TN Licensing Board Declaratory Order

[wabmorgan]

I'm not even sure ANYTHING has really been lost at this point.... including vision screenings.

The screening in question here were the ones being done outside the supervision of an optometrist and was considered basically a form of advertising for the optometry practice by employees of the Optical office. TN is a two door state, the Optometry practice must be separate from the Optical office. The Optical office may not advertise for the Optometry practice.

However, If the vision screening are done under the supervision of an Optometrist, I think the board will have little say in the issue.... that's not to say an Optometrist will chose to do so, but they may.

[BoardPetitioner]

I'm not even sure ANYTHING has really been lost at this point.... including vision screenings.

The screening in question here were the ones being done outside the supervision of an optometrist and was considered basically a form of advertising for the optometry practice by employees of the Optical office. TN is a two door state, the Optometry practice must be separate from the Optical office. The Optical office may not advertise for the Optometry practice.

However, If the vision screening are done under the supervision of an Optometrist, I think the board will have little say in the issue.... that's not to say an Optometrist will chose to do so, but they may.

wabmorgan, I agree with this post, I am glad you pointed out the screenings I questioned were the ones that were used as mass solicitation and basically forced on us to perform. I never asked if vision screenings could be performed by opticians or anyone else with or without supervision, I simply asked if they could be used for solicitation for professional services of an independent OD, and the Board simply answered "No". The statement in the draft of the order was erroneous, and I hope that it will be corrected. I am neither for or against opticians performing them, I do think they can give a false since of security, but I also think they are better than nothing for those who can't afford a routine complete exam to check if they see well. I can understand your concerns that the retail chains will push for deregulation, I had and still have the same concerns, but after much thought, research and advice, I felt that was something already taking place. One point I will make on that which may ease those concerns is this, if retail chains are found to be in violation of multiple statutes, and the board is trying to enforce statutes, then the retail chains make an effort towards deregulation, I believe it would be seen by politicians and lawmakers as an attempt by corporate chains to deprive TN citizens of qualified, professional eyecare in order to increase their on bankroll. As for future overload of licensed opticians, I really can't see it. There is too much growth in health care overall, people are living longer, and the baby boomer generation has just come into the presbyopic age. Listen, I apologize for giving you a hard time in earlier posts. I was a bit upset with the blame Roy had been placing undeservedly on the TDOA and myself and was getting a bit defensive. I think you know they are not the **** poor association Roy makes them out to be and that they have many good opticians serving who felt that my questions to the board were issues that certainly needed addressed. From our past conversation in Nashville, I think you are a "stand-up" optician and mutual friends have always spoken well of you. I sincerly hope I did not offend you too much. If you would like to give me a call to discuss this in a manner that can't be picked apart by everyone online, please feel free to do so, you can get my # from Jay, Kathy H., or most any WM optician in the Chattanooga/Knoxville area.

[BoardPetitioner]

It seems to me that the sole job the board has been trusted with, "protecting the interest of the public" was comprimised to protect the interest of opticians. A case such as this one makes it easier to justify not having licensure. No matter what anyone says or tells you licensure is not a means of acheiveing higher pay and ensuring all opticians have a job. I am afriad that this back and forth will not bring about any new revelations as the repecusions will be felt later on down the line.

BoardPetitioner,

I would like to point out that you are not responsible or do you speak for opticians as a whole. You speak for yourself, that is fine if you feel that vision screenings are not important for opticians if you speak for yourself, but to say that all opticians would benefit from a reduction in scope is arrogant and short sighted, in this case vision screenings were offered as a sacrificial lamb and the retunr was something that any legal deparment can run circles around. Did opticians really gain anything? The board only has power over opticians, so everyone in the store becomes and optometric tech and as such do not fall under the boards thumb. Their are so many ways I could come up with to circumvent anything that was percieveably gained, yet what was lost is lost and will be very difficult to gain again.

Mr. Chiling, I would like to point out a few things to you.
1. "Protecting the interests of the public" was about the exact phrase that can be found in the board minutes of the declaratory hearing, that the board cited for making their ruling. NEVER was anything mentioned of protecting opticians, their pay or their jobs available. I pointed out in this forum that the pay rates and job availability for opticians had significantly increased at one major chain in TN since these issues were brought to their attention. It did not start with me, it actually started around Oct.06 after another well respected optician/manager resigned their position via e-mail to several key corporate officials. In that resignation it was stated that the resignee was continually harassed about payroll of opticians to operate in compliance while over half the dispensaries throughout the rest of the state were not compliant. After that, many more issues were raised by many more opticians, including mine, and the hiring/pay frenzy was on because they certainly were not anywhere near compliance. This all took place well before the declaratory hearing but continues still.
2. No matter what anyone says or tells you, licensure in any field of practice is worked hard for, and the licensee should be paid accordingly for their skills and knowledge. To place untrained individuals in ANY healthcare position to save on payroll and increase profits is simply wrong. I don't really care how non-licensed people try to justify it, it is still detrimental to consumers and the field of practice involved.
3. I NEVER said that vision screenings were not important to opticians or that "all opticians benefited from a reduction in their scope of practice".
Once again it is being posted that I said things that were NEVER actually stated. What I did say was that I felt they gave a false sense of security and that problems could very easily be missed by them. A complete comprehensive eye exam by an OD or MD is the ONLY way to accurately evaluate eye health and visual acuity. What I did point out (because Roy stated the board cited laws which did not exixst) was that is was not listed in OUR states scope of practice for opticians and could be legitimately interpreted by a Board member as "examining the eye by any means or method" which is "strictly prohibited" from our scope of practice. NO one, including Roy, who I am sure has searched diligently, has given me a statute or reg from OUR state laws that says or insinuates otherwise. NO ONE ever offered up vision screenings as a "sacrificial lamb" during this hearing, it was simply an error in the wording of answers in the final draft. If you look back to the first post in this thread, you will see the question asked was about solicitation by screenings and the only answer the Board gave was "NO".
4. I believe opticians and consumers alike did gain from this. The chain ODs are independently contracted, so no, everyone can not just become an optometric tech to circumvent the law because they are employed by the chains, not the ODs.
5. "Legal departments running circles around" state health codes was precisely why these questions were presented to the Board to start with. According to the sentiments I get from you, Roy, and a few others, I should have just stayed quite and continue to watch as consumers got shoddy eyewear and technical advice, and opticians lost hours, positions, promotions, and jobs to unqualified and completely inexperienced employees or just decided to quit because they were tired of being directed to violate the law.

[HarryChiling]

Mr. Trew stated Question #4 is as follows:
4. Can optical employees go into the public sector and solicit business for optometrists by
means of verbal communication, business cards, and/or vision screenings?
Upon discussion, Mr. Wells made a motion, seconded by Ms. Chitwood, to give an answer of
“No” due to the law prohibiting opticians to perform screenings. The motion carried.
A roll call vote was conducted and all board members answered in the affirmative.
The Board stated the actions taken by the Board are to protect the health and welfare of the
citizens of the State of Tennessee.
With no other Board business to conduct, Ms. Chitwood made a motion, seconded by Mr. Risby
to adjourn the meeting at 2:58 p.m. The motion carried.
Ratified by the Tennessee Board of Dispensing Opticians on January 15, 2008.

I've read the minutes in full, your vendetta ended with a question that was not relevent that lead to a ruling about opticians performing screenings.

Nothing contained in these rules shall be construed to permit persons licensed under T.C.A. §§63-14-
101 through 63-14-121 to examine or exercise eyes, nor to diagnose, treat, or prescribe for any human
injury, disease or ailment.

Screenings are not examinations or exercises for the eyes, nor do they diagnose, treat, or prescribe for any ailments. So there really is no law that prevents opticians from screenings except now that the issue has been brought up and the boadr has made a ruleing, and the board is put in charge of interpreting the rules and regulations, in essence you opened pandora's box and now that people are upset you don't want to be held accountable for that.

(4) Orthoptics and Vision Therapy - Any person other than a doctor of medicine or an osteopathic
physician who examines, diagnoses, manages and treats conditions or diseases of the eye or eyelid is
considered to be practicing optometry in accordance with T.C.A. § 63-8-102(12). This includes
managing a patient through vision therapy, visual training, visual rehabilitation, orthoptics or eye
exercises. “Orthoptic training” means any ocular exercise for the correction or relief of abnormal
muscles or functions of the eyes in accordance with T.C.A. § 63-8-102(11). A person who hold
him/herself out as being able to remedy or relieve defects of vision or muscular anomalies or other
abnormal conditions of the eyes by engaging in orthoptic training or by adjusting, fitting or adapting
lenses or prisms to remedy or relieve defects of vision or muscular anomalies is engaged in the
practice of optometry, as defined in Tennessee Code Annotated 63-8-102(12).
(5) Eye Examination Requirements - All eye examinations performed by licensees shall include the
professionally recognized components listed in subpart (3) (a) 2. (i) of rule 1045-2-.08 for spectacles and
in subpart (3) (a) 2. (ii) of rule 1045-2-.08 for contact lenses...................................................... ...

2. If an optometrist advertises an examination fee or includes an examination as a service
provided in an advertised fixed fee the examination findings shall include all pertinent
tests and observations necessary to satisfy the standard of care. The following shall
constitute the professionally recognized components to be included in the examination
provided for the advertised fee and before the prescription requested is issued:
(i) Spectacles
(I) Visual acuity testing of each eye far and near point; and
(II) External examination including extra ocular motility and confrontation
fields, and
(III) Refraction (objective and subjective); and
(IV) Co-ordination testing; and
(V) Opthalmoscopy; and
(VI) Biomicroscopy; and
(VII) Tonometry.
(ii) Contact Lenses:
(I) All of the components required for spectacles prescriptions; and
(II) Keratometer reading of cornea curves; and
(III) Biomicroscopic evaluation of lid health, tear film integrity and corneal
integrity; and
(IV) Application of known diagnostic lenses to each eye to include evaluation of
acuity, over refraction and biomicroscopic evaluation of lens fit with use of
chemical dyes as indicated; and
(V) Adequate patient training in lens care, solutions, application and removal
along with proper wearing schedule, warning signs, and recall intervals; and
(VI) A minimum of two follow up visits over a minimum period of 2 months
which shall occur prior to determining the contact lens prescription. At each
visit visual acuity and biomicroscopic evaluation of the eyes with and
without lenses will be performed.

As you can see vision screening does not fall into the category of examinations or is it an integral part of an examination, by being poorly versed in you own state laws you in effect went in front of the board with the idea that you were going to help and effectively cut screenings out of an opticians scope. Did you eer think that when the board said "NO" to opticians performing screenings you would ask the board to define screenings? Or did yo ask the board to point to the rules that said "NO to opticians performing screenings"? In this case the board was wrong and you are probably gettng so much flak for this becuase you did not think of the repercusions of your actions. You still think your sh*t don't stink and it's a shamed because I know from the minutes that you went into the meeting with good intentions. Next time if there is a ext time take the time to read and understand what you are allowed and not allowed to do. Now weather you meant to offer screenign as a sacrifical lamb or not, in TN they are dining on Gyro's. :D

[BoardPetitioner]

I've read the minutes in full, your vendetta ended with a question that was not relevent that lead to a ruling about opticians performing screenings.



Screenings are not examinations or exercises for the eyes, nor do they diagnose, treat, or prescribe for any ailments. So there really is no law that prevents opticians from screenings except now that the issue has been brought up and the boadr has made a ruleing, and the board is put in charge of interpreting the rules and regulations, in essence you opened pandora's box and now that people are upset you don't want to be held accountable for that.

As you can see vision screening does not fall into the category of examinations or is it an integral part of an examination, by being poorly versed in you own state laws you in effect went in front of the board with the idea that you were going to help and effectively cut screenings out of an opticians scope.

Did you eer think that when the board said "NO" to opticians performing screenings you would ask the board to define screenings? Or did yo ask the board to point to the rules that said "NO to opticians performing screenings"? In this case the board was wrong and you are probably gettng so much flak for this becuase you did not think of the repercusions of your actions. You still think your sh*t don't stink and it's a shamed because I know from the minutes that you went into the meeting with good intentions. Next time if there is a ext time take the time to read and understand what you are allowed and not allowed to do. Now weather you meant to offer screenign as a sacrifical lamb or not, in TN they are dining on Gyro's. :D

Evidently you think YOUR "Sh*t don't stink" by being arrogant enough to think you are so well versed in our state's laws, you being from PA and all. Did you even bother to read the laws you just posted? If so you are not as well versed as you try to come across as being on our statutes or just ignorant. Take a closer look at this part of the statute YOU just posted and accused me of going in front of the Board being "poorly versed" in:

The following shall constitute the PROFESSIONALLY RECOGNIZED COMPONENTS to be included in the EXAMINATION provided for the advertised fee and before the prescription requested is issued:
(i) Spectacles
(I) VISUAL ACUITY TESTING OF EACH EYE FAR AND NEAR POINT

Isn't that exactly what a vision screening is, a VISUAL ACUITY TEST?
Now as You can see IT DOES fall under optometry's scope of practice not opticianry's. It IS an integral part of an eye examination! Man, you really missed the boat on that one didn't ya?
Next time YOU take the time to read and understand statutes your posting!
Don't be so arrogant as to think you can briefly look over a few statutes and know them, or to think you have any idea of the unethical and unlawful events that led to my petition for clarification of statutes.
These are the laws I and the board and 5 attorneys and the judge (yes a TN district court judge presided over and found no fault in the hearing) referred to in the petition as only Optician laws were admitted:

63-14-102
(2) Nothing in this section shall be construed to authorize or permit any dispensing optician to claim to be able to, or to offer, undertake or attempt, by any means or method, to examine or exercise eyes, fit contact lenses, or diagnose, treat, correct, relieve, operate or prescribe for any human ailment, deficiency, deformity, disease, injury, pain or physical condition; however, dispensing opticians may fit contact lenses in the presence of and under the direct supervision of a licensed optometrist or ophthalmologist.


63-14-104 It is unlawful for a dispensing optician to act as the agent or representative of any physician or optometrist on any account.

Performing mandatory screenings to gain patients for an OD would be considered acting as an agent or representative of an OD.
It can easily be seen why the Board felt that visual acuities/vision screenings fell outside optician's scope of practice and within optometry's.
You listed it in their scope of practice yourself!

And yes I did go before the Board with good intentions, and still have them. It is misinformed people like you and Roy who have not witnessed the illegal actions and directives that were taking place, or had yours and other opticians' livlihoods threatened for not wishing to violate our profession's code of ethics, that are trying to twist my intentions. Do not mistake my understanding of MY states statutes as arrogance again!

[HarryChiling]

Isn't that exactly what a vision screening is, a VISUAL ACCUITY TEST?

NO not in all cases, and that is why you had no business in opening up pandora's box. Do't get upset at me for your idiot move. I will give you an example of a vision screening that does not involve VA's http://www.photoscreener.com/ interestingly enough one of the most professional opticians I know in TN uses this systemt o help kids in TN and this ruling can be detrimental to his screenings and to the many children in your state that will lose out on this benefit. Now this quick and cost effective screenign could prevent many cases of refractive errors and muscle issues from ending amblyopia which at a certain age is pretty much irreversible so this ruling can and will do damage in this specific state and case. Oddly enough that system is from a company in, you guessed it PA the state that I am from, small world isn't it.

It amazes me that you would take the bait on that one, I didn't think you would be so easily lead into that one. Maybe that's why even with the statutes and rules posted right next to each other easily compared you still have foudn a way of miscontrueing the facts, keep in mind that I scoured the many pages of documents to excerpt the relevent quoted above because you seem to keep asking Roy for reference to the rules. Almost everything in bold in your post is wrong because you are equateing visual acuities with visual screenings. Critical thinking is obviously a trait that is and was lacking when you went in front of the board and now here on this board. It is very important that YOU not just glance over these rules, but comprehend them and the implications of changeing a single word in them, BTW these are not the rules in full I can provide you with the relevent link if you would like to read them over before your next response so we can teer this thread in a more intelegent course. You were right in addressing the issues you did and it is a shamed that one oversight has you marked with a scarlet letter, but I think your obligation now would be to try and correct the one simple mistake you made by meeting with the board and going over this issue.

As the saying goes, "The devils in the details". Well anyway good luck with your job working for a comapny that you found unethical enough to report to the board, yet by my bet are still employed with. Your intentions may have been good going in, but your arrogance and selfishness will ultimately harm your profession. Roy I see what you were saying about this guy.:hammer: And please try and stay out of PA, things ar bad enough here as it is, that goes for MD too.

[Roy R. Ferguson]

Hi All:

The following shall constitute the PROFESSIONALLY RECOGNIZED COMPONENTS to be included in the EXAMINATION provided for the advertised fee and before the prescription requested is issued:
(i) Spectacles
(I) VISUAL ACUITY TESTING OF EACH EYE FAR AND NEAR POINT

Isn't that exactly what a vision screening is, a VISUAL ACUITY TEST?

Please remember this ruling has been applied to all licensed opticians in Tennessee. If the petitioner’s interpretation holds, licensed opticians working under the supervision of Optometrists or Ophthalmologists will have no professional latitude. Licensed opticians who now perform COA/COT functions for Ophthalmologists or Ophthalmic Tech roles for Optometrists will be in violation of this Declaratory Order. This certainly appears to constrict job opportunities for opticians.

Roy

[Jubilee]

Call me silly..

But what I was interpreting was the list of components was just that.. a list of steps that are to be taken if performing a comprehensive exam.

(5) Eye Examination Requirements - All eye examinations performed by licensees shall include the
professionally recognized components listed in subpart (3) (a) 2. (i) of rule 1045-2-.08 for spectacles and
in subpart (3) (a) 2. (ii) of rule 1045-2-.08 for contact lenses...................................................... ...

2. If an optometrist advertises an examination fee or includes an examination as a service
provided in an advertised fixed fee the examination findings shall include all pertinent
tests and observations necessary to satisfy the standard of care. The following shall
constitute the professionally recognized components to be included in the examination
provided for the advertised fee and before the prescription requested is issued:
(i) Spectacles
(I) Visual acuity testing of each eye far and near point; and
(II) External examination including extra ocular motility and confrontation
fields, and
(III) Refraction (objective and subjective); and
(IV) Co-ordination testing; and
(V) Opthalmoscopy; and
(VI) Biomicroscopy; and
(VII) Tonometry.
(ii) Contact Lenses:
(I) All of the components required for spectacles prescriptions; and
(II) Keratometer reading of cornea curves; and
(III) Biomicroscopic evaluation of lid health, tear film integrity and corneal
integrity; and
(IV) Application of known diagnostic lenses to each eye to include evaluation of
acuity, over refraction and biomicroscopic evaluation of lens fit with use of
chemical dyes as indicated; and
(V) Adequate patient training in lens care, solutions, application and removal
along with proper wearing schedule, warning signs, and recall intervals; and
(VI) A minimum of two follow up visits over a minimum period of 2 months
which shall occur prior to determining the contact lens prescription. At each
visit visual acuity and biomicroscopic evaluation of the eyes with and
without lenses will be performed.

When it goes to specify that it must include 2 follow up visits, etc.. that to me is clarifying what the doc should be doing, but not eliminating what a optician, COT/COA or orthopist can do if allowed under their regulations.

For example, I do not know of any optometrist that does his or her own Insertion/Removal instruction. Typically they assign the appropriate person employed to take care of that item with the patient. Same as those who perform pretesting items.

Tennessee also have makes the use of orthopist to perform vision therapy in conjunction with a OD/MD. Once again, the doctor does not perform this function themselves, but makes sure an appropriately trained person does.

Cassandra

[Roy R. Ferguson]

Hi All:

For example, I do not know of any optometrist that does his or her own Insertion/Removal instruction. Typically they assign the appropriate person employed to take care of that item with the patient. Same as those who perform pretesting items.

Here is the rule for opticians in Tennessee.

Dispensing opticians may fit contact lenses only in the presence of and under the direct supervision of a licensed optometrist or ophthalmologist.

This was originally written to cover the independent optician working in an optical dispensary. As more and more dispensing opticians began to work with Optometrists and Ophthalmologists, a common sense approach was applied. Since no harm was demonstrated and the optician was working under supervision, this was never enforced against those individuals. All this seems to be changing.

Roy

[Barry Santini]

So, in Tennesse, I guess that DMV personnel are more qualified than dispensing opticians to give acuity/visual screening tests...yes?

???
Barry

[Jubilee]

Another question comes to mind..

When testing to see how well a new rx is working, don't we do some sort of screening, since we assess VAs in order to guage if a person can read 20/20, etc?

And as Barry pointed out.. So DMV employees, school volunteers, and other non optical persons are more qualified to perfom such screenings that licensed opticians are?

If LDOs can't do screenings cause there are in essence practicing optometry, why can people with NO OPTICAL TRAINING perform such tasks and it be ok? Seems to me that everyone without and OD or MD should be disqualified then....

Cassandra

[HarryChiling]

So, in Tennesse, I guess that DMV personnel are more qualified than dispensing opticians to give acuity/visual screening tests...yes?

???
Barry

Barry,

Again th edevils in the details, for instance:

If I stand a patient so many feet from a chart and ask them if they can see a ceratian line that's a screening, now if I quantify that with a 20/20 that's an acuity. The DMV uses the testing equipment on a pass fail basis which makes it mroe of a screening.

Jubilee,

The missing piece of the puzzle is that the board of opticians interprets the rules for opticians so for them to say screenings are not allowed they are limiting the scope of practice of opticians. Just the fact that visual acuities are considered part of a comprehensive exam doesn't make it and examination in and of itself, the reason for me quoteing that text from optometrys rules and regulations is to see that it specifically states visual acuities which are different than screenings, this detail was overlooked and the consequences I am afraid are that neither screenings or acuities will be allowed.

“No” due to the law prohibiting opticians to perform screenings

You will notice that the board member states that screenings are not allowed becuase it is stated in the rules, this is not the case as you can see here in the quoted text I have provided. If anyone wants to look at the full documents and form your own opinions as to what happened here they are in full.

Opticianry Rules
http://www.state.tn.us/sos/rules/0480/0480-01.pdf

Board Meeting Minutes
http://health.state.tn.us/Downloads/Do_Min102907.pdf

Optometry Rules
http://www.state.tn.us/sos/rules/1045/1045-02.pdf

[wabmorgan]

As I pointed out in a post above....

The screening in question here were the ones being done outside the supervision of an optometrist and was considered basically a form of advertising for the optometry practice by employees of the Optical office. TN is a two door state, the Optometry practice must be separate from the Optical office. The Optical office may not advertise for the Optometry practice and vice versa.

I think it would have been better for the board to have "defined" that these picticular vision screenings were a form of advertisement for the optometry practice and as such are prohibited by law.

Again, I doubt the board can restrict a vision screening from being done under the supervision of an Optometrist.

[Roy R. Ferguson]

Hi All:

Again, I doubt the board can restrict a vision screening from being done under the supervision of an Optometrist.

A licensed optician in Tennessee is being brought up on charges for performing a “refraction test” and a “visual acuity test” under the supervision of an Ophthalmologist. The hearing is scheduled on Mar 26.

Roy

[MERCURY]

Hi All:

Again, I doubt the board can restrict a vision screening from being done under the supervision of an Optometrist.

A licensed optician in Tennessee is being brought up on charges for performing a “refraction test” and a “visual acuity test” under the supervision of an Ophthalmologist. The hearing is scheduled on Mar 26.

Roy

Now, for anyone who believed any of the garbage that has been said about the Tennessee Dispensing Opticians Association. I'd like to know if there is anyone who would be so niave as to also think that the above is true ("brought up on charges for performing a "refraction test" and a "visual acuity test" under the supervision of an Ophthalmologist"). This is the kind of misinformation that has not only caused the bitterness in this forum, but it is also what Tennessee Opticians have had to put up with for years.

[Roy R. Ferguson]

Hi All:

I'd like to know if there is anyone who would be so niave as to also think that the above is true ("brought up on charges for performing a "refraction test" and a "visual acuity test" under the supervision of an Ophthalmologist").

My thoughts exactly! Until I saw the charges, it would never have occurred to me that such a thing could happen. Unfortunately, it is true and the hearing is scheduled on Mar 26, 2008 in Nashville, Tennessee. I would encourage you to attend the hearing. If you would like the address and time, I’ll be happy to supply it.

Here is an excerpt of the letter of notification:

I serve as Assistant General Counsel for the Tennessee Board of Dispensing Opticians. The Department has received a complaint against your license and an investigation was conducted. The investigation reveals that you performed a visual acuity test and a refraction test, which is outside of your scope of practice.

Here is an excerpt of the letter supplied to the Board by the supervising Ophthalmologist:

From May 2004 until and including the present time Mr. XXX has acted under my supervision. A review of the records clearly established that Mr. XXX fully and completely accomplished all procedures outlined by my written office policy pertaining to such activities.

Please try to attend the hearing.

Roy

[MERCURY]

Hi All:

I'd like to know if there is anyone who would be so niave as to also think that the above is true ("brought up on charges for performing a "refraction test" and a "visual acuity test" under the supervision of an Ophthalmologist").

My thoughts exactly! Until I saw the charges, it would never have occurred to me that such a thing could happen. Unfortunately, it is true and the hearing is scheduled on Mar 26, 2008 in Nashville, Tennessee. I would encourage you to attend the hearing. If you would like the address and time, I’ll be happy to supply it.

Here is an excerpt of the letter of notification:

I serve as Assistant General Counsel for the Tennessee Board of Dispensing Opticians. The Department has received a complaint against your license and an investigation was conducted. The investigation reveals that you performed a visual acuity test and a refraction test, which is outside of your scope of practice.

Here is an excerpt of the letter supplied to the Board by the supervising Ophthalmologist:

From May 2004 until and including the present time Mr. XXX has acted under my supervision. A review of the records clearly established that Mr. XXX fully and completely accomplished all procedures outlined by my written office policy pertaining to such activities.

Please try to attend the hearing.

Roy

I don't see where the COMPLAINT contains the words "UNDER THE SUPERVISION".

[wabmorgan]

Here is an excerpt of the letter supplied to the Board by the supervising Ophthalmologist:

From May 2004 until and including the present time Mr. XXX has acted under my supervision. A review of the records clearly established that Mr. XXX fully and completely accomplished all procedures outlined by my written office policy pertaining to such activities.

Maybe not..... but the responding Ophthalmologist clearly states it was under his/her supervision.

[MERCURY]

Maybe not..... but the responding Ophthalmologist clearly states it was under his/her supervision.

I would think that the purpose of the hearing is to determine if the supervision did indeed take place. Evidently the complaintant has a different opinion. All I'm saying is, contrary to what was originally said, charges were not brought on as a result of a complaint of supervised practices. The licensing board would have no basis for a hearing if this was the case. I would hope that the Optician was acting within his scope of practice and that will be the end result of the hearing.

[chip anderson]

Licensure means granting some right or privledge to the licensee, excluding the un-licensed from the same priviledge and collecting a tax for the state. Mearly this and nothing more.
Virtually all laws and licenses reguarding the optical business are to protect optometries right to control the business (with the exception of some federal regulations that exist mostly to establish power for the regulators).

Why claim otherwise.

Who is going to gain from sitting children in front of an eye chart. Possibly O.D.'s who without doubt are looking into getting some sort of number assigned to file insureance claims for this. Otherwise the is usually a free service provided by volunteers to find out who can and who can't see. Those that can't see are given a recommendation to see an "eye care professional". What's the point of regulating or having any contest for the right to do this? Can you say that an optician doing this would be less qualifited than a schoolteacher or lay volunteer?

No one is examining for disease directly and no one is "attempting to determine the refractive power of the eye."

This seems to be just a p****** contest with no prize awarded.

Chip

[Roy R. Ferguson]

Hi All:

I would think that the purpose of the hearing is to determine if the supervision did indeed take place. Evidently the complaintant has a different opinion.

The hearing is to determine if the licensed optician performed a refraction test and a visual acuity test; supervision is not in question. This will really determine if a licensed optician is allowed to perform ancillary duties under supervision.

All I'm saying is, contrary to what was originally said, charges were not brought on as a result of a complaint of supervised practices. The licensing board would have no basis for a hearing if this was the case.

This is an excellent point! The Board can limit the duties an optician can perform, even under supervision, but it cannot dictate how an Ophthalmologist supervises.

I would hope that the Optician was acting within his scope of practice and that will be the end result of the hearing.

If the ruling finds the licensed optician violated scope of practice rules, it seems all opticians performing dual roles will be called into question.

Roy

[HarryChiling]

Hi All:

I would think that the purpose of the hearing is to determine if the supervision did indeed take place. Evidently the complaintant has a different opinion.

The hearing is to determine if the licensed optician performed a refraction test and a visual acuity test; supervision is not in question. This will really determine if a licensed optician is allowed to perform ancillary duties under supervision.

All I'm saying is, contrary to what was originally said, charges were not brought on as a result of a complaint of supervised practices. The licensing board would have no basis for a hearing if this was the case.

This is an excellent point! The Board can limit the duties an optician can perform, even under supervision, but it cannot dictate how an Ophthalmologist supervises.

I would hope that the Optician was acting within his scope of practice and that will be the end result of the hearing.

If the ruling finds the licensed optician violated scope of practice rules, it seems all opticians performing dual roles will be called into question.

Roy

I am now kinda glad I don't live in a licensed state if this has become the norm. I am both an optician and perfom duties as a tech. If I was givent he choice on which to keep and which to lose I would be sad to say that the license as an optician would be the first to go. Here's my reason:

While opticianry has been around a lot longer than optometry, optometric tech, and ophthalmic tech. Our scope of practice is limited in many areas where as the other professions don't have many of these same limitations. Interestingly enough many of these limitations seem to be coming from ourselves so when you heard in an above post the famous quote, "I have seen the enemy and he is us" and my are we a viscious bunch. If he was performing his duties under an ophthalmologist's supervision then he was IMO well within the scope of an Ophthalmic Tech. The overlap between the two areas seems to be an issue that has come up on here more than a few times, I would think that the board would make a consideration in this case or at least that would be my hope.

[MERCURY]

Hi All:

Again, I doubt the board can restrict a vision screening from being done under the supervision of an Optometrist.

A licensed optician in Tennessee is being brought up on charges for performing a “refraction test” and a “visual acuity test” under the supervision of an Ophthalmologist. The hearing is scheduled on Mar 26.

Roy

The agenda is now posted for the Mar 26th Tennessee Licensing Board meeting and there is no listing of a hearing for someone being brought up on charges.