Should Opticians Refract - The Poll

I would say that if Opticians want to refract they should have to do some schooling for it. If optometry school is four years, part of it is understanding the science behind refracting. I'm sure most opticians would not enjoy taking a calculus based physics. I personally found my physics class like that very helpful. I think certain on the job training is useful, but that can only go so far. Almost all my engineers friends understand all the optics because they have the schooling and almost all my coworkers don't. Now if there was only a way to convince my friends to take a pay cut, I think I could make them good opticians.

If you want to learn refraction on you own, in the dark of night, I suggest that you get a copy of:

Refraction, A Programmed Text by Robert D. Reinecke, MD and Robert J. Herm, MD

They also have a Programmed Text on Strabismus.

Good stuff. Highly recommended.

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Originally Posted by bta89

I would say that if Opticians want to refract they should have to do some schooling for it. If optometry school is four years, part of it is understanding the science behind refracting. I'm sure most opticians would not enjoy taking a calculus based physics. I personally found my physics class like that very helpful. I think certain on the job training is useful, but that can only go so far...

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Funny thing is, this is precisely the way many (perhaps even most) COAs and COTs learn refraction. It's on the job. Minimal training. Sure the MD comes in to "check" things, but rarely makes changes in my experience. Refractions aren't billable medical codes of course, so they just don't put much stock in them at all broadly speaking. Many opticians see that and will question the need/utility of formal education in that regard.

It [quality education] obviously makes sense of course, but playing the devil's advocate here, I think that genie is already out of the bottle.

First you need to define “optician”. Many in my mind would not qualify for that title, never mind refracting.

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Originally Posted by idispense

First you need to define “optician”. Many in my mind would not qualify for that title, never mind refracting.

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Good point, unfortunately

My position is No, because there's no need for Opticians to refract. Where do we leave those newly minted and tenured Optometrists? In this industry (being as it is) ODs don't get much respect from Ophthalmologists.

And give Opticians little either. That is understandable. High school educations, primarily, and little real technical knowledge. ODs took the right path. Opticians stood nd watch and that continues. Both of these last couple of poster........I wonder i you have ever seen the rudimentary refractions. CHeck out You Tube and your mind may change. Refraction is not rocket science. I've trained hundreds since 1979 all workin in neat places and able to contribute far more than a simple PD or seg height.

Keep on with your PD and Sag Height measurements. Consider CL fitting.

The “problem” is that it doesn't take passing through a formal curriculum to make eyewear buyers reach 20/Happy.

The real metric, IMHO, would be to remove VCPs as the primary driver for patronage and create a metric around repeat business and a survey as to why they choose to repeat at an optical establishment.

B

Our MD has the technicians refract during the workup and he finalizes is. At some point, I feel like the techs end up doing a large part of what an optometrist does, but without the pay rate. I don't think I personally would want to do refractions. I can't stand when people can't give a straight answer - better one or two? Well one looks brighter, but two may be a little crisper? Well, then again...." etc. etc..

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Originally Posted by KrystleClear

Our MD has the technicians refract during the workup and he finalizes is. At some point, I feel like the techs end up doing a large part of what an optometrist does, but without the pay rate. I don't think I personally would want to do refractions. I can't stand when people can't give a straight answer - better one or two? Well one looks brighter, but two may be a little crisper? Well, then again...." etc. etc..

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I think you have made a gross underestimation of what an optometrist does, and an equally massive overvaluation of a tech.

Even speaking strictly about the refraction, between a tech/OMD and and OD, I will take the OD's refraction 10 out of 10 times. I won't even fill Rx's from most MD clinics near me anymore without auto-refracting and trial framing.

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Originally Posted by Kwill212

I think you have made a gross underestimation of what an optometrist does, and an equally massive overvaluation of a tech.

Even speaking strictly about the refraction, between a tech/OMD and and OD, I will take the OD's refraction 10 out of 10 times. I won't even fill Rx's from most MD clinics near me anymore without auto-refracting and trial framing.

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I am just speaking from my experience. I came from an office where the techs just worked the patient up and prepped them for the doc, but were not involved in refracting, diagnosing, or educating patients on their new diagnoses. Working with an OMD, techs do the workup, instill drops, administer testing and interpret, prep the charts with the diagnoses they think are appropriate and hand off to the OMD, who then takes a look with the slit lamp and goes over the notes from the tech and has the final say on the diagnoses. He has them look through the phoropter with the tech's MR and finalizes. I imagine it is pretty similar with most OMDs. I have known some that don't even put the MR in the phoropter to check if the patient is actually seeing well.

Our techs don't remove foreign bodies or put in punctal plugs, or any of the many other things that optometrists do. I did not mean to say that refracting is all the do. Our optometrist does a lot. I just meant that in my opinion, the refraction is the doctor's job. Just my opinion though. Our optometrist is excellent. He is extremely thorough. He works most days with no assistance from the techs, as they are all tied up with the OMD's patients. He is the most thorough doctor I have worked with, honestly. Some optoms just roll with the autorefractor and don't even dilate patients unless they're kids or diabetic - I have worked with many who finish the exam in five minutes or less. I worked with one in particular who only ever wrote the RX as per what the autorefractor said. We ended up with A LOT of remakes after rx checks.

We've been debating this question on this thread for 21 years and opticians still haven't been able to get organized enough to require licensure in all 50 state. We can't even agree on what it is that we do.

That’s 21 years of ineffective, non-existent, leadership that’s been incapable of penetrating the apathy and other problems that permeate
the issues. IMHO.

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Originally Posted by idispense

That’s 21 years of ineffective, non-existent, leadership that’s been incapable of penetrating the apathy and other problems that permeate
the issues. IMHO.

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Easy to blame someone else. Either you do the work or you don't. Personally, after nearly 50 years in the industry I'm just tired of trying.

At this point we should probably change the poll to "should opticians dispense"

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Originally Posted by Judy Canty

We've been debating this question on this thread for 21 years and opticians still haven't been able to get organized enough to require licensure in all 50 state. We can't even agree on what it is that we do.

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Crabs in a bucket!

those that want change should learn a few things :
- the efforts to change are unequal and less than the efforts to remain unchanged
- the present efforts to change don’t and never have worked , therefore they fall into this category “The definition of insanity is doing the same thing over and over again and expecting a different result”
- next those that want change should learn from those that have effected huge change in the same industry because those who were successful in less or the same time were effective leaders

- these are not words of criticism or to lay blame , these are words of guidance

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Originally Posted by fezz

crabs in a bucket!

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yup!

Speak to this:
- who are the greatest leaders of change in this industry ?
- what efforts were made to understand how they accomplished their goal ?

The poll “Should Opticians Refract “ is silly and needless . Any education of opticians should simply include refraction as a prerequisite. Why would it be polled ? It should just be taught. Everything an optician does is hinged on a refraction . The better question is: Why isn’t the most necessary course taught ?

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Originally Posted by idispense

The poll “Should Opticians Refract “ is silly and needless . Any education of opticians should simply include refraction as a prerequisite. Why would it be polled ? It should just be taught. Everything an optician does is hinged on a refraction . The better question is: Why isn’t the most necessary course taught ?

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Refractometry is taught in several COA accredited schools in the US. But that's not the real problem. The real problem is that it's easier to sit on the sidelines and complain than it is to actually do the work in every state.

How many optician schools are there in the USA and of those how many teach refraction as a prerequisite ?

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Originally Posted by idispense

How many optician schools are there in the USA and of those how many teach refraction as a prerequisite ?

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Visit the NFOS website and do your own research. I'm still working.

It wasn’t necessary for the greatest leaders of change in the optical industry to be opticians to control the direction of opticians.
It was only necessary for them to believe they could.

Would it make sense to identify and study those leaders ?