Its not you, most articles are a huge snore.
Its not you, most articles are a huge snore.
What is reality but a concept unique to each of us? Can anything be classed as real when our perceptions differ greatly on so many things? Just because we see something a particular way does not make it so.
Barry and other writers need to incorporate the latest business buzzword, "disruption" in all their articles...
https://en.wikipedia.org/wiki/Disruptive_innovation
I like your article "The Doctor is Out". How do these refractors handle people with amblyopia, retinal and macular issues, and cataracts? Do they diagnose or prompt patients to go to a specialist?
What is reality but a concept unique to each of us? Can anything be classed as real when our perceptions differ greatly on so many things? Just because we see something a particular way does not make it so.
Yours and other authors of the techie articles are essentially the only reason I read a particular trade rag. If there's no science, I don't bother looking at it. I also enjoy looking at the new products, influencing my purchasing decisions on occasion.Originally Posted by Barry Santini
I scrolled down to "Music" in the "examples of disruptive innovations" chart and found this bit of worthless dribble.
It did remind me of a quote by Steve Jobs concerning the music industry, and the butchering of sound quality from small file size, low resolution, digital music downloads.In the 1990s, the music industry phased out the single, leaving consumers with no means to purchase individual songs. This market was initially filled by illegal peer-to-peer file sharing technologies, and then by online retailers such as the iTunes Store and Amazon.com. This low end disruption eventually undermined the sales of physical, high-cost CDs.
http://www.dailymail.co.uk/news/arti...#ixzz25Nl4q228Interviewer Walt Mossberg said Jobs had expressed surprise that 'people traded quality, to the extent they had, for convenience or price'.
Science is a way of trying not to fool yourself. - Richard P. Feynman
Experience is the hardest teacher. She gives the test before the lesson.
Of the ones I included, only DVI does a complete medical eval that I know of. And yes, they can request a real-time medical consult with participating physicians.
B
Yes the measurement is is part of the medical chart ONCE TAKEN - and therefor the right of the patient. However, optometrist do not always "record" the PD as part of the routine exam, or in fact perform it. The equipment being used for your exam can make the measurements, but since it is often not "recorded" as part of the exam, unscrupulous practitioners often make use of this loophole in the federal law. If your PD measurement has not been recorded as part of your exam, then they are neither required to then measure your PD for you, or provide you with said measurement. You will often find offices using this 'out'. Professionally I see this as, if nothing else (including horrible ethics) as a violation of their oath. A violation that would not fly in any other branch of healthcare (excepting dermatologists - don't get me started on those hack-jobs). Good medicine is just good medicine, and it's our oath. http://www.aoa.org/about-the-aoa/eth...ric-oath?sso=y
Office of the Professions
Must an ophthalmic dispenser make a patient's pupillary distance measurement available to the patient?
Once an ophthalmic dispenser measures and records the patient's pupillary distance, it becomes part of the patient's records. As such, it would be available to the patient in accordance with the provisions of sections 29.1(b)(7) and 29.2(b) of the Rules of the Board of Regents and section 18 of the Public Health Law.
See all of it; ===========>
http://www.op.nysed.gov/prof/od/odfaq.htm
At the very least try calling the office staff's bluff. Come in a week later and innocently ask for a copy of your entire chart (your right, NYS (as well as many other) limit fees for this to no greater than $0.75 per page) just to see if your PD was in fact recorded by your practitioner (then contact your State Health Dep. of Professional Medical Conduct if lied to). Some decent law makers in Alaska, Arizona, Kansas, Massachusetts and New Mexico mandate that it be included in all prescriptions (hopefully this becomes a reality nationwide in the near future) thus eliminating fully alllllll of this.
Seek a new eye doctor, when booking your first exam make sure to request that a PD measurement be done as part of the exam and be ready to refuse to make an appointment with any practice that wont preform it. Also confirm with your practitioner, when they introduce themselves, that they will be providing you with a PD measurement as part of the exam (avoiding disconnect between promises made by appointment staff in the office, and the actual practitioner). Best wishes for better health, and better health care.
Last edited by E.E.Mort; 11-30-2016 at 11:52 PM.
Thanks for reviving this important topic, we all appreciate this. Curious, which online retailer do you represent? BTW, do you work for free?
Easy there, and no, I don't work for an online anything and don't appreciate your tactics there. I'm in an office like everyone else and hate all the underhanded tactics. Yes going to an optician and bluntly asking for a PD is not right - bad consumer. I was speaking from the perspective of a patient asking their optometrist for their pd - which no ethical optometrist should ever refuse to do.
I have never understood opticians. There is simply no way to provide the consumer with the vast selection available in the market - you just cant. Golden days of opticians is over and trying bully patients to avoid that fact is completely wrong.
Whether or not I work for free is, of course, completely irrelevant in healthcare. Looking for money, become a lawyer instead. That said, no one works for free, PD measurements (should) be bought and payed for as part of their optometrist's exam. If a practice is large enough to employ a optician to do 'service' to eye-wear then so be it. Holding patients hostage with PD measurements is wrong, if feels wrong, it sounds wrong, and you can see that it is wrong buy how many of these forum topics exist in the first place. If you are looking for excuses to coach your office staff with, to avoid giving your patients something they are asking for, its time to take a hard look in the mirror. It's the optometrist's job, they are writing a scrip defining a medical need - all information must be provided so that walking out of the optometrist's office (not optician's) that patient can meet that medical need.
Last edited by E.E.Mort; 11-30-2016 at 11:48 PM.
A PD (pupillary distance) is a mechanical measurement needed .......................
A PD (pupillary distance) is a mechanical measurement needed for the proper production of corrective lenses and their placement in eyeglass frames by the optical lab. So it is not really a part of the medical duty to examine and record it.
This has become a hot discussion point in the optical retail market since the first on-line opticals popped up on the internet.
Today where the most of the successful on line retailers have been bought up by the 2 largest optical corporations, world wide, they have sections on their websites to teach the public how to do, to measure it.
No new information there. And my point of view is that it should be part of the exam. In fact that was my whole point, so.... I disagree
Dear consumer, ( I call you that because if you were in the eye care field you'd know the following). The equipment used by an Optometrist takes binocular pupillary measurements. This is fine for non-aspheric, low power Rxs. But many prescriptions require monocular measurement, and not only a horizontal pupillary, but also a vertical measurement which requires the particular frame to be used fitted properly prior to taking that particular measurement. Pantoscopic tilt is taken into account to adjust the vertical OC placement. In fact, this vertical component is critical in progressive lenses.
Believe it or not, many in our field are concerned about the visual welfare of our patients. Many are anisometropic/Antimetropic. It would be unethical to simply supply a binocular PD to certain patients. You simply can't supply "all the information required" to properly fill an eye glass Rx since it is frame, in position of wear dependent.
If I've taken a PD and you request it I certainly would supply it, but please don't come back to me to trouble shoot why you may be having difficulty with your new glasses, and expect me to perform said service for free.
Last edited by optical24/7; 12-01-2016 at 08:13 AM.
exactly!
...............not really, if it is part of the Rx in New York State you will have to hand it over and can not withhold it.
Who hurt you?
Please, kind sir, provide your credentials re: optometric ethics.
Unfortunately for your argument, the definition of an eye exam is not subject to opinion.
It's up to the prescriber to release "medical records", right?
Maybe I don't read the NY State paper the right way ....................
Must an ophthalmic dispenser make a patient's pupillary distance measurement available to the patient?
Once an ophthalmic dispenser measures and records the patient's pupillary distance, it becomes part of the patient's records.
As such, it would be available to the patient in accordance with the provisions of sections 29.1(b)(7) and 29.2(b) of the Rules of the Board of Regents and section 18 of the Public Health Law.
I'm not saying to withhold it... I'm saying you can't provide the patient with ALL the measurements that they need to order well made glasses by just giving them their PD. The problem is they may need monocular PDs and vertical measurements as well which you can't get with out the frame. So if the pt wants to order online, how can you possibly supply them with everything they need to order well made specs. Unless you have the patient come back in with their frame that they got online and then you go over all their online options and measure them for the SH, PD, Panto, Frame wrap etc. So what Pd do you give them? If you give them just the binocular PD and they get progressives and have a prob, who's fault is it? If you give them binocular distance and they end up getting NVO...who's fault is it? Where do you stop? Just handing over Pds may create other problems.
We touched upon this years ago and defined DIY eyewear as adequate and POW measurements as optimized. Perhaps I'm a skeptical ******* and that all the DIY glasses I've neutralized over the last 15 years were made for people who all have perfect vertical placement in the "B" and 32.0 OU PD. The PD has just become a divisive tool between Refracting OD, DIY entity, and the FTC. The online entity wants to make the PD as the all encompassing critical measurement and that this will ensure Rx compliance.
I didn't attend the funeral, but I sent a nice letter saying I approved of it. Mark Twain
Yes, but patient right to copies of records is well spelled out in the law, as well as a procedure for the to refuse to release them, but good luck getting your reason to pass muster if it isn't absolutely solid. The only professions I have heard that have any luck refusing release are the detailed records from mental health providers.
The PD has just become a divisive tool ............................
You just said it all, and it will work for the online optical industry as it did in the optical retail many years ago.
I dunno. I don't suppose I will add anything useful to the conversation, but if I have the patient's PD and they want it, I give it, but I have always felt that the PD was between the patient and the fitter/dispenser. If I don't have it, because they typically don't purchase their eyewear from us, then I don't feel obliged, nor do I feel unethical.
Now that the online optical industry wants to (not) fit and dispense, they want us to do the work for them. I say if they want to (not) fit and dispense, they have to figure out a way to get their own PDs.
Sorry if I don't want to help you make a living. You're not exactly helping me. And you're not exactly doing the patient any good either by encouraging them to fragment their care. Save a few dollars? In the long run, really?
they advertise their finished products in magazines and mostly on the web ..........
Through increased sales of a few million pairs by the online optical retail industry this year, in which your largest optical corporations own and operate some of the most successful ones, the specialist around the corner will be needed more and more to service the products they are selling.
Their tactic towards the conventional retail trade is by advertising, to make them sell the newest expensive inventions, which are mostly rehashed modern versions of the "deja vue" in the older days, twenty, thirty years ago..
However they advertise their finished products in magazines and mostly on the web at rock bottom prices, but without any hands on service.
If eyeglasses selling opticians as well most optometrists want to keep business as is, they will have to start changing their age old policy of bundling everything into their selling price, to splitting their selling prices into an itemized item as for merchandise and professional service.
I don't know NYS law.Maybe I don't read the NY State paper the right way ....................
Must an ophthalmic dispenser make a patient's pupillary distance measurement available to the patient?
Once an ophthalmic dispenser measures and records the patient's pupillary distance, it becomes part of the patient's records.
As such, it would be available to the patient in accordance with the provisions of sections 29.1(b)(7) and 29.2(b) of the Rules of the Board of Regents and section 18 of the Public Health Law.
If the patient wants their optical "records" and they are determined by NYS to be "medical records", I think I'd be careful of HIPAA, then.
Most physicians' offices now take photo ID and scan it. I would assume an optical would need to do so, too.
Better read HIPAA. https://www.hhs.gov/hipaa/for-professionals/privacy/
I would assume NYS doesn't want to encourage violation of Federal Law. I hope they provide guidance for their optical dispensers, if they're using that trope.
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