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Thread: Opticianry and Optometry

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    Opticianry and Optometry

    May I ask why an optometrist needs to understand lens design? Do you work with opticians? Have you made the wrong career choice?

    I suspect if I wanted to learn ophthalmoscopy from an optometry forum you'd have issues? Sorry if it sounds jaded, it isn't meant to. I'm trying to understand how a clinician, trained in diagnosis of eye health disease has the desire to work with spectacle lenses.

    I do believe the Canadians have it right - optometry is about medical care, whereas opticianry is about dispensing prescriptions. Go Canucks!

    What do you think?


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    Master OptiBoarder OptiBoard Silver Supporter Barry Santini's Avatar
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    Quote Originally Posted by MarySue View Post
    May I ask why an optometrist needs to understand lens design? Do you work with opticians? Have you made the wrong career choice?

    I suspect if I wanted to learn ophthalmoscopy from an optometry forum you'd have issues? Sorry if it sounds jaded, it isn't meant to. I'm trying to understand how a clinician, trained in diagnosis of eye health disease has the desire to work with spectacle lenses.

    I do believe the Canadians have it right - optometry is about medical care, whereas opticianry is about dispensing prescriptions. Go Canucks!

    What do you think?

    I imagine that the practice of optometry, in a wholistic fashion, demands a working knowledge of ophthalmic optics, eyewear fabrication and ophthalmic dispensing.

    my 2 cents.

    Barry

    PS - Mary, I find your posts *always* informative and illuminating

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    Master OptiBoarder Darryl Meister's Avatar
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    I'm trying to understand how a clinician, trained in diagnosis of eye health disease has the desire to work with spectacle lenses.
    Keep in mind that writing a spectacle prescription requires at least a basic undestanding of ophthalmic optics. In a perfect world, where every optician has been trained extensively in ophthalmic optics, lenses, and dispensing, independent optometry might be less reluctant to completely entrust opticians with their patients after the exam.

    But, as it stands at the now, optometrists in the US undergo considerably more training in ophthalmic optics and dispensing than the majority of practicing opticians due to lack of education standards and requirements. Besides, clinicians in most branches of healthcare are generally "taught the basics," whether or not these are later entrusted to a nurse or technician.

    Remember that OptiBoard is a forum for eyecare professionals of all ilk, not just opticians.
    Darryl J. Meister, ABOM

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    Quote Originally Posted by Barry Santini View Post
    I imagine that the practice of optometry, in a wholistic fashion, demands a working knowledge of ophthalmic optics, eyewear fabrication and ophthalmic dispensing.

    my 2 cents.

    Barry

    PS - Mary, I find your posts *always* informative and illuminating
    Thanks Barry - I hope I've hidden my frustration at the lack of cooperation between professions (optometry and opticianry). Unfortunately, I've had first hand experience of optometry wanting to utilise the training and experience of a qualified d.o., but not wanting to support their advancement in any field. It feels a bit ... "servant know thy place" at times.

    My own training allows contact lens fitting and refraction training -which I believe makes me a better dispenser. I have never seen an optometrist lose his or her job because of my additional training.

    My real question I guess - is when will we opticians standardise our training world wide?

    :) Cheeky eh? Your posts are great - btw - hardly ever comment because you leave nothing unsaid. :cheers:

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    Quote Originally Posted by Darryl Meister View Post

    Remember that OptiBoard is a forum for eyecare professionals of all ilk, not just opticians.
    I stand corrected Darryl. Right as per your usual --- I think you might see from my response to Barry, the whole thing is a personal frustration, and shouldn't be aired online :)

    Thanks to both you and Barry for pulling my head in!
    Cheers

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    Master OptiBoarder Darryl Meister's Avatar
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    MarySue, I completely understand your frustrations. Just keep in mind that they're not optometry's fault, at least not in the US. ;)
    Darryl J. Meister, ABOM

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    Master OptiBoarder optical24/7's Avatar
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    Quote Originally Posted by Darryl Meister View Post
    MarySue, I completely understand your frustrations. Just keep in mind that they're not optometry's fault, at least not in the US. ;)


    Darryl, this is the first thing I've read of yours that I disagree with. Name me one local, state or national optometric society that promotes encourages or helps support licensure in non-licensed states. I know many OD's that support it personally, but their organizations do not. They fight it.

    I'm also the first one to say that opticians have put themselves in their position. Many enter the field because it is relatively easy to get into. Many more enter it only until they "get a real" job. The apathy of opticians is pathetic. But what put them in their apathetic state? It's the constant David vs Goliath state of mind that has set in from consistantly getting shot down. I'll echo what I hear from seasoned opticians in my state and others. "Why try? We don't have the money or political clout to fight". Why do we have to "fight" for licensure?

    The only way opticianry will rise to a professional level is with manditory education and licensure. But how many opticians actively standup for this? I can tell you that in my state, very, very few do...

    The sad fact is that when licensure comes, it will be because a few dedicated people work for it. And then those people will be more despised by their states fellow "opticians" (re: frame stylists) than by the other two "O's" because they will be forced to actually learn and demonstrate their competence to stay in the field.



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    Ditto what 24/7 said, at least from us up here in Minnisota.

    And now back to the subject.

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    Great post 24/7 and from my perspective your right very few opticians will respect you the more education you get, but those are not the ones you want to be hanging out with anyway. I find that optometrists tend to respect opticians with education even when they don't support it.
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    Couldn't agree more

    Quote Originally Posted by HarryChiling View Post
    Great post 24/7 and from my perspective your right very few opticians will respect you the more education you get, but those are not the ones you want to be hanging out with anyway. I find that optometrists tend to respect opticians with education even when they don't support it.
    If those of us who do have "registration" or "licensure" banded our resources, we could work towards a standadrd of education for all opticians. The sad thing is in my country, we can't even call ourselves opticians.

    Caroline MacIsaac-Powers of the College of Opticians in Ontario has in the past promoted this concept of standardisation, joining together to set a higher standard, etc.: at all Vision Expos in the States, with very low turnout. I suspect 24/7's suggestion of apathy is undeniably true.

    What can those of us around the world who want to see a furthering of skills and standards do? I for one would help out in any way my personal resources allowed. :cheers:

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    Master OptiBoarder Darryl Meister's Avatar
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    I usually stay with from political issues, since I generally try to remain as objective and impartial in this forum as possible, but in the spirit of friendly debate...

    Name me one local, state or national optometric society that promotes encourages or helps support licensure in non-licensed states... They fight it.
    Before describing my personal experiences in this matter, I will first pose this question to you: Is Optometry responsible for the success, or failure, of Opticianry? Is Ophthalmology responsible for the success or failure of Optometry?

    Optometry has made a great deal of progress over the past few decades with arguably even greater resistance from Ophthalmology. Of course, Opticianry has access to the same legislative opportunities that Optometry and Ophthalmology have.

    And it isn't just about money... It's about convincing policy makers that licensure is in the best interest of consumers. While money certainly helps, plenty of policies get pushed through by the "little guys." Just as Optometry has done on several occasions when expanding their own scope of practice, without concessions from Ophthalmology or Opticianry.

    I would argue that Opticianry's best hope of success is working with Optometry, not slinging rocks at them, to play on your David versus Goliath analogy. I would also assert that convincing Optometry of the benefits for both patients and optometrists could have gone a long way in driving licensing initiatives for Opticianry.

    As for my own personal experience... I was actually on the board of directors of the Opticians Association of Missouri when we were finally on the brink of pushing a licensure bill through state legislation. The state optometry association was actually willing to support our bill under only one condition: They did not want us to include contact lens fitting.

    Mind you, opticians in Missouri were not allowed to fit contact lenses in the first place, so this would not have been some great sacrifice if it meant at least legitimizing opticianry and spectacle dispensing. Nevertheless, several of the key decision makers in our organization refused to agree to this compromise with the optometrists, instead pursuing an "all or nothing" campaign strategy.

    It should come as no great surprise that our bill was eventually shot down. And the Opticians Association of Missouri eventually disbanded. Opticians in Missouri will not enjoy the benefits of licensed professionals anytime soon. But when I look at how close we came to convincing our state legislators to pull the trigger on licensing for opticians, I don't blame Optometry.

    I'm also the first one to say that opticians have put themselves in their position... But how many opticians actively standup for this? I can tell you that in my state, very, very few do... The sad fact is that when licensure comes, it will be because a few dedicated people work for it...
    I don't necessarily disagree with any of these points. I think they echo my own feelings, which I alluded to with my original comment. I will end with a link to an article available on OptiBoard that I think all opticians should read: Opticianry at a Crossroads, which was actually written by an optometrist.
    Darryl J. Meister, ABOM

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    I'm happy to see a civilized debate on this subject.

    I'm lucky, I guess. NY has had licensed opticians since I don't know when. We would not be able to run our practice as well as we do without licensed, knowledgeable staff. One of our four licensed opticians is a partner in the practice.

    Having been a part of the optometric association in NY, I can tell you that we do not sit around a table and try to think up ways in which we can thwart opticianry. Turf issues have come up in the past, but the biggest arena of turf battles is between optometry and medicine, specifically ophthalmology. Have we agreed on all aspects of scope of practice, I'm sure not, but the lines have been drawn long ago, and back biting is not well regarded in the State Board structure of our professions. I can tell you that any scope of practice expansions that optometry has enjoyed in NY have been based on proving (to the point of exhaustion) that the profession had the educational base in place first. Don't go down the path that optometry holds economic advantage over opticianry, because the state will do nothing to enhance any professions economic situation. It must be proven that change will enhance the well being of the public.

    Someone will pop up and say that we don't support optician refracting. I suppose you are right on this one, but since this overlaps with optometry's longstanding definition of being refractionists, it will be hard to overturn... Optometry was able to break into the field of medicine and treat eye disease. We did have to accept a great deal of limitations, BTW. Many of these have been eliminated as time went on. Opticianry will have to lead their fight on this one. You'll get resistance from optometry, but optometry knows better than to act like a bunch of jerks.

    I can tell you that today, in one of opticianry's premier programs in NYC, that opticians are being trained not only in traditional ophthalmic dispensing, but also in ophthalmic technicianry, such as refracting and auto-refracting, biomicroscopy, keratometry, and other forms of data collection and interpretation. This has made opticians more employable, and I would say, better able to take advantage of opportunities in the job marketplace.

    Sure, my statements represent MY global view of the subject at hand, but I hope some see where I am coming from.

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    This thread is not relevent to this section of the forum. This topic has always been posionous. This thread will inevitably end in poor taste, I hope that it ends now rather than continues.

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    This is all fine and dandy but where is the unified voice.

    Cudo's to all that have posted! Your replies have been thought out and eqully infomative and entertaining. Is there anything better than a healthy debate?!

    In this mind I ask a question. Given that we can all agree that licensure is as much aneeded if not anticipated thing, is a national argument for licensure being forever delayed by our own lack of unification?

    In the last newsletter from the OAA the general message was more about who was going to chair what committee than where the association was making in-roads. (One chairperson even suggested that to combate VSP opticains should sell half of their practices to an OD! but this is another discussion) There were no comments regarding the new Health Reform legislation or comments about how the OAA was working towards some sort of goal. There was a bit about trying to protect the name "Optician" and only allow certified professionals to use the title. (I'm not sure how you enforce something like this but the OAA is very proud to have won a 'Strawman' victory)

    Opticianry has evolved/devolved greatly in the last 22 years I have been practicing. When I look around at fellow 'Opticians' I don't see the professionals I was with when I started, I see part time housewives, college students working towards something else, and the occasional professional that has been beaten down to think they cant survive unless under a Dr's shingle. When I started I was with Professional Opticains, people that enjoyed the optical field, that enjoyed the process of being an optician.

    This year I opened my own office, I have no doctor and no staff, I am litterally on my own. I am an Opticiary with all that entails. The recent trend would say that my days are numbered, that the wolves at my door shall be bursting in to shutter my windows at any moment, but I'm here and patients are coming in.

    I'm am still hopeful opticianry will turn the corner and become greater than what it is, maybe even greater than what it was. Without a unified message, one voice to carry to the people and the legislature, the cause is lost and opticans will simply fade into history.

    KC

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    Master OptiBoarder OptiBoard Silver Supporter Barry Santini's Avatar
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    Quote Originally Posted by kcount View Post
    Opticianry has evolved/devolved greatly in the last 22 years I have been practicing. When I look around at fellow 'Opticians' I don't see the professionals I was with when I started, I see part time housewives, college students working towards something else, and the occasional professional that has been beaten down to think they cant survive unless under a Dr's shingle. When I started I was with Professional Opticains, people that enjoyed the optical field, that enjoyed the process of being an optician.

    This year I opened my own office, I have no doctor and no staff, I am litterally on my own. I am an Opticiary with all that entails. The recent trend would say that my days are numbered, that the wolves at my door shall be bursting in to shutter my windows at any moment, but I'm here and patients are coming in.

    I'm am still hopeful opticianry will turn the corner and become greater than what it is, maybe even greater than what it was. Without a unified message, one voice to carry to the people and the legislature, the cause is lost and opticans will simply fade into history.

    KC
    Yes, you're right in so many ways.

    Opticianry is like playing the saxophone. Easy to pick up. Hard to master.

    Don't worry about a unified voice. It ain't gonna happen in our lifetimes. There aren't enough clear thinkers that agree to support the movement.

    Watch your own back. Do your own thing. Keep delivering the best you can. Adjust your lifestyle to fit the economics.

    You'll be fine, and you'll enjoy what you do.

    Barry
    Last edited by Barry Santini; 12-29-2009 at 07:57 PM.

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    thanks for the vote of confidence Barry. Always enjoy your posts. Would love to pick your brain somday regarding the freeform PALS's. I simply dont know enough to feel confortable about selling/dispencing them.

    Now, I'm off to fret about display lighting.

    KC

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    Master OptiBoarder Darryl Meister's Avatar
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    This thread is not relevent to this section of the forum. This topic has always been posionous
    Which is why I chose to let it remain in the Ophthalmic Optics forum, where I am confident that the posts will remain both well thought out and respectful.
    Darryl J. Meister, ABOM

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    This guy is pretty smart...

    Quote Originally Posted by Darryl Meister View Post
    Which is why I chose to let it remain in the Ophthalmic Optics forum, where I am confident that the posts will remain both well thought out and respectful.
    ...where only the best and brightest ever dare venture!
    Wesley S. Scott, MBA, MIS, ABOM, NCLE-AC, LDO - SC & GA

    “As our circle of knowledge expands, so does the circumference of darkness surrounding it.” -Albert Einstein

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    Master OptiBoarder Darryl Meister's Avatar
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    where only the best and brightest ever dare venture!
    Yes, that goes without saying, of course. ;)
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    Master OptiBoarder rbaker's Avatar
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    Quote Originally Posted by optical24/7 View Post
    Darryl, this is the first thing I've read of yours that I disagree with. Name me one local, state or national optometric society that promotes encourages or helps support licensure in non-licensed states. I know many OD's that support it personally, but their organizations do not. They fight it.

    I'm also the first one to say that opticians have put themselves in their position. Many enter the field because it is relatively easy to get into. Many more enter it only until they "get a real" job. The apathy of opticians is pathetic. But what put them in their apathetic state? It's the constant David vs Goliath state of mind that has set in from consistantly getting shot down. I'll echo what I hear from seasoned opticians in my state and others. "Why try? We don't have the money or political clout to fight". Why do we have to "fight" for licensure?

    The only way opticianry will rise to a professional level is with manditory education and licensure. But how many opticians actively standup for this? I can tell you that in my state, very, very few do...

    The sad fact is that when licensure comes, it will be because a few dedicated people work for it. And then those people will be more despised by their states fellow "opticians" (re: frame stylists) than by the other two "O's" because they will be forced to actually learn and demonstrate their competence to stay in the field.

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    Quote Originally Posted by MarySue View Post
    May I ask why an optometrist needs to understand lens design? Do you work with opticians? Have you made the wrong career choice?
    I know I'm a little late to join this thread, but I just came across it, and had a view to share. It may be simple and may sound naive, but I think it fits.

    I've always kind of thought of myself as a pharmacist for vision correction. Just the same as you go to your physician to diagnose you, then he gives you a prescription, and you take it to the pharmacist who fills it. I worked in a pharmacy for a year in college (the only thing I've ever done besides opticianry), and for the most part, the pharmacist knows more about the drugs he provides than the doctor. The doctor definately needs to know the ins and outs of the medications he prescribes, but with new drugs coming out all the time, they mostly get this from reps that stop by to drop off pens and pads of paper and other trinkets. If I have a question about a medication, I call my pharmacist first.

    In the same light, ODs and MDs will need to know how the patient is expected to see out of the correction, but it's up to the optician to communicate with the patient to help decide the style of lens (Prog? FT?) and other aspects of their eyewear that are optional. We all have to work together. I depend on the doctors to write me an accurate prescription that's going to work. The doctors depend on me to fill the prescription in such a way that the patient achieves their best correction. The patient just wants to see clearly (and might as well look great, too).
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    Master OptiBoarder optical24/7's Avatar
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    We have a unique situation in Texas. Arguably, we are the closest state to getting mandatory licensure next. We have voluntary registration in the state. We got that out of a compromise 10 years ago after an interim study done by the state showed the importance of educating and registering opticianry tasks. We went from a high of almost 3000 (most thought this would lead to Licensure, thus the large number) opticians registered to little more than 300 today. It is clear that voluntary registration does not accomplish the intended goal of insuring competence in the field.

    We also have other unique things going on here. Lens duplication, CL fittings and refraction ability with MD write off. I know many opticians that fit CL’s out of their location, referred by an MD that doesn’t want to fool with them. Many of these same opticians are allowed to re-refract for fitting reasons or trouble-shooting patients that are non-adapting to the MD’s Rx. All perfectly legal here. Unlike the case in Missouri, why would any profession wish to legislate itself out of the opportunity to expand scope or take away abilities already practiced?

    Barry is quite right. Even the states that have licensure today don’t agree enough to have reciprocity between themselves. We are a long way from having anything meaningful or united on a national basis.

    So, we states are left to fend for ourselves. We must take a page from Optometry…Educate, then legislate. And to be honest with you, I have nothing personal to gain from licensure. In fact, a seasoned and educated optician has an edge in non-licensed states. I can point to my credentials and point out my expertise to clients, and ask if they have seen the same elsewhere. With the mediocrity of opticianry out there today, it’s tough not to stand out.

    I am thankful for this meaningful and respectful discussion.

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    Master OptiBoarder Darryl Meister's Avatar
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    CL fittings and refraction ability with MD write off. I know many opticians that fit CL’s out of their location, referred by an MD that doesn’t want to fool with them. Many of these same opticians are allowed to re-refract for fitting reasons or trouble-shooting patients that are non-adapting to the MD’s Rx...All perfectly legal here.
    The presence or lack of a license for opticians does not preclude anyone from continuing to work under the supervision of a licensed ophthalmologist. Even in your example with Texas, opticians are not legally permitted to sign off on the final contact lens fitting specifications, themselves. Otherwise, this would represent prescribing contact lenses.

    Unlike the case in Missouri, why would any profession wish to legislate itself out of the opportunity to expand scope or take away abilities already practiced?
    Removing a contact lens fitting provision from such a bill would not be changing the status quo one way or the other. If opticians could fit contact lenses under the supervision of another professional in the first place, which they often can, this would continue to be the case had such a bill been enacted. It is not limiting the scope of opticianry, it is just not expanding it to include independently prescribing contact lenses.

    Optometry became licensed professionals with a limited scope of practice first. Then, eventually, and only after establishing a significiant base of specially trained optometrists, optometrists fought successfully to expand their scope of practice. They did not start demanding concessions such as DPA and TPA right out of the gate.
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    If I may add there is also major divides in many areas of our profession. Educated/Certified/Uneducated, even among different schools; licensed/unlicensed states; old opticians/ new opticians; I could go on. Their is only retail chains as opposition now, they are stronger as a group and at this point I don't see optometry as opposition because they really don't need to be why would they waste one iota of energy on a group that has been legislatively stagnant for decades. At this point the profession needs support in my opinion. Education is a pipe dream since no school will offer a program without people to fill classes and no people will fill classes since you can get into the field without an education. Classic chicken and egg conundrum.
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    Quote Originally Posted by Darryl Meister View Post
    .....
    Optometry became licensed professionals with a limited scope of practice first. Then, eventually, and only after establishing a significiant base of specially trained optometrists, optometrists fought successfully to expand their scope of practice. They did not start demanding concessions such as DPA and TPA right out of the gate.

    I agree with you Darryl. We're not looking to expand scope with our bill. Simply amending our volunary bill to mandatory. Sounds simple, right? Since you've been there, I won't get into the resistance to change that goes into all politics, concessions are expected. We can't step backwards on what we already can do.

    When politicians and the public are told that opticians are not licensed in your state, or require even a high school education...That only a pulse is required to call yourself an optician, their mouths drop. Most think opticianry is a degreed position.

    I've done some informal polling, and opticians make the vast majority of lens design reccommendations for their patients. Also measure, order and verify final product, fit and confirm patient satisfaction with the result. Is it not common sense that a person with this responsibilty have accountable training, certification, and licensure? ( I know, in here, I'm preachin' to the choir..)

    And Harry, you'd be surprised by what big chain would like to see licensure, and reciprocity between states. I even attended a recent CE class that a walmart employee was taking. Their district manager is encouraging all personel to get an ABOC. So there are at least 2 chains promoting education.

    Licensure will come. But, unfortunately, there will be a fight...On such a common sense issue...

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