What is the most pressing issue?

**For-Life** · 02-17-2006, 03:33 PM

First I wanted to thank Steve for setting this forum up. Here we can talk about Canadian content such as Canadian suppliers, Canadian competitors, and Canadian issues.

Okay, so to start this off I wanted to hear the most pressing issue for you?

I would say with us in NW Ontario it would be the regulations. There has been a lot of pushing for new regulations and deregulations. Ontario is special with the fact that having a lincensed optician is so important and that the contact lens industry is so well regulated. However, in other ways there are some stupid regulations like ODs and ROs not being allowed to work with each other and ODs doing cost plus versus retail costing. I want to hear your opinions on the most pressing issues.

**Glock** · 02-17-2006, 05:46 PM

Most pressing issue? How about receptionists doing dispensing in a doctors office, which takes away work from an optician.

**Glock** · 02-17-2006, 05:47 PM

p.s. If I'm Canadian, does that mean I have to stay in the sub-forum?

**For-Life** · 02-17-2006, 06:46 PM

Originally Posted by Glock

Most pressing issue? How about receptionists doing dispensing in a doctors office, which takes away work from an optician.

that is part of the problem that I outlined in my issue.

We have dispensers not understanding why a patient is losing intermediate in their flat tops and thinking it is an rx error.

As a Canadian you can post where ever you want.

**Chris Ryser** · 02-18-2006, 10:40 AM

Originally Posted by For-Life

I would say with us in NW Ontario it would be the regulations. There has been a lot of pushing for new regulations and deregulations. Ontario is special with the fact that having a lincensed optician is so important and that the contact lens industry is so well regulated.

Here is an actual example to your post:

**C-10** · 02-18-2006, 12:06 PM

Originally Posted by Glock

Most pressing issue? How about receptionists doing dispensing in a doctors office, which takes away work from an optician.

The scariest think here is that these people out there don’t know what they are talking about. I had a person in the other day tell me that an OD will not put progressive in a four point because they had too many problems with them

If this is an Canadian form can we use EH!

Here from you later eh!

**francisOD** · 06-02-2006, 03:32 PM

Lots of problems with this industry in Ontario...where do I start...First I was happy to read of the Timmins center closing...those types of operations help nobody in the industry. The fact that the industry is well regulated from that stand point is good...There are many others out there though operating without opticians and it seems very difficult to close them down. I am concerned about independant going forward. The new changes at the college of Optometry now permit chain/box stores to hire optometrist for the first time. This regulation is not yet official but will lead to further erosion of independants and a growing market share for big box stores. Things like Lux expansion only worsen the situation. That is the biggest challenge I see...from an independant's point of view. I am sure I will think of more issue later. Until then: GO OILERS GO EH!!!

**francisOD** · 06-02-2006, 03:41 PM

C-10, I can understand your point about ODs and 4 points...good and bad ODs out there, hope you do not generalize though. As an OD, I can understand that in some situation with high cyls especially and patients that are known to be hard on frames and cheap 4 points can all lead to recommending these products less in certain situation. I would not generalize and say that progressive 4 points are good or bad for all patients and all scrips...but you have to educate your patient for this product...good ones like a silhouette with a Gradal top transition with carat advantage are quite costly and patient need to be aware of the issues that go with such a product. just my thoughts. :)

**loncoa** · 06-02-2006, 05:22 PM

I'd like to point out that there are indeed good and bad ODs and good ones will not have an uneducated receptionist responsible for eyeglass fittings. All of the functions that need to be performed in an optometrist's office are the direct responsibility of the OD. In the office I work in everyone is extensively trained. We perform fittings better than many opticians here in town, partially because we understand the health side of the fitting, and have access to the results of the exam other than just the prescription. When a patient is expected to acheive only 20/60 with their new rx due to macular degeneration or developing cataract, we have that information. There are also good opticians here in town but believe me, none of us can be correctly classified as receptionists. We are all Certified Optometric Assistants and most of us either used to be, or still are Registered Opticians. Not every OD leaves their staff ignorant.

**For-Life** · 06-02-2006, 05:50 PM

Originally Posted by loncoa

I'd like to point out that there are indeed good and bad ODs and good ones will not have an uneducated receptionist responsible for eyeglass fittings. All of the functions that need to be performed in an optometrist's office are the direct responsibility of the OD. In the office I work in everyone is extensively trained. We perform fittings better than many opticians here in town, partially because we understand the health side of the fitting, and have access to the results of the exam other than just the prescription. When a patient is expected to acheive only 20/60 with their new rx due to macular degeneration or developing cataract, we have that information. There are also good opticians here in town but believe me, none of us can be correctly classified as receptionists. We are all Certified Optometric Assistants and most of us either used to be, or still are Registered Opticians. Not every OD leaves their staff ignorant.

Yes, but if you have certain requirements on who can dispense, or who cannot. Even if it is a COA like yourself, and that COA's are properly trained. The problem is protecting the patient, and in the case where the OD does not want to hire an Optican or an COA then the patient can really suffer.

**francisOD** · 06-03-2006, 03:45 PM

If an OD's has that kind of office, not only will his patients suffer but his reputation as well. OD's draw people in mainly by word of mouth as advertising is very regulated and we are not allowed to use gimmicks like 2 for 1 or even the ludicrous 3 or 4 for 1. We can only survive by running a good business. Someone like you describ will not last long.

**For-Life** · 06-03-2006, 04:01 PM

Originally Posted by francisOD

If an OD's has that kind of office, not only will his patients suffer but his reputation as well. OD's draw people in mainly by word of mouth as advertising is very regulated and we are not allowed to use gimmicks like 2 for 1 or even the ludicrous 3 or 4 for 1. We can only survive by running a good business. Someone like you describ will not last long.

See in this city all but one OD is like that. Sure people do not stay with them, but they go see another and then another and then another. Well on a two year cycle that builds up. We are the only optical store in town (independently owned by an optician) that has a doctor do eye examinations. As we know many people purchase from the place who does the eye exam due to convenience, so what can you do?

For instance, I had a child today who needed his nose pads changed. The eye doctor who did them was closed today, the frame was too big, and the frame had cable temples that went beyond the ear.

I mean this is not just OD offices. There are plenty of opticians out there that cannot fit, but at least they are forced to take the training.

**chip anderson** · 06-03-2006, 05:23 PM

Don't know where the O.D.'s are well regulated and prevented from 2 for 1, or 4 for 1, or "complete eye exam and single-vision or bifocal glasses for $49.95" but it shure isn't here. Unless the "indenpendent doctor of optometry (but we can arrange your appointment for you) located next door" give some sort of exclusion.

Chip

**For-Life** · 06-03-2006, 06:48 PM

Originally Posted by chip anderson

Don't know where the O.D.'s are well regulated and prevented from 2 for 1, or 4 for 1, or "complete eye exam and single-vision or bifocal glasses for $49.95" but it shure isn't here. Unless the "indenpendent doctor of optometry (but we can arrange your appointment for you) located next door" give some sort of exclusion.

Chip

The doctors in Ontario are prevented from doing that through cost plus. Basically what happens is the doctor has to offer full disclosure to the patient, so the way it works is the only money the doctor makes off of a pair of glasses is a fitting fee. So lets say the fitting fee is $120 and we are doing a pair of Silhouttes with Physio 360, 1.67, D Alize, Transitions. Then the final price of the product is the cost of the Silhouttes, Physio 360's, 1.67 index, and transitions to the doctor plus a $120 fee.

**Ory** · 06-04-2006, 09:33 AM

Originally Posted by For-Life

The doctors in Ontario are prevented from doing that through cost plus. Basically what happens is the doctor has to offer full disclosure to the patient, so the way it works is the only money the doctor makes off of a pair of glasses is a fitting fee. So lets say the fitting fee is $120 and we are doing a pair of Silhouttes with Physio 360, 1.67, D Alize, Transitions. Then the final price of the product is the cost of the Silhouttes, Physio 360's, 1.67 index, and transitions to the doctor plus a $120 fee.

It certainly becomes a pain when someone orders very high end and a redo is necessary. That 120 disappears fast.

**For-Life** · 06-04-2006, 10:06 AM

Originally Posted by Ory

It certainly becomes a pain when someone orders very high end and a redo is necessary. That 120 disappears fast.

I bet it is. I really do not think it is a fair policy. I do not think it is fair for the OD's or the RO's.

**Ory** · 06-04-2006, 10:52 AM

Originally Posted by For-Life

I bet it is. I really do not think it is a fair policy. I do not think it is fair for the OD's or the RO's.

Agreed. It seems the college of optometrists is finally doing something about their rather oppressive regulations. We'll see if the therapeutics issue pushes those changes out of the way. Certainly hope not.

**francisOD** · 06-04-2006, 12:52 PM

Quote : "Unless the "indenpendent doctor of optometry (but we can arrange your appointment for you) located next door" give some sort of exclusion."

Yes, the OD in this case does not own any financial interest in the optical (at least is not permitted to) so the OD rules do not apply to opticians who own the optical and they can then write what ever they want.

**francisOD** · 06-04-2006, 01:16 PM

Do you pay for redos??

**loncoa** · 06-06-2006, 12:48 PM

Originally Posted by For-Life

Yes, but if you have certain requirements on who can dispense, or who cannot. Even if it is a COA like yourself, and that COA's are properly trained. The problem is protecting the patient, and in the case where the OD does not want to hire an Optican or an COA then the patient can really suffer.

The Optometric Profession itself has the regulations, and it is the OD themself who must take responsibility for their employees, just like in an Optical where there are some staff licensed and some who are not. The danger to the public is no greater.

**loncoa** · 06-06-2006, 12:52 PM

Not to mention that crappy or uncaring COAs or ROs have the exact same effect on the public that unlicensed folks who are crappy or uncaring in their work do. There are also many unlicensed folks who do a better job. Again it's someone's responsibility to ensure the work is being performed correctly. Whether the OD in charge or the RO in charge, whatever.

**For-Life** · 06-06-2006, 03:18 PM

Well remember we have a different Optometrict association in Ontario.

I can understand that there are better non-licenced (COA or RO) professionals than some licensed, but if you take a hundred of each you will see that overall a COA and RO is better. Remember, COA's and RO's are forced to train, but if you are just working for a store you are not.

**loncoa** · 06-07-2006, 05:29 PM

Of course it would be better if everyone was certified, but generalizations are useless to the patient. It only matters if someone skilled and knowledgeable is working with you, and that they have the right attitude. In the practice where I work, there are 9 COAs. 4 of those are also ROs. Of the other about 5 people who are dispensing none have less than 5 years experience and they have all been intensively trained and are as well educated as those who hold certificates. It really comes down (in Optometry, at least) to how the OD perceives their responsibility to the public. When we have new people training, every move they make is monitored and signed off by the staff who do have the knowledge. I just hope every employer is that conscientious and has such regard for their patient.
And again, as with opticals and Optometry clinics, you will have a mix of certified and non-certified folks. So, my point is...is an uncertified person who works in an Optometry clinic by definition a "receptionist"? If so, what do you call an uncertified person working in an optical? I think that you will find, that rather than try to further divide optometric assistants and people who work in opticals, that whoever you may be, whatever your title is, it's going to be your conscience, your knowledge and skill that make the difference. If you are really afraid of me taking work away from you because I work for the Optometrist, I take that as a compliment that you see me as a threat. I will do anything I can to serve that patient in a way that keeps them safe, happy, and coming back to see me whenever they need help or when they want something new. If I do a poor job, I suppose they'll be along your way eventually...

**For-Life** · 06-07-2006, 05:58 PM

But generalizations do help.

If I am looking for a business manager I would rather hire a honours of bachelors in commerce than someone with a high school degree. Why? Because I know that I have a much better chance of getting someone good with the HB.Comm than with the high school diploma. Additionally, it is hard to quantify how well someone knows their stuff, but a licence does help.

**loncoa** · 06-11-2006, 11:43 PM

Point is, you're already getting that diploma. It's on the wall in the OD's office. Slagging the assistant is the same as slagging the uncertified staff at the Optical. Most Opticals you go to, you have some certified and some uncertified staff. This was my point about "receptionists dispensing".

I'm not sure what it's like where you live, but in my area the people "dispensing" are often uncertified and doing their job under the supervision (or lack therof) of the RO in charge. I was addressing the person who is worried about receptionists dispensing. But I'm sure things are different where they live.
I've seen both sides out here. Generally no lack of competence in either court but independent RO's tend to be down on Optometry staff due to the above perceptions, and Optometry staff tend to be down on Opticians of any kind because they see them as less knowledgeable about the health side of the situation.

I've worked for quite a few years in both those situations, and also in the wholesale lab environment, and there seemed to be an approximately equal amount of people whose hearts were with the needs of the patient in all these professions. There were also some in each group who didn't give a damn.
It is totally useless to pit ourselves one against the other. We need to work together to keep the patient safe and happy and make a good living doing it.

This is a community for "Eyecare Professionals". There are many people who fall under this umbrella. I work side by side every day with people who are not ROs or COAs who are wonderfully skilled and knowledgeable people who can make competent decisions in every (and I mean every) area of eyecare. To belittle these folks, these men and women with children and families by labelling them "receptionists" and sending a message that they shouldn't be doing what they are doing, or that their worth is less because they work under an OD instead of under an RO, is unconscionable and mean. And it benefits the patient zero.