Optometry and Phoropters. Can one exist without the other?

[Oedema]

I would assume most ODs would take VAs with current spectacles before beginning a refraction. If VA was 20/15 OD and OS, with no other complaints, why would you bother refracting?

I almost never take acuities with habitual glasses, and almost always refract! It doesn't always make sense to me either, but its the most efficient way to doing things most of the time in my opinion.

I simply find it an annoying waste of time to take VA with their glasses - usually their glasses are in horrible condition, dirty, showing a patient how to hold an occluder takes too long, half the time the old folks tilt their chin and look through their add, they squish the occluder up against their face and glasses into eyelashes, and patients end up getting face grease all over more of my equipment (even if it is only an occluder!).

[LandLord]

I would assume most ODs would take VAs with current spectacles before beginning a refraction. If VA was 20/15 OD and OS, with no other complaints, why would you bother refracting?

[Oedema]

I used to dream about this utopia, as well. But it will never happen. Eyeglass pharmacists are
-opticians
-optometrists
-drug stores
-internet
-unlicensed optical shops

If spectacle income goes away, ODs can still make a living on refraction. If refraction goes away, OD's can still make a living on ocular health exams (although not a good one yet as per drk).

But for an optician, if spectacle income goes away, so does the optician.

In the US it would be possible in some places for an OD to make a living (not a great one...) without any refraction because they can bill for medical eye care services (separate from a refraction). Here in Canada this is just not possible as the current system basically requires we perform a refraction to meet the requirements to bill to the provincial health insurance. That and just about every patient that comes into our offices expects to have a refraction whether or not they really need one.

[drk]

I don't believe that for a second. Maybe the prospect of self-employment would go away, but there would still be a lot of money to be made working with/for ODs and MDs.

When I was younger, I was surprised to find that most executive chefs spend very little time in the kitchen, and more time managing the business side of the restaurant. Some have no contact with the kitchen at all, but instead manage hotels and/or resorts. I see the same scenario for opticians, as trouble shooters, practice managers, and of course, the occasional dispensing of eyewear.

In many scenarios I see, ODs will need opticians more and more.

[Johns]

But for an optician, if spectacle income goes away, so does the optician.

I don't believe that for a second. Maybe the prospect of self-employment would go away, but there would still be a lot of money to be made working with/for ODs and MDs.

When I was younger, I was surprised to find that most executive chefs spend very little time in the kitchen, and more time managing the business side of the restaurant. Some have no contact with the kitchen at all, but instead manage hotels and/or resorts. I see the same scenario for opticians, as trouble shooters, practice managers, and of course, the occasional dispensing of eyewear.

[LandLord]

I'll post my unpopular theory...

ODs should be the PCP
OMD should be the surgeons, to see one should require a referral from an OD.
Opticians should be the pharmacists.

I used to dream about this utopia, as well. But it will never happen. Eyeglass pharmacists are
-opticians
-optometrists
-drug stores
-internet
-unlicensed optical shops

If spectacle income goes away, ODs can still make a living on refraction. If refraction goes away, OD's can still make a living on ocular health exams (although not a good one yet as per drk).

But for an optician, if spectacle income goes away, so does the optician.

[LandLord]

I know many ODs that don't dispense or refract much and make a fine living.

What do they do to make the majority of their income?

[fjpod]

I'll post my unpopular theory...

ODs should be the PCP
OMD should be the surgeons, to see one should require a referral from an OD.
Opticians should be the pharmacists.

I like it.

I know many ODs that don't dispense or refract much and make a fine living. I won't say it's common place...yet???

[braheem24]

I'll post my unpopular theory...

ODs should be the PCP
OMD should be the surgeons, to see one should require a referral from an OD.
Opticians should be the pharmacists.

[LandLord]

Why not? You offer many services that are more valuable than just a refraction. Are you not offering pharmaceutical therapy? Ocular health exams? Disease management? Other valuable services? Are these services not in demand? Can you not charge sufficiently for them?

[drk]

Not a very good one.

[LandLord]

Put another way, is refraction still the essence of optometry? Can optometrists make a living without offering refractions?