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Thread: Opticians Becoming like Haberdashers?

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    Excalibur
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    Opticians Becoming like Haberdashers?

    Is opticianry becoming like haberdashery?

    http://en.wikipedia.org/wiki/Haberdasher

    With deregulation of opticians in some jurisdictions and changes in market forces, is the vocation of opticianry slowly becoming extinct like haberdashers?

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    I'm asking myself now wether or not to answer this logically, or shake my head at you for trying to expand the arguement to another thread.

    I'll try to take the high road here, and answer. I would have to say no, I don't think so. The problem is that it boils down to the public's opinion on wether or not we're needed. The unfortunate thing is the public gets it's queues from people of 'importance'. The more they're told that they don't need us, the more they believe it. It's not helping the matter any when it's the Doctors who don't think we're necessairy. Now, of course, not every doctor is like that. I work in an office with 4 ODs and 3 DOs, and we work wonderfully together, both Os realizing the other has something to bring to the table.

    There's no one answer to how to fix this though. Problems like people buying their glasses online, are adding fuel to the fire. A lot of people think we're not necessairy, that you can hire joe blow and teach him how to dispence. Sure. You can get people, and teach them how to fit glasses, and do adjustments. But why take a step back? I believe it was you who said we need to 'clean house', and I would agree. As a country (or countries, in the case of this forum) we need to get regulated nationally... but it's not as simple as that. It's worse so for the US, but for Canada as well, it's the ODs fighting us every step of the way when we try.

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    Quote Originally Posted by Excalibur View Post
    Is opticianry becoming like haberdashery?

    http://en.wikipedia.org/wiki/Haberdasher

    With deregulation of opticians in some jurisdictions and changes in market forces, is the vocation of opticianry slowly becoming extinct like haberdashers?
    I refuse to dignify this question with an answer. :hammer:

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    I think we already have. Especially since so many of us reguard ourselves as sales people. We should be painfully becoming aware that the internet is replacing "sales people" at a tremendous rate.


    Chip

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    ATO Member HarryChiling's Avatar
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    NO, I think the publics perception of an optician has been tarnished over the years. It does not help that the profession isn't regulated. Some offices would rather hire receptionists and call them opticians which should be against the law since it is misleading to the client purchaseing eyewear, I think this has lead to some degradation of our profession, but I think that all this can be overcome with education and a little PR.

    I dispise those in this profession that claim to have the publics best interest at heart and then subject the public to untrained and ill educated personnel masquaradeing as professionals. Some go so far as to even have scrubs as uniform in the office which is amazing. Some use words liek doctor and optometric physician as a means of createing confusion to try and capitalize on the publics misconceptions.

    Some in the industry are provideing eyewear online with fictitious formulas to adjust add powers for presbyopes and fictitious formulas that determine OC and PD placement.

    I did liek the comment that we need to clean house, but I believe it is an industry wide problem.
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    I think the biggest thing that has hurt the Opticians has been ODs dispensing. People now think of ODs as the person who sells glasses. Probably since there is so much direction during the exams.

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    Quote Originally Posted by For-Life View Post
    I think the biggest thing that has hurt the Opticians has been ODs dispensing. People now think of ODs as the person who sells glasses. Probably since there is so much direction during the exams.
    I disagree 100%. More than anything, I think it's the big chains that have hurt us as a profession. I've worked in both, and from personal experiance, I've been seen more as a professional in the ODs office than when working Retail. Here in the ODs office, I get people coming in specificly to see "The Optician". They know what were there for, and come to see us specificly when the need arises. On the other hand, when I worked retail, I was seen as a sales person, and little more. I was once told by a friend, when explaining what I did, that; "Oh, you're the guy who tells me my second pair is free.". That hurt, and it's not going to get better untill we start to show that our job has more to it than just selling frames.

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    ATO Member HarryChiling's Avatar
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    Quote Originally Posted by AdmiralKnight View Post
    it's not going to get better untill we start to show that our job has more to it than just selling frames.
    :cheers:
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    There must be some Canadian politics going on here, so I will stay out of even though I have an opinion.

    I initial question seems loaded, leading and biased.

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    Quote Originally Posted by MarcE View Post
    There must be some Canadian politics going on here, so I will stay out of even though I have an opinion.

    I initial question seems loaded, leading and biased.
    It is beyond Canada. Americans and Canadians are both facing this. So please comment.

    Actually, this thread should be moved to General Discussion.

  11. #11
    bilateral peripheral scotoma LandLord's Avatar
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    I think the question is legitimate. However, it is posed with no factual support.

    I'm not aware of deregulation in any jurisdiction in this country.


    A similarly baseless question might be:

    "With more and more optometrists frequenting gay bars, and changes in market forces, is optometry slowly becoming a homosexual profession like hairstyling?"

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    Commercial optometry/opticianry has, in my opinion, done more to damage the public view of eye care delivery than any other factor. An optician in Wal-mart, might just as easily be the guy stocking shelves, or greeting at the door, as far as the public is concerned. The optometrist working at Walmart is certainly regarded with less respect than an optometrist in a private "top-shelf" practice.

    If all optometrists and opticians practiced in a manner fitting their education/training/expertise, the public would have a far more favourable view of the said professionals.

    I am fortunate to practice in an area with the nearest "commercial" entity over 3 hours away. I receive GP referrals, daily, patients come to me for any and all eye problems, and I never have to explain what I can do.

    Unfortunately though, optometrists and opticains have prostituted themselves to the highest bidder, and as a result feel like they don't get the respect and recognition they deserve.

    I think the adage "you reap what you sow" applies to our respective professions.

    What do you think?

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    It may be different where you are but O.D.s with few exceptions have always dispensed. Seems they were origionally opticians and then became "refracting opticians", now evolving into something equilivant to dentists for the eye, under various terms.
    M.D.'s used to feel it was unethical to dispense or even distrubute any form of Rx. Some idiot optician started living well and they found out the optical business was profitable. Once this became common knowledge it ceased to be un-ethical. In fact in many medical schools medical ethics is no longer part of the corriculum. Let's face it, everyone else does it seems to be the standard of the day.
    And why not when the approach to success is now: "Legislate yourself into a position of exclusivity on products that have evolved to the point where skills are seldom needed.
    Such is the world today, we might as well live in it.

    Chip

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    Quote Originally Posted by Stonegoat View Post
    Commercial optometry/opticianry has, in my opinion, done more to damage the public view of eye care delivery than any other factor. An optician in Wal-mart, might just as easily be the guy stocking shelves, or greeting at the door, as far as the public is concerned. The optometrist working at Walmart is certainly regarded with less respect than an optometrist in a private "top-shelf" practice.

    If all optometrists and opticians practiced in a manner fitting their education/training/expertise, the public would have a far more favourable view of the said professionals.

    I am fortunate to practice in an area with the nearest "commercial" entity over 3 hours away. I receive GP referrals, daily, patients come to me for any and all eye problems, and I never have to explain what I can do.

    Unfortunately though, optometrists and opticains have prostituted themselves to the highest bidder, and as a result feel like they don't get the respect and recognition they deserve.

    I think the adage "you reap what you sow" applies to our respective professions.

    What do you think?
    Exactly. The unfortunate thing for Opticians is that it will hurt us much more in the long run than it will for Optometrists. We will slowly, but surely, be seen more and more as nothing but sales monkeys. While those ODs working in retail will be looked down a bit more by the general public, a lot of weight and respect is carried by the term "Doctor". No matter where you go, if you go to see "A Doctor" you feel like you're seeing a professional.

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    The Enemy

    I don't remember where this quote came from, and I roughly paraphrase, "I have seen the enemy and it is us". Regarding Opticians, anyway, until we get our house in order with standardized education and training across all jurisdictions and state-recognized certification and/or licensure we have a real problem and seemily are going the way of the haberdasher. In many jurisdictions, the only requirement to be an Optician in a pulse.....so what makes us better then the guy stocking the shelves at WalMart? Now someone from an unlicensed state will chime in and say they are the best Opticians on the planet and licensure or certification does not measure quality, but it is an indicator of some level of competence, if only minimal. There are GREAT Opticians from unlicensed states, and I respect them tremendously, because they did it despite the requirements, and it is a testament to their character, but I still feel Opticianry as a profession needs validation from someone other than ourselves.

    Independent Opticians are getting fewer and fewer. It was not the "Chains" that did us the most harm, because those in control of the earliest chains were Opticians who did not support licensing because they would have to pay higher salaries if licensure were in place (my opinion, but based on experience). ODs did not help, but in my region of the US did not have a great deal of respect until the 70s, when they tightened up educational requirements and demanded more and more of their future practitioners until they reached the heights they have obtained today. They fought for their profession. Wow, what a novel thought......Opticians need to follow the model they developed in an organized manner.

    Now, I know I sound harsh towards Opticiansry, but belive me, that is FAR from the truth. I support making Opticianry better as mush as anyone, and as Harry mentioned above, I have disdain for those who have done nothing for anyone other than themselves. But we must objectively review where we are and where we want to be. We need to strategically look to the future I often sound hypercritical of Optometry in posts here, but that is not true either. They are doing their best to improve every day, while Opticianry wonders what happened. Opticians in the US need to take a look at the Canadian Opticians and see what they have done to advance. They all have licenses, and a required FORMAL education.

    OK enough rambling. I am sure I'll raise the ire of someone here, but the future is coming. We all need to work together to become the best that we can be.

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    "I have seen the enemy and it is us." Pogo possum in the cartoon strip "Pogo."
    Not positive on exact wording, might have been: "I have seen the enemy and we are it." or something like that.

    Chip

  17. #17
    ATO Member HarryChiling's Avatar
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    There are some great strides being made, but I find myself constantly disappointed. I know many opticians who would rather talk about action than be about action. There is a model that has worked time and time again, it has been mapped out and available to opticians for years. The Canadian Opticians have taken this path and although difficult they are now reaping the fruits of their labor. Canada has now become a model for what opticians in the USA can and should acheive, but the road is difficult and along the way the naysayers say "the profession will go the way of the haberdasher", and speculate all kinds of wonderfull things. They are all just that speculation, some of it is based on logic, some on what would benefit their particular situation.

    From an OD's perspective what would be better than opticians going the way of the dinosaur? Less competition of course they would liek that and have tried legislatively to make it happen yet we are still her as a thron in the side. Every now and again things happen for instance this thread was brought about by a previous thread about Ontario Opticians being able to refract and although it started out civil eventually the true colors came through. I found it interesting that an OD that responded that they agreed that opticians should be able to refract later was so adament about the fact that it was worng and it was refered to as "regressive care". Same thing happened in the state of PA, optometry was for opticians beign licensed, but at the last minte changed their minds and used their influence to squash a bill. Since then the state has suffered from the same issues that all other non licensed states suffer from that gets mentioned here all the time, "any idiot can dispense, so the chains open up shop all over town squeezing out private practices (OD and Opticians)". They pay low wages so they are able to undercut the private practice by cuting labor costs, but they are wise enough to put these sales monkeys in white lab coats or fancy sports jackets therefore emulateing a professional.

    Dr. McDoanlad hit the nail on the head with the chains. They are against licensure it wold hurt their business model. If they had it their way soon opticians will refract they may hire on doctor to staff a store and the hire a gaggle of refracting opticians. Call it a super optical, larger than a walmart open 24/7 one doctor OK'ing refraction and the gaggle of opticians writing scripts. Of course they would have the largest selection, lowest prices, and an on site lab. Sound familiar it's almost reminicent of a large chain that plagues the US.

    Quote Originally Posted by wmcdonald
    "I have seen the enemy and it is us".
    Truer words have never been spoken (btw do I get extra credit for this) :D

    Quote Originally Posted by Stonegoat
    I think the adage "you reap what you sow" applies to our respective professions.
    You are right, but I think that we are a lot more alike than most optometrists would liek to admit. I think the problem is that when were cut it takes a while before your professions bleeds. The backlash of non licensed dispensers has hurt both of us, of course it didn't hurt you as much and it took a while.
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  18. #18
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    Quote Originally Posted by HarryChiling View Post
    I found it interesting that an OD that responded that they agreed that opticians should be able to refract later was so adament about the fact that it was worng and it was refered to as "regressive care".
    WRONG.

    I SAID that opticians should be able to refract but NOT independent of DIRECT OMD or OD supervision. GET THAT STRAIGHT and don't say things I did not say. Understand?? :finger:

  19. #19
    Excalibur
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    Quote Originally Posted by wmcdonald View Post
    I don't remember where this quote came from, and I roughly paraphrase, "I have seen the enemy and it is us". Regarding Opticians, anyway, until we get our house in order with standardized education and training across all jurisdictions and state-recognized certification and/or licensure we have a real problem and seemily are going the way of the haberdasher. In many jurisdictions, the only requirement to be an Optician in a pulse.....so what makes us better then the guy stocking the shelves at WalMart? Now someone from an unlicensed state will chime in and say they are the best Opticians on the planet and licensure or certification does not measure quality, but it is an indicator of some level of competence, if only minimal. There are GREAT Opticians from unlicensed states, and I respect them tremendously, because they did it despite the requirements, and it is a testament to their character, but I still feel Opticianry as a profession needs validation from someone other than ourselves.

    Independent Opticians are getting fewer and fewer. It was not the "Chains" that did us the most harm, because those in control of the earliest chains were Opticians who did not support licensing because they would have to pay higher salaries if licensure were in place (my opinion, but based on experience). ODs did not help, but in my region of the US did not have a great deal of respect until the 70s, when they tightened up educational requirements and demanded more and more of their future practitioners until they reached the heights they have obtained today. They fought for their profession. Wow, what a novel thought......Opticians need to follow the model they developed in an organized manner.

    Now, I know I sound harsh towards Opticiansry, but belive me, that is FAR from the truth. I support making Opticianry better as mush as anyone, and as Harry mentioned above, I have disdain for those who have done nothing for anyone other than themselves. But we must objectively review where we are and where we want to be. We need to strategically look to the future I often sound hypercritical of Optometry in posts here, but that is not true either. They are doing their best to improve every day, while Opticianry wonders what happened. Opticians in the US need to take a look at the Canadian Opticians and see what they have done to advance. They all have licenses, and a required FORMAL education.

    OK enough rambling. I am sure I'll raise the ire of someone here, but the future is coming. We all need to work together to become the best that we can be.

    A good and honest post. IMHO. :o

  20. #20
    ATO Member HarryChiling's Avatar
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    Quote Originally Posted by Excalibur View Post
    WRONG.

    I SAID that opticians should be able to refract but NOT independent of DIRECT OMD or OD supervision. GET THAT STRAIGHT and don't say things I did not say. Understand?? :finger:
    To quote:

    http://www.optiboard.com/forums/show...98&postcount=8
    I don't see any problems in patient care if an optician refracts as long as it is part of a complete assessment under the supervision of an OD or OMD.
    http://www.optiboard.com/forums/show...9&postcount=17
    which brings me to another observation....
    refraction-only visits were the 'norm' decades ago. Going to this sort of scenario is regressive patient care.
    If you haven't looked inside the patient's eye, how can it be called an assessment? This is certainly is not in the patient's best interest.
    There are many, many patients I see monthly that would be far worse off if all I counted on was refractive data to judge their eyehealth/visual prognosis.
    http://www.optiboard.com/forums/show...6&postcount=94
    Most of those who lobby for independent refraction have little or any clinical knowledge or experience. Opticianry would be far more ahead if these people placed accredited and credible education first, and legal changes second -- much like optometry did over the last 50 years to expand into ocular therapeutics. If they really wanted to do good for the people they see, they would learn refraction, learn pathology and become optometrists or ophthalmologists.
    You did mention refraction under the direct supervision of an OD or OMD, then later you reffered to it as regressive care. If you care to explain what this means by all means I am listening, but it's all there. If what you menat was opticians should be able to refrcat while you watch then your later comment about every optometrist sshould own an optician would be correct. Here in the states as it stands OMP are allowed to refract under the direct supervision of an OMD, so changeing the laws in the way I think you suggest means OD's can sip a pina collada while watching opticians refract all their patients.

    (Independent Stand Alone Refractions) This is what every opne seems to keep argueing about, Excalibur you keep seperateing the safe guards that are being put into place from the stand alone refraction. It by all means doesn;t mena that over night every optician will be able to refract it takes 6 years through NAIT to get there and if I am correct it takes 8 years to get through optometry school. On top of that their are screening guidelines to seperate the higher risk patients which need to be reffered to an OD or OMD.
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  21. #21
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    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.

  22. #22
    ATO Member HarryChiling's Avatar
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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.
    That is the role of an OMP, however as it stands now they can only perform these procedures under the direct supervision of an ophthalmologist. You are saying that opticians should do exactly that but do it under an optometrists. What you suggest if you look at it from my perspective is expanding your scope of practice, not opticians. As it stands now optometrists are not allowed to delegate these task to their personel, what you suggest is a model to make that happen.
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  23. #23
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    Quote Originally Posted by HarryChiling View Post
    That is the role of an OMP, however as it stands now they can only perform these procedures under the direct supervision of an ophthalmologist. You are saying that opticians should do exactly that but do it under an optometrists. What you suggest if you look at it from my perspective is expanding your scope of practice, not opticians. As it stands now optometrists are not allowed to delegate these task to their personel, what you suggest is a model to make that happen.
    I use trained, certified technical staff to do my data gathering and dispensing. An optician is not necessary in my office but it would not hurt.

  24. #24
    ATO Member HarryChiling's Avatar
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    Quote Originally Posted by Excalibur View Post
    I use trained, certified technical staff to do my data gathering and dispensing. An optician is not necessary in my office but it would not hurt.
    The certified optometric assistant program you mentioned in the previous thread is a one year correspondence course that you proctor (I won;t question your ethic on the proctoring since you haven't lead me to question it). The program has 4 modules, one on frame and one on lenses. That would be the equivalent of 3 months on frames and 3 months on lenses, opticians in CA have to go through a 2 year course to become opticians and pass a national examination. Weather you see it or not you cheapen the profession with optometric assistants, and I have heard arguements that opticiasn just want to look like OD's that's why we want to refract, but you hire staff that are meant to look like opticians to your patient.

    An optician is not necessary in your office, then you don't dispense.
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  25. #25
    Excalibur
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    Quote Originally Posted by HarryChiling View Post
    The certified optometric assistant program you mentioned in the previous thread is a one year correspondence course that you proctor (I won;t question your ethic on the proctoring since you haven't lead me to question it). The program has 4 modules, one on frame and one on lenses. That would be the equivalent of 3 months on frames and 3 months on lenses, opticians in CA have to go through a 2 year course to become opticians and pass a national examination. Weather you see it or not you cheapen the profession with optometric assistants, and I have heard arguements that opticiasn just want to look like OD's that's why we want to refract, but you hire staff that are meant to look like opticians to your patient.

    An optician is not necessary in your office, then you don't dispense.
    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.

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