how can this be legal...

[MikeAurelius]

Not entirely hypocritical when you consider that these laws would be at the state level, not the federal level. The federal laws are archaic and detrimental to everyone except for a handful of bullies. I always said I believe in government big enough to keep other entities from being bullies without becoming a bully itself.

Then you haven't been paying attention to the states (and their residents) who continually call for less regulation, but insist on more when it directly affects them. Especially since you live in one of them.

[drk]

"Smaller government"...why is it when people claim they want less regulation, and the results of less regulation come about, all of a sudden, more regulation is wanted?

Hardly Mike.

It's people disregarding the spirit of the law through loopholes that need tightened.

If you want unregulated health care, vote that way.

[drk]

More laws to handicap opticians with a license instead of regulating unlicensed activity online?

If that's the priority in which the professional associations see the industry's problems, God help us.

Low hanging fruit gets picked.

We all know internet commerce is interstate and apparently sacred.

[drk]

Then you haven't been paying attention to the states (and their residents) who continually call for less regulation, but insist on more when it directly affects them. Especially since you live in one of them.

Ok, you got everyone with that one, Mike. People are to be 100% for regulation or 100% against or suffer your charge of hypocrisy. Tyranny or anarchy are our only choices.

[MikeAurelius]

Not true Dr. K. Not true at all. The hypocrisy is from the folks who call for regulation, then want it back when it turns out badly. I'm trying real hard to avoid the use of the "p" word, but it's difficult.

But there has to be some admittance of the fact that when voters elect folks who want "small government", those who then claim that smaller government and lesser regulations have hurt their business, are usually the ones to be calling for more laws and more regulations. The common voter and the business man are usually two different people, and there are usually more of the common men than business men. So who is to blame?

Do you say "I told you so", take your bat and ball and go home? Do you play the game? Do you sit on the sidelines and sulk?

With smaller government and lesser regulation, some people are going to be hurt, usually those who "profit" or have an advantage given to them by the "large government" and "more regulations". You talk about the "spirit of the law". What is that precisely? Can you define it? Is it real? Does it really mean what you think it means?

Let's say you make widgets. There are onerous government regulations that prohibit the use of some chemicals you need to make widgets. So, you spend bazzilions of dollars to find a critter who will write a law, and vote the way you want, and convince his fellow critters to do the same. The law passes, and you can now make widgets for cheaper and faster, and you rake in a gazillion bucks. But...six months later, your employees start getting sick from the chemicals, and pretty soon, they are all in the hospital and no one will work for you as long as you use those chemicals. Point of the example: every decision has unintended consequences. There's no way to forsee them coming, they just hit you in the face. Small government and less regulation means just that. You can't unride the horse.

Less regulation usually means no laws creating new regulations will be written. Small(er) government means that even if the new regulations are written, there's no one around to enforce them.

Those are YOUR choices. With respect, of course!

[Tigerclaw]

Not true Dr. K. Not true at all. The hypocrisy is from the folks who call for regulation, then want it back when it turns out badly. I'm trying real hard to avoid the use of the "p" word, but it's difficult.

But there has to be some admittance of the fact that when voters elect folks who want "small government", those who then claim that smaller government and lesser regulations have hurt their business, are usually the ones to be calling for more laws and more regulations. The common voter and the business man are usually two different people, and there are usually more of the common men than business men. So who is to blame?

Do you say "I told you so", take your bat and ball and go home? Do you play the game? Do you sit on the sidelines and sulk?

With smaller government and lesser regulation, some people are going to be hurt, usually those who "profit" or have an advantage given to them by the "large government" and "more regulations". You talk about the "spirit of the law". What is that precisely? Can you define it? Is it real? Does it really mean what you think it means?

Let's say you make widgets. There are onerous government regulations that prohibit the use of some chemicals you need to make widgets. So, you spend bazzilions of dollars to find a critter who will write a law, and vote the way you want, and convince his fellow critters to do the same. The law passes, and you can now make widgets for cheaper and faster, and you rake in a gazillion bucks. But...six months later, your employees start getting sick from the chemicals, and pretty soon, they are all in the hospital and no one will work for you as long as you use those chemicals. Point of the example: every decision has unintended consequences. There's no way to forsee them coming, they just hit you in the face. Small government and less regulation means just that. You can't unride the horse.

Less regulation usually means no laws creating new regulations will be written. Small(er) government means that even if the new regulations are written, there's no one around to enforce them.

Those are YOUR choices. With respect, of course!

No offense, I am no political novice, not by a long shot. You are comparing apples to oranges. Wanting government to get out of the way of small business owners by reducing the red tape and pointless hoops to jump through for the purpose of being able to point to the voters and say "hey look, we're doing stuff!" and to feed the narcissism of a dozen power-hungry bureaucrats isn't the same as saying we need to restrict the practices of medicine and optometry to doctors, especially those who can adequately do their jobs and not just crank out prescriptions by cutting the wrong corners.
As for Texas, the libertarian attitude you describe is still in second or third place, if not lower.

[rbaker]

Hardly Mike.

It's people disregarding the spirit of the law through loopholes that need tightened.

If you want unregulated health care, vote that way.

A "loophole" is a point of law which does not benefit you.

[Tigerclaw]

A "loophole" is a point of law which does not benefit you.

Doesn't mean that the law is written as intended. The spirit of the law is often ignored, regardless of how people who oppose loopholes are often the only ones pointing them out, which would make perfect sense.

[rbaker]

We might also consider the difference between laws and regulations.

[rbaker]

All of these opinions beg the broader question "is Administrative Law unlawful?"

This provocative question has become all the more significant with the expansion of the modern administrative state. While the federal government traditionally could constrain liberty only through acts of Congress and the courts, the executive branch has increasingly come to control Americans through its own administrative rules and adjudication, thus raising disturbing questions about the effect of this sort of state power on American government and society.

We can extend this to the State Governments and to State Licensing/Regulating Boards.

[MikeAurelius]

All of these opinions beg the broader question "is Administrative Law unlawful?"

A libertarian would probably say its not.

HOWEVER, let's stay away from politics, so this thread isn't closed down.

[mervinek]

I can see how this could be good for people who are homebound. I just had a patient who is in the hospital and has end stage cancer, she only has months to live. Family wanted to get her new glasses since all she can do now is watch TV and her old glasses aren't cutting it. This would have been great for her.

[drk]

What would be better is an inpatient visit from a doctor, not a visit from a cellphone.

[drk]

Question to you opticians:

Will you fill "Blink" "Rxs"? (I use that term loosely, since it's really a cell phone measurement signed off on by an unscrupulous OD.)

I mean, most of this crap is designed to go straight to equally scrupulous "online opticians", but what if one walks into your office? What's your policy on filling these dubious measurements generated by a cell phone?

What should your state boards' policy be?

[EyeCare Rich]

Great question drk. I am curious if the Rx actually looks different than a standard Dr signed Rx??? I guess this what would determine it for me. If it is a signed, dated, within the expiration Rx, yes I would fill it. If it does not have a signiture, date, expiration date, no way, no how. How would we know any different from the printed rx? Maybe I'm looking at the small picture here, being from the sticks and not the big city where these hair brained ideas come from.

[CNG]

Question to you opticians:

Will you fill "Blink" "Rxs"? (I use that term loosely, since it's really a cell phone measurement signed off on by an unscrupulous OD.)

I mean, most of this crap is designed to go straight to equally scrupulous "online opticians", but what if one walks into your office? What's your policy on filling these dubious measurements generated by a cell phone?

What should your state boards' policy be?

I think the question that we have to really ask is if it equivalent in quality as a in person refraction. As a licensed optician, I care about the health of my patients as well as the quality of OMD or OD who is working in my store. I will bet that most independent opticians will embrace this technology but will continue to feed these patients to their in house Doctor for health evaluation at a later date. If this technology is dead on accurate then we will see this change otherwise it will fade... It may be legal to an extend in most locations since opticians need the prescription signed by the OD/OMD. Now the question is wil the in house doctor agree to it...I think he will or even be the one signing the scripts.

[Jarhead Daddy]

I think the question is, "To whom do one's eyes belong?" If my eyes belong to me, then who are you to tell me I can or cannot purchase glasses or contact lenses without your permission (an Rx)? On what basis do we deny that right to adult patients?

[drk]

You're not understanding.

You have the right to practice medicine upon yourself.

But you do not have the right to practice medicine on others.

[MikeAurelius]

^^^+1000

They are in my head, I get to decide who takes care of them and who makes the eyewear.

[drk]

Would you restate, MA?

OK, I get it. Your eyes are "in your head".

You do have a right to do what you want, again, but you don't have the right to do it to others' eyes.

[MikeAurelius]

My eyes are in my head. *I* decide who exams them and who fills the Rx.

(My response was meant for JarHead)

[acesrwylde]

I don't want to be the devil's advocate here, however, I find that most people are up in a roar about this to be interesting. Basically what is going on is they are doing a refraction for a patient, and there is a technician on site to supervise. That technician then sends the information to the doctor and the doctor signs off on it. I have been in many ophthalmologist offices that basically do the same thing. They have one of their technicians work up the refraction and then have the doctor sign off on this. How is this any different? They make it clear on their site that this is not a full exam or comprehensive in any fashion. Not only that, but they are also charging a lot of money for a refraction. Most places that I have worked for will charge $30-$50 for just a refraction. So this company is charging you $20-$40 more for the convenience of being able to do it from your home. Honestly I think this is a great idea, however, we do need to make sure people understand that this is not the same as a full comprehensive exam. I think that us as opticians need to stop spouting out sarcastic remarks about our patients and their ignorance and instead spend that time talking with them and communicating with them about the reasons why something like this is risky and may not be the best choice for them. We had to do the same thing when contacts and glasses became readily available online, and for those of us that took the time and worked with our patients, we find that we still have a great patient base that is consistent and loyal.

[EyeCare Rich]

[QUOTE=acesrwylde;505480]Basically what is going on is they are doing a refraction for a patient, and there is a technician on site to supervise. That technician then sends the information to the doctor and the doctor signs off on it. I have been in many ophthalmologist offices that basically do the same thing. They have one of their technicians work up the refraction and then have the doctor sign off on this. How is this any different? They make it clear on their site that this is not a full exam or comprehensive in any fashion. Not only that, but they are also charging a lot of money for a refraction. Most places that I have worked for will charge $30-$50 for just a refraction. So this company is charging you $20-$40 more for the convenience of being able to do it from your home. Honestly I think this is a great idea, however, we do need to make sure people understand that this is not the same as a full comprehensive exam. I think that us as opticians need to stop spouting out sarcastic remarks about our patients and their ignorance and instead spend that time talking with them and communicating with them about the reasons why something like this is risky and may not be the best choice for them."

Most of your statement is correct acesrwylde, but when in the office of the OMD, or OD, the patient is getting a comprehensive exam. I also think that along with the autorefraction (which is what this system is)the technician is doing an actual refraction based off of the autorefraction. Unless this machine is way more accurate (which I sincerely doubt)than current high priced autorefractors, the patient/customer is not getting the best refraction possible. I would have to also hear their verbage with the customer to be certain they are reccomending a comprehensive exam before I could be comfortable with the idea of the system they are creating.

Did anyone look at the "technicians" they are hiring for this??? This is where I find big fault in the system. Just my 2 pennies.

[acesrwylde]

Rich, that is a good point. It worries me when they call their technicians "Visioneers". For a venture like this they should only be hiring certified technicians who have a long history of working with doctors on refractions. As long as the business owners are getting the correct people, then there is no reason why this idea couldn't work.

[drk]

I don't want to be the devil's advocate here, however, I find that most people are up in a roar about this to be interesting. Basically what is going on is they are doing a refraction for a patient, and there is a technician on site to supervise. That technician then sends the information to the doctor and the doctor signs off on it. I have been in many ophthalmologist offices that basically do the same thing. They have one of their technicians work up the refraction and then have the doctor sign off on this. How is this any different? They make it clear on their site that this is not a full exam or comprehensive in any fashion. Not only that, but they are also charging a lot of money for a refraction. Most places that I have worked for will charge $30-$50 for just a refraction. So this company is charging you $20-$40 more for the convenience of being able to do it from your home. Honestly I think this is a great idea, however, we do need to make sure people understand that this is not the same as a full comprehensive exam. I think that us as opticians need to stop spouting out sarcastic remarks about our patients and their ignorance and instead spend that time talking with them and communicating with them about the reasons why something like this is risky and may not be the best choice for them. We had to do the same thing when contacts and glasses became readily available online, and for those of us that took the time and worked with our patients, we find that we still have a great patient base that is consistent and loyal.

1. I think before you get all gushy about it you should see if it works.
2. Sloppy ophthalmology notwithstanding, at least there is supposed to be a physician or a highly trained technician in person. Who are these "guys" going to be? Former pizza deliverymen?