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Thread: Breaking News in the Great Glasses Court Case

  1. #76
    ATO Member HarryChiling's Avatar
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    Quote Originally Posted by Excalibur
    Of the 3 "O's", optometry has had the greatest success from a legislative perspective across North America. Optometry is a 'centrist' profession, meaning it provides the widest breadth of diagnostics and treatment modalities for the vast array of ocular anomalies.
    You are absolutely correct, and they have gained this wide scope of practice by chipping away at both ends of the profession. Optometry has not only used their legislative powers to grow their scope of practice, but they are always using those same legislative powers to oppose the other O's professions, which they have no business doing. For that reason I will always speak my mind and keep trying to spark a fire to push opticianry forward.

    Quote Originally Posted by Excalibur
    .... and regular ophthalmic consults/assessments help in reducing the risk of eye disease despite what a refractionist might say.
    Again right on the money, however pairing refraction with an ophthalmic consult/assesment is not only unnecessary, but archaic. That is an old model that no longer applys, their is a need for refraction seperate from assesments. And refractionists don't to my knowledge doubt that. Try to look at it from the other side of the fence your patients, for whatever reason, your fees are too high, they hate to wait in your office and go through all the rigamarole, they just had their eyes checked a short while ago and just feel they need a slight tweek. I am only touching on the various reasoning behind it.
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  2. #77
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    Quote Originally Posted by Gary View Post
    Your arguments, reasoning and logic are flawed Shawn .

    The reason to do a full exam is prevention of disease and it is in the best interests of the patient .

    Unbundling the refraction from the eye health check up is purely profit motivated and not in the best interests of the patient.

    Putting untrained people in charge of equipment that they have no understanding of is ridiculous. Put these people through a real refraction and training course and maybe I will think differently . If you want to be an optometrist then it's simple ... take the same training they did . And if you want to be an optician then take that training and learn what the job is all about . If you want to run a chain of optical stores then run them properly and do FREE EYE EXAMS though an optometrist or ophthalmologist .

    Cutting every corner possible is not for humanitarian reasons but purely for profit in my opinion !

    The optometrists I know do a great job and they are decent people . Don't slam them based on profits . They work hard and they are diligent.

    If you have any doubts about this compare it to safety inspections required for cars and emissions testing . The public has proven over and over again that they would continue to drive unsafe vehicles and would continue polluting the environment , except that now these things are mandatory. And it is for everyone's good , including their own.

    It must be past noon somewhere :cheers:
    Hey Gary, again I can totally see your point. And I do agree with you that as an option, a complete eye examination should be availble- to those who chose to get one.

    What I have trouble understanding, is the totalitarian attitude that
    "The reason to do a full exam is prevention of disease and it is in the best interests of the patient. Unbundling the refraction from the eye health check up is purely profit motivated and not in the best interests of the patient." Best interest of the public? Who decided that? And what I am saying is that if I choose not to pay to get what is for my "best interests", who are you to decide that I am wrong? If I can see clearly, and I am content... who is anyone else to decide about my health and wether it is correct or incorrect? Why do I need to pay to see? You mention profit driven, but as a whole people would be spending less on eyeglasses and contact lenses if they didn't have to pay for an eye examination... isn't that true? So how can we be profit driven if we are reducing the total amount of money spent?

    Your need to bring up profit factor to an optician with my view is silly. Only because my view is that we want to provide a measurement free of charge... that is for no money. So really Gary, how would someone with that view be profit driven?
    You might say that more people would come because they wouldn't have to pay for an eye examination. And that is my point exactly, adults would choose not to pay for a new prescription. What is wrong with that? :D

  3. #78
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    Quote Originally Posted by Excalibur View Post
    Of the 3 "O's", optometry has had the greatest success from a legislative perspective across North America. Optometry is a 'centrist' profession, meaning it provides the widest breadth of diagnostics and treatment modalities for the vast array of ocular anomalies. This has created some marginalization of opticianry and ophthalmology. It is, however, important to recognize that each of the professions does have it's strengths.

    If adults believe that the best interests lie in providing free-standing 'refractionaries', then perhaps this should be made a part of the federal government's election platform. And yes, "patients don't know what they don't know" ... I see this all the time in my practice when I (and my colleagues) diagnose asymptomatic eye disease. As you know, the eye does not have a sophisticated 'early warning system'.... and regular ophthalmic consults/assessments help in reducing the risk of eye disease despite what a refractionist might say.

    ---------
    Again, Excalibur I respect your opinion, but you are not addressing the case at point.
    I have never questioned the notion that "ophthalmic consults/assessments help in reducing the risk of eye disease despite what a refractionist might say". So I don't understand where the part "despite what a refractionist might say" came from, because clearly that was never stated by me.
    What I did say, and what you continually choose not to address is the fact that as an adult, if I choose not to have this complete eye examination, why does that mean I don't get a new prescription for my eyes? Please answer this question, and please don't try to make a point by brining up comments I do not support and did not make.

  4. #79
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  5. #80
    Master OptiBoarder mike.elmes's Avatar
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    Gary, we use the Eyelogic System, as do MANY others in Alberta., and we do not cut corners....and we DO know what we're doing.I hope I don't have to type in CAPITOLS to make you understand!! The public can read and write....we very simply explain our proceedures and limitations and they either fall into the criterea set out to govern sight testing or they don't. No one is being deceived, ITS THAT SIMPLE!!

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    Quote Originally Posted by Gary View Post
    What is wrong Shawn is very simple . The people doing it presently DO NOT KNOW WHAT THEY ARE DOING !

    THEY ARE CUTTING CORNERS !

    THE PUBLIC DOES NOT KNOW WHAT THEY ARE NOT GETTING AND THEY ARE BEING DECEIVED and preyed upon .

    IT IS THAT SIMPLE !

    Shawn , if OHIP paid for your eye exam at an ohthalmologist or optometrist would you go there and have it done if it was free and cost you nothing ?
    Gary to run an Eyelogic machine you really don't need to know much about anything. As long as you know how to use a keyboard and a mouse, you're set! If someone is using a manual phoropter and trial lenses, then yes some in depth training would be beneficial.

    You are correct the public isn't clear on what is happening- and again I wish people were getting more information to make an intelligent decision for themselves. I feel that educating the public is essential. With regards to your comments on the public is being prayed upon and deceived- you are open to your view. I disagree, only because I don't feel it is coming from a place of malice.

    To answer your question Gary- Yes I would go to have an eye exam if it was paid for by the government or even if it was not. I went when OHIP covered eye exams, and I go now and pay out of my pocket. Nothing has changed for me. What I hate is having to have my entire eye checked just to get my new refractive error measured. :bbg:

    And again Gary, you manage to avoid the main question- why don't adults have a choice? Do you disagree with adults having the choice between a complete eye exam they pay for, or a measure of their refractive error for free?

    And try to ease up on the caps. This isn't an agrument or a fight. It's simply an open forum for people to bring forward their views and have discourse. I appreciate an opposing view. :)

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    Personally, I think the Eyelogic system could actually improve eye care safety.

    The reason is, during an Eyelogic test, people are clearly told that their eye health is not being checked.

    In contrast, when getting an ocular health exam + refraction from an optometrist, the patient is never told that some eye diseases will only be detected by an ophthalmologist. Therefore, a false sense of security is applied.

  8. #83
    Excalibur
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    "In contrast, when getting an ocular health exam + refraction from an optometrist, the patient is never told that some eye diseases will only be detected by an ophthalmologist. Therefore, a false sense of security is applied."

    Your statement is nonsense.

    Optometrists are held to the SAME medico-legal standard as ophthalmologists when managing patients.

  9. #84
    Excalibur
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    "why don't adults have a choice? Do you disagree with adults having the choice between a complete eye exam they pay for, or a measure of their refractive error for free?"

    -----------

    Again, I say "patients don't know what they don't know".

    Perhaps we should start letting dental hygienists start opening stand alone teeth-cleaning clinics too? After all, who really needs to see a dentist if all they need to do is get their tartar removed? Or why see a family doctor for birth control pills -- they are relatively safe, so let's make them available in high-school vending machines. Performing a refraction in tandem with an ocular health assessment guarantees that the patient will have their eye health checked. How many of you also feel that over-the-counter reader availability is a good thing for patients? Frankly, I tell patients with simple reading rxs that OTC readers aren't necessarily bad as long as they see me regularly so I can check their fundi.

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    but thats where you lose me...OTC readers aren't so bad if you do ophthalmoscopy at periodic intervals? So how is optician-performed refraction different? How is it bad if you tell people to get the same checks done for eye disease? Your argument that people will forego eye exams for simple refraction holds true in both cases...some people will heed your advice about eye exams when purchasing drugstore readers and some will not. Some people will heed your advice and get regular eye exams if opticians perform refractions, and some will not. You can't have it both ways. You cannot say OTC readers are "not so bad if you get eye exams too" and not say the same thing about optician-performed refraction. And in niether case do you have a means of insuring your advice is met. At least with OPR, there is advice given, in writing, and verbally of the importance of eye health examinations, and people at risk for age-related complications are screened out. But they can (and do) purchase OTC readers by the bushel. BTW, dental hygienists in B.C. do stand alone, and the state of our oral health in B.C. is fine.

  11. #86
    Excalibur
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    Dave,

    Read Justice Crane's decision of Nov 2006, and read the Ontario HPRAC regulations from May 2006. Their findings boil down to refractions not being in the public interest if there is no concurrent eye health assessment. And yes, OTC readers are not so bad if they are clinically appropriate. The problem is that by doing a refraction only how can you guarantee that a patient will be assessed for an other ocular anomaly? You can't. You are providing libertarian 'care'. You state that the patient should be allowed 'free will' and freedom to lose their optic nerve if they have early glaucoma, or a have an early retinal break ignored because it's not bothering them. Such callous disregard, veiled in 'freedom of choice' does no patient any good. You do a refraction in an optical shop, give the 'client' a form and then tell them that 'this is not a full eye check up so you better go get a real one in the future because there may be something else going on anyway' flies in the face of reality. Once they get your 'rx', it's highly unlikely they will do anything else other than get their specs. I suspect that many refractionists are performing this act only to sell a pair of specs and could care less if one of their clients have something else going on. A refraction should only be performed at the same time as a health assessment. Period. Your way is the way it was done 100 years ago in the back of jewelery shops, and I must humbly inform you that clinical care has progressed significantly since that time.

    Quote Originally Posted by Dave Nelson View Post
    but thats where you lose me...OTC readers aren't so bad if you do ophthalmoscopy at periodic intervals? So how is optician-performed refraction different? How is it bad if you tell people to get the same checks done for eye disease? Your argument that people will forego eye exams for simple refraction holds true in both cases...some people will heed your advice about eye exams when purchasing drugstore readers and some will not. Some people will heed your advice and get regular eye exams if opticians perform refractions, and some will not. You can't have it both ways. You cannot say OTC readers are "not so bad if you get eye exams too" and not say the same thing about optician-performed refraction. And in niether case do you have a means of insuring your advice is met. At least with OPR, there is advice given, in writing, and verbally of the importance of eye health examinations, and people at risk for age-related complications are screened out. But they can (and do) purchase OTC readers by the bushel. BTW, dental hygienists in B.C. do stand alone, and the state of our oral health in B.C. is fine.

  12. #87
    OptiBoard Professional Ory's Avatar
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    Quote Originally Posted by Caddy View Post
    In contrast, when getting an ocular health exam + refraction from an optometrist, the patient is never told that some eye diseases will only be detected by an ophthalmologist. Therefore, a false sense of security is applied.
    Please name one.

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    Quote Originally Posted by shawn b View Post
    From what I see the issue is quite basic.
    Optometrists do not want to loose their profits to opticians who are dispensing based on a computer generated script. :finger:

    Opticians however would like to offer residents of Ontario an alternative to a complete eye examination...
    I almost hate to add to this discussion, as the two sides will probably never agree, BUT, there are two sides.

    Shawnb (and others) you say, "it's quite basic. Optometrists do not want to lose their profits..", but the other side says, "opticians only want the right to refract so they can sell more glasses, make more profits and not for the good and welfare of the public."

    Both sides can make "good and welfare" claims and both sides can make "greed and profit" claims.

    Opticians want the right to offer refractions, they say, "for free", but why should this be so? They will say it's for the good of the public, but could it be so as to make a quick eyeglass sale and turn a profit? "Free" won't last very long, and it shouldn't. Refraction and prescribing are learned skills that require many hours of learning in a classroom, AND the examination of hundreds of patients in a supervised clinical setting. Computers or no computers. The public should pay for this, just as they might pay for a tune-up on their car. If you hide the cost of a refraction in the cost of a pair of glasses, and then tell the public they got a refraction for free, you are being disingenuous. And please, before I get lectured about this, I realize that some optometrists and commercial optical operations have been doing this for a century already.

    I've often heard statements by opticians on this forum that prescribing and selling glasses under the same roof is a conflict of interest. I agree this can be a problem for the public if they place their trust in someone who is dishonest. But this world is full of examples similar to ours. Dentists diagnose your cavities?, then they charge you to fill them. OMDs diagnose your cataracts?, and then charge you to take them out, and some of them will even sell you the glasses. And I hear ad nauseum on this forum that the examination/dispensing model of physicians and pharmacists should be our model in eyecare, but there have been tons of cases where pharmacists and physicians were in collusion to prescribe/dispense/refer simply for profits. So, no model will guarantee the protection of the public.

    So, my friends, I fear nothing will be resolved. There is no "higher ground" here. There is no right side and wrong side. Battles like this usually wind up in the legislature and some arbitrary set of rules will be set up, and most of us will follow them honestly...until the next challenge evolves.

    In the spirit of staying with the thread, I don't think Great Glasses and it's owner(s), and pets, are the model that ANYONE would use to advance a cause such as optician refracting.

  14. #89
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    FJPOD,

    Thank you for the post. I think you summarized this controversial issue very well.

    ---------------------
    Quote Originally Posted by fjpod View Post
    I almost hate to add to this discussion, as the two sides will probably never agree, BUT, there are two sides.

    Shawnb (and others) you say, "it's quite basic. Optometrists do not want to lose their profits..", but the other side says, "opticians only want the right to refract so they can sell more glasses, make more profits and not for the good and welfare of the public."

    Both sides can make "good and welfare" claims and both sides can make "greed and profit" claims.

    Opticians want the right to offer refractions, they say, "for free", but why should this be so? They will say it's for the good of the public, but could it be so as to make a quick eyeglass sale and turn a profit? "Free" won't last very long, and it shouldn't. Refraction and prescribing are learned skills that require many hours of learning in a classroom, AND the examination of hundreds of patients in a supervised clinical setting. Computers or no computers. The public should pay for this, just as they might pay for a tune-up on their car. If you hide the cost of a refraction in the cost of a pair of glasses, and then tell the public they got a refraction for free, you are being disingenuous. And please, before I get lectured about this, I realize that some optometrists and commercial optical operations have been doing this for a century already.

    I've often heard statements by opticians on this forum that prescribing and selling glasses under the same roof is a conflict of interest. I agree this can be a problem for the public if they place their trust in someone who is dishonest. But this world is full of examples similar to ours. Dentists diagnose your cavities?, then they charge you to fill them. OMDs diagnose your cataracts?, and then charge you to take them out, and some of them will even sell you the glasses. And I hear ad nauseum on this forum that the examination/dispensing model of physicians and pharmacists should be our model in eyecare, but there have been tons of cases where pharmacists and physicians were in collusion to prescribe/dispense/refer simply for profits. So, no model will guarantee the protection of the public.

    So, my friends, I fear nothing will be resolved. There is no "higher ground" here. There is no right side and wrong side. Battles like this usually wind up in the legislature and some arbitrary set of rules will be set up, and most of us will follow them honestly...until the next challenge evolves.

    In the spirit of staying with the thread, I don't think Great Glasses and it's owner(s), and pets, are the model that ANYONE would use to advance a cause such as optician refracting.

  15. #90
    ATO Member HarryChiling's Avatar
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    Fjpod,

    It's good to hear your point of view, I agree that GG is no model for anything and that is agreed upon by all I believe. I do want to add that your comment about

    Quote Originally Posted by Fjpod
    Shawnb (and others) you say, "it's quite basic. Optometrists do not want to lose their profits..", but the other side says, "opticians only want the right to refract so they can sell more glasses, make more profits and not for the good and welfare of the public."

    Both sides can make "good and welfare" claims and both sides can make "greed and profit" claims.
    Do not apply to opticians here in the states, I hate to say this because it is not what I believe, but something that has been forced on my profession. I as an optician do not have to take the patients welfare into account when I make decisions. In our state opticians have tryed to be part of the health care system and it has been optometry and retail chains that have insured that opticians remain sales oriented staff, apparetly their is no harm that can be done by anybody making and selling glasses. So in a sense yes it does make great business sense to have opticians refract, after all no harm can come of improper lenses placed in front of someones eyes (refraction). Optometrists as doctors on the other hand do have to take into consideration the good and welfare of the public they serve and for that you have my respect, however your profession has on numerous occasions, legislatively been devious and have colluded with public servants of the state to squash bills that were meant for the good of the public (licensed opticians). I hold myself to higher standards than optometry holds me too.

    Quote Originally Posted by Excalibur
    Your way is the way it was done 100 years ago in the back of jewelery shops, and I must humbly inform you that clinical care has progressed significantly since that time.
    It wasn't clinical care back then and the arguement is that refraction is not clinical care now. Back then you would have been called an optician and you should have been proud to call yourself that. It was this past prestige that optometry built its foundations on so for you to bellitle it is to shake the very foundations of your own house. Back then opticians had to have skills in metalurgy, optics, chemistry, art, science and various other skills to perform the jobs that they did. It was optometry that split off and created a profession that focused on the science of refraction, at first you did not have the right to call yourselves doctors because you refracted. That did not mean that the science in opticianry was lost. To this day a majority of optometrists don't have a clue how to fabricate a pair of eyeglasses with the very same equipment in their offices, while many opticians are trying to learn refraction and various other diagnostic skills. If we are not allowed to use them for the good of the public on our own then why are we trusted to use them in the offices of optometrists. The AOA has even created a paraoptometric field where they have their techs learning all these skills, why would they do that if opticianry already has these skills.

    I think optometry needs to step back and take a look at the whole picture objectively. The precious scripts you write and hold so highly are allowed to be fabricated by dimwits in your very same office, and the motivation is to save a few bucks. If this isn't greed I don't know what is. As an optician, I value my art and skills, but every optometrist in town hires an idiot and starts making eyeglasses based on cost instead of value therefore devalueing my products and skills to the point where in my state the public just doesn't respect what I do. If opticians were to offer refractions for free, guess whos services would be devalued? Any takers, how long before your level of respect is nill? Realisticaly the arguement over refraction is over "dollars and sense" (absolutely not misspelled). As an optician in a state that does not recognize me in the health care system it's OK for me to argue the monetary advatages and I peform refractions everyday when I take a old pair of glasses off a client and place the new ones on and they say their old one is better, I take the old pair back and neutralize (which should have been done by the doctor who prescribed the Rx) and find many cases where the pd was wrong in the old pair. (not the doctors fault right, it should be; are you neutralizing for prism?), or I find that the base curves are wrong (not the doctors fault right, does magnification factor into your prescribing at all?), the point is that many times these patients have to go back to a doctor who is p*ss*ed about wasteing precious chair time on this patient again, or the patient has to schedule more time off of work to get to see the doctor, when I have already diagnosed the problem, is this the model that works. It only works because I get all the blame and headaches from the transaction. Maybe this seems like a good arguement for OD's to have despensaries in their offices, but you only exagerate the situation. Refraction should be closer to the supply side of the chain to better serve the public, it makes business sense and it does no harm.

    If the arguement is that refractions are a way of getting the public in to see the OD so that they can check the health than why are so many OD's allowing their patients to opt out of a dilation, isn't this where most cases of disease are caught. And if it's not about the money why are OD's working for chains that have quotas on visual field exams?

    I truly do appreciate these discussions, becasue it helps to strengthen both sides, I see it in the posts and arguements of the ones who are always ready and willing to discuss it.
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  16. #91
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    Harry,

    You stated that "it does make great business sense to have opticians refract, after all no harm can come of improper lenses placed in front of someones eyes (refraction)"

    I disagree. If a child is prescribed or dispensed an incorrect rx, you can induce amblyopia. By the same token, you can miss amblyopia by not thoroughly assessing a child ocular status either -- in many cases, a simple dry refraction can miss latent hyperopia.

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

  17. #92
    ATO Member HarryChiling's Avatar
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    Quote Originally Posted by Harrychiling
    Do not apply to opticians here in the states, I hate to say this because it is not what I believe, but something that has been forced on my profession. I as an optician do not have to take the patients welfare into account when I make decisions. In our state opticians have tryed to be part of the health care system and it has been optometry and retail chains that have insured that opticians remain sales oriented staff, apparetly their is no harm that can be done by anybody making and selling glasses. So in a sense yes it does make great business sense to have opticians refract, after all no harm can come of improper lenses placed in front of someones eyes (refraction).
    Excalibur,

    It is nice to see you using all that education of yours to quote me out of context. If you are going to quote me to say I am wrong please read what you quote, otherwise you risk making a donkey out of yourself. I actually agree that harm can and does come of idiots being allowed to sell glasses, but your counterparts here in the states would have to pay educated opticians more and that cuts into their bottom lines so their stance is that opticians don't need to be educated or licensed. I have worked in a pediatric practice for a year and our office specialized in starbismus and amblyopia, and I saw the number of PD's that were off in children with these conditions and the galsses that were made by complete idiots that called themselves opticians only made the situation worst and may have even lead to further damage. I take monocular PD's for all children that come to my office and I occlude when I take my measure, and measure the pupil reflex, or in children that will not sit still sometimes I go from inner to outer canthus.

    Now would I be wrong in questioning your education when your retention of the information your read shows that you can not complete a paragraph without losing focus. I do not have to be a doctor to diagnose this as tunnel vision, just as I believe you are not a doctor because you refract. You earned the right to call yourselves a doctor when you went beyond refracting. It is the same history that opticians look to when furthering our scope of practice. Our foundations are the same, you cannot say we have bad genes when we come from the same family.
    Last edited by HarryChiling; 12-10-2006 at 03:10 PM.
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  18. #93
    Excalibur
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    Looks like you are quite conscientious -- no sarcasm intended or implied. I highly doubt most of your colleagues are as diligent. Sounds like we are two concerned practitioners who care about the welfare of humankind and do not believe that stand-alone refractionists do the public any good.

    PS. your posts are good but your spelling needs a little work. :finger:

    Quote Originally Posted by HarryChiling View Post
    Excalibur,

    It is nice to see you using all that education of yours to quote me out of context. If you are going to quote me to say I am wrong please read what you quote, otherwise you risk making a donkey out of yourself. I actually agree that harm can and does come of idiots being allowed to sell glasses, but your counterparts here in the states would have to pay educated opticians more and that cuts into their bottom lines so their stance is that opticians don't need to be educated or licensed. I have worked in a pediatric practice for a year and our office specialized in starbismus and amblyopia, and I saw the number of PD's that were off in children with these conditions and the galsses that were made by complete idiots that called themselves opticians only made the situation worst and may have even lead to further damage. I take monocular PD's for all children that come to my office and I occlude when I take my measure, and measure the pupil reflex, or in children that will not sit still sometimes I go from inner to outer canthus.

    Now would I be wrong in questioning your education when your retention of the information your read shows that you can not complete a paragraph without losing focus. I do not have to be a doctor to diagnose this as tunnel vision, just as I believe you are not a doctor because you refract. You earned the right to call yourselves a doctor when you went beyond refracting. It is the same history that opticians look to when furthering our scope of practice. Our foundations are the same, you cannot say we have bad genes when we come from the same family.

  19. #94
    ATO Member HarryChiling's Avatar
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    Looks like you are quite conscientious -- no sarcasm intended or implied. I highly doubt most of your colleagues are as diligent. Sounds like we are two concerned practitioners who care about the welfare of humankind and do not believe that stand-alone refractionists do the public any good.

    PS. your posts are good but your spelling needs a little work. :finger:
    I truly do care about the people that come through my offices doors and although the state does not consider me a health care proffesional, I hold myself to those standards, as for the spelling; lets just say I am glad I have a spell checker and upset that it has made me so lazy. :D I disagree on the refraction though, I think that there are competent enough opticians that are already refracting and have heard nothing but good things abotu them and wish them luck. I am suprised that the most obvious question whenever this topic comes up is never asked.

    If allowed to refract would you?
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  20. #95
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    Quote Originally Posted by Ory View Post
    Please name one.
    I wish I could but I'm not a surgeon and neither are you.

  21. #96
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    Quote Originally Posted by Caddy View Post
    I wish I could but I'm not a surgeon and neither are you.
    You do not need to be a ophthalmic surgeon to detect or treat eye disease.

    Family physicians and pediatricians treat eye disease with varying success. Optometrists are trained to detect and treat eye disease, and do so very well where legislation allows. In fact, where optometrists have obtained therapeutic legislation privileges no laws have been repealed and no malpractice insurance has increased beyond the usual rate of inflation. :D

  22. #97
    Excalibur
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    Or... if allowed to refract in conjunction with an optometrist or ophthalmologist, would you?

    -----------
    Quote Originally Posted by HarryChiling View Post
    I truly do care about the people that come through my offices doors and although the state does not consider me a health care proffesional, I hold myself to those standards, as for the spelling; lets just say I am glad I have a spell checker and upset that it has made me so lazy. :D I disagree on the refraction though, I think that there are competent enough opticians that are already refracting and have heard nothing but good things abotu them and wish them luck. I am suprised that the most obvious question whenever this topic comes up is never asked.

    If allowed to refract would you?

  23. #98
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    Quote Originally Posted by HarryChiling View Post
    Fjpod,

    It's good to hear your point of view, I agree that GG is no model for anything and that is agreed upon by all I believe. I do want to add that your comment about



    Do not apply to opticians here in the states, I hate to say this because it is not what I believe, but something that has been forced on my profession. I as an optician do not have to take the patients welfare into account when I make decisions. In our state opticians have tryed to be part of the health care system and it has been optometry and retail chains that have insured that opticians remain sales oriented staff, apparetly their is no harm that can be done by anybody making and selling glasses. So in a sense yes it does make great business sense to have opticians refract, after all no harm can come of improper lenses placed in front of someones eyes (refraction). Optometrists as doctors on the other hand do have to take into consideration the good and welfare of the public they serve and for that you have my respect, however your profession has on numerous occasions, legislatively been devious and have colluded with public servants of the state to squash bills that were meant for the good of the public (licensed opticians). I hold myself to higher standards than optometry holds me too.



    It wasn't clinical care back then and the arguement is that refraction is not clinical care now. Back then you would have been called an optician and you should have been proud to call yourself that. It was this past prestige that optometry built its foundations on so for you to bellitle it is to shake the very foundations of your own house. Back then opticians had to have skills in metalurgy, optics, chemistry, art, science and various other skills to perform the jobs that they did. It was optometry that split off and created a profession that focused on the science of refraction, at first you did not have the right to call yourselves doctors because you refracted. That did not mean that the science in opticianry was lost. To this day a majority of optometrists don't have a clue how to fabricate a pair of eyeglasses with the very same equipment in their offices, while many opticians are trying to learn refraction and various other diagnostic skills. If we are not allowed to use them for the good of the public on our own then why are we trusted to use them in the offices of optometrists. The AOA has even created a paraoptometric field where they have their techs learning all these skills, why would they do that if opticianry already has these skills.

    I think optometry needs to step back and take a look at the whole picture objectively. The precious scripts you write and hold so highly are allowed to be fabricated by dimwits in your very same office, and the motivation is to save a few bucks. If this isn't greed I don't know what is. As an optician, I value my art and skills, but every optometrist in town hires an idiot and starts making eyeglasses based on cost instead of value therefore devalueing my products and skills to the point where in my state the public just doesn't respect what I do. If opticians were to offer refractions for free, guess whos services would be devalued? Any takers, how long before your level of respect is nill? Realisticaly the arguement over refraction is over "dollars and sense" (absolutely not misspelled). As an optician in a state that does not recognize me in the health care system it's OK for me to argue the monetary advatages and I peform refractions everyday when I take a old pair of glasses off a client and place the new ones on and they say their old one is better, I take the old pair back and neutralize (which should have been done by the doctor who prescribed the Rx) and find many cases where the pd was wrong in the old pair. (not the doctors fault right, it should be; are you neutralizing for prism?), or I find that the base curves are wrong (not the doctors fault right, does magnification factor into your prescribing at all?), the point is that many times these patients have to go back to a doctor who is p*ss*ed about wasteing precious chair time on this patient again, or the patient has to schedule more time off of work to get to see the doctor, when I have already diagnosed the problem, is this the model that works. It only works because I get all the blame and headaches from the transaction. Maybe this seems like a good arguement for OD's to have despensaries in their offices, but you only exagerate the situation. Refraction should be closer to the supply side of the chain to better serve the public, it makes business sense and it does no harm.

    If the arguement is that refractions are a way of getting the public in to see the OD so that they can check the health than why are so many OD's allowing their patients to opt out of a dilation, isn't this where most cases of disease are caught. And if it's not about the money why are OD's working for chains that have quotas on visual field exams?

    I truly do appreciate these discussions, becasue it helps to strengthen both sides, I see it in the posts and arguements of the ones who are always ready and willing to discuss it.
    Harry, I mean you no disrespect, but I essentially disagree with most of what you said here. You speak as if opticianry holds a higher moral ground. It doesn't. This is a turf battle. Since no one can agree, solutions will be worked out, to our liking or not, by the legislature, which is essentially the people.

    You speak as if everything that is wrong with opticianry is optometry's fault, and that every action taken by optometry is due to greed. You need to take a step back and look at things objectively. (See how both sides can use the same arguements). We can go back and forth for days citing the good and bad within our professions. We will never run out of instances that we can use to make our points...and that's THE point...they are OUR POINTS, not moral rights and wrongs.

    And BTW, refraction is ABSOLUTELY a clinical function. It involves a practitioner working on a subject. It involves making a refractive diagnosis and prescribing something. It involves educating the patient and making recommendations. I don't think whether it is or isn't makes it a function that an optician can or cannot do, since opticians already work on subjects when they dispense.

    Anyway, professionals should project their strengths, strengthen their knowledge base, and work in concert with others around them, not put them down or make assumptions. This is not about morality, it's about turf.

  24. #99
    ATO Member HarryChiling's Avatar
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    Quote Originally Posted by Excalibur
    Or... if allowed to refract in conjunction with an optometrist or ophthalmologist, would you?
    No, I wouldn't. I enjoy the smell of ethyl glycol in the morning thats my folgers. (I don't really enjoy the smell of my tint unit and understand the harmful nature of that smell, just using it to illustarte my point)

    Quote Originally Posted by fjpod
    You speak as if everything that is wrong with opticianry is optometry's fault
    It would help if our profession can introduce a bill to strengthen our profession without optometry always there to squash it. I am sure you support the AOA and in doing so you have funded some of the same efforts that I speak of. Why is it so important to optometry, that opticianry remains a non licensed profession? I bet your hair stylist is licensed.

    Quote Originally Posted by fjpod
    Harry, I mean you no disrespect, but I essentially disagree with most of what you said here. You speak as if opticianry holds a higher moral ground. It doesn't. This is a turf battle.
    I am glad to see that we have danced around the whole issue of moral ground and good for the patient. Now we call a spade a spade. I totaly agree that it is a turf battle. Optometry as a profession is fighting it on both sides, your scope of practice is so wide and still expanding. Some people are looking into the furture and predicting surgical privledges, or LASIK, the skys the limit. At the same time I found out the other day that optometry tryed to introduce a bill to stop opticians from using polarized lenses and therapeutic tints in the state of PA. I won't say greed, but I will put it out there if anyone is looking for an adjective.
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  25. #100
    ATO Member HarryChiling's Avatar
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    Amazing how I can say anything on this board, but if it is not pro-optometry the negative points go flying in their. Whats funny is the fact that this board is a great resource because people do speak their minds and if you feel the need to hand out negatives on ocassion please hand out positive ones to the peope who truly deserve them as well.

    Oh and Excaliber, man up and sign your negative points or at least try to conceal the fact that it's you being a jerk a little better. Hint, don't post immediately after giving a negative point. The time stamp gives you away. It is this back biting behavior that in my mind justifys my stance against optometry. I understand that the actions of one does not condemn the whole bunch, but everytime we have this type of conversation the same thing happens to me. I get a negative point and it is not signed by the person who gave it.

    I repeat EVERYTIME, you all even think alike, it is the same canned response.
    Last edited by HarryChiling; 02-21-2007 at 04:58 AM.
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