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Thread: Optometry vs Opticianry......Why does it have to be WAR?

  1. #1
    Master OptiBoarder OptiBoard Gold Supporter Judy Canty's Avatar
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    Perhaps I'm just becoming grumpy in my old age...

    But I’ve had it with the bickering, back-biting, smarter-than-you attitudes in this industry. I believe the reason behind our inability to communicate with each other across professional lines is simply that we don’t want to. Opticians seem to like the bottom of the optical food chain.



    As a group, we don’t support college-based education in any meaningful way, because we don’t make it a prerequisite for hiring nor do we encourage co-workers or employees to seek it. After all, requiring that level of competency usually means higher salaries.



    More than half of us don’t support state licensure, because more than half of the states don’t require it. We’d have to work together with state and national organizations to achieve it and that’s just asking too much. Most of our professional organizations represent only a fraction of the Opticians in their respective states. Too many of us see licensure as just another income source for state governments rather than an indication to the consumer that there is some level of skill and knowledge required to practice.



    Many Optometrists and Ophthalmologists support the concept of college-educated and licensed Opticianry. However, the actions of their respective state and national organizations and even their own hiring practices belie their words. If a college-educated, licensed professional is good for your practices, then require it and pay accordingly. If state licensure is important to your practices then support efforts to achieve it, even if it means associating with Opticians.



    My bottom line is this: If you want to fight, then fight. If you want to want to be the smartest one in the room, fine. I’ll afford you as much professional courtesy and respect as I’m given, but nothing more. At the end of the day, all any of us want is to have a meaningful profession, a modicum of respect and a decent lifestyle for our families and ourselves.










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    Paper Shuffler GOS_Queen's Avatar
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    Well put! I think you've summed it up very well.

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    Cape Codger OptiBoard Gold Supporter hcjilson's Avatar
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    Optometry vs Opticianry......Why does it have to be WAR?

    In a thread recently closed, the question of the animosity between Optometry and Opticianry came up. I wondered How and why it started? and Why does it continue to this day? What can be done to end the war?


    In the spirit of Professionalism and with the knowledge that Optiboarders from outside the professions are watching, keep this thread civil.
    "Always laugh when you can. It is a cheap medicine"
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    Bad address email on file NC-OD's Avatar
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    Okay- Here's a Sampling of the OD bashing on Optiboard.

    I went until my mouse finger got tired of clicking:
    -------------------------------------------------------

    Rule #2 of the optical business: "The Doctor is always right!"
    no matter what that fool says.



    The problem ODs have is that they have an identity crisis ..You are NOT A REAL Physician. You are a wanna be right?


    .... do your self a favor and to your poor patients and become an MD if your treating eye disease t an inferior level...and yes do the pinhole test at least as CYA kinda thing.


    Does it bother anyone else that Optometry is practicing medicine witout a license?


    Recently in Colorad, Optometry used the Sunset Review Process to make changes in their statutes, which included the unsupervised treatment of glaucoma, Iritis and the use of oral antiviral medications.

    Dentists are required to drill into and cut into tissues as a part of their education whereas OD's are not trained to perform Lasik nor are they taught to incize soft tissues, or to understand the interaction of medications or what to do if a bad result should occur. Their training and expertise is all topical, but again what an OD can do leaglly is up to the law, but I'm afraid I wouldn't let an OD cut my nails.


    The fact is that their degree is not MD. Frankly a retinal tomography is no big deal. It will be interesting how the ODs manage to milk this technology in the management of glaucoma.


    OD's practice medicine under the guise of the law but not with a license in medicine.


    ODs are NOT physicians by any stretch of imagination or definition. In states where the use of the term has been legislated, it is simply a function of their strong political lobby and legislators who are not intelligent enough to know the difference. Nurse practicioners are much closer to the definition of physician than optometrists.


    Actually I think it is a dichotomy for OD's, on one hand to pretend that they have the public health and welfare in mind when they protect their position, and then to pretend to be physicians in order to confuse the public to gain customers. The only real common thread is these two positions is pretention.


    Optometrist's refract (I don't see a problem with OD's dilating; however, punctal plugs may be going too far.)


    I can think of no circumstance where an Optometrist should be allowed to prescribe narcotics.


    OD's can dispense medications as well and I can't stop them from doing so since they have a legal right to do this, but I would never let an OD dispense medications to me (personally). For this I would consult an MD first (again personal preference).


    The point here is that optometry has successfully played upon ignorance of the public, leading them to believe that they are just another specialist in the medical community.


    Of course optometry did not buy the right to obtain DPA or TPA privilages, they presented their case and by and large the lesislators saw it only as a turf battle among medical doctors because EVEN THEY do not know the difference! A case of mistaken identy from which optometrey has now receive the windfall profits of American consumer ignorance.


    I have great respect for what an OD does but the fact of the matter remains an OD does not complete medical school and therefore (IMO) should not be dispensing medications of any kind and should not be removing foreign bodies from the eye.


    What I am saying is that the reality is that OD's are practicing medicine and this is by legislation rather than qualifying for a traditionally accepted medical degree.


    While people know much more about the difference between psychiatrrists and psychologists than they do OD and OMD, presenting ones self as a physician knowing that this is a traditionally medical term and knowing that the public is unknowing is like presenting onself as a physic physician or healer. It is more an attempt at very clever deception than education.


    It is a sign of our times when optometrists who have worked so hard in working the legislatures to expand their scope of practice....without attending medical school... dont get the needed respect that a physician gets. A real doctor some say must attend medical school.


    Rare is the OD who is a good dispenser of the products he / she prescribes. If you took away the wholesale lab babysitters who often walk OD's through dispensing difficulties you would have a lot of OD's getting out of the eyewear dispensing business.

    I have never seen an OD Rx that prescribed a slab-off.


    Optometrists are primarily concerned with vision. While they can detect disease, and in some states treat disease, they can't do surgery. If they have their own dispensary, they may know something about glasses, but it's rare for an OD to be as expert as an optician.


    There is a lot more to fitting contact lenses than reading the label on a box, doctors do it that way.


    Please note that all these ethical discussions are aimed at the ophthalmological/optician relationship. This is not relevant to O.D.'s and O.D. ethics or lack of same is whole other subject.


    ….In many ways (in my humble assesment), The job of an OD is a bit redundant(that is if LDO's could refract). If there is any major eye problems, they refer on to the MD's. As it stands now the only reason that we can't refract is the OD's dont want to share the money!


    ……Now as an addenum I do know that some states forbid the above practices (with laws bought and paid for by O.D. lobbies in thier own behalf).


    O.D.'s are making every effort to "become more doctor like," precribe medicine, try to perform non-invasive surgery, treat disease (including glaucoma, and other disease that is mostly treated by super-subspecialist [cornea or retina M.D.'s]. This from a group that just a few years ago was forbidden [on paper but not in practice] from calling themselves "doctor" or representing themselves as physicians.


    An Optometrist is basically an optician that can refract anyway. Anytime a major concern arises they send you off the the Opthalmologist anyway!


    How many times have you heard a patient say "Oh, I won't get my eyes examined here. I go to a real doctor".


    ……And of course the guy doing this could't call himself "Doctor" but then , O.D.'s could not legally until recently.


    It would be an honor to hire an OD and call him optometric physician or what ever he want to call himself as long as he works for ME! you Optometric gods. I would love to set his fees, force him to really work arrive early leave late 15 minute morning and afternnon break and 30 minutes lunch....


    Are optometrists that treat glaucoma really giving the patient all the options available.? Do they offer LTPs etc to their patients? or only rely in the prescribing authority that they have on certain drugs?


    I know some ODs that are epilation happy! They do not need a phoropter to this or 4 years of schooling but it pays well....


    O.D.'s should have to refer all patient's who could not be refracted to 20/30 or better to an O.M.D.
    Last edited by NC-OD; 01-22-2006 at 12:45 PM.

  5. #5
    Master OptiBoarder OptiBoard Gold Supporter Judy Canty's Avatar
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    This was in answer to what question?

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    Manuf. Lens Surface Treatments
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    Blue Jumper How to end the war...........................

    Quote Originally Posted by hcjilson
    I wondered How and why it started? and Why does it continue to this day? What can be done to end the war?
    Absolutely nothing. This has gone on in North America probably longer than I know of it ...................which would put it around 1961.

    This war has been going on in Canada as well as the USA and and there will be no end to it as very well stated in above postings.

    The funny part is that there are no similar wars going on in European and other countries it is a North American exclusive.

    So my suggestion is, to look into the fact why in other parts of the globe there is a lot more harmony in this matter, and a more civilized behaviour. We could learn a lot from countries like the UK, Germany, France, Austria and Switzerland as well as many more.

  7. #7
    Bad address email on file NC-OD's Avatar
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    Quote Originally Posted by Judy Canty
    This was in answer to what question?
    Me?

    These quotes were in response to my implication that every "turf bashing" thread on optiboard was started by one of the regular posters. They bash ODs. An OD replies back civily trying to give the facts and it becomes a yelling match with people throwing insults to the Optometrist and the posts are eventually closed. This is the standard.

    I do not see ODs bashing Opticians on optiboard and if someone could post those quotes, I'll be happy to take back this statement.

    Optiboard is a very OD-unfriendly forum most times...........or at least it ends up that way. And it shouldn't be--- but for a few instigators.

  8. #8
    Master OptiBoarder OptiBoard Gold Supporter Judy Canty's Avatar
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    So, I'll ask again. What question in this thread are you addressing? If you've come here to continue a pointless argument, I'll shut it down. If you have something constructive to add, by all means do so.

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    Cape Codger OptiBoard Gold Supporter hcjilson's Avatar
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    I think, Judy, that was.....

    I think, Judy, that was a feeble attempt to escalate the war. NC OD is not interested in the expansion of "scope of practice" anywhere else but in Optometry.

    He said: " I've said many times that I highly respect most every optician I have ever met." He has a strange way to show it.

    I wonder which of his unattributed quotes above led him to the conclusion that Opticianry should roll over and play dead while Optometry continues to try and legislate it out of existance?
    "Always laugh when you can. It is a cheap medicine"
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    Bad address email on file NC-OD's Avatar
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    Wow. I guess I give up. I thought I was being completely clear. I think someone asked in the other thread (maybe I'm wrong) why I was irritated (or something to that effect). I'm am trying to post why. It is the relentless Optometry bashing that goes on here. I am in no way trying to flame the fire.......just pointing out what is obvious to me. If no one can see it except me, I'll accept that and move on. I've posted examples of the hundreds of inflammatory remarks above and all I get is a threat to close the post. How about "yes, I agree these remarks are uncalled for, unprofessional and inflammatory and should have been deleted long ago". That might be appropriate.

    As to the expanding role of Opticianary. I'm all for it. I've said it many times before. Get a basic-level education program for all opticians and go for it. I, for one, will never stand in anyone's way to expand their education or abilities. I actually think a refracting role for opticians is a good idea. It would save us all alot of headaches and remakes. And I reminded the bashers-- the way to advance is not by trying to put others down. You've NEVER seen me post anything derogatory about ANY optician or the profession, have you?

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    OptiBoardaholic OptiBoard Silver Supporter Alvaro Cordova's Avatar
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    NC-OD I just want to let you know as an optician that I understand what you are going through as an OD because my girlfriend is going to be one as well. She dislikes the idea the idea that the public and OMDs disparrage the education she has gone through or have this perception that the refraction is all she does. I know that this is not true. I think OMDs and ODs are essentially similar except in their roots and of course the surgery issue. While Optometrists were prescribing opticians, they had a richer background in optics which is why despite the inability to use cycloplegics for an eye exam (in the past), used simple optical principles to fog the patient and the get a valid Rx. ODs have learned the body through the eyes. The OMDs on the other hand have a different approach which is initially more biological in nature than optical. ODs also have made strides in vision therapy which the OMDs have ignored for whatever reason. I think there is a place for everybody. OMDs do not place that much emphasis on refraction as optometrists do and I have to say that whenever I get an Rx from an OMD it is almost always a remake and there is one OMD that I will simply state to patients that "we are not a Dr. X approved place, please find out from your doctor where you can go with your Rx." I do this to avoid bad mouthing people because a) I really don't know him or her b) Just because his or her refractions aren't consistently good doesn't mean that the Dr X is a bad Doctor, usually far from it (I have heard of these same people as being excellent surgeons) it just means that the doctor may be a bad refractionist or they have a bad tech (The tech thing bothers me though). With that said, I really enjoy picking the brain of an OMD. They are some of the brightest people I have ever met. I think it is inevitable that ODs will expand their scope of practice because there aren't enough OMDs to go around and opticians will expand their scope of practice because of the lack of ODs to go around too. A little overlap isn't bad.

    There are some things I would like to see on an Rx though. The slab off thing is something I can figure out on my own or I could use dissimilar segs, but I would love to see a vertex distance on higher Rxs > 10 D. I keep hearing that there is a standard of 12 mm, but you get that one person who has the phoropter set at 13, 14 or 15 (with good intent since 13-14 mm is where most eyeglasses end up) and screws up the whole thing :). Another thing would be the Visual Acuity with glasses on if worse than 20/20. Many patients don't remember if they have a catract or some other condition and worse still many don't believe that such conditions as diabetes will change the Rx. Some will automatically believe I'm phishing for excuses for poor wormanship than legitmate troubleshooting so a VA would be nice.

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    Bad address email on file NC-OD's Avatar
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    Thanks for your comments. Everything you say is true, I believe. I always try to put the pts BCVA on the Rx (and I do give out spec and CL rx-unasked- to everyone because it's the right thing to do). Thanks for reminding me about documenting vertex distance. I do forget that sometimes. I just had a -15.00 guy that took his rx to Walmart. I didn't put down the vertex distance (he is my best friend and was talking too much:) ). They didn't call to ask either. Hope is gets what he wants with those $39 glasses :shiner:

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    Bad address email on file QDO1's Avatar
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    The actual argument ought to be about why de-regulation allows a 2 tier system for dispensing - qualified Opticians, and totally unqualified dispensers

    the majoritory of the worlds dispensings are done by the latter... sounds friggin scary to me.

  14. #14
    OptiBoardaholic OptiBoard Silver Supporter Alvaro Cordova's Avatar
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    Quote Originally Posted by NC-OD
    Thanks for your comments. Everything you say is true, I believe. I always try to put the pts BCVA on the Rx (and I do give out spec and CL rx-unasked- to everyone because it's the right thing to do). Thanks for reminding me about documenting vertex distance. I do forget that sometimes. I just had a -15.00 guy that took his rx to Walmart. I didn't put down the vertex distance (he is my best friend and was talking too much:) ). They didn't call to ask either. Hope is gets what he wants with those $39 glasses :shiner:
    I work for a National Vision which are inside many Walmarts. We are limited in what we can handle and trying to convince our labs that a certain course of action is preferred is extremely time consuming (iseikonic lenses are almost always impossible). I hope he gets the proper care. I've dispensed some amazing stuff here so don't be too frightened. :)

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    Bad address email on file NC-OD's Avatar
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    Quote Originally Posted by theDude
    I work for a National Vision which are inside many Walmarts. We are limited in what we can handle and trying to convince our labs that a certain course of action is preferred is extremely time consuming (iseikonic lenses are almost always impossible). I hope he gets the proper care. I've dispensed some amazing stuff here so don't be too frightened. :)
    Yea, I'm more concerned for the optician than the patient (my friend). He's a real PIA. Will really drive you crazy. He was set to have a phakic IOL performed but the surgeon wisely decided against it. My friend demands 20/10 vision :D

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    OptiBoardaholic OptiBoard Silver Supporter Alvaro Cordova's Avatar
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    Quote Originally Posted by QDO1
    The actual argument ought to be about why de-regulation allows a 2 tier system for dispensing - qualified Opticians, and totally unqualified dispensers

    the majoritory of the worlds dispensings are done by the latter... sounds friggin scary to me.
    And that's the crux of the issue. In NJ, our state board is ever more vigilant while in PA (not even an hour from me), there is no board to monitor the field. I know of many who have certified themselves voluntarily in PA, but it isn't fair to those who get certified if the cashier at JCPennies becomes an optician and can get hired to perform the same function (and poorly I might add) at a lower price. If the corporation, and it is mainly the corporations who do this, do not percieve any value in the certifications and or education attained, then we will only get more of the same. What I want to see is more access to education with monetary assistance to opticians and finally get some of these states licensed or at least on their way to a better field environment that is more homogenous across the states. I would also like to see the AOA and other organizations to back us too (legislatively or at least not oppose any legislation) which translates to rank and file ODs to contact their organizations on our behalf. Will it happen, I have no idea, but I have my suspicians it will be yes as it dawns on most of us that many corps are simply acting in an irresponsible manner and taking away all of our ethical responsibilities to our patients. This is one of the Noblest professions I have ever had the pleasure in working in and I would like it to remain that way.

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    Actually NC: The lab I was working in that had rule #2 posted was a CL mfg. company: "Serving the Medical Profession Exclusively." The company didn't even speak to O.D.'s.

  18. #18
    Master OptiBoarder OptiBoard Gold Supporter Judy Canty's Avatar
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    Chip, I'll ask you the same thing. What question in this thread are you addressing?

  19. #19
    Bad address email on file QDO1's Avatar
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    chucks the boxing gloves into the ring...

  20. #20
    Allen Weatherby
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    Interesting North American Problem

    This battle of optician vs. OD's as Chris Ryser points out is an obvious result of governmental regulations and industry control not working properly.

    I am neither an optician or an OD but work in the industry with both, mostly opticians.

    Another north american only problem is our system of personal credit. Something like 80% of individuals have inaccuracies on their credit reports. This information almost always creates problems of some kind for the consumer. On top of these inaccuracies it is up to the consumers to pay money and take a great deal of time to correct inaccuracies which they had no part in. Identity theift is huge in the US in Europe it is almost non-existant. I believe the problem is with the appearance of industry regulation and the different degrees of regulation from state to state.

    In general I would say most OD's are more quaified than most opticians for their field than most opticians, however I would not say that the optiboard members in general seem very knowledgable and passionate about their field.

    There are many reasons for the variance in the qualification levels of optians. I would say it is equal to a current high school public education today. You can find a high school graduate who can't do even do simple math, and you can also find a high school graduate who will go on to graduate from M.I.T., (very knowledgable in math). Opticans are similar with different states requiring such different skill levels. I am sure many optiboard member opticans who have worked with other marginal opticians. And I doubt that they would not let anyone they knew use this marginal optician for fitting new glasses.

    My opionion is that the problem between opticians in general and OD's in general, is that the skill level of opticians is so broad that the OD's have to deal with, that they are never sure if their patient is seeing a really good optician or a marginal optician.

    Now think about the average eyewear patient. They don't know the difference by title between the three O's in many cases. They also assume that these experts they are seeing are qualified. If a patient moves from one state to another I doubt that one of the considerations is to check on the optician licensing requirements. The fact is they can move from a state where there is a 90% chance of having a good optican see them to a state that has 50% or less of the opticians who could qualify to work in the previous state.

    I think the debate is real however the solution revolves around the regulatory factors. If no states had any requirement for being licensed, at least the consumers would know this. Now the assumption is that an Optician is an expert in their field and there is not one nationally recognized standard that 90% of opticians can point to with confidence that says "THIS OPTICIAN IS QUALIFIED". In some locations they can find an optician by finding breathing person to hire and say "Now you are an Optician" I don't think the same can be said for an OD.

    This is not an Optician or OD bashing so please don't take it as one. It is my opinion, trying to objectively report the big picture. Comments welcome, just don't accuse me of bashing one or the other.

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    Judy: I was addressing NC's list. The first thing on the list was mine but it did not have a reference to O.D.'s. M.D.'s were the target.

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    Now Judy: Why there is a war. O.D.'s have for the past 80 years or so attempted to legislate themselves into a positon of monopoly in the optical business. We complain of "Unlicensed States". The reason they are unlicensed is O.D. opposition or unwanted help in obtaining licenseing. By unwanted help, O.D.'s in our state have ammended bills (when we actually thought we had a chance of getting one through) to state that we could not determine seg. ht.'s, P.D.'s, bifocal types or "touch a contact lens." In other states they have attempeted to apply thier drug "ability" to apply to flouresene so that opticians could not use it.

    Is it any wonder that animostiy (rampant amoung the older set who can remember when M.D.'s thought it was unethical to dispense and O.D.'s didn't have a slit-lamp and most of them were afraid of contact lenses?

    Chip

  23. #23
    Master OptiBoarder OptiBoard Gold Supporter Judy Canty's Avatar
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    Chip,
    If it were up to me, NC-OD's post would have been deleted. I viewed it as an attempt to restart a dead issue.

    Either we all start looking for common ground or the consuming public will do it for us as evidenced by the huge increase in consumer-posed questions on this board. The professionalism of all three O's is on the line and we are doing little if anything to shore it up.

  24. #24
    Bad address email on file NC-OD's Avatar
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    Quote Originally Posted by Judy Canty
    Chip,

    Either we all start looking for common ground or the consuming public will do it for us as evidenced by the huge increase in consumer-posed questions on this board. The professionalism of all three O's is on the line and we are doing little if anything to shore it up.
    Exactly. And this is why LIES should not be tolerated on this forum. Saying ODs can only prescribe some topical drops and OTC allergy meds is simply a LIE. It does not serve the public well. What if one of my patients read it? Would they think I was practicing outside my scope? Would they seek care elsewhere without telling me? Would they attempt to report me to the Board of Optometry? It should not be tolerated. Am I the only one that cares about the TRUTH?

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    Judy,

    I'm not sure how to end the war. I've been an OD for 28 years and had no idea how much the profession of opticianry hated optometry (or it seems like many of the regulars on this board do). I guess I've been living in a vacuum...???

    In numerous threads, I have done nothing more than offer technical advice and have received a bashing, and then the tread deteriorates from there.

    NC-OD is right. This board is OD unfriendly. Anti-optometry statements and remarks are rampant without provocation. It just seems to be part of the lexicon. Yet, I have never seen a post by an OD who made an anti-optician remark unless provoked. (I have to include myself in this group since I lost it when Dannyboy posted his anti-optometry diatribe.) The Dude has said the most level-headed and sensible things I have heard here so far.

    A recurring theme I hear here is that organized optometry tries to supress opticianry. While this is true, the same is true of ophthalmology against optometry. Optometry has gotten ahead in spite of it, or maybe even because of it. I'm not sure why opticianry hasen't gotten further, but I suspect it is the lack of licensure in all states and lack of an educational standard. And, I hear from a lot of opticians on the board that they fear higher educational standards might lock them out of a job or license.,,so they want to be left alone.

    I'm sure there are opticians who will take exception to my last paragraph ...which is OK, but to make derogatory statements about my profession is an unacceptable way to respond.

    Another recurring theme I hear on the board is that ODs can't possibly be ethical if they dispense the glasses they prescribe. Yet OMDs provide the surgery they recommend, and opticians provide upgraded goods when it may not have been necessary...so why are only ODs unethical? I would like someone to explain this to me.

    Anyway, after getting an education on Optiboard during the last month or so, I fear the war will never end. Each of the three Os is going to have to take responsibility for their own success or failure.

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