Ontario Opticians refracting?

[HarryChiling]

In most cases your patient becomes your CUSTOMER, you merchant!!!

Hey hey hey, wait a minute there, you can't go around calling people merchants.:D

[Barry Santini]

this sight-testing dogfight is about the money.

No...I disagree. If "sight-testing was about money, then most places wouldn't:

1. Give away the exam *free*
2. Discuss *capture* ratios
3. Finagle Rx "hand-offs"
4. Discuss how Dr.s can/should recommend from the chair...or on the Rx.

No, it's really about the who sells the eyewear...where the real money is.

Exams (or more properly, refractions), for me, are about getting the best vision I can for my clients.

Barry

[HarryChiling]

No...I disagree. If "sight-testing was about money, then most places wouldn't:

1. Give away the exam *free*
2. Discuss *capture* ratios
3. Finagle Rx "hand-offs"
4. Discuss how Dr.s can/should recommend from the chair...or on the Rx.

No, it's really about the who sells the eyewear...where the real money is.

Exams (or more properly, refractions), for me, are about getting the best vision I can for my clients.

Barry

I agree, it is nice to hear that and it is a great perspective. It would be nice to have an optician who cares to refract.

I have had cases where I have made lenses for high myopes (-21.00 and above) I will often use lenticulars on high index stock and send them out for AR coat. The labs I use woud charge a fortune for these so I do them in house and send them out. The patients reactions are usually one of joy since they often get lenses that look better than anything they have ever seen. I am usually proud of the work and like to dispense these personally and ask they only come in when I am there to dispense. Sometimes and it happens more than I would like, the atient immediately puts them on and has issues seeing, now keep in mind if I am going to spend that much time on the lenses I have sepent that much time on the fit as well (VD, mono PD's etc.) when the doctor changes the Rx and I have had ones change the Rx by (0.50, or 2% which meets ANSI standards), I have had doctors opps wrote the cyl wrong. If I was allowed to refract this person would immediately get re-refracted just so that I can be confident that the Rx meets or exceeds the patients expectations.

Oh, it's about money alright. I lose money and the patients confidence when a doctor just gives a haphazard refraction. And when I make a lens that requires my time and effort I get really really PO'd that some nitwit playing doctor is messing up my craft.

RANT MODE OFF

(All OD's or OMD's don't fall into the above mentioned boat just as all opticians don't fall into the untrained boat so lets stop with the generalities and accept reafraction for what it is the neutralization of optical errors)

[Excalibur]

"(All OD's or OMD's don't fall into the above mentioned boat just as all opticians don't fall into the untrained boat so lets stop with the generalities and accept reafraction for what it is the neutralization of optical errors)"


Of course refraction is the neutralization of optical errors. That is not in dispute. It is the act of routinely separating this act from the rest of the diagnostic procedures that are part of the management plan that is not in the patient's best interest.

Laws are written to protect the majority of individuals from the harmful acts of a minority. Thus, preventing independent refraction by law or regulation is necessary and should continue. Routine independent refraction is not designed for the 'better good' and does not, in the big scheme of things, improve patient welfare and care.

Sorry... got a run now and spin some dials... after all, isn't this what optometrists only know how to do?? :hammer:

[HarryChiling]

Laws are written to protect the majority of individuals from the harmful acts of a minority. Thus, preventing independent refraction by law or regulation is necessary and should continue. Routine independent refraction is not designed for the 'better good' and does not, in the big scheme of things, improve patient welfare and care.

Just to give you a heads up, no educated individual is going to use this as a valid or even logical reason. You can't argue that since it's a law it shoudl be a law that in itself is assinine. If we were to use your same logic, since now refraction is being allowed and the law is changeing then it should be allowed and since OD's are now the minority fighting it from happening, the majority (opticians) that is fighting the minority (optometry) to prevent harmfull acts.:hammer:

I'd stay stick to spinning dials, it may be the only thing you know how to do.:D

[HarryChiling]

BTW, to end the arguement about the harmfull for patients, clients, customers.

http://www.canlii.org/eliisa/highlig...00bcca296.html

Apparently the arguement that it is harmfull didn't fly.

[LandLord]

many OD's hire untrained staff and hand them a PD ruler and send them out on the dispensing floor with little knowledge.

This happens on every streetcorner in Ontario and its exactly the reason that so many opticians are pushing for refraction. It's not about making MORE money, it's about optometrists taking away OUR money and at the same time spitting in our faces with the so-called optometric assistant.

Any opticians ever see a want ad that states:


"Busy optometric practice seeks full time optician/optometric assistant/receptionist. No experience necessary."

How does that ad make you feel?

[Oedema]

BTW, to end the arguement about the harmfull for patients, clients, customers.

http://www.canlii.org/eliisa/highlig...00bcca296.html

Apparently the arguement that it is harmfull didn't fly.

Did you even read the judgment? :hammer:The judge did not rule of whether or not there is harm to patients by sight testing, the judgment, in summary, says that under BC law, the BC Optometry regulator does not have the authority to seek injunctive relief against someone who is not an optometrist.

[Excalibur]

Just to give you a heads up, no educated individual is going to use this as a valid or even logical reason. You can't argue that since it's a law it shoudl be a law that in itself is assinine. If we were to use your same logic, since now refraction is being allowed and the law is changeing then it should be allowed and since OD's are now the minority fighting it from happening, the majority (opticians) that is fighting the minority (optometry) to prevent harmfull acts.:hammer:

I'd stay stick to spinning dials, it may be the only thing you know how to do.:D

A law that keeps routine independent refractions as illegal is sound practice and in the standards of care. I understand that this is difficult to get this point across to anyone not directly involved in clinical care. That is also why I don't waste time debating matters with children or the mentally handicapped or insane. It's like trying to pee against a hurricane.

Governments will not take opticianry seriously until it standardizes its education requirements and regulations, creates credible university-based clinical programs and regulates itself. Perhaps a small donation from one known as Bruce Bergez will create an honorable opticianry training program to advance independent refractions!

[Excalibur]

This happens on every streetcorner in Ontario and its exactly the reason that so many opticians are pushing for refraction. It's not about making MORE money, it's about optometrists taking away OUR money and at the same time spitting in our faces with the so-called optometric assistant.

Any opticians ever see a want ad that states:


"Busy optometric practice seeks full time optician/optometric assistant/receptionist. No experience necessary."

How does that ad make you feel?

It tell us that dispensing is generally a pretty simple thing to do... that's what it tells us. :D

[Stonegoat]

Qiulk question to independant sight-testers. Yesterday I had a 53 years old male patient complaining that his vision seemed a bit "off". His last exam was less than one year ago. He was correctable to 20/20 OD, OS with a low minus Rx. Examination of the fundus OS revealed clinically significant macular edema. This is a serious ocular condition. How do you handle this situation? This is serious stuff and it's real.

[Excalibur]

Qiulk question to independant sight-testers. Yesterday I had a 53 years old male patient complaining that his vision seemed a bit "off". His last exam was less than one year ago. He was correctable to 20/20 OD, OS with a low minus Rx. Examination of the fundus OS revealed clinically significant macular edema. This is a serious ocular condition. How do you handle this situation? This is serious stuff and it's real.

You know their answer to that..... it's rare, it almost never happens, yada yada. Don't get me started on this because I can give them case after case after case.

Problem is that they don't know what they don't know. :hammer:

[HarryChiling]

Did you even read the judgment? :hammer:The judge did not rule of whether or not there is harm to patients by sight testing, the judgment, in summary, says that under BC law, the BC Optometry regulator does not have the authority to seek injunctive relief against someone who is not an optometrist.

Yes, and after the optometrists did not get their way (haveing and injunction placed on the optician) they retorted with:

After these reasons were released the appellant sought leave to re-open argument to bring to the court’s attention the Health Professions Act, R.S.B.C. 1996, c. 183, and the Health Professions Statutes Amendment Act, 1993, S.B.C. 1993, c. 5. The submission was that those Acts should lead to a different result on the standing issue and the appellant should succeed. On this submission to re-open argument, the judge concluded:
I am satisfied that, having heard full submissions and having regard to the refusal of the Attorney-General to become involved in this litigation as a party, the original decision is correct.

The attorney general never got involved beacuse it was not harmfull to the public and the judge agreed.

[HarryChiling]

It tell us that dispensing is generally a pretty simple thing to do... that's what it tells us. :D

Amazing that many of the OD's I talk to argue about the nuances of refraction and the difficulty in mastering it, yet the fabricateing of the powers prescribed from that all important skill are trivial at best from these same OD's. Like it or not we are tied together dependent upon each other. Opticians are trying to change that, which means as an OD you can differentiate yourselves by provideing better refractions and better eyeware or you can try and stop change from happening. The weak in their field will try and stop change, don't let it be you.

[AdmiralKnight]

Of course it is. No one here is talking about having people stop going to get their health checkup. Chances are, if someone has had an eye exam (new glasses too?) less than a year ago, they're not going to go get a refraction, they're going to go back to their OD to get a partial checkup. No on here is saying this should stop. From what I know of macular edma (which isn't everything, I won't lie) Is that it's most common cause is Diabetes, eye surgery, etc. Serious things that would, in themselves, call for eye health checkups. I think the problem you're having is thinking that it's just going to be joe blow flippin a phoroptor. As Mike.Elms pointed out earlier in this thread, the patients will go through a screening process to deem wether they'll be fine with just a refraction, or wether or not they should go get a full medical exam. It's not going to be some random person, who's only worked in the optical field for 2 days spinnin the dials... unlike some of the people working in ODs offices. It strikes me as very hippocritical for ODs to take this stance when they reap so many financial benifits of hireing non-licensed opticians to do A licensed Optican's job... then complain about what's best for their patients when we want to refract.

*edit* Post was in reply to Stonegoat's last post

[Excalibur]

Yes, and after the optometrists did not get their way (haveing and injunction placed on the optician) they retorted with:



The attorney general never got involved beacuse it was not harmfull to the public and the judge agreed.

The judge was a moron. As someone stated earlier in the thread... some laws make no sense. This is one of them!

Opticians often don't know what they don't know.

[Excalibur]

The judge was a moron. As someone stated earlier in the thread... some laws make no sense. This is one of them!

Opticians often don't know what they don't know.

Q:what's the difference in skill level b/w a licensed optician and a non-licensed optician?

A: NONE! :)

[HarryChiling]

The judge was a moron. As someone stated earlier in the thread... some laws make no sense. This is one of them!

Opticians often don't know what they don't know.

If you look at the bottom of the brief 2 other judges signed off, so that's 3 judges that obviously don't know what they don't know but you do know. Again maybe just stick to flippin dials, these are grown folk talkin in here. :D

[Oedema]

Of course it is. No one here is talking about having people stop going to get their health checkup. Chances are, if someone has had an eye exam (new glasses too?) less than a year ago, they're not going to go get a refraction, they're going to go back to their OD to get a partial checkup. No on here is saying this should stop. From what I know of macular edma (which isn't everything, I won't lie) Is that it's most common cause is Diabetes, eye surgery, etc. Serious things that would, in themselves, call for eye health checkups.

But you're assuming that these patients, like the case stonegoat describes, know that they have diabetes.

However, it is estimated that up to one half of all Diabetics in Canada (about 1 million people) and the United States do not know they have the disease.

See how so many of these patients go years undiagnosed, without medical care, and then think when their vision gets blurry (b/c of macular edema) that glasses are the solution when in fact they need intensive medical managment? If you dispense a pair of glasses that patient may have their 20/20 vision, but now you've failed to identify and delayed treatment of a condition that has major consequences, on vision, life and limb.

[HarryChiling]

But you're assuming that these patients, like the case stonegoat describes, know that they have diabetes.

However, it is estimated that up to one half of all Diabetics in Canada (about 1 million people) and the United States do not know they have the disease.

See how so many of these patients go years undiagnosed, without medical care, and then think when their vision gets blurry (b/c of macular edema) that glasses are the solution when in fact they need intensive medical managment? If you dispense a pair of glasses that patient may have their 20/20 vision, but now you've failed to identify and delayed treatment of a condition that has major consequences, on vision, life and limb.

You've convinced me that every patient needs a eye health evaluation, but that is no tthe point here since they need one before they can have a refraction either way so why are we still argueing.

[AdmiralKnight]

That's exactly my point. No one here is saying patients shouldn't have a medical exam. THEY SHOULD. And it should be in the law (or whatever it becomes) that to get an independant refraction, they need to have had a medical exam within a certain time period.

[Oedema]

Yes, and after the optometrists did not get their way (haveing and injunction placed on the optician) they retorted with:



The attorney general never got involved beacuse it was not harmfull to the public and the judge agreed.

I suppose that is why the judge came to the conclusion with "considerable reluctance."

Safety of sight testing was never the issue before the court, the issue was enforcing the optometry act as it is written.

When the judge states that the original judgemnt is correct, he is not concerned about whether or not sight testing is right or wrong, it is a matter of whether the association has standing to discipline or seek an injunction against someone that is not a member (ie not an optometrist).

[AdmiralKnight]

Q:what's the difference in skill level b/w a licensed optician and a non-licensed optician?

A: NONE!

So, basicly, you're saying to everyone here, instead of argueing your point logically, you're just going to revert to name calling, and insult more than 2/3 of the people on this board. Wow.

[Excalibur]

If you look at the bottom of the brief 2 other judges signed off, so that's 3 judges that obviously don't know what they don't know but you do know. Again maybe just stick to flippin dials, these are grown folk talkin in here. :D

95% of North America permits ODs to rx meds to their patients.

2% of North America permits opticians to independently sight test.

Looks like the optoms are doing just a LITTLE bit better convincing the courts and legislators whose services are more important to the public.

[Excalibur]

So, basicly, you're saying to everyone here, instead of argueing your point logically, you're just going to revert to name calling, and insult more than 2/3 of the people on this board. Wow.

name calling? huh?

also... please set your spell checker to the 'ON' position.

Thank you.