chains and dispensaries within Tennessee be licensed opticians?


Seems a little broad here.  Does this mean the VP of retail operations at LC has to be licensed?  I read into this that a dispensary in an MD owned office, with a practice manager who also supervises the optical shop would need a license.

I like the concept, just seems too broad based.

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## AdmiralKnight

I have no problem with requireing a STORE manager have their license. They're the ones dealing with the day to day OPTICAL problems. When I managed for Lux, my manager, the regional, was not licensed, but he wasn't in charge of optical problems. He delt with problem patients, staff issues etc etc. And whenever there was a patient problem that had to do with optical issues, it was basicly "Handle it, Chris." and I did. That's how it should be. Any further than that, and it's just rediculous. Territorial managers? VP's? WHY? Those positions are purely for business pratices. Yes, it's an optical company, but there are people in places below with the proper backgrounds to deal with the optical aspects.

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## HarryChiling

> I have no problem with requireing a STORE manager have their license. They're the ones dealing with the day to day OPTICAL problems. When I managed for Lux, my manager, the regional, was not licensed, but he wasn't in charge of optical problems. He delt with problem patients, staff issues etc etc. And whenever there was a patient problem that had to do with optical issues, it was basicly "Handle it, Chris." and I did. That's how it should be. Any further than that, and it's just rediculous. Territorial managers? VP's? WHY? Those positions are purely for business pratices. Yes, it's an optical company, but there are people in places below with the proper backgrounds to deal with the optical aspects.


I like that, and agree the manager since they have direct contact with patients should have a license, any higher and it does become unnecessary.

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## AngryFish

My thinking is that as long as there is a licensed optician on the clock who is responsible for the dispensing that takes place under their watch, the best interests of the consumer and the intention of the law are both served. I dont think it is important that the manager or regional manager or any other individual be licensed so long as any dispensing that is done is done under the supervision of a state licensed optician.

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## BoardPetitioner

You had the correct response from the start, but facts omitted by Mr. Ferguson and lack of statutes to refer to, has swayed your opinion from  seeing the repercussions of unlicensed upper management with only profits in their mindset. The reasoning behind the statute in question regarding supervisors, reflects your initial responses. Direction is passed down from the top-- available payroll, marketing, frame and lens availability, sales goals, evaluations, pay rates, who gets terminated or promoted, etc. The questions from the petition were submitted because  many of our optician laws and regulations were being disregarded and misinterpreted to increase profits to the degree that a patient could be purchasing prescription eyewear from someone with NO license, apprenticeship, or even a weeks worth of optical experience. No matter how high in management an optician is, if he/she is supervised by one with no risk of losing their license, the time WILL come when the optician is put in a situation where he/she either follows ILLEGAL direction or risks promotability, reprimand, and/or termination. 

Here is the statute referred to in the third question it is from the Tennessee State Code Annotated, Title 63 Professions of the Healing Arts, Chapter 14 Dispensing Opticians Section 103 Paragraph (d)_ It is unlawful for any person to practice or offer to practice as a dispensing optician as an employee of any person not engaged primarily in the practice as dispensing optician as a licensee under this chapter, or of any firm or corporation not engaged primarily in the practice of dispensing opticians under the actual and personal supervision of partners, officers, managers or stockholders who possess valid unrevoked licenses as dispensing opticians entitled to practice within this state in accordance with the provisions of this chapter._ I believe the statute covers all the possibilities of supervision. 

As for Mr. Ferguson's remark about an optician supervising only two apprentices, new rules have been made this year to accomadate an alterenate sponsor optician in case one is off or sick, Mr. Ferguson is aware of this as an attendee of the petition hearing because the chairman of the state board made reference to it when the same question arose during the  hearing! He was at the previous board meetings that the rules were proposed in as well. As for the question Mr. Ferguson proposed in regards to student opticians not recieving their intern training, another paragraph (f) in the same section of state code addresses that as well, it reads: _It is lawful for any "apprentice dispensing optician" or "student dispensing optician" to perform any of the services or do any of the acts included in the definition of "dispensing optician" contained in this chapter; provided, that such "apprentice dispensing optician" or "student dispensing optician" does so under the direct supervision, direction and control of a dispensing optician, optometrist or ophthalmologist licensed by the state of Tennessee or the equivelent amount of time under the supervision of such licensed professionals of another state that has dispensing opticianry licensure criteria at least as strict as Tennessee and practicing in strict accordance with all of the terms and provisions of this chapter: and provided further, that a licensed optician inspects the finished glasses and fits them to the face of the patient._ I believe Mr. Ferguson should be aware of this statute as well since he was a former intructor to optician students!

I am not quite sure of Mr. Ferguson's agenda, but I do know however he was giving both written and verbal advice to the three attorneys opposing the petition! Sorry for the length of response, I just felt that some facts should be brought forth.

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## eyesonjohn

So did the board make any formal actions on your petition.

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## BoardPetitioner

> So did the board make any formal actions on your petition.


The board clarified the statutes in question which cover the definition of dispensing opticians, supervision of opticians and apprentices, and solicitation for ODs. Their final order did not change existing laws, but only clarified them in simpler terms for those who would misinterpret or ignore them.

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## AngryFish

The licensed optician is obligated to follow the law and if it is a choice between the law and the company policy the law wins the policy loses. If the law states, for example, that all dispensing must take place under a licensed optician, the business has little to gain by terminating an employee who has the qualifications required by law for the entity to do business for no reason after all, without a licensed optician on site there is no business to conduct. If business is being conducted without a licensed optician then you have a cause of action against the business and therefore a legal remedy. 

  If as you state many of your laws are being violated by various business entities there is legal remedy to address that in place without having to engage in what would appear to be such a Herculean effort of taking on issues like “definition.”, if you take this logic of everyone all the way to the top must be licensed out to its fruition, you have a board of directors and they are ultimately accountable to who, the share holder.  

  Opticians are not licensed to prescribe and as such they can be employees of others who are not licensed to or prescribe. The only exception to this that I am aware of is in the case of doctors. Any one who is licensed to prescribe cannot be employed or supervised by someone who is not. And there may be an exception to this, as in the case with optometry in certain states. 

  State laws vary and I am suggesting that what I have said is very general in nature. I base this response on what I have read in this string. I am still not clear, however, on what your intention is. What is a specific goal of this action? I would love to learn more.

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## BoardPetitioner

By alternate sponsor optician which was provided for in new rules earlier this year as you are well aware. (responding to Roy's apprenticeship question)

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## BoardPetitioner

> The licensed optician is obligated to follow the law and if it is a choice between the law and the company policy the law wins the policy loses. If the law states, for example, that all dispensing must take place under a licensed optician, the business has little to gain by terminating an employee who has the qualifications required by law for the entity to do business for no reason after all, without a licensed optician on site there is no business to conduct. If business is being conducted without a licensed optician then you have a cause of action against the business and therefore a legal remedy. 
> 
>   If as you state many of your laws are being violated by various business entities there is legal remedy to address that in place without having to engage in what would appear to be such a Herculean effort of taking on issues like “definition.”, if you take this logic of everyone all the way to the top must be licensed out to its fruition, you have a board of directors and they are ultimately accountable to who, the share holder.  
> 
>   Opticians are not licensed to prescribe and as such they can be employees of others who are not licensed to or prescribe. The only exception to this that I am aware of is in the case of doctors. Any one who is licensed to prescribe cannot be employed or supervised by someone who is not. And there may be an exception to this, as in the case with optometry in certain states. 
> 
>   State laws vary and I am suggesting that what I have said is very general in nature. I base this response on what I have read in this string. I am still not clear, however, on what your intention is. What is a specific goal of this action? I would love to learn more.


To know for myself and all other interested opticians that the laws currently in force mean what they say, not what corporate management far higher up the chain than dispensary level have reworded and directed optical staff to follow. There may be further future action so details are limited.

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## BoardPetitioner

The law also covers stockholders, so all are accountable. The other health related fields in TN have similiar wording in their statutes that prevent someone not licensed in the particular field of practice from superviseing or having financial interest in the licensed practice.

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## Roy R. Ferguson

Hi All:

First, let me say that I have no agenda. The questions from the Declaratory Order were not changed and were posted exactly as the Tennessee Board of Dispensing Opticians received them.  I was simply seeking comments from members of OptiBoard.

Second, the ruling on 29 Oct seems to be in conflict with previous Board positions regarding alternate sponsoring opticians.  I do not recall this being discussed in the hearing.  Perhaps it was and I missed that point.  Im sure the Board will clarify this issue in the future.

Finally, I certainly do not recall giving both written and verbal advice to the three attorneys opposing the petition.  If anyone has knowledge of my involvement in such activities, please share them with me.  

Roy R. Ferguson, PhD

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## vprl

Maybe a little off track but there sure is a lot of false confidence in ones abilities just because they hold a license. I happen to manage a franchise and no I do not have a license and have three people with no license working with me that are also not licensed. We work under direct supervision of the O.D. that owns our location therefore we are operating within the state law. I have worked with Licensed Opticians in the past that struggled to read prism, could not read a lensometer correctly, and generally relied on the "Dr. needs to re-check" line without doing any trouble shooting. Most would have a real struggle in the lab where I believe an opticians knowledge should originate.

I am not trying to bash anyone or trying to lump any one group together. Just wanted you to know that there are those of us out here that strive to do what's best for the patient first and foremost whether we are licensed or not and whether we are in a corporate setting or not. We take great pride in the quality of our work and making sure we meet the needs and wants of our patients and along the way we try to be as profitable as possible.

I'm sure the next question will be as to why I have not attained a license yet and I will be happy to answer that when time allows.  Right now I'm late for my tee time.:D:D

Thanks:cheers:

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## cash1

please excuse my spelling and such!!! but! in tennessee the prob. isnt the lic. board. they just inforce the laws!!!! in my opinion they have done verry well with their rulings for a long time. but! the laws that are on the books are old out dated and mostly do great harm to the opticians . cant refract, cant put in an ctl. without a dr. in the room,if anyone is in trouble here in tennessee it is the optician! if wal-mart, lenscrafters, any large optical place like that if they aint using lic. opticians then the attorney general must get in the act, the board of lic opticians can only mess with lic opticians. but the tennessee dispencing opticians assoc. who should be changing the laws to protect the opticians as well as the people we fit with glasses and contacts ,will not!!! where is the t.d.o.a.? i dont wanna make this too long but tennessee needs some solid leadership who will help with changing the laws!!!!:cheers:p.s. i think roys agenda is to make tennessee and the rest of the states better for all opticians!

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## BoardPetitioner

> please excuse my spelling and such!!! but! in tennessee the prob. isnt the lic. board. they just inforce the laws!!!! in my opinion they have done verry well with their rulings for a long time. but! the laws that are on the books are old out dated and mostly do great harm to the opticians . cant refract, cant put in an ctl. without a dr. in the room,if anyone is in trouble here in tennessee it is the optician! if wal-mart, lenscrafters, any large optical place like that if they aint using lic. opticians then the attorney general must get in the act, the board of lic opticians can only mess with lic opticians. but the tennessee dispencing opticians assoc. who should be changing the laws to protect the opticians as well as the people we fit with glasses and contacts ,will not!!! where is the t.d.o.a.? i dont wanna make this too long but tennessee needs some solid leadership who will help with changing the laws!!!!:cheers:p.s. i think roys agenda is to make tennessee and the rest of the states better for all opticians!


I think you have been misguided with regards to the TDOA and the State Boards authority with the laws.
1. The laws are not outdated at all, they protect the consumer by limiting who can provide service for them and what services each field can provide. In your reference to refracting, are you to young to remember that the Optometry Association pushed hard for deregulation of opticians because a very small minority of opticians were pushing for refraction? The optometrists will not give up their core business of refraction, and rightly so. If opticians could refract legally, they still would not have authority to diagnose the health of the eyes. How many consumers do you believe would schedule comprehensive examinations if they could get a $20 refraction from an optician? How many cases of macular degeneration, diabetes retinopathy, and even brain tumors, would go undiagnosed if opticians were refracting?
2. The board has complete authority to levy fines on anyone practicing without a license, and can turn a violator over to a circuit or chancery court if violations continue. They also have authority to close down a dispensary  running without optician coverage. The TDOA does not have this Authority. The State Board Proposes new rules and regs, not the TDOA. The TDOA can lobby and advise the State Board and legislators, but has NO authority to make a new law or rule.                                           3. The TDOA Board members were at the petition hearing and showed up in full force to show support of the issues on the agenda. They also spoke with several Board adminstrators afterwards about TDOA concerns. I can tell you for fact that the TDOA board and members have recently been contacting state legislators to let them know about the importance of the optician field in preparation for the 2008 review. They are the only organization I am aware of who actively work behind the scenes with legislators to preserve our license. Maybe you should research further before you knock the only organization who lobbys on your behalf. You say the TDOA should be changing laws to protect opticians, wasn't it the last attempt to change the law and add refracting to our duties, which is backed by Roy, that nearly had our field deregulated?

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## AdmiralKnight

> You had the correct response from the start, but facts omitted by Mr. Ferguson and lack of statutes to refer to, has swayed your opinion from seeing the repercussions of unlicensed upper management with only profits in their mindset. The reasoning behind the statute in question regarding supervisors, reflects your initial responses. Direction is passed down from the top-- available payroll, marketing, frame and lens availability, sales goals, evaluations, pay rates, who gets terminated or promoted, etc. The questions from the petition were submitted because many of our optician laws and regulations were being disregarded and misinterpreted to increase profits to the degree that a patient could be purchasing prescription eyewear from someone with NO license, apprenticeship, or even a weeks worth of optical experience. No matter how high in management an optician is, if he/she is supervised by one with no risk of losing their license, the time WILL come when the optician is put in a situation where he/she either follows ILLEGAL direction or risks promotability, reprimand, and/or termination.


I'm sorry, but bull. It's amazing how you talk down to people for simply having a different opinion than yours.

I worked for a company that was run exactly the way you're trying to stop, and believe me, there was no problem with having unlicesend people in higher places. Lets take exactly what YOU wrote and break it down.




> Direction is passed down from the top-- available payroll, marketing, frame and lens availability, sales goals, evaluations, pay rates, who gets terminated or promoted, etc.


How exactly is this a problem? How does this fall ANYWHERE near needing a license to do? I just don't see an issue here. These are purely business pratices, and have no need for an optician to do.





> The questions from the petition were submitted because many of our optician laws and regulations were being disregarded and misinterpreted to increase profits


Can you give us some examples of this? What exactly are these evil corporations doing? I'm curious.




> No matter how high in management an optician is, if he/she is supervised by one with no risk of losing their license, the time WILL come when the optician is put in a situation where he/she either follows ILLEGAL direction or risks promotability, reprimand, and/or termination


MAYBE. You're making huge assumptions here. Just because the manager has no lisence to loose, does not mean there are no concequences. If a law is broken, there are concequences. Fines, etc etc. 

In the end, it comes down to accountability. If an optician is given a situation as you put it, it should be handled the same way it's handled in any other non-optical company. If you work for any company whatsoever and your boss asks you to do something illegal, or risk being fired... well that's illegal. It's a seperate issue all together, and has nothing to do with wether or not the person has an Optician's license. Do you really think that having EVERYONE up the ladder in these corporations having licenses will change anything? If the president of a company has two choices, 1) loose his license if he's found doing something illegal, as you stated, or 2) do it anyway and make millions of dollars... do you really think that license will mean ANYTHING to that person.?

Bleh.  :Mad:

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## cash1

if i have a tn. disp. lic. and i am doing refractions for the dr. in his office and i am turned in could i lose my lic? if i am putting in a ctl. on a person and the dr. is in the room next door could i lose my lic.? if anyone they hire off the streets is hired by the dr. they can!! stupid old laws! i am not talking about opticians refracting in there on office with no dr. around. and when was the last time a wal-mart was closed down from no lic in the building.... or any other place in tennessee? and the t.d.o.a. should write these new laws and get with the government guys and pass them! oh! no money there huh? oh and by the way  my name is lindsey dodson!!!! and i do know my way around all the boards in tennessee. so there now you know who i am!!!!:cheers:

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## LDO IN TN.

AMEN! Boardpetitioner
I attended the hearing and will confirm the fact that TDOA was there in full force to support a declaratorial order. These people took time off from their jobs, as they have many times in the past, to stand up for your profession when some opticians in the state attempt to destroy the only organization which stands between you and deregulation. Yes Roy did sit with and confer with legal councel for the NAOO. I was saddened by the way these attorneys chose to belittle my profession. If these people had their way no optician would be regulated and their corporation would have total control over a buch of eyeglass peddlers. I have spent a great deal of time on capitol hill and beleive me I know the friends and enemies of the profession. 
The next time you attend a continuing education session ask the presenter where the money he collects from his sessions go. 
Boardpetitioner is to be commended, for he has stepped forward and is standing up for what is right and shows the class that is lacking in certain small segments of our profession in Tennessee.

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## cash1

roy i know this is making you go:hammer:you go roy you talk to the naoo the tdoa and any one else who will talk to ya! roy has done a lot of education and optics is his game!get off who is the bad guys here. it is the laws people, the laws!! not roy not me not the lic boaed not the tdoa. hey roy how much did you make by going to nashville? bet the tdoa uses there per diem.

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## BoardPetitioner

> if i have a tn. disp. lic. and i am doing refractions for the dr. in his office and i am turned in could i lose my lic? if i am putting in a ctl. on a person and the dr. is in the room next door could i lose my lic.? if anyone they hire off the streets is hired by the dr. they can!! stupid old laws! i am not talking about opticians refracting in there on office with no dr. around. and when was the last time a wal-mart was closed down from no lic in the building.... or any other place in tennessee? and the t.d.o.a. should write these new laws and get with the government guys and pass them! oh! no money there huh? oh and by the way my name is lindsey dodson!!!! and i do know my way around all the boards in tennessee. so there now you know who i am!!!!:cheers:


According optician state law TCA 63-14-102 opticians are "specifically prohibited from engaging in the practice of ocular refraction," so yes you can lose your license, and I know of no statutes that allow for an untrained person off the streets to refract either, if I am wrong please advise me to the correct statutes. And yes last year a business was closed and heavily fined for operating without a license in TN. The TDOA does not write the laws they can recommend legislature but all new laws or rules are presented by the Health Related Division with wording approved by the State Licenseing Board.

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## BoardPetitioner

> roy i know this is making you go:hammer:you go roy you talk to the naoo the tdoa and any one else who will talk to ya! roy has done a lot of education and optics is his game!get off who is the bad guys here. it is the laws people, the laws!! not roy not me not the lic boaed not the tdoa. hey roy how much did you make by going to nashville? bet the tdoa uses there per diem.


The NAOO has sued several optometry boards in many states to further corporate interests to the detriment of professional services. Just google National association of optometrists and opticians/board to see for yourself. Beware of who you tell others to speak to on behalf of opticians. The TDOA board members were not paid anything to attend, I personally missed out on a days pay, and spent $50 in gas. The others I believe I can vouch for had similiar expenses that were not reimbursed.

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## cash1

so you can only speak to only who you feel i should speak to? i am not for the naoo. but i feel ya need to know your enemy. and by the way do you really not know of a person who does refractions for a dr. who isnt the dr.?

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## BoardPetitioner

> I'm sorry, but bull. It's amazing how you talk down to people for simply having a different opinion than yours.
> 
> I worked for a company that was run exactly the way you're trying to stop, and believe me, there was no problem with having unlicesend people in higher places. Lets take exactly what YOU wrote and break it down.
> 
> 
> 
> How exactly is this a problem? How does this fall ANYWHERE near needing a license to do? I just don't see an issue here. These are purely business pratices, and have no need for an optician to do.
> 
> 
> ...


What if there were an optician new to the field who came to work for a corporate optical, worked there several years while being held to less than 34 hours a week because his payrate was higher, even though more hours were wanted and requested and optical sales were being made while the optician was off. And what if this same optician had apllied for a dispensary management position on several different occasions and was passed over on each one for a non-licensed manager. What if he finally decided enough was enough and decided to leave the field all together. Would this not be an example of how controlling payroll, payrates, and promotions could effect an opticians career and livelihood as well as the best interests of the patient who expect they are receiving services by someone properly trained? Now if the dispensary he worked at had 3-4 opticians and he were low man on the totem pole, that would be different but if optician hours are cut to save on payroll while nonlicensed persons are allowed to sell and dispense without a licensed optician or optometrist supervising, and promotions are given to unqualified persons because they don't know the rules and will follow direction without question because they know no better, would that be a good hypothetical example of why laws should be followed?

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## BoardPetitioner

> so you can only speak to only who you feel i should speak to? i am not for the naoo. but i feel ya need to know your enemy. and by the way do you really not know of a person who does refractions for a dr. who isnt the dr.?


I do not personally know an optician refracting. I do know of one case the Division is looking into. Knowing your "enemy", and giving them helpful tips are two very differnt things!

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## AdmiralKnight

I fully agree that non-licensed people should not be able to have the final say on sales, and no where did I say that laws should not be followed, but let me give YOU a non-hypothetical situation. 

Your story was very familior to me, because it basicly discribed me to a t. I started working for lux about 6 months before becoming fully licensed. I recieved my licence and worked there for about 3 years, becoming a manager after two. I was the only license in the office, but I had two sales associates, 'frame stylists', whatever you want to call them. I worked my 40 hours a week, but we were open about 70 hours throughout the whole week. So there were about 30 hours a week with no license. People came in, talked with my associates, who helped them find frames they liked. They however, did NOT have the final say in the sale. Those patients would come back when I WAS in the office for me to take the measurements, talk about lenses, etc etc. Was this an ideal situation? Of course not, but it does work. And no laws are being broken. The girls did no adjustments, no measurements, nothing to break the law, and yet the office was open for patients. 

As for your situation, I'm sorry, but if you're not happy with your job, find another one. Don't leave the field because of one crappy place. I'm still curious though. What makes you think if the regional in your example were licensed, this person would get his extra hours, or get the promotion? Yes, companies have to think about money, they have to or they go bust. That doesn't change if the person making those decisions have a license attached to them. Which is why, to me, it doesn't make any sence for anyone higher than store manager to need one.


*Edit*

And those rules about people coming back to me for measurements were not instituted by ME. It was from MY bosses, those non-licensed people. Why? Because it's smart. And it's the law. Breaking the law = loosing money.

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## BoardPetitioner

[quote=AdmiralKnight;212215]I'm sorry, but bull. It's amazing how you talk down to people for simply having a different opinion than yours.
I did not realize I was talking down to anyone. I apologize if you feel I have spoken down to you. As for comments directed to Roy's questions, he was well aware that apprentices would soon have alternate sponsors and that other statutes applied to student opticians, he was trying to get the negative response he wanted and eventually got. I have not written anything an this forum "lightly" I have already stated that I am limited to what examples or scenarios I can give. But there are plenty of bad scenarios within corporate opticals in TN.

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## AdmiralKnight

I just find it strange that they would try to change the law isntead of enforcing the current one. If laws are being broken by these companies, charge them.

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## BoardPetitioner

> I just find it strange that they would try to change the law isntead of enforcing the current one. If laws are being broken by these companies, charge them.


The board did not change any laws, just clarified the laws in question.  They were actually already in the state code.  I agree that they need to be enforced and companies charged. They needed clarified because some companies were trying to reword certain parts to their benefit and forcing opticians to follow the companies interpretations.

----------


## Dannyboy

> Maybe a little off track but there sure is a lot of false confidence in ones abilities just because they hold a license. I happen to manage a franchise and no I do not have a license and have three people with no license working with me that are also not licensed. We work under direct supervision of the O.D. that owns our location therefore we are operating within the state law. I have worked with Licensed Opticians in the past that struggled to read prism, could not read a lensometer correctly, and generally relied on the "Dr. needs to re-check" line without doing any trouble shooting. Most would have a real struggle in the lab where I believe an opticians knowledge should originate.
> 
> I am not trying to bash anyone or trying to lump any one group together. Just wanted you to know that there are those of us out here that strive to do what's best for the patient first and foremost whether we are licensed or not and whether we are in a corporate setting or not. We take great pride in the quality of our work and making sure we meet the needs and wants of our patients and along the way we try to be as profitable as possible.
> 
> I'm sure the next question will be as to why I have not attained a license yet and I will be happy to answer that when time allows. Right now I'm late for my tee time.:D:D
> 
> Thanks:cheers:


Well as far as the law in Florida you are really not practicing opticianry in any sense of the word as your location is owned by an Optometrists, you are merely an assistant of this optometrist in providing care. Your optometrists is held liable for any of your actions wether he likes it or not. The Opticianry board has no say if you provide good or bad care in your case. 

The license which you do not have enables to actually be in business for yourself and dictate the quality of care that you want to give. Being a licensed practitioner is no small thing in our state as we are tested and pay a heavy fee to get licensed and maintain that license. The board of Opticianry do penalize bad opticians. I am sorry that you have met opticians that do not know how to read a prism. The licensure of the optician is a benchmark. Who does the benchmark for your quality work?
It is easy to negate or waterdown what one does not have. By the way nothing wrong working for an OD but really who checks your quality work? If you mess up, no big deal as you are not responsible. A quarter up or a quarter down...a few mm off or a crocked progressive...

See the way I see lab people are usually held accountable for remakes or breaks...the optician must keep his job and tactfully fail what bad jobs the lab is trying to pass...Sure a lab manager, or any person of hierachy can intimidate a licensed optician. In Florida any corporation or owner of a licensed optical establishment is held accountable for that precise reason.I know many many opticians who have lab experience. I would never go into business unless I had such experience but again without such license one cannot practice opticianry. 

dannyboy:finger:

----------


## LDO IN TN.

Only when they dominate the doctors and nurses and tell them how to perform surgery and care for patients.

----------


## AngryFish

Can someone offer me a little help with this one? I have not been able to figure out what law(s) have been broken or who is alleged to have broken them and I have read the posts twice. I read a lot of hearsay and hypothetical situations but I cannot seem to find any facts.

  DannyBoy is right. If you are working under the license of an optometrist, you can do almost anything he or she is willing to take responsibility for so you being a licensed anything is a moot point. You could refract under his or her license for that matter. The prohibition against refracting is directed at licensed opticians who, in the course of their duties under the law, are being held out as licensed opticians and are therefore forbidden to refract. This _specific_ code section is NOT addressed to ANY other persons. I dont think it is a matter of pointing anyone in the direction of the right statues, but a matter of understanding what they mean in a legal context.

  I also think there is a misinterpretation or contextual problem with some of the legal language we are trying to interpret. Can anybody succinctly help me? I am trying to get a handle on a possibly important topic but it seems as though there are four or five unrelated things being passed around with a bit of misunderstanding and confusion.

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## cash1

if a lic. optician is working for a dr. od or md and is refracting. he or she can lose his lic. even if the dr. is there. if he puts a contact in someones eye and the dr. isnt in the room!!!! he or she can lose their lic. now if they hire someone off the streets and teach them to do these things it is ok!the laws are on the opticians board and they will here the case!

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## cash1

sorry ! some tennessee laws just blow my mind! that i will have to live with or change. but dont think for one min. that roy is out to hurt any lic. optician that is crazy. one of the best speakers around. plus i have been at board meeting where he has helped opticians,when sometimes it seems the board doesnt want to. sometimes the laws want let the board help,even if they want to. so i will drop this and go on and learn more about freeform lens!:cheers:

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## hcjilson

Got caught up in the football wars and missed this thread completely. It has gone off in tangents so often it is difficult to follow so if anyone would care to summerize to this point it would be helpful. By way of introduction, I am a member of the MA board of Registration. I have read Roy's initial post and was surprised to learn that students in a formal education program were not exempted from compliance in a co-op experience. That could be easily remedied by ammending the rules and regs.
again my apologies for jumping in this late.

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## Roy R. Ferguson

Hi All:

Often the best of intentions fall under the law of unintended consequences.  For instance, question four asks if optical employees are permitted to do certain acts for Optometrists.  Since the Opticians Board has no control over these employees, Im not sure what the outcome will be.  Its doubtful that Optometrists will appreciate opticians attempting to define and limit the scope of employment for such individuals.

As often is the case in this forum, ad hominem attacks quickly replace any meaningful discussion of issues.  So far in this thread I have been accused of giving both written and verbal advice to the three attorneys opposing the petition, and backing an attempt to change the law and add refracting to our duties.  Since I do not recall engaging in either activity, I respectfully request the charges be supported or retracted.  

Roy R. Ferguson, PhD

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## hcjilson

To Whom it may concern.
Until the author of the allegations either substantiates his accusations or retracts same, the accusations are unsubstantiated and should be treated as such. I have contacted the author by PM and have asked for any supporting documentation. Unsubstantiated charges are a violation of posting guidelines and are treated harshly.

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## wabmorgan

> Hi All:
> 
> Often the best of intentions fall under the law of unintended consequences. For instance, question four asks if “optical employees” are permitted to do certain acts for Optometrists. Since the Opticians Board has no control over these employees, I’m not sure what the outcome will be. It’s doubtful that Optometrists will appreciate opticians attempting to define and limit the scope of employment for such individuals.


The "Optical Employees" being refered to are the empolyees that work for chain(s) or other privately held opticals in which the optical store/shop are not owned by an optomerist.

----------


## Roy R. Ferguson

> The "Optical Employees" being refered to are the empolyees that work for chain(s) or other privately held opticals in which the optical store/shop are not owned by an optomerist.


(4) Can optical employees go into the public sector and solicit business for optometrists by means of verbal communication, business cards, and/or vision screenings?

The unintended consequences would seem to be:
1. Nothing prevents Lawn & Garden employees from taking over this function.
2. Optical employees also work for independent Optometrists. 
3. I doubt the Tennessee Board of Dispensing Opticians has the power to police such employees.

Roy

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## wabmorgan

> (4) Can optical employees go into the public sector and solicit business for optometrists by means of verbal communication, business cards, and/or vision screenings?
> 
> The unintended consequences would seem to be:
> 1. Nothing prevents Lawn & Garden employees from taking over this function.
> Roy


:finger:Don't give them any ideas there :bbg::D :lol:

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## Optician1960

Bottom line is that Licensed Opticians should be doing the right thing for their customers no matter who they are working for, even self employed. This includes understanding the State Regulations and assuring that the people working with them are adhering to the regs. If they are being asked to do things that are questionable, then they should do the right thing and ask for clarification (from the OD, LO, Manager or other qualified person). 1 challenge we all have is understanding "exactly" what the regs mean. There is a good amount of grey out there in the regs and even members of Boards and Opt. Assoc disagree often times on what they mean. As an example, if there was no grey, then the declaritory meeting in Tenn would not have been needed. Having been in the field and worked from wholesale to retail and worked with OD's, Corporate and Local Licensed Opticians, it is 99% of the time, the individual dispenser who is making the decision to do the right thing or the wrong thing for the customer, not the owner (OD, Local LO, or Corporate). Let's also keep in mind that no matter who the owner is, they are in business to make money, and hopefully they are all successful and working to give the consumer a great product and experience. We must all work together to ensure the consumer has a great experience no matter where they go so that we can build long term growth within the industry (I think we have seen a slow down overall in the last few years).

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## chip anderson

Be careful what you wish for.  Some of this wording could put the few manufactures of contacts and the people in all optical labs out of work.  I suspect the percentage of licensed opticians in these establishments is near zero.   And they do meet the defintion of "taking orders for prescription contact lenses" ,  etc.

Chip

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## wabmorgan

There is an exemption in TN to wholesale labs. No LO or OD requied since the product is not being "dispensed" to the pateint at that point.

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## hlpnu2c

:finger: What is truly sad about the entire thing is that things have been misrepresented on here. Things that BoardPet has said are not true. Roy has done more for the Opticians in TN and supports us all. BoardPet needs to be a bit more careful on how things are worded because some of us know the truth about what happened in the board meetings. And some of us trust Roy a heck of a lot more than we trust BoardPet. 

BoardPet has valid points, but actions have been started that have spiraled out of control. There is no need to take on the world. Don't get me wrong, fight YOUR battle. But the rest of us don't want to be involved. ( the majority of us because you do have your few supporters that are dwindling as we speak because of these actions ).

Roy, I would be mad as heck at this person. It's ok though because you know that you have more supporters than BoardPet. You have the respect of many opticians in TN and around the states. You have done mounds of work for us, I appreciate you. You know that BoardPet is just trying to rattle everything that can be rattled because they are losing ground and people are tired of listening to the mess they have created. We are all tired of this mess. Let it drop.

Cheers to Roy.
:cheers:
hlpnu2c

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## Roy R. Ferguson

Hi All:

To the best of my knowledge, the scope of practice for opticians in Tennessee has not changed since it was first written.  As a result, opticians licensed in the state are held hostage to standards that can be easily misapplied.  For instance, TCA 63-14-102 (1) reads: _A person registered under the provisions of this chapter is specifically prohibited from engaging in the practice of ocular refraction ._  While the original intent was meant to insure opticians did not offer refractions to the public under their license, it has recently been interpreted to mean such functions *could not* be performed under the supervision of an Ophthalmologist or Optometrist.  In offices where opticians fill multiple roles this could prove problematic.   

Consider this conundrum:  _dispensing opticians may fit contact lenses in the presence of and under the direct supervision of a licensed optometrist or ophthalmologist._  In the past it was accepted that an optometrist or ophthalmologist could supervise licensed opticians in their office as they deemed appropriate.  If a more strict reading were applied, it would mean an optometrist or ophthalmologist who did not want to remain in the room while contact lenses were being fit would employ an unlicensed assistant to perform that function.  

This is where we find ourselves in Tennessee and why I remain concerned about the law of unintended consequences.

Roy

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## Roy R. Ferguson

Hi All:

The Declaratory Order was released and I managed to obtain a copy. Please read and comment.

*ORDER* 
This matter came to be heard before the Tennessee Board of Dispensing Opticians (hereinafter the Board) on the 29th day of October, 2007, pursuant to a Petition for Declaratory Order filed by the Petitioner on May 1, 2007. Presiding at the hearing was the Honorable Mattielyn B. Williams, Administrative Judge, assigned by the Tennessee Secretary of State. The Department of Health (hereinafter the Department) was represented by Nicole L. Armstrong, Assistant General Counsel in the Office of General Counsel. The Petitioner was represented by H. Chris Trew, Esq. The intervening party, the National Association of Optometrists and Opticians, was represented by John C. Lyell, Esq., and Martha M. Gentry, Esq. After consideration of the Petition for Declaratory and argument, the Board found as follows:

(1) A person who is not a licensed optician or an apprentice optician in Tennessee may not sell or take orders for prescription contact lenses, or perform any of the duties related to dispensing opticians, which include but are not limited to frame and lens selection for glasses, prescription interpretation and entry, pupillary distance and segment measurements, rx neutralization, fitting and adjusting prescription eyewear, and dispensing prescription eyewear, including plano contact lenses.

(2) An apprentice optician cannot perform optician duties described in #1 above without the direct supervision of the sponsoring optician.

(3) Store managers and district managers of optical chains and dispensaries in Tennessee must be licensed opticians.

(4) Opticians cannot perform vision screenings.

The Board takes this action for the protection of the public.

Ordered by the Tennessee Board of Dispensing Opticians on the 29th day of October, 2007.

Kelly Godsey, D.P.O
Chairman
Tennessee Board of Dispensing Opticians

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## hcjilson

What do you have to be in Tennessee to do a vision screening? ........a Registry of Motor Vehicle Clerk?



PS- I mean no disrespect to Tennessee RMV folk.

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## chip anderson

Actually I thought screenings were generally done by lay volunteers and school teachers.

Since DL regualtions don't apply to "undocumented immegrents" do these regulations apply to them?

Good to hear from you again Roy

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## Roy R. Ferguson

Hi All:

It appears only opticians are prohibited from doing vision screenings in Tennessee.  What will happen when an Optometrist or Ophthalmologist asks one of their licensed opticians to participate in a health fair is yet to be seen.  Do other states have this prohibition?

Roy

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## chip anderson

Roy:  
Depends on how many legislators the optometrists can buy in each state.

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## wabmorgan

Bump

----------


## Judy Canty

Am I missing something here?  The order seems to benefit Opticianry in TN with the exception of vision screenings.  

My only question is how or if this order applies to the employees of ODs and MDs?

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## wabmorgan

It doesn't apply to ODs or MDs. The Board of Opticians does not have any regulatory power over them. As a result, a chain could in thoery hire an OD for the employees to work "under". 

In the short run.... it might appear to be a good thing.... depends on your viewpoint.... long term.... could be a different story. 

TN's Board of Opticians is already under sunset review for 2008, I just hope this doesn't push us off the edge and we wind up regretting this. I know with this in mind... the major chains will be trying to get our licensees pulled. They have tried it several times before and with a lot less on the table than this. 

It won't matter what the board passed if it ceases to exist.

----------


## LDO IN TN.

> It doesn't apply to ODs or MDs. The Board of Opticians does not have any regulatory power over them. As a result, a chain could in thoery hire an OD for the employees to work "under". 
> 
> In the short run.... it might appear to be a good thing.... depends on your viewpoint.... long term.... could be a different story. 
> 
> TN's Board of Opticians is already under sunset review for 2008, I just hope this doesn't push us off the edge and we wind up regretting this. I know with this in mind... the major chains will be trying to get our licensees pulled. They have tried it several times before and with a lot less on the table than this. 
> 
> It won't matter what the board passed if it ceases to exist.


I don't think there should be any concern over the chains putting forth any greater effort than they have in the past to eliminate Tennessee's Licensing Board.  They lost in the declaratory order, so my prediction would be that they will now attempt to own the Board and thus control it.  If they load the Board up with their employees, corporations will not have to worry about "their" interpetation of the law, for they can simply make their own laws.  The liberal attitude is, if you can make everything legal it will eliminate crime.
In Tennessee, the state association has, for many years, spent thousands of dollars and many hours of work saving our license.   If state assoiations continues to exist in the future they may take on a different role.  They may, in the future have to work to eliminate licensing boards to save their profession.

----------


## HarryChiling

> Am I missing something here? The order seems to benefit Opticianry in TN with the exception of vision screenings. 
> 
> My only question is how or if this order applies to the employees of ODs and MDs?


Dr. Ferguson has been working on educateing opticians to screen young children for various refractive conditions using a photo system. The ones affected are the young ones since no one else seems to want to perform these screenings or has a system set up to perform these screenings. 




> the National Association of Optometrists and Opticians,


Lobbyists:
http://www.legis.state.pa.us/cfdocs/...izationId=1402

I am sure I don't have to tell you this but for other opticians it may come as a suprise, the NAOO which seems to always rear their heads in ugly places is actually a front for the corporate chains.

The only information you will find on them is a PO Box and a bunch of lawyers and lobbyists at their ready.  In 2006 they spent nearly $400K dollars amoung their lobbyists.  They are more than likeyl going to be there trying to get rid of TN licensure.

Post Office Box 459
Marblehead, OH 43440

----------


## Stormy

While I don't see any reason why an optcian should not be allowed to do vision screenings I'd like to share my experience in this regard.We had two licensed opticians "on the premises."One optician would be instructed by the non-licensed mngr. to go out into the store to vision screenings and the other optician to set "modulars"I'll let you guess who was left in the store to sell and fit eyewear.What's wrong with this picture?

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## HarryChiling

More info on NAOO:

President Michael Cohen - Cole Vision Corp.
Vice President Lionel Gilels - Empire Vision Center
Vice President Paul Sass - ?
Secretary and Treasurer - Franklin Rozak (TN may know him as the goon that shows up and pushes the assoc. agenda)

EIN: 51-0235104

PO Box 459
Marblehead, OH 43440 

Phone: (419)798-2031
Org Type: 501(c)(6)

Mission Statement: The organizations primary purpose is to provide continuing education for members about current and new products and their application and to provide information as to laws, rules, and regulations for the retail optical industry.

In 2005 They raked in about a quarter million dollars on provideing seminars for their members? (Yeah Right)  Then they turned around and spent $90K or roughly 1/4 of the assoc. money on lobbyists that are trying to pass legislation in the corporate opticlas interests.  So next time you see a CE sponsored by them or affiliated with them run don't walk to the door.

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## wabmorgan

> It doesn't apply to ODs or MDs. The Board of Opticians does not have any regulatory power over them. As a result, a chain could in thoery hire an OD for the employees to work "under". 
> 
> In the short run.... it might appear to be a good thing.... depends on your viewpoint.... long term.... could be a different story. 
> 
> TN's Board of Opticians is already under sunset review for 2008, I just hope this doesn't push us off the edge and we wind up regretting this. I know with this in mind... the major chains will be trying to get our licensees pulled. They have tried it several times before and with a lot less on the table than this. 
> 
> It won't matter what the board passed if it ceases to exist.





> I don't think there should be any concern over the chains putting forth any greater effort than they have in the past to eliminate Tennessee's Licensing Board. They lost in the declaratory order, so my prediction would be that they will now attempt to own the Board and thus control it. If they load the Board up with their employees, corporations will not have to worry about "their" interpetation of the law, for they can simply make their own laws. The liberal attitude is, if you can make everything legal it will eliminate crime.
> In Tennessee, the state association has, for many years, spent thousands of dollars and many hours of work saving our license. If state assoiations continues to exist in the future they may take on a different role. They may, in the future have to work to eliminate licensing boards to save their profession.


I would have PLENTY of FEAR. 

I can't envison the chains EVER being able to hire enough LDOs or appretnices to comply with this order.... even if they do, what do you think is going to be the LONG TERM effects of having so many LDOs??? 

Lastly, there are several mgrs that not licensed in the chain stores, especially at the big W.

These factors give the chains a greater cause than EVER to try to get licensure eliminated.

When the people(citizens) start to complain because they can't pick up their eye wear because there is no LDO, complain because they can't get waited on, ect... the complaints will eventually wind up on the hill to the representatives and senators and they may very well decide NOT to support us in our licensure efforts. 

LOOK AT HOW MANY STATES DO NOT HAVE LICENSURE!!!!!!!!

I hope this works out for best, but I think the board may well have taken a dangerous road here.

----------


## HarryChiling

> I would have PLENTY of FEAR. 
> 
> I can't envison the chains EVER being able to hire enough LDOs or appretnices to comply with this order.... even if they do, what do you think is going to be the LONG TERM effects of having so many LDOs??? 
> 
> Lastly, there are several mgrs that not licensed in the chain stores, especially at the big W.
> 
> These factors give the chains a greater cause than EVER to try to get licensure eliminated.
> 
> When the people(citizens) start to complain because they can't pick up their eye wear because there is no LDO, complain because they can't get waited on, ect... the complaints will eventually wind up on the hill to the representatives and senators and they may very well decide NOT to support us in our licensure efforts. 
> ...


Does the board have any powers to enforce the regulations and if so do they visit shops that are not in compliance?  They don't want to hire more LDO's not that their isn't enough.  Heck the need is obviously there, they just don't want to and I agree the one thing you can count on is the corporate opticals breathing down the politicians necks to get rid of licensure.

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## wabmorgan

They can "visit" shops but rarly do so.... usually only if they have recived a complaint. 

As for being enough LDOs.... they are already in short supply in TN anyway.

----------


## Stormy

> I would have PLENTY of FEAR. 
> 
> I can't envison the chains EVER being able to hire enough LDOs or appretnices to comply with this order.... even if they do, what do you think is going to be the LONG TERM effects of having so many LDOs??? 
> 
> Lastly, there are several mgrs that not licensed in the chain stores, especially at the big W.
> 
> These factors give the chains a greater cause than EVER to try to get licensure eliminated.
> 
> When the people(citizens) start to complain because they can't pick up their eye wear because there is no LDO, complain because they can't get waited on, ect... the complaints will eventually wind up on the hill to the representatives and senators and they may very well decide NOT to support us in our licensure efforts. 
> ...


Actually, most of the big chains will only hire a manager if he/she is licensed.Why? The manager is always the one who is expected to put in the most hours...more hours more coverage.More bang for your buck....kill two birds with one stone...etc..etc...Usually the only reason that they will hire a non-licensed person as manager is that they simply can't find an optician that is willing to do two jobs for the price of one.

I think Tn has done a good thing for you optiicans.They have eliminated some of that grey area which should translate into job security. At least initially.Unfortunatley long term effects could mean:
1. Less pay
2.Demand for more optiicans may spawn new and less stringent requirements in order to become licensed.ie Do you know all the letters in the alphabet?I shudder to think.

----------


## Judy Canty

Every post in this thread should be reason enough to actively support your professional organizations at the local, state and national levels.  NAOO does not speak for either Opticians or Optometrists.  The speak for and are supported by corporate entities.  Either we all work together or we're all unemployed or underemployed together.

----------


## LDO IN TN.

> Every post in this thread should be reason enough to actively support your professional organizations at the local, state and national levels. NAOO does not speak for either Opticians or Optometrists. The speak for and are supported by corporate entities. Either we all work together or we're all unemployed or underemployed together.


I couldn't agree more.  The sad part is we have for profit continuing education competing with the state association in Tennessee and the only one who has a lobbyist and attorney on payroll is the state association.  If opticians can find CE hours that are $5.00 cheaper than their association they will go for it.  If you ask opticians in our state if they think ignorance and apathy exists in our profession, they will answer "I don't know and I don't care".  Sadly, these are the same individuals who will ask why the association didn't do more and yet they didn't bother to support it.

----------


## wabmorgan

Bump

----------


## chip anderson

There are enough CE hours out there for free. So why should the cost of same matter?
In fact 90&#37; of those we have to sit through are basic BS and sales pitches.  So what has
"education" got to do with the matter.   Unfortunately and in part because of the aforementioned
aspects of "education" most of us attend CE courses only for certification, not knowledge.  Didn't 
used to be that way.

Chip

----------


## tmorse

> The part of this that is BAD for us is requiring only the LDO and apprentices being the only ones able to do anything. This may cause a temporary wage war but in the long run it will lead to lower wages for LDOs at the point that there are more LDOs in the market place.


Not the experience in Ontario, Canada... Only LDO's and apprentices can dispense and for the last 40 years... yet wages still the highest in Canada and plenty of work.

----------


## HarryChiling

The big picture is that TN opticians not being able to perform vision screenings means that children in the state that are currently benefiting form vision screenings will be taking one step back in eyecare.  Forget pay is licensure is revoked, think about the many consumers that will get progressively worst eyewear, look at current posts on this forum for news about TX opticals provideing shoody eyewear, look at NY opticals not having licensed opticians on staff.  These are stories ripped from the current news about the alarming state of eyecare.  I am afraid that corporations have done major damage to the reputation of our profession and have doen everything within their power to make dispensing look like a cheap parlor trick instead of the art and science it is.  I wish TN good luck in this trying year and if I can dig up any dirt for you give me name, rank, and serial number.

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## wabmorgan

One could only hope that would be the outcome here.... but I doubt it.... especially given the highly "retail" enviorment in the US. 

Typically though.... if you increase the number of LDOs, pay goes down becasue of a lack of demand.

If our licinsure get revokes.... it will lead to most LDOs leaving the field. 

Would you work for half of what you were making???

----------


## JennyP

For those who aren't familiar with some of our TN regulations:
1) Each Licensed Optician (who is eligible by virtue of having been licensed long enough and who is "in good standing" with the board) may have 2 apprentices.
2) Applicants for apprenticeship are screened and many who apply are rejected or told to reapply for various reasons. 
3) There is ONE school for opticianry in TN, and it is not centrally located in the state, or even in a highly populated area. (I know because I graduated with an A.S. in their 1st class back in '73!) This community college program begins a new class of students every TWO years, limiting the number of potential graduates and potential licensed opticians. 
4) Even if you enroll and study in the college program you still have to pass the ABO and NCLE and the state practical exams as do the apprenticeship people. 
5) Our continuing ed credits required for maintaining our licenses must be via proctored and face-to-face classes, not mail-in or online study guides (which may be good for review and learning even if not for credit).
6) There are not enough licensed opticians in TN to meet the demand of the regulations and still maintain customer-friendly hours and convenience (ie: driving less than 10 miles from home).

Now for the rant:
I am licensed here in TN. I work at a chain store. I am not salaried. Once upon a time it was my goal to manage one of our stores. For 7 years I worked as a sales supervisor (key holder) AND optician (non-salararied, basically a token supervisor with no extra benefits and many more headaches). I didn't have the highest #s and I had some grey hair which may have interferred with my goal of moving up to salary. I finally figured out that it was in my best interest to step down from the key holder position and concentrate on what I did best: customer service, trouble shooting and dispensing. 
Recently it has been a blessing that I did not have the added burden of management responsibility. My husband has been very ill and has had 5 brain surgeries and bypass heart surgery in the last 18 months and two episodes of blood clots that had to be treated with time in the hospital. My store's management team has finagled the part time use of opticians from 2 of our other stores to cover my days off and any unscheduled absences as we had one wonderful optician retire and 2 others seek other positions. I currently have one apprentice and I am in the process of trying to sign up a second apprentice.

I think I work with the finest team in the city, maybe in the state, and they know that they can call on me when any optical question arises (I may not know all the answers but I have a lot of great references to tap!) Some of my team have better fashion sense in their little fingers than I have in my whole body, and I think we compliment each other in skills and abilities. I think its a shame to deny our customers/patients/clients their skills simply because they don't have a licensed optician to sign up under. (I know on busy Sundays when we have only 2 people working our retail floor and a store full of shoppers needing help and wanting glasses, heaven is definitely not the word that comes to mind! I'd hate to think our TN Board plans to encourage this kind of licensed h**l. 
We need more schools and better promotion of our specialty with good pay. It won't come overnight. 
 I, for one, will quit if it gets worse. I do NOT need the stress. 

By the way: Roy, last year you said it would be like this!
Hey, when are you coming back to Chattanooga??

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## Roy R. Ferguson

Hi All:

This thread has slipped slightly so let me address a copy of issues that has popped up.  My company, The Learning Curve, is that group that supplies continuing education to opticians in Tennessee.  Is this something I wanted to do?  Not really.  The courses began in response to requests from opticians throughout the state who felt alienated from the state society.  Their complaints were wide and varied but I do not recall one concerning cost.  

In Tennessee we have one opticianry program that is located in the Eastern part of the state.  While Director of this program in the early 1990s, I wrote and proposed a distance learning program designed to provide an educational component for the states apprentices.  The idea was to teach this coursework until a sufficient demand was demonstrated in an area to justify an additional opticianry(s) program.  This was vehemently opposed by the state society.

In 1992 when the OAA adopted a minimum education resolution, the Tennessee Dispensing Opticians Association (TDOA) was the only state society that voted to oppose the resolution.  In later years the organization was offered, and refused to support, two college programs designed to provide college degrees to licensed opticians in the state.

Twenty years ago the TDOA was arguably one of the finest state societies in the United States.  When the past few years are examined, beyond paying a lobbyist and the vague fighting for our license argument, it is difficult to locate positive ideas, positions, or programs espoused by the group.  The organization did support the resent declaratory order that Ill discuss in another post.

Respectfully,
Roy

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## Roy R. Ferguson

Hi All:

To examine the practical aspects of this declaratory order on the Tennessee licensed optician, consider the optician who is opening an independent dispensary.  The employees must include one licensed optician who can directly supervise no more than two apprentices registered under that license.  If the optician goes on vacation, or becomes ill and does not wish to close the operation, another licensed optician must be hired and signed up as a supervisor.  That is an impossible process to accomplish on short notice.

If one, or both, apprentices become ill or pregnant, a short term unlicensed replacement cannot be hired since a Tennessee optician can only supervise a maximum of two registered apprentices.  The Optometrist down the street can open a similar operation, staff it with unlicensed fashion consultants, and never visit the operation.  In Tennessee these unlicensed employees can fit both eyeglasses and contact lenses without direct supervision from the Doctor.

Since store managers and district managers of optical chains and dispensaries in Tennessee must be licensed opticians, watch for these positions to be either eliminated or the positions renamed in the near future.  

Finally, opticians cannot perform vision screenings.  Does this mean that the licensed optician working with an Optometrist or Ophthalmologist cannot do vision screenings at a health fair?  Does this mean the students enrolled in the Roane State Community College Opticianry Program can no longer do vision screenings in the community?  What about the prevention of childhood blindness through the use of the PhotoScreening camera?  Does this mean the Licensing Board would rather children go blind than allow an optician to participate in the program?  Has the Board decided that the only Tennessee citizen not qualified to perform vision screenings is a licensed optician?

The bottom line is the TDOA supported this declaratory order and all the ramifications.  While action was intended to apply to chain firms in Tennessee, the final order appears to be much broader.

Roy

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## Stormy

I am not licensed in Tn.but am very interested in what's going on there.I'm licensed in South Carolina.The law here clearly states that penalties for violations of it can be imposed against a corporation, association or person aiding and abetting in a violation.However the board insists that they only have jurisdiction over a licensed optiician. If this is true who has jurisdiction over the corporation etc... and at what point do they step in if a violation has occurred?Thus far it appears that some of the(non-licensed)decision makers are in no way being held accountable for their actions.
I would love to get some feedback from optcians holding licenses in other states. It may help to shed some light on the REALLY big picture.Let's face it, the big chains already have their pie chart. We are all just looking at a slice of it.

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## chip anderson

This is one of the reasons why I often say: "Be carefull what you wish for" in licenseing and legislation.  First thing you know those that should not have any authority over you are making the rules.

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## wabmorgan

Bump

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## Stormy

[quote=Roy R. Ferguson;223811]Hi All:

To examine the practical aspects of this declaratory order on the Tennessee licensed optician, consider the optician who is opening an independent dispensary. The employees must include one licensed optician who can directly supervise no more than two apprentices registered under that license. If the optician goes on vacation, or becomes ill and does not wish to close the operation, another licensed optician must be hired and signed up as a supervisor. That is an impossible process to accomplish on short notice.

If one, or both, apprentices become ill or pregnant, a short term unlicensed replacement cannot be hired since a Tennessee optician can only supervise a maximum of two registered apprentices. The Optometrist down the street can open a similar operation, staff it with unlicensed fashion consultants, and never visit the operation. In Tennessee these unlicensed employees can fit both eyeglasses and contact lenses without direct supervision from the Doctor.

Since store managers and district managers of optical chains and dispensaries in Tennessee must be licensed opticians, watch for these positions to be either eliminated or the positions renamed in the near future. 

Finally, opticians cannot perform vision screenings. Does this mean that the licensed optician working with an Optometrist or Ophthalmologist cannot do vision screenings at a health fair? Does this mean the students enrolled in the Roane State Community College Opticianry Program can no longer do vision screenings in the community? What about the prevention of childhood blindness through the use of the PhotoScreening camera? Does this mean the Licensing Board would rather children go blind than allow an optician to participate in the program? Has the Board decided that the only Tennessee citizen not qualified to perform vision screenings is a licensed optician?

The bottom line is the TDOA supported this declaratory order and all the ramifications. While action was intended to apply to chain firms in Tennessee, the final order appears to be much broader.

Roy Some of these positions may be eliminated.And some of them should be!At the disrict level I would imagine that many don't have a clue,at least that's been my experience.Even at the regional level I have seen people in power that came from loss prevention......Huh? Yeah?

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## wabmorgan

W
huh???

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## BoardPetitioner

> Hi All:
> 
> 
> 
> 
> 
> If the optician goes on vacation, or becomes ill and does not wish to close the operation, another licensed optician must be hired and signed up as a supervisor. That is an impossible process to accomplish on short notice.
> 
> 
> ...


 I hope I quoted this correctly? I tried to edit this to address only the lines quoted, I am not trying to change any of the authors comments, only respond to them.

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## BoardPetitioner

What good is it anyway, to be licensed in a profession of the healing arts in TN, if you let persons with no license, training, certification, and/or experience perform some or all of the duties of your particular licensed profession and those same persons directing you on how to perform the duties you studied, trained, tested, and paid to obtain a license for? Is being an optician really only worth a few dollars more to hang your license in a dispensary and let anyone and everyone perform your licensed dutiues because your non-licensed supervisor said it was OK? How many of your duties are you willing to relinquish before your licensed services or a fellow optician's are no longer required because there is enough non-licensed staff available? How many of you know opticians whose hours were cut but non-licensed sells and services were still being provided? Maybe it's happened to some of you. If ODs or MDs let a person who is not licensed refract, just one small, mechanical portion of their overall duties, then how long before that same person is writing RXs or even attempting foreign body removals? The consumers' health and well being is the licensed health care providers responsiblity, are there really some of you who truly feel that this can be provided for better by persons not licensed and in many cases hired without any experience? I hope surgeons don't use this same idealology! The laws referred to in this declaratory order have always been in place. They were put in place to protect the citizens of Tennessee from receiving ophthalmic goods and services from persons who do not have a clue. They were put in place to protect licensed optical professions from being performed by people not qualified to do so. There are no other reasons for putting them in place. Why should they not be clarified and enforced?

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## wabmorgan

Post Deleted

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## Roy R. Ferguson

_Hi All:_

*If an optometrists wishes to provide exams or services while on vacation or sick they normally have someone with proper credentials fill-in or else do not provide them. They do not simply let anyone else perform their duties who is not an OD or MD.*

_That is very true and an excellent point. In this case, the Doctor simply obtains the services of another OD or MD and the office is covered. In the event of sudden illness, the licensed optician in Tennessee may also hire a temporary replacement. This replacement may not supervise the apprentice(s) registered to the first optician until approved by the Board. This is a lengthy process at best. Until Board approval is received the apprentices may perform no services, even under the supervision of this licensed optician. For the independent optician this is a sizeable hurdle._

*Where in the state code or State Board rules for Optometry or Opticianry do you find a statute or rule that approves or condones unlicensed employees fitting, adapting, or dispensing ophthalmic materials or services.*

_In 1988, a complaint was filed with the Board of Dispensing Opticians regarding two Optometrists operating a satellite office staffed with an unlicensed salesclerk. The ODs were physically present in the office four hours each week. During the other 36 hours the receptionist/salesclerk dispensed eyeglasses and contacts. This was investigated and confirmed on two different occasions by state investigators. On April 26, 1993 the Division of Health Related Boards wrote:_
_The complaint you filed against Dr. XXX XXX has been received and reviewed by both the Board Consultant and our legal staff. Based on our review, it was determined that no action should be taken at this time._

_The reasons for that action are as follows:_

_1. No violations of the Practice Act._*Does it not seem odd that only dispensaries owned by opticians would be required to provide prescription ophthalmic materials by licensed or apprenticed staff only?*

_Another excellent point! Please refer to the previous paragraph._

_Roy_

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## BoardPetitioner

> _Hi All:_
> 
> *If an optometrists wishes to provide exams or services while on vacation or sick they normally have someone with proper credentials fill-in or else do not provide them. They do not simply let anyone else perform their duties who is not an OD or MD.*
> 
> _That is very true and an excellent point. In this case, the Doctor simply obtains the services of another OD or MD and the office is covered. In the event of sudden illness, the licensed optician in Tennessee may also hire a temporary replacement. This replacement may not supervise the apprentice(s) registered to the first optician until approved by the Board. This is a lengthy process at best. Until Board approval is received the apprentices may perform no services, even under the supervision of this licensed optician. For the independent optician this is a sizeable hurdle._
> 
> *Where in the state code or State Board rules for Optometry or Opticianry do you find a statute or rule that approves or condones unlicensed employees fitting, adapting, or dispensing ophthalmic materials or services.*
> 
> 
> ...


Roy, 
I am not argueing that the process of transferring sponsorship could not be made easier by possibly printing the form from the board web site and faxing it to the board administrator or something of that nature for those rare emergency ocassions. Maybe that is something you or the TDOA can propose to the board. What I am argueing is that the best way to have dispensary coverage is by qualified personell. NOT by having one license in a dispensary with seven sales techs or "stylists" fitting progressives and the like under the "umbrella license". You surely would agree with this.

As for the case from 1993 you refer to above, I couldn't agree more that the board advisors and attorneys do as little as possible in efforts to stop non-licensed services. As you know, the actual six member board never even views a complaint until the investigations division and the board advisor and attorney decide it is important enough for the board to hear. In this particular case however, optician law states that nothing in our laws should be construed as requireing the licensure of employees of ODs or MDs because our statutes do not supercede theirs. But the optometry statutes from best I can tell does prohibit this. Perhaps the complaint should have been made to the optometry board. Although I am not sure if their advisor would have ever let it go before that board either. Maybe if we can get opticians to quit complaining about not being able to perform vision screenings and complain about people performing their entire job description without license, then opticians could get some beneficial things accomplished. And by the way, as all can see, my question referring to vision screenings was not about whether we could perform them, but whether we were allowed to solicit business for independent ODs with screenings and other means. The answer, as you know, was "NO", the answer was not at any time given as "No opticians can not perform vision screenings." The question was asked by counsel as written in the petition, then answered with the voted response of "NO". The Final order you posted here, was the Board attorney's final rendition of the proceedings. It was also requested that the supervisor order should read "dispensary managers and the next level of supervisors should be licensed" so that the psosition title could not just be changed, the board attorney rejected that as well. So much for state employees huh. Let me know if you have any more insight on the OD licensed coverage question, it is most interesting and perplexing.

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## wabmorgan

Bump

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## BoardPetitioner

> This "umbrella" you reference is *exactly* the way it has been defined in the past.... and now why what the board has "defined" as law will cause so many vast problems.
> 			
> 		
> 
> The way who defined it, your employer? To my knowledge, this is the first declaratory order issued by the Optician Board clarifying misinterpreted satutes. You're right though, plenty of people who did not know what they were talking about have said that anyone with any amount of experience could sell and dispense as long as a license was "somewhere in a 5 mile radius" etc. Keep in mind we are governed by the same health division as pediatricians and other doctors. Would you want your children who were ill to have an appointment with a pediatrician, only to be seen by some person who (unknown to you) used to work in shoe sales a month before? What would you do if this "fill-in" gave your children the wrong prescription for their illness and they got sicker? How is it any different if we let people with no experience fill prescriptions that we are supposed to fill? The only "vast problems" I see enforcing the statutes that have ALWAYS been there is problems for the corporate retail chains who have knowingly and purposely violated them in the past, and for the non-licensed people encroaching on our profession who either have never bothered to get licensed because they did not want the responsibilty or were not intelligent or disciplined enough to pass the tests.
> 
> 
> 
> 
> ...


Why are you so confused on what people have the best interests of opticians in mind?

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## wabmorgan

Bump

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## Barry Santini

> What I am argueing is that the best way to have dispensary coverage is by qualified personell.


Here! Here!  I say it DOESN"T matter whether someone is licensed...or not.  As long as the skill set is there, and business is held accountable through licensure of the BUSINESS.

Or, perhps, we need give the lay public an "exam" of competancy at the cash register when they're purchasing OTC *anything* optical...

????

Barry

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## Roy R. Ferguson

Hi All:

I hate to beat this very dead horse, but it is necessary to point out an obvious point one more time.  We are attempting to breathe life into a very malfunctioning apprenticeship system that has never provided the enrolled person a proper background and continues to do a disservice to the consumer.  This is a highly technical field requiring knowledge with breadth and depth impossible to present, or retain, in an on-the-job situation.  This can only be accomplished in a formal educational setting.  The heart of our current problems in Tennessee can be traced directly to the archaic, nonfunctioning, apprenticeship program.

We had the opportunity to enrich the Tennessee apprenticeship program with a formal educational component in the early 1990s.  The plan was to first provide the apprentices with a college-level certificate program taught on-demand by adjunct faculty.  In this way we would have been able to track where the demand existed, allowing us to open one or two more opticianry schools in the state.  Eventually, the apprenticeship program could have been replaced.  This program was strongly opposed by the TDOA and went down in defeat.  Actually, strongly opposed is an understatement.  Words such as poisonous, venomous, malevolent, caustic, and acrimonious, are perhaps more accurate.  If you have any questions regarding this ask my former students or the current vice-president of the TDOA.

We should not be arguing about whether an optician is qualified to supervise and teach two opticians.  In my opinion most are not and this is why no other health related field clings to this method of imparting knowledge.  This must be done in a formal setting.  Teaching is a difficult task that requires preparation, dedication, and involves a large number of skill sets that must be mastered.  We are here today discussing these issues because in the 1990s the TDOA chose to embrace ignorance and mediocrity rather than knowledge and excellence.

I will now apologize to all for my rant.  While I predicted these problems many years ago, I take no pleasure in having to witness the outcomes.  

Roy

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## HarryChiling

> Hi All:
> 
> I hate to beat this very dead horse, but it is necessary to point out an obvious point one more time. We are attempting to breathe life into a very malfunctioning apprenticeship system that has never provided the enrolled person a proper background and continues to do a disservice to the consumer. This is a highly technical field requiring knowledge with breadth and depth impossible to present, or retain, in an on-the-job situation. This can only be accomplished in a formal educational setting. The heart of our current problems in Tennessee can be traced directly to the archaic, nonfunctioning, apprenticeship program.
> 
> We had the opportunity to enrich the Tennessee apprenticeship program with a formal educational component in the early 1990s. The plan was to first provide the apprentices with a college-level certificate program taught on-demand by adjunct faculty. In this way we would have been able to track where the demand existed, allowing us to open one or two more opticianry schools in the state. Eventually, the apprenticeship program could have been replaced. This program was strongly opposed by the TDOA and went down in defeat. Actually, strongly opposed is an understatement. Words such as poisonous, venomous, malevolent, caustic, and acrimonious, are perhaps more accurate. If you have any questions regarding this ask my former students or the current vice-president of the TDOA.
> 
> We should not be arguing about whether an optician is qualified to supervise and teach two opticians. In my opinion most are not and this is why no other health related field clings to this method of imparting knowledge. This must be done in a formal setting. Teaching is a difficult task that requires preparation, dedication, and involves a large number of skill sets that must be mastered. We are here today discussing these issues because in the 1990s the TDOA chose to embrace ignorance and mediocrity rather than knowledge and excellence.
> 
> I will now apologize to all for my rant. While I predicted these problems many years ago, I take no pleasure in having to witness the outcomes. 
> ...


Roy,
Well said, I was one that dd embrace the OJT because I was taught that way, but when I thin more and more about it the desire to learn was there which made me seek knowledge mroe than my employer was willing to take the time and teach.  I have family that teaches and I see the dedication and the numerous hours that go into putting together lesson plans and plotting a course that ultimately leads to the student comprehending a skill.  I would agree that opticians shoud embrace education and that our jbs when performed competently requires knowledge and technical skills that require more than just OJT.  Sam Johnson of ROATx has beenpuching a campaign for states that don't have licensure to educate, they have partnered with NAIT in CA to provide education to opticians in the US.  I am currently part of the first class at NAIT for US students and actually just finished my mid term, whihc I though was a good test overall.  So far a few states have embraced it and theri are a few opticiasn that have embraced it.  I got to tell you I was an optician hard pressed to avoid the education that I have anyway trough my own learning, but I find that the education isn't necessarily for me, but for my profession.  If I take the opportunity to "Raise the Bar" then I stand a better chance of convincing others to do the same and after a while there shoudl be no reason that OJT will need to exist.

I can say that in all the enviornments I have worked that their has never been a structured program or a set amount of time alotted to learning on the job.  OJT has just become a vehicle for cheap labor and it is being utilized by both corporate chains and independent opticals with very real consequences that are being seen across the country.  I look forward to the day when OJT is gone.

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## Roy R. Ferguson

Hi All:

*OJT has just become a vehicle for cheap labor and it is being utilized by both corporate chains and independent opticals with very real consequences that are being seen across the country. I look forward to the day when OJT is gone.*

The NAIT program is a huge step forward for opticians in those states lacking an opticianry program or do not have access to a distance learning program.  Those states using this educational vehicle have made a bold move in the right direction and are to be congratulated for this huge step forward.  

My surprise when I advocated a formal education program for apprentices in Tennessee was that the opposition did not come from corporate folks or Optometry; it was orchestrated by the state society.  After making a presentation regarding the program the only question was from the TDOA president who asked, All I want to know is how much are you going to get out of this?  As a salaried faculty member, the state paid me the same if I instructed 10 students or 100. This he could not understand.  The famous quote the president and vice-president of the college liked to toss my direction each time I was called in to discuss the latest TDOA complaint was from that individual.  It was, Roy aint teaching those students nothing.

So, almost 20 years later, we find the same organization supporting the loss of vision screening by opticians while attempting to patch a non-existent apprenticeship program through a declaratory order.  In my opinion, our problems in Tennessee are not based in the evil corporations or Optometry.  Our difficulties were spawned and nurtured over the years by a few individuals who lurked in the shadows resisting any positive change for opticianry.  Fortunately, the leadership in many other states is not as regressive.

Roy

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## Judy Canty

As always, Roy.  We have met the enemy and he is us!

----------


## BoardPetitioner

> Hi All:
> 
> *OJT has just become a vehicle for cheap labor and it is being utilized by both corporate chains and independent opticals with very real consequences that are being seen across the country. I look forward to the day when OJT is gone.*
> 
> The NAIT program is a huge step forward for opticians in those states lacking an opticianry program or do not have access to a distance learning program. Those states using this educational vehicle have made a bold move in the right direction and are to be congratulated for this huge step forward. 
> 
> My surprise when I advocated a formal education program for apprentices in Tennessee was that the opposition did not come from corporate folks or Optometry; it was orchestrated by the state society. After making a presentation regarding the program the only question was from the TDOA president who asked, All I want to know is how much are you going to get out of this? As a salaried faculty member, the state paid me the same if I instructed 10 students or 100. This he could not understand. The famous quote the president and vice-president of the college liked to toss my direction each time I was called in to discuss the latest TDOA complaint was from that individual. It was, Roy aint teaching those students nothing.
> 
> So, almost 20 years later, we find the same organization supporting the loss of vision screening by opticians while attempting to patch a non-existent apprenticeship program through a declaratory order. In my opinion, our problems in Tennessee are not based in the evil corporations or Optometry. Our difficulties were spawned and nurtured over the years by a few individuals who lurked in the shadows resisting any positive change for opticianry. Fortunately, the leadership in many other states is not as regressive.
> ...


Roy,
The TDOA nor I supported removal of vision screenings from our duties. We supported not being required and forced to solicit business for independent optometrists by way of vision screenings and other methods. The final order was drafted by the states attorney advisor to the boards, Nicole Armstrong, and did not reflect the question of solicitation nor the only answer given to the question which was "NO". You were there, you know this! If you have issue with that part of the order, you should take it up with the states Assistant General Councel Nicole Armstrong not the TDOA. As for apprenticeship, the TDOA and I supported only opticians and appentices/students performing optician duties, not the mass employment of zero experienced sales floor personel performing the duties under the "umbrella license" of one optician. You stated yourself in a previous statement what a technical field it is and that even apprentices did not get the training needed to the detriment of the consumer. So when you refer to the TDOA "attempting to patch a non-existent apprenticeship program through a declaratory order", are you also saying that you support these zero experienced "sales techs" providing prescription products to the consumers? If not then what exactly is your solution to the solicitation and unqualified staffing? And why have not proposed your solution if you have one to the State? You have all these criticisms and failings of this order, and yet before it ever came to the point of filing a petition, I called YOU Roy on several occasions at your Learning Curve# and a home # that was given to me from a mutual friend, and left at least 5 messages to return my call because I needed advice on these employment issues and was told you were familiar with the state code, and as I had attended several of your CE classes, thought you would speak with me. You never bothered to return any of my calls. Yet when I saw you at the January 07 State Board meeting and caught you in the hall, you read over my list of employment issues and statute questions and told me I was doing the right thing and that it would benefit all opticians, and that those things had been problems in the retail dispensaries for a long time. I have two other opticians who were there and can confirm that, one was the same optician who gave me your home number.  You can see their names on the board minutes for that meeting as opticians attending. I was also told by several opticians who attended YOUR CE classes this past year that you mentioned my issues with corporate employment practices to your attendees, and told them that it was beneficial to their profession to support me in any way they could other than financially as I wasn't requesting nor needing financial support with it. So can you clear this up for me, because it appears that you supported this until you found out the TDOA did also, and when a FEW opticians were unhappy with some of the wording in the final order, you quickly took the oppurtunity to once again slam the TDOA and blame them for the short-comings of the State Board, the education of opticians, and anything else you could come up with. As for them not supporting optician education, it is my understanding that they contributed over $60,000 to the founding of the only college program we offer at Roane State. Am I wrong about that, and if not, then how much of your money have you contributed to the college education of opticians? I questioned existing laws to the Board, and did not ask for any new ones or any changes to existing ones. The final wording of the order in answers for #3 & #4 do not reflect the true wording of the statutes questioned. My attorney's proposed draft of the final order did, but was refused by the Board's Assistant General Councel partly due to the NAOO's objections who were hired to do just that by the "evil corporations" as YOU put it that opticians should not be worried about. I do not believe corporations have the best interest of opticians on their mind, I believe the TDOA even though they have made some mistakes, do have opticians best interests in mind. I believe the corporate retail chains pay their contributions and support for opticians and optometrists to the NAOO who then fight "tooth and nail" to eliminate any current or new license measures that stand in the way of them making more profit. I believe these things because I have witnessed and been an example of them first hand. I do not believe that you are so naive as to believe ANY regulated field is safe from corporate strategies if that field limits the corporation's profits. I will continue to support the TDOA because I have personally seen their funds used to support opticianry. I hope others do also because like I have said before, I don't see anyone else contributing PAC funds or hiring lobbyists on behalf of opticians, do you Roy.

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## Barry Santini

These excerpted passages interest me...




> You stated yourself in a previous statement what a technical field it is and that even apprentices did not get the training needed to the detriment of the consumer. 
> 
> I do not believe corporations have the best interest of opticians on their mind...
> 
> I believe the corporate retail chains pay their contributions and support for opticians and optometrists to the NAOO who then fight "tooth and nail" to eliminate any current or new license measures that stand in the way of them making more profit. 
> 
> I do not believe that you are so naive as to believe ANY regulated field is safe from corporate strategies if that field limits the corporation's profits.


Interesting...with so much of this thread offering substantiation for why clients prefer and patronize (over the long term) businesses with trained, competant and motivated personel, you've got to wonder just who in these corporations really understands where their long-term business health originated from.

Barry

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## Roy R. Ferguson

Hi All:

Please remember that brevity is a virtue and paragraphs are our friend.

*The TDOA nor I supported removal of vision screenings from our duties.*

This is referred to as the law of unintended consequences.  Lack of intent does not mitigate damage.

*are you also saying that you support these zero experienced sales techs providing prescription products to the consumers?*

No, Im on record as opposing the apprenticeship route and developed a program to help replace it.  This educational program was actively opposed by the TDOA.

*left at least 5 messages  You never bothered to return any of my calls.*

I do attempt to return all calls.  After reviewing my phone logs, I am unable to locate any of your contacts.

*they contributed over $60,000 to the founding of the only college program we offer at Roane State.*

Most of this contribution came from donated, used equipment that was discarded while I was Program Director.  I would urge you to ask for copies of all canceled checks relating to this donation.

*I do not believe corporations have the best interest of opticians on their mind*

By definition, a corporations major concern is the corporates best interest.

*I believe the TDOA do have opticians best interest in mind.*

What positive steps has this organization advocated to improve opticianry over the past 20 years?  

*I dont see anyone else contributing PAC funds or hiring lobbyists on behalf of opticians, do you Roy.*

PAC contributions can be viewed at TDOA.org.  Im curious when my Titan contribution ($200.00 +) will be posted.  

Roy

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## BoardPetitioner

The Tennessee State Opticians Board has recently posted the ratified minutes of the October 07 meeting and declaratory hearing. These minutes more closely reflect the true nature of the hearing and the final order. They can be found at this site: http://health.state.tn.us/Boards/Do/minutes.htm
There is also links at this site to the Rules and Regulations and the TN State Code regulating opticians and optometrists. Anyone wishing to debate the statutes should at least read and understand them before making assumptions that the rules have changed. Read them word for word as I have and then tell me how to interpret the rules. Pay close attention to the statutes referred to in the original petition posted at the first of this thread by Roy. Please let me know if you feel most corporate opticals are compliant Then read the code of ethics in the rules and regs and see if each of you who are employed at a chain in TN are compliant. I found 2(b)&(k) to be very interesting when apllied to the questions and answers in the Declaratory Order. Hope my response isn't too long this time Roy, guess it just takes more words to tell WHOLE story.

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## Roy R. Ferguson

Hi All:

Please read the following from the 29 Oct 07 Tennessee Board of Dispensing Opticians minutes.
Mr. Trew stated Question #4 is as follows:

4. Can optical employees go into the public sector and solicit business for optometrists by means of verbal communication, business cards, and/or vision screenings?

Upon discussion, Mr. Wells made a motion, seconded by Ms. Chitwood, to give an answer of No due to the law prohibiting opticians to perform screenings. The motion carried.Now, open the Rules and Regulations portion and find the law prohibiting opticians to perform screenings.  Im having difficulty locating it.  Thanks.

Roy

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## BoardPetitioner

Yes, the law we referred to in the petition was 63-14-104 which addresses acting as an agent or representative of an optometrist on any account being unlawful. However statutes 63-14-102 (1) & (2) do go into detail about attempting to examine by any means or method being strictly prohibited, I guess it lies in the definition of examine. You have to open the State Code to find those statutes. Does that help you find it? Remember I asked that you read the Rules & Regs and the State Code word for word before debating them. While there refer to 63-8-102 (8) & (12) in the Optometry Chapter of the State Code which defines the practice of Optometry. Wouldn't a vision screening be considered "observing symptoms and/or signs with various intruments and techniques"? Aren't vision screenings performed for "the purpose of ascertaining defects of vision" as quoted from the definition of Optometry?

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## wabmorgan

Bump

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## cash1

in my humble opinion ;)the board should fight to make more things for us to do, like put a contact lens in someones eye without a dr. in the room. i see what the board is doing and i do belive they are helping,but dont give away things we can do. i know we will fight the corporate chains"naoo"and the optometry board but if there is nothing we can do whats the point? " quit taking from my pie" we need to expand on our profession, not to give up things. tn. opticians need to be able to do anything an optician can do as well as any thing a optometry tech can do, tn opticians are lic. by the state not just certified.

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## Barry Santini

> *are you also saying that you support these zero experienced sales techs providing prescription products to the consumers?*


Yes, logically I *do*...._as long as "John Q. Public" can buy over-the-counter optical *anything*, and gets to make the "prescribed" choice themselves._

 IMHO, its either legislation and licensed techs/dispensers, or if we allow OTC anything, then its a free-for-all.

In fact, how many of us have clients with corrections of -0.75D (and more....I've seen up to -2.00D!) and drive rountinely without eyewear.  Whose stopping them? Whose checking them?

I suggest that *all* traffic stops include license, registration, insurance and... an _optical_ "breathalizer" test for a tight acuity/contrast sensitivity standard when driving.

And whose "responsible" for prescribing their (default) add power for DV use?

????

Barry

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## optical24/7

> I suggest that *all* traffic stops include license, registration, insurance and... an _optical_ "breathalizer" test for a tight acuity/contrast sensitivity standard when driving.
> 
> 
> Barry


Barry, don't give the OD's any ideas! You _know_ they are always trying to expand their scope of practice......An OD with a badge, a gun and a phoropter is a scary thing. And we now know that a lowly optician wouldn't be able to administer a "optical breathalizer"....at least in TN.!!!


:D:D:D

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## harry a saake

this brings up another point, are not dmv personnel doing screenings when you apply for a drivers license, what training makes them authorities?

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## Barry Santini

> this brings up another point, are not dmv personnel doing screenings when you apply for a drivers license, what training makes them authorities?


Nothing, other than their ability (at least in NY state) to tell a potential testee (?) where the 6 foot (*!!!!!!*) demarcation point is to take the acuity test.

6 feet, fer goodness sake! Besides sitting the hood ornament on your Rolls or Jaguar, just how does a 6 foot distance correlate to real-world driving conditions?

Oh, I forgot. How prescient of the NYS DMV. They were "ahead" of their time, now that deliveries of the (Mercedes) SMART car ( only 6 foot long!) have begun.

Barry

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## Roy R. Ferguson

Hi All:

From the posts it appears the petitioner, who is a TDOA Board member and the TDOA Board and Officers, supported the Declaratory Order.  From the petitioners last post it appears all parties were aware that a request was being made to apply Optometric rules to the practice of Opticianry.  The more it is reviewed, the stranger this issue becomes.

*The TDOA Board and Officers along with other supporting members of your* *Association attended in support of the Declaratory Order. (ref: TDOA.org)*

* Optometry Chapter of the State Code which defines the practice of Optometry. Wouldn't a vision screening be considered "observing symptoms and/or signs with various intruments and techniques"? Aren't vision screenings performed for "the purpose of ascertaining defects of vision" as quoted from the definition of Optometry?*

Roy

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## HarryChiling

Roy,

Again, I am sorry to hear once again about such a devastating ruling.  For the layman (apparently the board member) it is quite simply put as a restriction in the scope of practice of an optician.  What was gained could easily be circumvented, but what was lost cannot so unfotunately opticians in this case lose and it amazes me that the board doesn't see this.  Maybe it's time for a new board?

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## chip anderson

If one had an eye chart in the office with a line and a note on the chart: "If you can't see *this* from behind *this* line, you need to see the eye doctor."  Would this constitute "vision screening?"  Or "Sight Testing?"

If we ask, "Then what can you see?" are we in trouble?

And yeah, I know there is more to an eye exam than this?

Chip

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## Roy R. Ferguson

Hi Harry:

*Upon discussion, Mr. Wells made a motion, seconded by Ms. Chitwood, to give an answer of No due to the law prohibiting opticians to perform screenings. The motion carried.*

I truly have no idea where this interpretation originated.  The board member is a licensed optician who stated a position and avoided referencing the applicable law or rule.  To complete the confusion, the Board failed to provide a definition of what constitutes vision screening.

Roy

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## Roy R. Ferguson

Hi Chip:

What happens when a licensed optician hands the patient a reading card?  Is this vision screening/sight testing?  

Roy

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## chip anderson

I guess we could alway have the eyechart and reading card presented by the receptionist.  Hopefully she doesn't have to be licensed.

Chip

I ain't licensed but I have at one time or another taken retinal pictures, done field of vision screen tests, and a lot of things.   The fact that these test are run, doesn't mean that any interpretation or diagnosis, or prescriptions were written.   What is the problem.   If I tell a doctor that I see an ulcer, it's still up to him to confirm and do something about it.  I am not  taking away anything from his medical/optometric practice, just possibly screening out the piece of dust in the eye from the sick or damaged eye and saving him some time.

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## BoardPetitioner

> Hi All:
> 
> From the posts it appears the petitioner, who is a TDOA Board member and the TDOA Board and Officers, supported the Declaratory Order. From the petitioners last post it appears all parties were aware that a request was being made to apply Optometric rules to the practice of Opticianry. The more it is reviewed, the stranger this issue becomes.
> 
> *The TDOA Board and Officers along with other supporting members of your* *Association attended in support of the Declaratory Order. (ref: TDOA.org)*
> 
> *Optometry Chapter of the State Code which defines the practice of Optometry. Wouldn't a vision screening be considered "observing symptoms and/or signs with various intruments and techniques"? Aren't vision screenings performed for "the purpose of ascertaining defects of vision" as quoted from the definition of Optometry?*
> 
> Roy


Once more, I guess my posts are longer because I try to be informitive and tell the whole story, unlike what you have once again done here by leaving off the first of the sentence referring to the statutes from post #107 in this thread. The first of my sentence referred first to the statutes in the optician's Chapter 14 of the code. I only referred to the optometry laws in this thread for further clarification, because I have already seen from prior posts that Roy tries to argue a statute without referring to all of the statutes. Furthermore, I think all of you should be aware that Roy is trying to deceive everyone in an effort to further trash our state asscociation, the TDOA. It is very common knowledge among opticians here in TN that Roy is very much against the TDOA. I think anyone who has read all of this thread can easily see that. The deceit I refer to can be found in the 2nd sentence of his post I am quoting here where he states "all parties were aware that a request was being made to aplly Optometric rules to the practice of Opticianry" (I am not quoting his entire sentence since my response is attached to it). Roy was at the hearing and knows very well that the Board as well as the attorneys present were only allowed to refer to the Optician's State Code and Rules and Regs. At NO time were they allowed to be intoduced, referred to, or "applied" as Roy stated. The statutes I referred to in the first of my sentence that Roy conveniently left off, and the Board referred to is as follows:
*63-14-102. Practice of dispensing opticians defined  Prohibited practices. *

Practice of dispensing opticians means the preparation, adaptation and dispensing of lenses, spectacles, eye glasses and optical devices to the intended user thereof on the written prescription of a physician or optometrist, duly licensed to practice the physician's or the optometrist's profession, and the dispensing of frames as a unit or individually to the intended user thereof.
 *(1) * A person registered under the provisions of this chapter is specifically prohibited from engaging in the practice of ocular refraction, orthoptics, visual training, prescribing contact lenses or the prescribing of subnormal vision aids or telescopic spectacles.
 *(2) * Nothing in this section shall be construed to authorize or permit any dispensing optician to claim to be able to, or to offer, undertake or attempt, by any means or method, to examine or exercise eyes, fit contact lenses, or diagnose, treat, correct, relieve, operate or prescribe for any human ailment, deficiency, deformity, disease, injury, pain or physical condition; however, dispensing opticians may fit contact lenses in the presence of and under the direct supervision of a licensed optometrist or ophthalmologist.


To examine by any means or method seems to be a fair interpretation of a vision screening.
The following statute was also referred to:
*63-14-104. Revocation or suspension of license. *

It is unlawful for a dispensing optician to act as the agent or representative of any physician or optometrist on any account. 


I also included the definition of dispensing opticians above, I can not find anything in it (or anywhere else in our laws) that states vision screenings, pretests, visual fields, visual accuities, auto-refracting, refracting or any other exam tests or screenings are part of our professional duties or ever have been. On the other hand, ALL of those things DO fall under the definitions of optometry duties. So how was a duty taken away that was never really ours to begin with? If the Board was strict on their interpretation perhaps it was because they knew that vision screenings could give a false sense of well being as in "I can read all the lines, I don't need an exam", to bad the screening did not catch the diabetes, or the swollen retina or the brain tumor. Are you opticians who say you've lost a duty prepared to take on the liability for that? Or what about the children who will not get screenings from opticians as some of you stated? Well what about the children who as we all SHOULD know can accomodate vision so well, that have passed these "screenings" only to find out later that they needed significant correction all along. Would any of you want some ticked off parent sueing you because their kids grades were poor until the child got prescription glasses, and after your "screening" the year or two before when the kid passed it. I know most of you tell people that pass one that they should still get a complete exam, but really how many people take the time and money to do so if they have already been told by a LICENSED OPTICIAN that they could see the 20/20 line?

Then perhaps the Board recalled what happened the last time the TN Optometric Association got wind of opticians performing their duties. Surely you recall Roy, it was around 2000-2001 when they decided to support the Sunset of our Optician Board. You know, when the TDOA who "hasn't done anything positive for opticians in the past twenty years" as you previously stated, once again spent over $60,000 fighting to keep our Board intact. As I recall, the three major issues they stated having with opticians were as follows:
1. The board was not enforcing their laws and regulations. Which is what they were doing with this order you continue to try to debunk.
2. The removal of the apprenticeship program. Which you supported then  and still do according to your earlier responses blaming the TDOA for supporting apprenticeship.
3. The instruction of refraction at the college opticianry program, which you were instructing. 

It seems that the issues they had were issues the TDOA supported correcting.

And yet once again this past summer you sent out letters all over the state, for financial support of an optician under investigation by the state for allegedly performing outside his scope of practice, in which you stated the charges were "he performed a visual accuity test and a refraction test, and filled out a blank prescription pad".  You sent this letter knowing full well the optometric association would be keeping close watch on the case, and what their stance on the charges would be. You also knew full well our sunset review was set for this year and the optometrists who supported it last time, would not appreciate the support of refraction by opticians this time. But you sent it anyway! I guess the TDOA will have to spend another $60,000 to convince the optometrists and legislature that most of us opticians believe if we enforce the laws we have and NOT let those unauthorized by the state to perform OUR duties, then there will be plenty of work for us to perform, and we probably wouldn't even have time to do these vision screenings and refractions you covet so much!

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## Roy R. Ferguson

Hi All:

Again, please remember that brevity is a virtue and paragraphs are our friend.

*The deceit I refer to can be found in the 2nd sentence of his post I am quoting here where he states "all parties were aware that a request was being made to aplly Optometric rules to the practice of Opticianry" (I am not quoting his entire sentence since my response is attached to it).*
This was based on your statements and the post on the TDOA website. It was certainly not my goal to misstate intentions. If the TDOA Board and Officers were not aware of the position they were supporting, I certainly apologize.

*I also included the definition of dispensing opticians above, I can not find anything in it (or anywhere else in our laws) that states vision screenings, pretests, visual fields, visual accuities, auto-refracting, refracting or any other exam tests or screenings are part of our professional duties or ever have been.*
Please clarify this point for me. Is it your position that licensed opticians are prohibited from performing these duties under all circumstances?

*Well what about the children who as we all SHOULD know can accomodate vision so well, that have passed these "screenings" only to find out later that they needed significant correction all along. Would any of you want some ticked off parent sueing you because their kids grades were poor until the child got prescription glasses, and after your "screening" the year or two before when the kid passed it.*
I’m not sure I understand this statement. As you may know, I’ve been participating in a program to screen the vision of children between the ages of one and six. Are you suggested that such efforts to prevent childhood blindness are illegal?

*As I recall, the three major issues they stated having with opticians were as follows:*
_1. The board was not enforcing their laws and regulations. Which is what they were doing with this order you continue to try to debunk._
Bad enforcement and bizarre interpretation is perhaps worse than a laissez-faire attitude.

*2. The removal of the apprenticeship program. Which you supported then and still do according to your earlier responses blaming the TDOA for supporting apprenticeship.*
I’m guilty. I do support the replacement of opticianry apprenticeship with formal education. 

*3. The instruction of refraction at the college opticianry program, which you were instructing.* 
Actually, I was the Program Director and according to the college catalog and my course descriptions, this is not a true statement.

From the tone and content of your Declaratory Order it would appear that your struggle is with the “large retail optical chains within Tennessee.” Why are licensed opticians in the state being dragged into your fight? Must we all suffer for you to achieve your goal?

Roy

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## Roy R. Ferguson

Hi All:

*I also included the definition of dispensing opticians above, I can not find anything in it (or anywhere else in our laws) that states vision screenings, pretests, visual fields, visual accuities, auto-refracting, refracting or any other exam tests or screenings are part of our professional duties or ever have been. On the other hand, ALL of those things DO fall under the definitions of optometry duties. So how was a duty taken away that was never really ours to begin with?*

It is not my intent to misconstrue this statement.  So, for clarification, would it be proper to state this restriction of professional duties was an intentional goal of the Declaratory Order and that the TDOA Board and Officers supported your position?

*Roy*

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## Barry Santini

> I also included the definition of dispensing opticians above, I can not find anything in it (or anywhere else in our laws) that states vision screenings, pretests, visual fields, visual accuities, auto-refracting, refracting or any other exam tests or screenings are part of our professional duties or ever have been. On the other hand, ALL of those things DO fall under the definitions of optometry duties. So how was a duty taken away that was never really ours to begin with? 
> 
> If the Board was strict on their interpretation perhaps it was because they knew that *vision screenings* *could give a false sense of well being* as in "I can read all the lines, I don't need an exam", to bad the screening did not catch the diabetes, or the swollen retina or the brain tumor. 
> 
> Are you opticians who say you've lost a duty prepared to take on the liability for that?


I think that the excerpted, bold statement I've highlighted above (and tried to surround with the intended context) is the heart of almost any arguement out there as to why licensed and trained ophthalmic dispenser should *not* be able to extend the scope of their skills practice to include vision screenings and/or refraction. I believe that the underlying assumption is "look, we've done it this way (optometric/ophthalmologic) all along, and the public *assumes* that *any* type of vision screening is equivalent to an eye-health check."

This may, in fact, be true..._at this time._

There is *no* reason that both qualified dispensers and the public cannot be educated (and trained) to think and understand otherwise about vision screenings and refraction. Don't you agree?

IMHO, this has become just a politically-charged argurment to maintain the status quo, without a real-world, step-back-for-a-minute perspective about just how much *eye-health-caregiver-gatekeeping* the public expects, or even wants, everytime their refractive state exhibits a change.

I believe the entire eyewear industry both being held hostage to, and holding the public hostage,  to this status quo.

I suggest that all ODs (and MDs) think about moving their practices from appearing to be based on "sight-correction" gatekeepers, to ones that focus on the most up-to-date scientific and medical knowledge, employing the latest screening and diagnostic procedures, with the goal to deliver the public the finest present and prophylatic vision-care available.

Barry

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## wabmorgan

Bump

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## BoardPetitioner

> I think that the excerpted, bold statement I've highlighted above (and tried to surround with the intended context) is the heart of almost any arguement out there as to why licensed and trained ophthalmic dispenser should *not* be able to extend the scope of their skills practice to include vision screenings and/or refraction. I believe that the underlying assumption is "look, we've done it this way (optometric/ophthalmologic) all along, and the public *assumes* that *any* type of vision screening is equivalent to an eye-health check."
> 
> This may, in fact, be true..._at this time._
> 
> There is *no* reason that both qualified dispensers and the public cannot be educated (and trained) to think and understand otherwise about vision screenings and refraction. Don't you agree?
> 
> IMHO, this has become just a politically-charged argurment to maintain the status quo, without a real-world, step-back-for-a-minute perspective about just how much *eye-health-caregiver-gatekeeping* the public expects, or even wants, everytime their refractive state exhibits a change.
> 
> I believe the entire eyewear industry both being held hostage to, and holding the public hostage, to this status quo.
> ...


I do agree with most all of your comments, but I also feel I have honestly tried to have a real world perspective and keep the best interests of the consumers and opticians at the forefront. I believe a review of the #1 post of this thread that shows the original petition and the answers given as posted by Roy Ferguson would show that. The ability to perform vision screenings was never even a question on the petition, the solicitation for business by use of them was. The draft of the final order was erroneous in wording of some answers. I am hopeful it will be corrected to reflect the true questions and answers. I am really disappointed that this has become a politically charged arguement, that was not my intention either. But I could not continue to let Roy place blame for mis-written answers to perfectly legitimate questions on our optician association and myself for supporting the questions. Roy supported the questions and recognized the problems himself back in Jan.07 when I personally consulted with him about it at a previous board meeting. I think you have made some very good points, I hope you feel the same about some of mine.

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## BoardPetitioner

> What is being missed here is that these laws were created to prevent an LDO from practicing as an Optometrist.
> 			
> 		
> 
> These laws were created to protect the consumers.
> 
> 
> 
> 
> ...


You never responded to one of my earler questions. Do you know anyone in the company you work for who has lost hours, promotions, or overall professional value due to plenty of non-licensed coverage? Or a salaried optician who was required to work 60-70 hours a week with no extra pay, to provide "licensed coverage" for untrained staff and save payroll. If so, what is more important, being the only person other than an OD authorized to prepare, adapt and dispense prescription eyewear, or performing vision screenings?

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## BoardPetitioner

> Hi All:
> 
> *I also included the definition of dispensing opticians above, I can not find anything in it (or anywhere else in our laws) that states vision screenings, pretests, visual fields, visual accuities, auto-refracting, refracting or any other exam tests or screenings are part of our professional duties or ever have been. On the other hand, ALL of those things DO fall under the definitions of optometry duties. So how was a duty taken away that was never really ours to begin with?*
> 
> 
> 
> 
> 
> It is not my intent to misconstrue this statement. So, for clarification, would it be proper to state this restriction of professional duties was an intentional goal of the Declaratory Order and that the TDOA Board and Officers supported your position?
> ...


The TDOA supported the questions and answers given in your #1 post on this thread. Nothing more, nothing less! Just as you stated to myself as well as opticians attending your CE classes, that you supported the questions before the hearing ever took place. Maybe its your fault, since you supported the questions then, that the board attorney's draft of the final order stated "Opticians can't perform vision screenings"...makes about as much sense as blaming the TDOA for supporting the questions huh? I know you are just trying to make the most of an oportunity to discredit the TDOA, but really Roy, that arguement just don't make sense! Why don't you give it a rest?

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## wabmorgan

Bump

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## BoardPetitioner

> Hi All:
> 
> 
> 
> 
> 
> Again, please remember that brevity is a virtue and paragraphs are our friend.
> 
> 
> ...


All right now, go ahead and twist some the comments I've made here into something else accusatory.

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## BoardPetitioner

> Originally Posted by *wabmorgan*  
> _Quote:_
> _What is being missed here is that these laws were created to prevent an LDO from practicing as an Optometrist._ 
> 
> 
> _The law were written to protect the consumer by preventing LDOs from practicing as an Optometrist._ 
> 
> _Quote:_
> _Not to STOP an LDO from preforming these job related duties under the supervision of an Optometrist._ 
> ...


The laws were created to protect consumers from all sorts of unethical practices, not just opticians practicing as optometrists. You should really look them over.
So do you perform your vision screenings under the supervision of an OD? And once again neither the petition nor the board addressed duties under supervision of an OD. I see you once again did not answer the last question. I guess it's a tough one huh?

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## wabmorgan

Bump

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## wabmorgan

Bump

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## Fezz

Where are we going with this?

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## Jubilee

> I also included the definition of dispensing opticians above, I can not find anything in it (or anywhere else in our laws) that states vision screenings, pretests, visual fields, visual accuities, auto-refracting, refracting or any other exam tests or screenings are part of our professional duties or ever have been. On the other hand, ALL of those things DO fall under the definitions of optometry duties. So how was a duty taken away that was never really ours to begin with? If the Board was strict on their interpretation perhaps it was because they knew that vision screenings could give a false sense of well being as in "I can read all the lines, I don't need an exam", to bad the screening did not catch the diabetes, or the swollen retina or the brain tumor. Are you opticians who say you've lost a duty prepared to take on the liability for that? Or what about the children who will not get screenings from opticians as some of you stated? Well what about the children who as we all SHOULD know can accomodate vision so well, that have passed these "screenings" only to find out later that they needed significant correction all along. Would any of you want some ticked off parent sueing you because their kids grades were poor until the child got prescription glasses, and after your "screening" the year or two before when the kid passed it. I know most of you tell people that pass one that they should still get a complete exam, but really how many people take the time and money to do so if they have already been told by a LICENSED OPTICIAN that they could see the 20/20 line?


Let me understand what you are trying to say. I am reading that your argurment against LDOs being able to perform vision screenings is because since they are licensed, the perception is they are more of a professional and have an increased liabilty than a layman who performs routine screenings at health fairs and schools?

As an active volunteer with several optical based charities, I am absolutely dumbfounded by this idea for several reasons.

1) Many programs such as the Lion's Club, Prevent Blindness, and others use LDOs and other extensively trained personell not only to train their volunteers, but to have them perform actual screenings as well. Eliminating their ability to help in this area is huge blow and I believe that you have mistaken the issues.

2)While an eye exam certainly can reveal diabetes, hypertension and other such diseases, and a simple screening does not.. I don't think that anyone will sue and be successful for saying the failure to detect a systemic disease at a SCREENING is malpractice. I do not know of any person in the past 83 years that the Lions Club or the 100 years of Prevent Blindness America has been performing such duties being sued for such nonsense.

3) What about the real concerns that many of our school aged kids are only being diagnosed with preventable causes of blindness such as refractive error and amblyopia after the failure of one of these screenings performed mostly by laypeople and licensed opticians. While these groups receive the support of optometrists and ophthamologists who will perform more extended services if the need is warranted based UPON THE SCREENING, they themselves rarely do the screenings.

4) I would think that it would be better to have an LDO or other optometric certified or at least experienced personell perform these screenings. The breadth of knowledge that 20/20 doesn't mean perfect vision, or to be able to look for muscle balance issues and other indicators.. combined with a more thorough knowledge of how light, vision and the physiology of the eye work can really educate our participants in the screening about why exams and having qualified persons help with your eyewear selection is so important. Thus gives more active support and generates good will for your profession.

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## BoardPetitioner

> I don't perform vision screenings. I NEVER HAVE!!!!!!!!!!!!


Then why are you argueing that you have lost a duty that you never have even performed? How can you possibly believe that losing a duty you don't perform and is not listed in your scope of practice, outweighs the benefit of requireing opticians to be licensed or apprenticed?

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## cash1

jubilee!!! right on!!! well said!

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## Roy R. Ferguson

Hi All:

Here are some of the issues with this Declaratory Order that Im trying to sort out.
1. When Optometrists and Ophthalmologists own optical dispensaries, will those outlets be required to adhere to the same supervision requirements?  To do otherwise would place the chain firms and dispensaries owned by licensed opticians at a competitive disadvantage.
2. What licensing requirements must optical chains and dispensaries lacking a store manager or district manager follow?
3. May optical employees working under the supervision of Ophthalmologists and Optometrists perform vision screenings?
4. May licensed opticians working under the supervision of Ophthalmologists and Optometrists perform vision screenings?

Roy

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## HarryChiling

> You never responded to one of my earler questions. Do you know anyone in the company you work for who has lost hours, promotions, or overall professional value due to plenty of non-licensed coverage? Or a salaried optician who was required to work 60-70 hours a week with no extra pay, to provide "licensed coverage" for untrained staff and save payroll. If so, what is more important, being the only person other than an OD authorized to prepare, adapt and dispense prescription eyewear, or performing vision screenings?


I heard someone recently say, "licensure is a means of protecting the people", I love the fact that the board took into consideration the value and pay of licensed opticians, but I can't help but to feel that it is misplaced.  The board should not be making rules or interpreting rules to protect licensure, licensure should be there to protect the people from unlicensed opticians.

So now the rules are set and a hard line has been drawn n the sand, who is going to enforce these rules?  And as Roy has mentioned on numerous occasions, are these rules only enforced upon optician owned opticals or does it cover optometric and ophthalmic offices as well?

You have mentioned that vision screening are not in the scope of practice of an optician, however I beg to differ.  Opticiasn are fabricateing eyewear to meet specs, the specs we recieve from prescribers is a Rx.  In most cases this Rx will be a means of allowing the patient to see to a certain VA, if it is less than 20/20 there should be some indication of that on the Rx, otherwise I would assume it is 20/20.  Visual Acuity is an important tool in determining if the vision is acceptable.  Without it were one step closer to being in the dark.  Just an opinion from an out of state optician, who is not licensed, but can perform vision screenings.

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## Roy R. Ferguson

Hi All:

*The instruction of refraction at the college opticianry program, which you were instructing.*

*I am sorry, I got that from a letter sent out by the Optometry Association to every optometrist in the state back in 2001. I guess Representative Odum was misinformed and misinformed all those ODs.*

Here are a few exerts from Mr. Odoms letter.  I left Roane State Community College in 1996, approximately seven years prior to this communication.  It appears the bulk of his comments were directed towards the TDOA and the Licensing Board.  I fail to locate any references concerning me.

Roy

TO: TOA Membership
FROM: Gary Odom, Executive Director
RE: General Assembly Review of Optician Licensing Law
DATE: February 3,2003

The TOA Board has been very concerned about the State Opticians' Association attempting for several years to repeal the apprenticeship route for licensure and mandating a two-year degree as the only route to licensure. 
There was even a period when Roane State was teaching refraction to optician science students as opposed to only basic optician skills and the Optician Association of America has supported legislative efforts in other states authorizing opticians to perform refraction. 
In addition, there is no evidence that the Tennessee Opticians Board has done anything to protect the public. In recent years, the only disciplinary action taken against opticians has resulted from opticians failing to complete the Boards continuing education requirement.
For four years the Tennessee Dispensing Optician Association tried, with the help of the Opticians Board, to convince the legislature to pass a bill eliminating the apprenticeship route to licensure and requiring all persons wanting to be licensed as opticians to complete a two-year educational program at Roane State Community College. The legislature thought their proposal was a bad idea and refused to pass the bill. In 1999, the Opticians Board took matters into their own hands and adopted a rule requiring one year of formal education at Roane State Community College to be licensed as an optician, This was done contrary to the advice of the Board's own attorney. The State Attorney General ruled in - February 2001 that this rule is illegal and cannot be enforced. We should all be concerned about a Board which flagrantly ignores the advice of its own legal counsel as well as the intent of the legislature.
Persons employed by optometrists and ophthalmologists are not licensed and frequently perform the same functions as opticians. There is no objective evidence that the quality of services provided by these trained but unlicensed personnel is in any way of less quality than those provided by licensed opticians.

----------


## rep

a state association that has been for decades attempting to restrict retail chains from dispensing glasses and in the process has restricted licensed opticians from working under the direction of Optometrist, Ophthalmologist and service organizations. 

TDOA is a perfect example of a state association that does not support formal education and instead uses vast amounts of membership money fighting NAOO and the Optometry Association attempting to stop them from dispensing under the umbrella of an OD or an MD. 

They knew quite well in my opinion what the effects of this legislation would be and that it would affect the thousands of licensed opticians working for retail chains, OD's and MD's. They did not care. Their goal is to keep them from working in any environment other than an indenpendent office. 

Licensed Opticians in Tennessee have lost. Now 3-O offices will think twice before hiring a licensed optician even though they are better trained, more qualified and have much more training and experience than novices off the street. This is a disservice to public health but that too is, not their concern. This will lower the value and directly affect the salaries of licensed opticians in the state. 

Congratulations TDOA for another "job well done"

Rep

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## wabmorgan

Bump

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## wabmorgan

Bump

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## BoardPetitioner

> I was specifically referring to the issue of vision screening....
> 			
> 		
> 
> So was I. If you don't perform them, then you must of had reason not to since your employer required a weekly quota and pushed the solicitation of business with them. You must have felt that the direction from your non-licensed DM was wrong or you would have happily performed them, if not then why didn't you do the required 100 screenings a week?
> 
> 
> 
> 
> ...


If that is a real problem, then it was created by the retail chains by peppering the state with dispensaries on every corner, and not keeping a demand for licensed coverage over the past 10-15 years. As I recall opticians overall in the retail sector had become little more than a preventive measure for board inspection, and made just a couple of dollars more than an optical employee with no experience. Most people coming out of high school and planning their careers would look at that as a dieing profession, I have thought so myself on several ocassions.The nursing profession went through similiar issues with lack of nursesfor a good while, their field has grown in leaps and bounds, and the market is not flooded with them nor has their pay dropped, but has significantly increased.
Your arguements seem to me to be unfounded on any fact, and illogical. And you still do not want to honestly answer the question I asked you about knowing opticians who have suffered due to non-compliant staffing. At least I know why Roy has issues, he wants to discredit the TDOA and evidently does do lots of screenings. I can't figure out where you are coming from or why. You don't do screenings and you seemed to be very frustrated with the same issues when Randy and I spoke with you at the CE hours in Nov06, what or who has changed your perspective?

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## wabmorgan

> Quote:
> _You are wrong about that, some national chains did exist then and these same issues occured then, thus the needs for the laws. Most of the laws were put on the books in the 50's do you not think corporations existed in the 50's?_


 
Lenscrafters, Pearle, Eyemasters, Wal-Mart, Sams did not even exits in the 50's. 

Just who were the "corporations" that existed in the 50's in the optical field????

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## wabmorgan

Bump

----------


## BoardPetitioner

> Hi All:
> 
> *The instruction of refraction at the college opticianry program, which you were instructing.*
> 
> *I am sorry, I got that from a letter sent out by the Optometry Association to every optometrist in the state back in 2001. I guess Representative Odum was misinformed and misinformed all those ODs.*
> 
> Here are a few exerts from Mr. Odoms letter. I left Roane State Community College in 1996, approximately seven years prior to this communication. It appears the bulk of his comments were directed towards the TDOA and the Licensing Board. 
> 
> 
> ...


You also failed to state that this letter was a direct response to another letter sent to ODs which you helped compose and had you listed as one rep in a liason for the OAA. The primary content spoke of how opticians had built optometry into what it is today, and the goal was to encourage ODs to oppose their own association. Not a good idea during a review period as they clearly stated in their complete response letter. Seems the TDOA did support higher education and eventual repeal of apprenticeship, until we very nearly lost licensed status over it, contrary to your previous posts.

----------


## BoardPetitioner

> Lenscrafters, Pearle, Eyemasters, Wal-Mart, Sams did not even exits in the 50's. 
> 
> Just who were the "corporations" that existed in the 50's in the optical field????


National Optical was one, I am sure there were more.

----------


## Roy R. Ferguson

Hi All:

*You also failed to state that this letter was a direct response to another letter sent to ODs which you helped compose and had you listed as one rep in a liason for the OAA. The primary content spoke of how opticians had built optometry into what it is today, and the goal was to encourage ODs to oppose their own association. Not a good idea during a review period as they clearly stated in their complete response letter.* 

HUH?

*Seems the TDOA did support higher education and eventual repeal of apprenticeship, until we very nearly lost licensed status over it, contrary to your previous posts.*

The TDOA opposed formal education for Tennessee opticians when a formal plan was in place to advance the issue.  Once the plan was effectively defeated by the organization, verbal support was forthcoming.  One of those We killed the goose; long live the golden eggs moments.

Roy

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## wabmorgan

Post deleted.

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## HarryChiling

It seems to me that the sole job the board has been trusted with, "protecting the interest of the public" was comprimised to protect the interest of opticians.  A case such as this one makes it easier to justify not having licensure.  No matter what anyone says or tells you licensure is not a means of acheiveing higher pay and ensuring all opticians have a job.  I am afriad that this back and forth will not bring about any new revelations as the repecusions will be felt later on down the line.  

BoardPetitioner,

I would like to point out that you are not responsible or do you speak for opticians as a whole.  You speak for yourself, that is fine if you feel that vision screenings are not important for opticians if you speak for yourself, but to say that all opticians would benefit from a reduction in scope is arrogant and short sighted, in this case vision screenings were offered as a sacrificial lamb and the retunr was something that any legal deparment can run circles around.  Did opticians really gain anything?  The board only has power over opticians, so everyone in the store becomes and optometric tech and as such do not fall under the boards thumb.  Their are so many ways I could come up with to circumvent anything that was percieveably gained, yet what was lost is lost and will be very difficult to gain again.

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## wabmorgan

I'm not even sure ANYTHING has really been lost at this point.... including vision screenings. 

The screening in question here were the ones being done outside the supervision of an optometrist and was considered basically a form of advertising for the optometry practice by employees of the Optical office. TN is a two door state, the Optometry practice must be separate from the Optical office. The Optical office may not advertise for the Optometry practice. 

However, If the vision screening are done under the supervision of an Optometrist, I think the board will have little say in the issue.... that's not to say an Optometrist will chose to do so, but they may.

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## BoardPetitioner

> I'm not even sure ANYTHING has really been lost at this point.... including vision screenings. 
> 
> The screening in question here were the ones being done outside the supervision of an optometrist and was considered basically a form of advertising for the optometry practice by employees of the Optical office. TN is a two door state, the Optometry practice must be separate from the Optical office. The Optical office may not advertise for the Optometry practice. 
> 
> However, If the vision screening are done under the supervision of an Optometrist, I think the board will have little say in the issue.... that's not to say an Optometrist will chose to do so, but they may.


wabmorgan, I agree with this post, I am glad you pointed out the screenings I questioned were the ones that were used as mass solicitation and basically forced on us to perform. I never asked if vision screenings could be performed by opticians or anyone else with or without supervision, I simply asked if they could be used for solicitation for professional services of an independent OD, and the Board simply answered "No". The statement in the draft of the order was erroneous, and I hope that it will be corrected. I am neither for or against opticians performing them, I do think they can give a false since of security, but I also think they are better than nothing for those who can't afford a routine complete exam to check if they see well. I can understand your concerns that the retail chains will push for deregulation, I had and still have the same concerns, but after much thought, research and advice, I felt that was something already taking place. One point I will make on that which may ease those concerns is this, if retail chains are found to be in violation of multiple statutes, and the board is trying to enforce statutes, then the retail chains make an effort towards deregulation, I believe it would be seen by politicians and lawmakers as an attempt by corporate chains to deprive TN citizens of qualified, professional eyecare in order to increase their on bankroll. As for future overload of licensed opticians, I really can't see it. There is too much growth in health care overall, people are living longer, and the baby boomer generation has just come into the presbyopic age. Listen, I apologize for giving you a hard time in earlier posts. I was a bit upset with the blame Roy had been placing undeservedly on the TDOA and myself and was getting a bit defensive. I think you know they are not the **** poor association Roy makes them out to be and that they have many good opticians serving who felt that my questions to the board were issues that certainly needed addressed. From our past conversation in Nashville, I think you are a "stand-up" optician and mutual friends have always spoken well of you. I sincerly hope I did not offend you too much. If you would like to give me a call to discuss this in a manner that can't be picked apart by everyone online, please feel free to do so, you can get my # from Jay, Kathy H., or most any WM optician in the Chattanooga/Knoxville area.

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## BoardPetitioner

> It seems to me that the sole job the board has been trusted with, "protecting the interest of the public" was comprimised to protect the interest of opticians. A case such as this one makes it easier to justify not having licensure. No matter what anyone says or tells you licensure is not a means of acheiveing higher pay and ensuring all opticians have a job. I am afriad that this back and forth will not bring about any new revelations as the repecusions will be felt later on down the line. 
> 
> BoardPetitioner,
> 
> I would like to point out that you are not responsible or do you speak for opticians as a whole. You speak for yourself, that is fine if you feel that vision screenings are not important for opticians if you speak for yourself, but to say that all opticians would benefit from a reduction in scope is arrogant and short sighted, in this case vision screenings were offered as a sacrificial lamb and the retunr was something that any legal deparment can run circles around. Did opticians really gain anything? The board only has power over opticians, so everyone in the store becomes and optometric tech and as such do not fall under the boards thumb. Their are so many ways I could come up with to circumvent anything that was percieveably gained, yet what was lost is lost and will be very difficult to gain again.


Mr. Chiling, I would like to point out a few things to you. 
1. "Protecting the interests of the public" was about the exact phrase that can be found in the board minutes of the declaratory hearing, that the board cited for making their ruling. NEVER was anything mentioned of protecting opticians, their pay or their jobs available. I pointed out in this forum that the pay rates and job availability for opticians had significantly increased at one major chain in TN since these issues were brought to their attention. It did not start with me, it actually started around Oct.06 after another well respected optician/manager resigned their position via e-mail to several key corporate officials. In that resignation it was stated that the resignee was continually harassed about payroll of opticians to operate in compliance while over half the dispensaries throughout the rest of the state were not compliant. After that, many more issues were raised by many more opticians, including mine, and the hiring/pay frenzy was on because they certainly were not anywhere near compliance. This all took place well before the declaratory hearing but continues still.
2. No matter what anyone says or tells you, licensure in any field of practice is worked hard for, and the licensee should be paid accordingly for their skills and knowledge. To place untrained individuals in ANY healthcare position to save on payroll and increase profits is simply wrong. I don't really care how non-licensed people try to justify it, it is still detrimental to consumers and the field of practice involved.
3. I NEVER said that vision screenings were not important to opticians or that "all opticians benefited from a reduction in their scope of practice".
Once again it is being posted that I said things that were NEVER actually stated. What I did say was that I felt they gave a false sense of security and that problems could very easily be missed by them. A complete comprehensive eye exam by an OD or MD is the ONLY way to accurately evaluate eye health and visual acuity. What I did point out (because Roy stated the board cited laws which did not exixst) was that is was not listed in OUR states scope of practice for opticians and could be legitimately interpreted by a Board member as "examining the eye by any means or method" which is "strictly prohibited" from our scope of practice. NO one, including Roy, who I am sure has searched diligently, has given me a statute or reg from OUR state laws that says or insinuates otherwise. NO ONE ever offered up vision screenings as a "sacrificial lamb" during this hearing, it was simply an error in the wording of answers in the final draft. If you look back to the first post in this thread, you will see the question asked was about solicitation by screenings and the only answer the Board gave was "NO".
4. I believe opticians and consumers alike did gain from this. The chain ODs are independently contracted, so no, everyone can not just become an optometric tech to circumvent the law because they are employed by the chains, not the ODs.
5. "Legal departments running circles around" state health codes was precisely why these questions were presented to the Board to start with. According to the sentiments I get from you, Roy, and a few others, I should have just stayed quite and continue to watch as consumers got shoddy eyewear and technical advice, and opticians lost hours, positions,  promotions, and jobs to unqualified and completely inexperienced employees or just decided to quit because they were tired of being directed to violate the law.

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## HarryChiling

> Mr. Trew stated Question #4 is as follows:
> 4. Can optical employees go into the public sector and solicit business for optometrists by
> means of verbal communication, business cards, and/or vision screenings?
> Upon discussion, Mr. Wells made a motion, seconded by Ms. Chitwood, to give an answer of
> “No” due to the law prohibiting opticians to perform screenings. The motion carried.
> A roll call vote was conducted and all board members answered in the affirmative.
> The Board stated the actions taken by the Board are to protect the health and welfare of the
> citizens of the State of Tennessee.
> With no other Board business to conduct, Ms. Chitwood made a motion, seconded by Mr. Risby
> ...


I've read the minutes in full, your vendetta ended with a question that was not relevent that lead to a ruling about opticians performing screenings.




> Nothing contained in these rules shall be construed to permit persons licensed under T.C.A. &#167;&#167;63-14-
> 101 through 63-14-121 to examine or exercise eyes, nor to diagnose, treat, or prescribe for any human
> injury, disease or ailment.


Screenings are not examinations or exercises for the eyes, nor do they diagnose, treat, or prescribe for any ailments. So there really is no law that prevents opticians from screenings except now that the issue has been brought up and the boadr has made a ruleing, and the board is put in charge of interpreting the rules and regulations, in essence you opened pandora's box and now that people are upset you don't want to be held accountable for that.




> (4) Orthoptics and Vision Therapy - Any person other than a doctor of medicine or an osteopathic
> physician who examines, diagnoses, manages and treats conditions or diseases of the eye or eyelid is
> considered to be practicing optometry in accordance with T.C.A. &#167; 63-8-102(12). This includes
> managing a patient through vision therapy, visual training, visual rehabilitation, orthoptics or eye
> exercises. “Orthoptic training” means any ocular exercise for the correction or relief of abnormal
> muscles or functions of the eyes in accordance with T.C.A. &#167; 63-8-102(11). A person who hold
> him/herself out as being able to remedy or relieve defects of vision or muscular anomalies or other
> abnormal conditions of the eyes by engaging in orthoptic training or by adjusting, fitting or adapting
> lenses or prisms to remedy or relieve defects of vision or muscular anomalies is engaged in the
> ...


As you can see vision screening does not fall into the category of examinations or is it an integral part of an examination, by being poorly versed in you own state laws you in effect went in front of the board with the idea that you were going to help and effectively cut screenings out of an opticians scope. Did you eer think that when the board said "NO" to opticians performing screenings you would ask the board to define screenings? Or did yo ask the board to point to the rules that said "NO to opticians performing screenings"? In this case the board was wrong and you are probably gettng so much flak for this becuase you did not think of the repercusions of your actions. You still think your sh*t don't stink and it's a shamed because I know from the minutes that you went into the meeting with good intentions.  Next time if there is a ext time take the time to read and understand what you are allowed and not allowed to do.  Now weather you meant to offer screenign as a sacrifical lamb or not, in TN they are dining on Gyro's. :D

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## BoardPetitioner

> I've read the minutes in full, your vendetta ended with a question that was not relevent that lead to a ruling about opticians performing screenings.
> 
> 
> 
> Screenings are not examinations or exercises for the eyes, nor do they diagnose, treat, or prescribe for any ailments. So there really is no law that prevents opticians from screenings except now that the issue has been brought up and the boadr has made a ruleing, and the board is put in charge of interpreting the rules and regulations, in essence you opened pandora's box and now that people are upset you don't want to be held accountable for that.
> 
> 
> 
> 
> ...


Evidently you think *YOUR* "Sh*t don't stink" by being arrogant enough to think you are so well versed in our state's laws, you being from PA and all. Did you even bother to read the laws you just posted? If so you are not as well versed as you try to come across as being on our statutes or just ignorant. Take a closer look at this part of the statute YOU just posted and accused me of going in front of the Board being "poorly versed" in:

The following shall constitute the *PROFESSIONALLY RECOGNIZED* *COMPONENTS* to be _included_ in the *EXAMINATION* provided for the advertised fee and before the prescription requested is issued:
(i) Spectacles
(I) *VISUAL ACUITY TESTING OF EACH EYE FAR AND NEAR POINT*

Isn't that exactly what a vision screening is, a VISUAL ACUITY TEST?
Now as *You* can see *IT DOES* fall under optometry's scope of practice not opticianry's. *It* *IS* an integral part of an eye examination! Man, you really missed the boat on that one didn't ya?
Next time *YOU* take the time to read and understand statutes your posting!
Don't be so arrogant as to think you can briefly look over a few statutes and know them, or to think you have any idea of the unethical and unlawful events that led to my petition for clarification of statutes.
These are the laws I and the board and 5 attorneys and the judge (yes a TN district court judge presided over and found no fault in the hearing) referred to in the petition as only Optician laws were admitted:

63-14-102
*(2)* Nothing in this section shall be construed to authorize or permit any *dispensing optician* to claim to be able to, or to offer, undertake or attempt, by any means or method, to examine or exercise eyes, fit contact lenses, or diagnose, treat, correct, relieve, operate or prescribe for any human ailment, deficiency, deformity, disease, injury, pain or physical condition; however, dispensing opticians may fit contact lenses in the presence of and under the direct supervision of a licensed optometrist or ophthalmologist.


63-14-104 It is unlawful for a dispensing optician to act as the agent or representative of any physician or optometrist on any account.

Performing mandatory screenings to gain patients for an OD would be considered acting as an agent or representative of an OD.
It can easily be seen why the Board felt that visual acuities/vision screenings fell outside optician's scope of practice and within optometry's.
You listed it in their scope of practice yourself!

And yes I did go before the Board with good intentions, and still have them. It is misinformed people like you and Roy who have not witnessed the illegal actions and directives that were taking place, or had yours and other opticians' livlihoods threatened for not wishing to violate our profession's code of ethics, that are trying to twist my intentions. Do not mistake my understanding of MY states statutes as arrogance again!

----------


## HarryChiling

> Isn't that exactly what a vision screening is, a VISUAL ACCUITY TEST?


NO not in all cases, and that is why you had no business in opening up pandora's box. Do't get upset at me for your idiot move. I will give you an example of a vision screening that does not involve VA's http://www.photoscreener.com/ interestingly enough one of the most professional opticians I know in TN uses this systemt o help kids in TN and this ruling can be detrimental to his screenings and to the many children in your state that will lose out on this benefit. Now this quick and cost effective screenign could prevent many cases of refractive errors and muscle issues from ending amblyopia which at a certain age is pretty much irreversible so this ruling can and will do damage in this specific state and case. Oddly enough that system is from a company in, you guessed it PA the state that I am from, small world isn't it.

It amazes me that you would take the bait on that one, I didn't think you would be so easily lead into that one. Maybe that's why even with the statutes and rules posted right next to each other easily compared you still have foudn a way of miscontrueing the facts, keep in mind that I scoured the many pages of documents to excerpt the relevent quoted above because you seem to keep asking Roy for reference to the rules. Almost everything in bold in your post is wrong because you are equateing visual acuities with visual screenings. Critical thinking is obviously a trait that is and was lacking when you went in front of the board and now here on this board. It is very important that YOU not just glance over these rules, but comprehend them and the implications of changeing a single word in them, BTW these are not the rules in full I can provide you with the relevent link if you would like to read them over before your next response so we can teer this thread in a more intelegent course. You were right in addressing the issues you did and it is a shamed that one oversight has you marked with a scarlet letter, but I think your obligation now would be to try and correct the one simple mistake you made by meeting with the board and going over this issue.

As the saying goes, "The devils in the details". Well anyway good luck with your job working for a comapny that you found unethical enough to report to the board, yet by my bet are still employed with. Your intentions may have been good going in, but your arrogance and selfishness will ultimately harm your profession. Roy I see what you were saying about this guy.:hammer:  And please try and stay out of PA, things ar bad enough here as it is, that goes for MD too.

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## Roy R. Ferguson

Hi All:

*The following shall constitute the PROFESSIONALLY RECOGNIZED COMPONENTS to be included in the EXAMINATION provided for the advertised fee and before the prescription requested is issued:
(i) Spectacles
(I) VISUAL ACUITY TESTING OF EACH EYE FAR AND NEAR POINT

Isn't that exactly what a vision screening is, a VISUAL ACUITY TEST?*

Please remember this ruling has been applied to all licensed opticians in Tennessee.  If the petitioners interpretation holds, licensed opticians working under the supervision of Optometrists or Ophthalmologists will have no professional latitude.  Licensed opticians who now perform COA/COT functions for Ophthalmologists or Ophthalmic Tech roles for Optometrists will be in violation of this Declaratory Order.  This certainly appears to constrict job opportunities for opticians.

Roy

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## Jubilee

Call me silly..

But what I was interpreting was the list of components was just that.. a list of steps that are to be taken if performing a comprehensive exam. 




> (5) Eye Examination Requirements - All eye examinations performed by licensees shall include the
> professionally recognized components listed in subpart (3) (a) 2. (i) of rule 1045-2-.08 for spectacles and
> in subpart (3) (a) 2. (ii) of rule 1045-2-.08 for contact lenses...................................................... ...
> 
> 2. If an optometrist advertises an examination fee or includes an examination as a service
> provided in an advertised fixed fee the examination findings shall include all pertinent
> tests and observations necessary to satisfy the standard of care. The following shall
> constitute the professionally recognized components to be included in the examination
> provided for the advertised fee and before the prescription requested is issued:
> ...




When it goes to specify that it must include 2 follow up visits, etc.. that to me is clarifying what the doc should be doing, but not eliminating what a optician, COT/COA or orthopist can do if allowed under their regulations.

For example, I do not know of any optometrist that does his or her own Insertion/Removal instruction. Typically they assign the appropriate person employed to take care of that item with the patient. Same as those who perform pretesting items.

Tennessee also have makes the use of orthopist to perform vision therapy in conjunction with a OD/MD. Once again, the doctor does not perform this function themselves, but makes sure an appropriately trained person does.

Cassandra

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## Roy R. Ferguson

Hi All:

*For example, I do not know of any optometrist that does his or her own Insertion/Removal instruction. Typically they assign the appropriate person employed to take care of that item with the patient. Same as those who perform pretesting items.*

Here is the rule for opticians in Tennessee.  

*Dispensing opticians may fit contact lenses only in the presence of and under the direct supervision of a licensed optometrist or ophthalmologist.*

This was originally written to cover the independent optician working in an optical dispensary.  As more and more dispensing opticians began to work with Optometrists and Ophthalmologists, a common sense approach was applied.  Since no harm was demonstrated and the optician was working under supervision, this was never enforced against those individuals.  All this seems to be changing.

Roy

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## Barry Santini

So, in Tennesse, I guess that DMV personnel are more qualified than dispensing opticians to give acuity/visual screening tests...yes?

???
Barry

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## Jubilee

Another question comes to mind..

When testing to see how well a new rx is working, don't we do some sort of screening, since we assess VAs in order to guage if a person can read 20/20, etc?

And as Barry pointed out.. So DMV employees, school volunteers, and other non optical persons are more qualified to perfom such screenings that licensed opticians are?

If LDOs can't do screenings cause there are in essence practicing optometry, why can people with NO OPTICAL TRAINING perform such tasks and it be ok? Seems to me that everyone without and OD or MD should be disqualified then....

Cassandra

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## HarryChiling

> So, in Tennesse, I guess that DMV personnel are more qualified than dispensing opticians to give acuity/visual screening tests...yes?
> 
> ???
> Barry


Barry,

Again th edevils in the details, for instance:

If I stand a patient so many feet from a chart and ask them if they can see a ceratian line that's a screening, now if I quantify that with a 20/20 that's an acuity.  The DMV uses the testing equipment on a pass fail basis which makes it mroe of a screening.  

Jubilee,

The missing piece of the puzzle is that the board of opticians interprets the rules for opticians so for them to say screenings are not allowed they are limiting the scope of practice of opticians.  Just the fact that visual acuities are considered part of a comprehensive exam doesn't make it and examination in and of itself, the reason for me quoteing that text from optometrys rules and regulations is to see that it specifically states visual acuities which are different than screenings, this detail was overlooked and the consequences I am afraid are that neither screenings or acuities will be allowed.  




> No due to the law prohibiting opticians to perform screenings


You will notice that the board member states that screenings are not allowed becuase it is stated in the rules, this is not the case as you can see here in the quoted text I have provided.  If anyone wants to look at the full documents and form your own opinions as to what happened here they are in full.

Opticianry Rules
http://www.state.tn.us/sos/rules/0480/0480-01.pdf

Board Meeting Minutes
http://health.state.tn.us/Downloads/Do_Min102907.pdf

Optometry Rules
http://www.state.tn.us/sos/rules/1045/1045-02.pdf

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## wabmorgan

As I pointed out in a post above.... 

The screening in question here were the ones being done outside the supervision of an optometrist and was considered basically a form of advertising for the optometry practice by employees of the Optical office. TN is a two door state, the Optometry practice must be separate from the Optical office. The Optical office may not advertise for the Optometry practice and vice versa. 

I think it would have been better for the board to have "defined" that these picticular vision screenings were a form of advertisement for the optometry practice and as such are prohibited by law. 

Again, I doubt the board can restrict a vision screening from being done under the supervision of an Optometrist.

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## Roy R. Ferguson

Hi All:

*Again, I doubt the board can restrict a vision screening from being done under the supervision of an Optometrist.*

A licensed optician in Tennessee is being brought up on charges for performing a refraction test and a visual acuity test under the supervision of an Ophthalmologist.  The hearing is scheduled on Mar 26.  

Roy

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## MERCURY

> Hi All:
> 
> *Again, I doubt the board can restrict a vision screening from being done under the supervision of an Optometrist.*
> 
> A licensed optician in Tennessee is being brought up on charges for performing a refraction test and a visual acuity test under the supervision of an Ophthalmologist. The hearing is scheduled on Mar 26. 
> 
> Roy


Now, for anyone who believed any of the garbage that has been said about the Tennessee Dispensing Opticians Association.  I'd like to know if there is anyone who would be so niave as to also think that the above is true ("brought up on charges for performing a "refraction test" and a "visual acuity test" under the supervision of an Ophthalmologist").  This is the kind of misinformation that has not only caused the bitterness in this forum, but it is also what Tennessee Opticians have had to put up with for years.

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## Roy R. Ferguson

Hi All:

*I'd like to know if there is anyone who would be so niave as to also think that the above is true ("brought up on charges for performing a "refraction test" and a "visual acuity test" under the supervision of an* *Ophthalmologist")**.* 

My thoughts exactly!  Until I saw the charges, it would never have occurred to me that such a thing could happen.  Unfortunately, it is true and the hearing is scheduled on Mar 26, 2008 in Nashville, Tennessee.  I would encourage you to attend the hearing.  If you would like the address and time, Ill be happy to supply it.  

Here is an excerpt of the letter of notification:

*I serve as Assistant General Counsel for the Tennessee Board of Dispensing Opticians.  The Department has received a complaint against your license and an investigation was conducted.  The investigation reveals that you performed a visual acuity test and a refraction test, which is outside of your scope of practice.*

*Here is an excerpt of the letter supplied to the Board by the supervising Ophthalmologist:*

*From May 2004 until and including the present time Mr. XXX has acted under my supervision. A review of the records clearly established that Mr. XXX fully and completely accomplished all procedures outlined by my written office policy pertaining to such activities. * 

*Please try to attend the hearing.*

*Roy*

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## MERCURY

> Hi All:
> 
> *I'd like to know if there is anyone who would be so niave as to also think that the above is true ("brought up on charges for performing a "refraction test" and a "visual acuity test" under the supervision of an* *Ophthalmologist")**.* 
> 
> My thoughts exactly! Until I saw the charges, it would never have occurred to me that such a thing could happen. Unfortunately, it is true and the hearing is scheduled on Mar 26, 2008 in Nashville, Tennessee. I would encourage you to attend the hearing. If you would like the address and time, Ill be happy to supply it. 
> 
> Here is an excerpt of the letter of notification:
> 
> *I serve as Assistant General Counsel for the Tennessee Board of Dispensing Opticians. The Department has received a complaint against your license and an investigation was conducted. The investigation reveals that you performed a visual acuity test and a refraction test, which is outside of your scope of practice.*
> ...


I don't see where the COMPLAINT contains the words "UNDER THE SUPERVISION".

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## wabmorgan

> *Here is an excerpt of the letter supplied to the Board by the supervising Ophthalmologist:*
> 
> *From May 2004 until and including the present time Mr. XXX has acted under my supervision. A review of the records clearly established that Mr. XXX fully and completely accomplished all procedures outlined by my written office policy pertaining to such activities.*


Maybe not..... but the responding Ophthalmologist clearly states it was under his/her supervision.

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## MERCURY

> Maybe not..... but the responding Ophthalmologist clearly states it was under his/her supervision.


I would think that the purpose of the hearing is to determine if the supervision did indeed take place.  Evidently the complaintant has a different opinion.  All I'm saying is, contrary to what was originally said, charges were not brought on as a result of a complaint of supervised practices.  The licensing board would have no basis for a hearing if this was the case.  I would hope that the Optician was acting within his scope of practice and that will be the end result of the hearing.

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## chip anderson

Licensure means granting some right or privledge to the licensee, excluding the un-licensed from the same priviledge and collecting a *tax* for the state.  Mearly this and nothing more.
Virtually all laws and licenses reguarding the optical business are to protect optometries right to control the business (with the exception of some federal regulations that exist mostly to establish power for the regulators).

Why claim otherwise.

Who is going to gain from sitting children in front of an eye chart.  Possibly O.D.'s who without doubt are looking into getting some sort of number assigned to file insureance claims for this.  Otherwise the is usually a free service provided by volunteers to find out who can and who can't see.  Those that can't see are given a recommendation to see an "eye care professional".   What's the point of regulating or having any contest for the right to do this?  Can you say that an optician doing this would be less qualifited than a schoolteacher or lay volunteer?

No one is examining for disease directly and no one is "attempting to determine the refractive power of the eye."

This seems to be just a p****** contest with no prize awarded.

Chip

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## Roy R. Ferguson

Hi All:

*I would think that the purpose of the hearing is to determine if the supervision did indeed take place. Evidently the complaintant has a different opinion.* 

The hearing is to determine if the licensed optician performed a refraction test and a visual acuity test; supervision is not in question.  This will really determine if a licensed optician is allowed to perform ancillary duties under supervision.

*All I'm saying is, contrary to what was originally said, charges were not brought on as a result of a complaint of supervised practices.  The licensing board would have no basis for a hearing if this was the case.* 

This is an excellent point!  The Board can limit the duties an optician can perform, even under supervision, but it cannot dictate how an Ophthalmologist supervises.

*I would hope that the Optician was acting within his scope of practice and that will be the end result of the hearing.*

If the ruling finds the licensed optician violated scope of practice rules, it seems all opticians performing dual roles will be called into question.  

Roy

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## HarryChiling

> Hi All:
> 
> *I would think that the purpose of the hearing is to determine if the supervision did indeed take place. Evidently the complaintant has a different opinion.* 
> 
> The hearing is to determine if the licensed optician performed a refraction test and a visual acuity test; supervision is not in question. This will really determine if a licensed optician is allowed to perform ancillary duties under supervision.
> 
> *All I'm saying is, contrary to what was originally said, charges were not brought on as a result of a complaint of supervised practices. The licensing board would have no basis for a hearing if this was the case.* 
> 
> This is an excellent point! The Board can limit the duties an optician can perform, even under supervision, but it cannot dictate how an Ophthalmologist supervises.
> ...


I am now kinda glad I don't live in a licensed state if this has become the norm.  I am both an optician and perfom duties as a tech.  If I was givent he choice on which to keep and which to lose I would be sad to say that the license as an optician would be the first to go.  Here's my reason:

While opticianry has been around a lot longer than optometry, optometric tech, and ophthalmic tech.  Our scope of practice is limited in many areas where as the other professions don't have many of these same limitations.  Interestingly enough many of these limitations seem to be coming from ourselves so when you heard in an above post the famous quote, "I have seen the enemy and he is us" and my are we a viscious bunch.  If he was performing his duties under an ophthalmologist's supervision then he was IMO well within the scope of an Ophthalmic Tech.  The overlap between the two areas seems to be an issue that has come up on here more than a few times, I would think that the board would make a consideration in this case or at least that would be my hope.

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## MERCURY

> Hi All:
> 
> *Again, I doubt the board can restrict a vision screening from being done under the supervision of an Optometrist.*
> 
> A licensed optician in Tennessee is being brought up on charges for performing a refraction test and a visual acuity test under the supervision of an Ophthalmologist. The hearing is scheduled on Mar 26. 
> 
> Roy


The agenda is now posted for the Mar 26th Tennessee Licensing Board meeting and there is no listing of a hearing for someone being brought up on charges.

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