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  1. #101
    Master OptiBoarder optical24/7's Avatar
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    Quote Originally Posted by drk View Post
    Refraction IS covered as a special diagnostic procedure under certain circumstances. Look it up.

    Subjective feedback during a refractive procedure is certainly helpful, but that's a far cry from someone "refracting themselves". I was pretty sure you were talking about choosing OTC readers as "self-refracting" anyway.

    The public is whom we serve, but they don't make the rules. They vote for leaders who appoint supposed experts to serve the public by regulating various private industries, including health care. This is not a democracy, and we don't have a "giant tally" of whether something is policy or not. It's in the hands of experts. I thought you'd join me in being one of them.

    Why certain states aren't licensed is beyond me. Why certain states face de-licensure we can all agree has less to do with public safety and more to do with special interest lobbies wanting regulation removed so they can make more money.
    I'm on your side doc, just playing devil's advocate.

  2. #102
    OptiBoard Novice barefootoptics's Avatar
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    Do away with # 1 and # 2 (for starters) and you will see anyone who has the $$$ to open an optical dispensary do it - just for the $$$, not because of the Licensed Profession that is it. - - - - Just my 2-cents worth for now.

  3. #103
    Master OptiBoarder optical24/7's Avatar
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    Quote Originally Posted by drk View Post

    Opticianry: yes or no? In your professional opinion, should we do away with 1. state dispensing regulations/standards, 2. state licensure of opticianry, 3. state optometry practice regulation, 4. spectacle correction as prescription only, 5. contact lens wear as prescription only?

    .
    Online already bypasses 1-4. (As do OTC readers). Most states don't require #2. There's (well) documented potential harm with CL's. The same cannot be said about eye glasses.

  4. #104
    Master OptiBoarder optical24/7's Avatar
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    Sorry if my questions or statements upset you, but be prepared to have a resounding response to them should your elected regulators ask the same.

  5. #105
    What's up? drk's Avatar
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    That's why I'm here. I'm going to respond. It will be glorious. And probably futile.

  6. #106
    Compulsive Truthteller OptiBoard Gold Supporter Uncle Fester's Avatar
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    We're just the latest...

    Quote Originally Posted by drk View Post
    I'm a little ****** off at some of the comments, and I'll say why.

    What we're seeing at the big-picture level is deregulation of our segment of health care.

    Some here seem to think that good ol' progress has obsoleted the need for professionals, therefore regulation is passe.

    What I'm seeing is flouting of existing regulation and a well-funded attempt to remove what regulation barriers still exist.

    Opticianry: yes or no? In your professional opinion, should we do away with 1. state dispensing regulations/standards, 2. state licensure of opticianry, 3. state optometry practice regulation, 4. spectacle correction as prescription only, 5. contact lens wear as prescription only?

    I can point to examples of pressure on all five of these aspects.
    Citibank accidentally leaked a secret memo a few years ago that flat out stated our country is now an oligarchy run by the wealthy few who can manipulate Washington to do their bidding.

    http://politicalgates.blogspot.com/2...bombshell.html

    The answer will only come when enough of us take a line from the movie "Network" and not only scream "I'm mad as he!! and not going to take it anymore", but actually look to radically change who and how our government is run.

    Oopps- Out on that thin ice of politics on Optiboard again so I'll step back...
    Last edited by Uncle Fester; 09-10-2015 at 12:12 PM. Reason: Thanks Barry...Liked Broadcast News too!!!

  7. #107
    Master OptiBoarder OptiBoard Silver Supporter Barry Santini's Avatar
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    The movie was called Network

  8. #108
    Master OptiBoarder OptiBoard Silver Supporter Barry Santini's Avatar
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    Quote Originally Posted by drk View Post
    That's why I'm here. I'm going to respond. It will be glorious. And probably futile.
    I thank G** that you and other docs are here, too.

    B

  9. #109
    Manuf. Lens Surface Treatments
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    Redhot Jumper The public is whom we serve, but they don't make the rules.

    Quote Originally Posted by drk View Post

    The public is whom we serve, but they don't make the rules. They vote for leaders who appoint supposed experts to serve the public by regulating various private industries, including health care. This is not a democracy, and we don't have a "giant tally" of whether something is policy or not. It's in the hands of experts.

    But politicians are for sale, and they tell their experts what to do.
    .............and the large corporations know that too well.

  10. #110
    O.D. Almost Retired
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    While I agree with the notion that the top 1% wealth in the US have more influence on elections than they should, that doesn't require a revolution to fix. Just some intelligent watching what politicians do and voting accordingly by the public.





    In politics as in many contests:

    There is no try. There is only do or not do.
    There is no tie. There is only win or lose.

  11. #111
    Master OptiBoarder OptiBoard Silver Supporter Barry Santini's Avatar
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    Quote Originally Posted by drk View Post
    What's a "well-corrected emmetrope"?
    Emetrope: A person who's vision does require glasses, i.e., a prescription.
    This could mean that they have a vision error from -0.50 to +0.75, and spherical equivalents that total this.
    No corrective lenses indicated on license, i.e., 20/40 or better.

    Well corrected emetrope: Theoretically true PLANO; 0.00D

    B

  12. #112
    O.D. Almost Retired
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    Quote Originally Posted by Barry Santini View Post
    Emetrope: A person who's vision does require glasses, i.e., a prescription.
    This could mean that they have a vision error from -0.50 to +0.75, and spherical equivalents that total this.
    No corrective lenses indicated on license, i.e., 20/40 or better.

    Well corrected emetrope: Theoretically true PLANO; 0.00D

    B
    That is incorrect. Emmetropia is a distance (far) refraction of 0.00. It doesn't say a thing about a need for glasses. (remember presbyopia?)

    And it's possible to have emmetropia in one eye and a significant ametropia in the other.

  13. #113
    Compulsive Truthteller OptiBoard Gold Supporter Uncle Fester's Avatar
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    Quote Originally Posted by drk View Post
    That's why I'm here. I'm going to respond. It will be glorious. And probably futile.
    Our states OD's have already embraced the horror and the sun still comes up in the morning.

    Question- drk, why are you beating your head against the wall?
    Answer- Because it feels so good when I stop!

  14. #114
    What's up? drk's Avatar
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    Quote Originally Posted by Barry Santini View Post
    I thank G** that you and other docs are here, too.

    B
    Don't go all nice on me, Barry. I'm looking for a fight.

  15. #115
    What's up? drk's Avatar
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    Quote Originally Posted by Barry Santini View Post
    Emetrope: A person who's vision does require glasses, i.e., a prescription.
    This could mean that they have a vision error from -0.50 to +0.75, and spherical equivalents that total this.
    No corrective lenses indicated on license, i.e., 20/40 or better.

    Well corrected emetrope: Theoretically true PLANO; 0.00D

    B
    I see where you're coming from.

    I love you, Barry.

  16. #116
    What's up? drk's Avatar
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    Quote Originally Posted by Uncle Fester View Post
    Our states OD's have already embraced the horror and the sun still comes up in the morning.

    Question- drk, why are you beating your head against the wall?
    Answer- Because it feels so good when I stop!
    Because Edmund Burke.


    Quotes
    "The only thing necessary for the triumph of evil is for good men to do nothing."





    "When bad men combine, the good must associate; else they will fall one by one, an unpitied sacrifice in a contemptible struggle."





    "Those who don't know history are destined to repeat it."

  17. #117
    Eyes eastward... Uilleann's Avatar
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    Quote Originally Posted by drk View Post
    That's why I'm here. I'm going to respond. It will be glorious. And probably futile.
    "We who are about to die, salute you!"
    -Opticianus Maximus Americanus

    Quote Originally Posted by drk View Post
    Because Edmund Burke.

    Quotes
    "The only thing necessary for the triumph of evil is for good men to do nothing."

    "When bad men combine, the good must associate; else they will fall one by one, an unpitied sacrifice in a contemptible struggle."

    "Those who don't know history are destined to repeat it."
    Deregulation has been a century long trend in opticianry/dispensing/eyeglasses & contact lenses. It's origins and driving forces can be seen in a number of factors - not the least of which include large, moneyed corporations and their associated lobbyists, ignorant public perception of the value of eye health care vs its actual associated costs, and of course apathetic and toothless organizations nationwide who have done nothing to either educate the public at large, or organize to challenge the managed care and corporate behemoths in their mad race to the bottom.

    I think most of us would embrace a change in the other direction, but this is hardly a new trend and certainly not one that appears likely to change direction at this point regardless of the amount of effort put forth by us "little guys" in the field. Licensure is fragmented and in reality meaningless to the US consumer, particularly with the birth of online dispensing practices. The three Os appear to constantly be at each others throats when it comes to claiming their piece of the patient/client pie. No one can agree on reasonable nation wide education or training scenarios for dispensers in particular. And I would easily estimate that the number of new practices opening that feel they must buy in whole hog to the managed care/buying group/franchise system vastly outpaces the number who remain clear of those options. And of course, in so doing, they give up large swaths of the control of their businesses.

    I don't say any of this to paint an overly pessimistic view of the industry. It simply is what it has become. The shift in towards commodity and retail vs medicine began before any of us were born, and seems likely to continue on well after we are gone.

    My curiosity lies in what the FTC wants to accomplish as it revisits the rule book. Are we wanting to shift the eyewear industry even further away from any resemblance to medicine in any form? Are we wanting to define an acceptable level of potential harm to patients before we draw a line? Are we wanting to define if there is indeed any harm done at all in incorrectly fit/manufactured/dispensed eyewear? Are we wanting to allow the mega corps and managed care to continue to define what patients health and eyecare needs should be and categorize everyone into pre-defined columns which they can continue to maximize their profit bases from?

    Or do we simply want to throw the old rules to the wind, and embrace optical anarchy in all it's post apocalyptic splendor? Would that really be so bad?

  18. #118
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    Quote Originally Posted by drk View Post
    Don't go all nice on me, Barry. I'm looking for a fight.
    We are currently engaged in a fight, I am prepared to take it outside in the parking lot. So far today 1 LC debacle; nice fellow and his poly FT 28, LC can't figure out the problem; 15 min to solve it. The next was a WP, they induced compound prism, along with some of the worst edging I've ever seen. Patient got glasses from me 3 years ago so I provided him with IPD along with an explanation(a reminder of issues he had, that brought him to me 3 years ago). It required 25 min of my time to explain all that went wrong with his WP. He may come back and he may not, it's a "free market". I won't go into all the details but that is 40 minutes of my day. I understand the argument that this brings people back to me for a second time but it also interrupts the flow of my day and my coffee gets cold.
    William Belickis chef/owner of one of my favorite restaurants; Mistral Kitchen (plug), was once asked about the most over-blown dinning concept. His answer; farm to table. His explanation; why brag about something that you should be doing. If your going to be a Bear in my forest you better be a freaking Grizzly. I'm done being Mr Nice, I'm calling out your crap, and If someone is within earshot of our conversation, too damn bad.
    Last edited by Paul Smith LDO; 09-10-2015 at 01:54 PM.
    I didn't attend the funeral, but I sent a nice letter saying I approved of it. Mark Twain

  19. #119
    Master OptiBoarder OptiBoard Silver Supporter Barry Santini's Avatar
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    Quote Originally Posted by Dr. Bill Stacy View Post
    That is incorrect. Emmetropia is a distance (far) refraction of 0.00. It doesn't say a thing about a need for glasses. (remember presbyopia?)

    And it's possible to have emmetropia in one eye and a significant ametropia in the other.
    Interesting...

    Let's create a working definition of emmetropia. Go.

    B

  20. #120
    Compulsive Truthteller OptiBoard Gold Supporter Uncle Fester's Avatar
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    Quote Originally Posted by Barry Santini View Post
    Interesting...

    Let's create a working definition of emmetropia. Go.

    B
    I'd rather see it as a new thread.

    2 cents

  21. #121
    What's up? drk's Avatar
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    Wow, Uilleanne. That was epic.

    There's something kind of Mad Max about your last line, though.Click image for larger version. 

Name:	maxresdefault.jpg 
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  22. #122
    What's up? drk's Avatar
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    Quote Originally Posted by Paul Smith LDO View Post
    Patient got glasses from me 3 years ago so I provided him with IPD along with an explanation(a reminder of issues he had, that brought him to me 3 years ago). It required 25 min of my time to explain all that went wrong with his WP. I won't go into all the details but that is 40 minutes of my day.
    Click image for larger version. 

Name:	The-Simpsons-bully-kid-laughing-Google-Images.jpg 
Views:	14 
Size:	47.6 KB 
ID:	12327

    (Ok, I'm in trouble for that.)

  23. #123
    Master OptiBoarder OptiBoard Silver Supporter ak47's Avatar
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    "For those about to rock, we salute you"

    I prefer Angus Young's quote, "For those about to rock, we salute you"

    Fiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiire !!!

    Quote Originally Posted by Uilleann View Post
    "We who are about to die, salute you!"
    -Opticianus Maximus Americanus



    Deregulation has been a century long trend in opticianry/dispensing/eyeglasses & contact lenses. It's origins and driving forces can be seen in a number of factors - not the least of which include large, moneyed corporations and their associated lobbyists, ignorant public perception of the value of eye health care vs its actual associated costs, and of course apathetic and toothless organizations nationwide who have done nothing to either educate the public at large, or organize to challenge the managed care and corporate behemoths in their mad race to the bottom.

    I think most of us would embrace a change in the other direction, but this is hardly a new trend and certainly not one that appears likely to change direction at this point regardless of the amount of effort put forth by us "little guys" in the field. Licensure is fragmented and in reality meaningless to the US consumer, particularly with the birth of online dispensing practices. The three Os appear to constantly be at each others throats when it comes to claiming their piece of the patient/client pie. No one can agree on reasonable nation wide education or training scenarios for dispensers in particular. And I would easily estimate that the number of new practices opening that feel they must buy in whole hog to the managed care/buying group/franchise system vastly outpaces the number who remain clear of those options. And of course, in so doing, they give up large swaths of the control of their businesses.

    I don't say any of this to paint an overly pessimistic view of the industry. It simply is what it has become. The shift in towards commodity and retail vs medicine began before any of us were born, and seems likely to continue on well after we are gone.

    My curiosity lies in what the FTC wants to accomplish as it revisits the rule book. Are we wanting to shift the eyewear industry even further away from any resemblance to medicine in any form? Are we wanting to define an acceptable level of potential harm to patients before we draw a line? Are we wanting to define if there is indeed any harm done at all in incorrectly fit/manufactured/dispensed eyewear? Are we wanting to allow the mega corps and managed care to continue to define what patients health and eyecare needs should be and categorize everyone into pre-defined columns which they can continue to maximize their profit bases from?

    Or do we simply want to throw the old rules to the wind, and embrace optical anarchy in all it's post apocalyptic splendor? Would that really be so bad?

  24. #124
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    Quote Originally Posted by drk View Post
    Click image for larger version. 

Name:	The-Simpsons-bully-kid-laughing-Google-Images.jpg 
Views:	14 
Size:	47.6 KB 
ID:	12327

    (Ok, I'm in trouble for that.)
    Et tu, drk, et tu. It is a long standing policy, I will provide your IPD if I have made glasses for you. I will now use it to my advantage and point out the short comings of any and all competitors work done using our Rx's and measurements.
    Victorious warriors win first and then go to war, while defeated warriors go to war and seek to win. Sun Tzu
    I didn't attend the funeral, but I sent a nice letter saying I approved of it. Mark Twain

  25. #125
    Compulsive Truthteller OptiBoard Gold Supporter Uncle Fester's Avatar
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    What's say we wind down the thread on this happy note...

    Quote Originally Posted by Uilleann View Post
    Or do we simply want to throw the old rules to the wind, and embrace optical anarchy in all it's apocalyptic splendor? Would that really be so bad?
    It's already upon us!

    The first, white horse, was ridden by optometry. The second, fiery red horse, was ridden by the industry. The third, black horse, was ridden by independent opticals.

    Most Christians know who rides the pale horse.

    http://www.gotquestions.org/four-hor...pocalypse.html

    So basically look in the mirror to see who's at fault.

    Now go carve a niche that let's you survive because it gets much worse after the Apocalypse...




    (This is meant purely as parody.)
    Last edited by Uncle Fester; 09-11-2015 at 10:20 AM. Reason: tweak...

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