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Thread: Opticians Becoming like Haberdashers?

  1. #26
    ATO Member HarryChiling's Avatar
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    Quote Originally Posted by Excalibur View Post
    In most cases, dispensing frames and lenses is not rocket science. My certified staff do great on frame adjustments too, and frankly no worse (and often better) than the people that do this sort of stuff in the local optical shops. If the staff require assistance (and they do work quite closely with me), I handle the technical/professional side of things.

    I guess you just don't get it (even my young grade school kids would understand and agree with my arguments here... unlike yourself) --- dispensing a 'bum' pair of specs rarely (or maybe never) affects patient outcomes in any serious or irreparable way. But independently refracting has MUCH more risk of harm as documented very well (and often) elsewhere on this board.

    So, in summary maybe you're a lot less important than you think you are. Opticians have some importance, perhaps in more technical areas in laboratories and lens design. They don't really need to be present in a doctor's office to maximize patient experience and outcome. They should certainly not independently refract without direct doctor supervision. And frankly, in most cases certified optometric assistants do an excellent job of assisting with patient care with less attitude than guys like you.
    I reserve the attitude for guys like you. Iguess that about sums it up you provide "BUM"eyewear to your patients, I guess that's why you go by Excalibur and I go by my name. I am not important at all, the service I provide to my clients are the most important thing in my mind and in theirs while they are with me, it is schmucks like you that have degraded my profession and yours.

    Don't worry Excaliber pull that mighty sword (what's best for the patient) outa that rock you call your head and insert elsewhere.
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  2. #27
    Excalibur
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    Quote Originally Posted by HarryChiling View Post
    I reserve the attitude for guys like you. Iguess that about sums it up you provide "BUM"eyewear to your patients, I guess that's why you go by Excalibur and I go by my name. I am not important at all, the service I provide to my clients are the most important thing in my mind and in theirs while they are with me, it is schmucks like you that have degraded my profession and yours.

    Don't worry Excaliber pull that mighty sword (what's best for the patient) outa that rock you call your head and insert elsewhere.
    There you go again.... whining. So whose your daddy? :D

    We RARELY ever dispense an incorrect rx or one that causes adaptation problems. We get a ton of GP and other specialty referrals because we do great work. Yup... we must be a disgrace to the community... give me a break. You obviously have a reading disability because you supposedly read my posts and then try to quote me with completely different terminology. And you're telling me that my staff are somehow less capable than you? Excuse me for personalizing this, but you really aren't the sharpest tool in the optical shed.

    Pout all you want but it won't get you anywhere.
    Last edited by Excalibur; 12-07-2007 at 04:46 PM.

  3. #28
    Excalibur
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    "Harry the Haberdasher"

    Has a nice ring to it!

  4. #29
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    Quote Originally Posted by Excalibur View Post
    Excuse me for personalizing this, but you really aren't the sharpest tool in the optical shed.

    I have seen the shed, and I have seen many of the tools that reside there. Let me be the first to say-Harry IS the sharpest knife in that shed. Its a shame that you have never dealt with an Optician of his ability. The personal attacks are uncalled for.

  5. #30
    ATO Member HarryChiling's Avatar
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    Quote Originally Posted by Excalibur
    dispensing a 'bum' pair of specs rarely (or maybe never) affects patient outcomes in any serious or irreparable way. But independently refracting has MUCH more risk of harm as documented very well (and often) elsewhere on this board.

    Very inetersting, whose doing the documenting? Define rarely in context to what's best for the patient?

    If you get to assume that all opticians would provide substandard refractions and miss pathology, why won't you allow me to assume that all staff that are not opticians provide "bum" eyewear.

    Quote Originally Posted by Excalibur
    There you go again.... whining. So whose your daddy? :D
    Welcome to the dark side, I got tough skin and actually enjoy it better this way, cupcake. ;)
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  6. #31
    Excalibur
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    Quote Originally Posted by Fezz View Post
    I have seen the shed, and I have seen many of the tools that reside there. Let me be the first to say-Harry IS the sharpest knife in that shed. Its a shame that you have never dealt with an Optician of his ability. The personal attacks are uncalled for.
    Read Harry's posts. He is in attack mode and his posts are absolutely shameful and rude.

    If he's the 'sharpest' optician you have, you are in a sorry state of affairs! :(

  7. #32
    ATO Member HarryChiling's Avatar
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    Quote Originally Posted by Excalibur View Post
    "Harry the Haberdasher"

    Has a nice ring to it!
    My father was a tailor, my mother was a tailor, my grandmother was a tailor. I know what haberdasher measn and it has no sting. Matter of fact I have seen Ronald Regan in his underwear wile my dad was fitting him for a custom made suit. His wife would have my mother hand emroider table cloths at white house events. I come from a long line of talented people, the trade is unimportant we take pride in what we do so we are always the best or spend many sleepless nights trying to be the best.
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  8. #33
    Excalibur
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    Quote Originally Posted by HarryChiling View Post
    Very inetersting, whose doing the documenting? Define rarely in context to what's best for the patient?

    If you get to assume that all opticians would provide substandard refractions and miss pathology, why won't you allow me to assume that all staff that are not opticians provide "bum" eyewear.



    Welcome to the dark side, I got tough skin and actually enjoy it better this way, cupcake. ;)
    You really are slow. What is the greater likelihood of harm? dispensing an rx that is incorrect or missing a glaucoma or some other pathology?

    Give me a break.

  9. #34
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    I wonder how many optiboarders even know what a haberdasher is?

  10. #35
    ATO Member HarryChiling's Avatar
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    Quote Originally Posted by Excalibur View Post
    You really are slow. What is the greater likelihood of harm? dispensing an rx that is incorrect or missing a glaucoma or some other pathology?

    Give me a break.
    You can't have it both way's when your arguement always comes downt o what's best for the patient. NO HARM is best for the patient. Yes their is far more likely hood of a refraction without a health assesment being harmfull to a client than dispensing of eyewear. But that's why they are working on safe guards and screening to reduce that risk.

    The world isn't black and white there ius rtisk every where, but the data supplied earlier that you keep refering too has no meaning and wasn't really meant to have meaning.

    I don't want to keep argueing with you, sweetheart.
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  11. #36
    Excalibur
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    Quote Originally Posted by HarryChiling View Post
    My father was a tailor, my mother was a tailor, my grandmother was a tailor. I know what haberdasher measn and it has no sting. Matter of fact I have seen Ronald Regan in his underwear wile my dad was fitting him for a custom made suit. His wife would have my mother hand emroider table cloths at white house events. I come from a long line of talented people, the trade is unimportant we take pride in what we do so we are always the best or spend many sleepless nights trying to be the best.

    And as Ronald Reagan would say.... "there you go again...."

    and Mr Harry... you are no Ronald Reagan... or for that matter... you are no JFK.

    Take pride in your vocation. It is a noble one. But opticianry is going the way of haberdashery. Optometry is very successfully caring for the 'fat part' of the bell curve of eye problems, and opticianry has been marginalized. Optometry works very well with ophthalmology on the grass roots level, gets a lot of research funding, and is growing its influence in hospital and research based environments because it has an excellent talent based of people who are working on principles ahead of profits. I proudly include myself in this group.

    So... go to your local bar. Sip back a few cold ones and go sell a lot of glasses tomorrow. And don't forget to stop by your local computer shop and buy a decent spell checker-- your posts are giving us all a headache. You're probably a pretty good guy, but don't make yourself more important than you are.

  12. #37
    Excalibur
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    Quote Originally Posted by HarryChiling View Post
    You can't have it both way's when your arguement always comes downt o what's best for the patient. NO HARM is best for the patient. Yes their is far more likely hood of a refraction without a health assesment being harmfull to a client than dispensing of eyewear. But that's why they are working on safe guards and screening to reduce that risk.

    The world isn't black and white there ius rtisk every where, but the data supplied earlier that you keep refering too has no meaning and wasn't really meant to have meaning.

    I don't want to keep argueing with you, sweetheart.
    Sorry Hairy... but as a happily married male, I don't swing that way.

    Here is the safeguard -- do the refracting and ocular diagnostic checking in one office, together, as per my model cited earlier in this thread. It's that easy. All other attempts at 'safeguards' are BS and smoke and mirrors.

  13. #38
    ATO Member HarryChiling's Avatar
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    Quote Originally Posted by Excalibur View Post
    So... go to your local bar. Sip back a few cold ones and go sell a lot of glasses tomorrow. And don't forget to stop by your local computer shop and buy a decent spell checker-- your posts are giving us all a headache. You're probably a pretty good guy, but don't make yourself more important than you are.
    I tihk I wlil go to my lcoal bar and hvae a dirnk, srroy if I gvie you a haedhcae. :D
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  14. #39
    ATO Member HarryChiling's Avatar
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    Quote Originally Posted by Excalibur View Post
    Sorry Hairy... but as a happily married to a male, I swing that way.

    Here is the safeguard -- do the refracting and ocular diagnostic checking in one office, together, as per my model cited earlier in this thread. It's that easy. All other attempts at 'safeguards' are BS and smoke and mirrors.
    Will opticians be allowed to hire an OD in yoru model? Will refrction require a health assesment at every visit?

    It could make sense, but you don't agree with it which is fine, but it's easier to just say so then to beat around the bush and I was just jokeing abotu the sweetheart thing I didn't know you seriously swung that way.
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  15. #40
    Excalibur
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    Quote Originally Posted by HarryChiling View Post
    Will opticians be allowed to hire an OD in yoru model? Will refrction require a health assesment at every visit?

    It could make sense, but you don't agree with it which is fine, but it's easier to just say so then to beat around the bush and I was just jokeing abotu the sweetheart thing I didn't know you seriously swung that way.
    1. Health assessment frequency is at the discretion of the doctor who is responsible for the patient's care.
    2. Opticians cannot hire the doctor. The doctor is the prescriber, and being hired by the optician may lead to influence of the prescriber by the employer.
    3. Doctor can hire an optician.

  16. #41
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    Quote Originally Posted by Excalibur View Post
    My position on how things should be conducted is very simple. I will keep it simple so you understand it. :hammer:

    1. Patient presents in office.
    2. Completes history form (if new patient)
    3. Staff review history form.
    4. Technical staff/optician perform acuities, objective/subjective refraction, and other tests as directed by doctor eg. visual fields, tonometry, gonioscopy, etc etc
    5. Doctor is provided results when consults with patient. Discusses history and chief complaint. Reviews findings. May confirm refractive data. Examines anterior segment.
    6. Staff dilate patient. Patient waits and/or may consult with optician or other technical staff about eyewear requirements, etc.
    7. Patient's retina is evaluated via binocular/monocular ophthalmoscopy. Findings and recommendations discussed with patient. Patient proceeds to front desk to book any further appointments, or further discuss eyewear recommendations with optician and/or technical staff.

    Notice how the optician/technical staff performed the refraction, and the doctor examined the patient during the visit. The clinical bases were covered and full scope care was provided. There was no phony doctor-patient relationship a la remote Rx-signing by a doctor who has never seen the patient. Everything was done in my model above-board in the best interest of the patient.... and that is how I do it in my clinic.

    Simple? of course. Effective? Certainly. Ubiquitous? not yet. Difficult to do? Nope.
    Substitute " walmart greeter" for optician/technical staff in a whole lot of OD, MD practices.

  17. #42
    ATO Member HarryChiling's Avatar
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    Quote Originally Posted by Excalibur View Post
    1. Health assessment frequency is at the discretion of the doctor who is responsible for the patient's care.
    2. Opticians cannot hire the doctor. The doctor is the prescriber, and being hired by the optician may lead to influence of the prescriber by the employer.
    3. Doctor can hire an optician.
    That part is interesting, we have gone for so many years with OD's dispensing what they prescribe without ethics being called into play, let's just assume for sake of arguement that this is because OD's are ethicaly solid. If an optician were to hire an OD all of a sudden their could be influence.

    I would think that the influence of money would be a driving force in both these arguements so why would one be allowed while the other is not.

    The point of gaining rights as to refract is to allow opticians to be more in control of their profession, your model just enslaves them even further.

    Optometrists have adopted a medical model and this is opinion and experience dispised the optical part of the practice, but their comes a certain point where your profession has stretched itself to thin. Opticians are now realizing how much more scope of practice we can acheive adn I look forward to my future as Harry "the haberdasher" Chiling.
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  18. #43
    Master OptiBoarder keithbenjamin's Avatar
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    I'm probably not one of the sharpest tools in the shed either, but I'm not sure I understand why refractions and health assessments must be inextricably and legally tied. Sure, a refraction is an opportunity for an exam, but don't people without refractive errors require eye exams? So, why not take it a step further and make it a legal requirement that every man, woman, and child visit their local OD for an annual exam. And while we are passing nanny legislation, throw in annual mammographies, prostate exams, colonoscopies, blood tests, and any other exam you can think of that might be good for me. ...and of course the tax pay... I mean the Government should pay for it all.

    The bottom line is independently refracting opticians would deal a huge financial blow to the optometric profession (which I can sympathize with) but any other arguments are BS and smoke and mirrors.

    Given the current state of affairs, I don't think ODs have much cause for concern.

    -Keith
    Last edited by keithbenjamin; 12-07-2007 at 05:59 PM.

  19. #44
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    Quote Originally Posted by keithbenjamin View Post
    I'm probably not one of the sharpest tools in the shed either, but I'm not sure I understand why refractions and health assessments must be inextricably and legally tied. Sure, a refraction is an opportunity for an exam, but don't people without refractive errors require eye exams? So, why not take it a step further and make it a legal requirement that every man, woman, and child visit their local OD for an annual exam. And while we are passing nanny legislation, throw in annual mammographies, prostate exams, colonoscopies, blood tests, and any other exam you can think of that might be good for me. ...and of course the tax pay... I mean the Government should pay for it all.

    The bottom line is independently refracting opticians would deal a huge financial blow to the optometric profession (which I can sympathize with) but any other arguments are BS and smoke and mirrors.

    Given the current state of affairs, I don't think ODs have much cause for concern.

    -Keith
    Is it that difficult for patients to have a refraction and eye health assessment together, at the same visit? Is it so much of an inconvenience? I doubt it. There are enough ODs and OMDs in the overwhelming majority of this continent (ie. North America) that accessibility is not an issue for 95% of the population. Where financial cost is an issue, I trust that welfare or some social safety net exists in most areas.

    If you can't do it 'right', why do it all? why give a patient false hope by giving them a refraction only and telling them all is well.

    Folks... my agenda may well be interpreted as being a matter of self-preservation, but I have 16,000 patients in my database. That's enough for a few doctors to manage. I don't need to see another new patient again in my career, and I've only be practicing approximately 15 yrs. With simple attrition and not recalling patients and attracting new ones, I'll still be busy 20 yrs from now. My agenda is simply to do what's right, and what is right is to assess the patient's vision and ocular health at the time of their visit. Why de-compartmentalize something into a refraction (by a sight tester at site A) and then (maybe) an eye health assessment (at site B) by a doctor? This is not in the interest of the patient, and is simply being considered by sight-testers for profit sake. Their agenda is simply profit ahead of principle rather than the other way around.

  20. #45
    ATO Member HarryChiling's Avatar
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    Quote Originally Posted by Excalibur
    If you can't do it 'right', why do it all? why give a patient false hope by giving them a refraction only and telling them all is well.
    Tell your opticians, I mean optomertic technicians that. While ou are at it why even create a position such as an optometric technician when their are so many opticians available to fill the position. Your points have all been brougt up before and they are really no longer valid in a few places and eventually I feel that it will be this way across your country and maybe even ours if we can get our act together.

    You would be in a better position to embace it and poise your office to take advantage of it or fight it tooth and nail and regret the opportunities you missed while shaig your fist.
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  21. #46
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    Quote Originally Posted by HarryChiling View Post
    Tell your opticians, I mean optomertic technicians that. While ou are at it why even create a position such as an optometric technician when their are so many opticians available to fill the position. Your points have all been brougt up before and they are really no longer valid in a few places and eventually I feel that it will be this way across your country and maybe even ours if we can get our act together.

    You would be in a better position to embace it and poise your office to take advantage of it or fight it tooth and nail and regret the opportunities you missed while shaig your fist.
    Simple economics is why I won't hire an optician at this time, as well as restrictions on hiring one in my area.

    Two optometric technicians can be hired at the cost of one optician. This allows better efficiency, more attentive service, and they work closely with me in the practice so all of the patient's optical needs are taken care of. Therefore no need to hire an optician, although if one of my techs decided to move on, I might hire an optician if the regulations are changed and opticians become available at $15 or $20/hr or so.

  22. #47
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    Quote Originally Posted by Excalibur View Post
    Simple economics is why I won't hire an optician at this time, as well as restrictions on hiring one in my area.

    Two optometric technicians can be hired at the cost of one optician. This allows better efficiency, more attentive service, and they work closely with me in the practice so all of the patient's optical needs are taken care of. Therefore no need to hire an optician, although if one of my techs decided to move on, I might hire an optician if the regulations are changed and opticians become available at $15 or $20/hr or so.
    and simple economic is why some Opticians want to refract without OD or OMD supervision.

  23. #48
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    Quote Originally Posted by For-Life View Post
    and simple economic is why some Opticians want to refract without OD or OMD supervision.
    Yes, and at the risk of causing more cases like these:

    http://www.optometrists.bc.ca/webupl...studies_04.pdf

    There is no harm in having well-trained certified optometric technicians working in my office, consulting with me, and assisting with my patient cases, yet there is ample risk of causing harm by doing independent sight testing. The link above lists many cases of such harm. I trust there are many, many more cases like these that didn't even make this 'honor' roll.

    How sad that some opticians want to pad their pockets by sight testing rather than protect the public.

  24. #49
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    How sad that some opticians want to pad their pockets
    Simple economics is why I won't hire an optician at this time, as well as restrictions on hiring one in my area.

    Two optometric technicians can be hired at the cost of one optician.
    Whos padding their pockets now doc??

  25. #50
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    As revealing as this thread is as to how little respect there is cross-profession in this industry, I honestly think it should be closed. It's been nothing but mudslinging for the past few pages, and while there is truth to both sides of this argument, its obvious that neither side is going to sway the other. This is a professional forum, and a lot of the posts in this thread haven't been anywhere near that caliber. If you really want to have this debate, the PM system would probably be a better bet than this open forum. The public can read this, and it shows badly on the entire Opthalmic community to see such bickering. :\

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