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Thread: Tennessee Licensing Sunset

  1. #1
    Rising Star
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    Tennessee Licensing Sunset

    Hi All:

    The following correspondence was sent to optometrists in Tennessee from the Tennessee Optometric Association. I thought you might be interested in the reasoning behind efforts to eliminate optician licensing.

    Roy R. Ferguson, PhD

    TO: TOA Membership
    FROM: Gary Odom, Executive Director
    RE: General Assembly Review of Optician Licensing Law
    DATE: February 3,2003

    During the next few months the Tennessee Licensing Board for Opticians will once again undergo a "Sunset" review by the Tennessee General Assembly. The sunset review is a process where each agency of State Government is reviewed periodically in order to determine if the agency has a mission that is important for the general public and further that the agency is completing that mission in an effective manner. Agencies that fail to meet these standards are discontinued under the "Sunset" process. The actual "Sunset" or termination of an agency occurs when the laws creating the agency are not re-authorized by the General Assembly. The Government Operations Committees of the Legislature are responsible for the conducting the review but in order for an agency to be continued there must be legislation enacted by the full House and Senate.

    The TOA Board has maintained a position of supporting the legislature's effort to fully review the merits of a licensing process for opticians. The TOA Board has been very concerned about the State Opticians' Association attempting for several years to repeal the apprenticeship route for licensure and mandating a two-year degree as the only route to licensure. Most opticians in the state, including all current members of their Licensing Board, have become licensed through the apprenticeship route. Currently, only Roane State Community College in Harriman offers an associate degree in optician science. Clearly an elimination of the apprenticeship route for licensure would reduce dramatically the number of opticians in this state which would increase the cost of eyewear to consumers. Further, there is no objective evidence that the associate degree in optician science prepares the optician any better to perform the services they are currently licensed to perform. There was even a period when Roane State was teaching refraction to optician science students as opposed to only basic optician skills and the Optician Association of America has supported legislative efforts in other states authorizing opticians to perform refraction. Currently Canadian opticians are seeking authority to perform glaucoma testing and stand-alone refraction without supervision from an optometrist or ophthalmologist. "In reality, they want to produce a prescription to sell more eyewear," said Alberta Association of Optometrists Executive Director Peggy Sloan in a recent AOA News article. In addition, there is no evidence that the Tennessee Opticians Board has done anything to protect the public. In recent years, the only disciplinary action taken against opticians has resulted from opticians failing to complete the Board’s continuing education requirement.

    We wanted to once again summarize why the TDO Board believes the legislature should closely examine the merits of licensing opticians in Tennessee.

    1. Only 21 states license or regulate opticians. All these laws were passed prior to 1982. Not a single state has passed a licensing law for opticians in the last 18 years. This is evidence that there is no strong public policy reason to license or regulate opticians. Contact with those states that do not license opticians indicates that there is no difference in the quality of optical services nor is there a proliferation of optical shops as the TDOA suggests.
    2. For four years the Tennessee Dispensing Optician Association tried, with the help of the Opticians Board, to convince the legislature to pass a bill eliminating the apprenticeship route to licensure and requiring all persons wanting to be licensed as opticians to complete a two-year educational program at Roane State Community College. The legislature thought their proposal was a bad idea and refused to pass the bill. In 1999, the Opticians Board took matters into their own hands and adopted a rule requiring one year of formal education at Roane State Community College to be licensed as an optician, This was done contrary to the advice of the Board's own attorney. The State Attorney General ruled in - February 2001 that this rule is illegal and cannot be enforced. We should all be concerned about a Board which flagrantly ignores the advice of its own legal counsel as well as the intent of the legislature.
    3. The persons who work in the commercial labs - filling the prescriptions from eye doctors - are not required to be licensed under the current law. In fact, there are only a couple of licensed opticians working for commercial labs in this state. Persons employed by optometrists and ophthalmologists are not licensed and frequently perform the same functions as opticians. There is no objective evidence that the quality of services provided by these trained but unlicensed personnel is in any way of less quality than those provided by licensed opticians.
    4. The public does not benefit from the licensure of opticians. In fact, the argument can be made that the public probably pays higher prices for their glasses because of the licensing law. Allowing the board to sunset would seem to be in the public's best interest.

    In order for the optician licensing act to be continued legislation will need to be passed to extend the life of the licensing board If this legislation does not pass the licensing law will expire. I have attached a listing of the House and Senate Government Operations Committee. I will continue to keep the membership informed about this issue during the course of this session.

  2. #2
    Optical Educator
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    interesting timing, Roy

    Hi Roy,

    Isn't it interesting that we are currently having a discussion of how the 3 O's should work together?

    It is time for opticians to take their heads out of the sand and wake up and take action.

    PS: I am sure that you will be extremely helpful in fighting this, including letting the legislature know that people can also receive their AS degree via distance learning and do have access. Is there anything we can do to help? Mark Miller from our board has alot of good data and can help out as well.

    Can TN opticians fit CL?

    Best Regards, Doctor,

    : )

    Laurie

  3. #3
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    Good Luck!

    Dr. Ferguson:
    I know you and others will fight the good fight. Many ODs who post regularly here should read this clearly to understand why Opticians feel disdain towards their profession. It is ridiculous to claim on one hand that they should be allowed to advance educationally and at the same time limit us. There is limited research that shows people who have been trained in schools fare much better on board exams than those who train via Apprenticeship. It makes sense to recognize that education is an important and necessary issue unless you are competing with us, then you want to hold us down as much as possible. If the ODs were sincere about their professional integrety, they would strongly support legislation for us, not fight us at every turn! Optometry would like us out of the picture. And talk about access; there are only 16 or 17 Schools of Optometry. At least we have Apprenticeship as poor as it is. Our access is far greater than Optometry. I have many good friends in Optometry and they are generally good people, but it is ridiculous for them to constantly mix in our affairs. Refraction will not cause deadly disease. It would not hurt for Opticians to learn to refract. We would not be able to do it independently without specific legislation....but then that is how they got pharmecutical agents isn't it?

    Now to our own....we are our own worst enemy. We want to remain a licensed health care profession, but aren't willing to put forth the sweat it takes to move ahead. We MUST educate ourselves to a higher level just to remain status quo. We guard Apprenticeship like it was the Holy Grail, and don't recognize we are the ONLY health care profession that still utilizes it, for good reason: it is an ineffective method of training dependent on the iindividual trainer. We have such varied definitions from state to state that even we don't know what we are. Many Opticians on this board don't believe in licensing, and will probably be thrilled that this is happening, but I deeply feel they are wrong. We need legislated recognition in every state, not just 22 of them. In many educational sessions I see Opticians who can't perform even the simplest computations. How can they correctly analyze an Rx? We must break from the tradition and move into the 21st Century. If not, Tenn. will not be the only state suffering. We all need to come to the side of the Tennessee Opticians NOW. The factions within the state need to once and for all get over it and move to the common good. The national leadership must stop jockeying for personal gain and support the states. Roy...let me know if my services are needed in any way. I will be glad to come to your state and help whenever necessary. I know others will too. Please call me if you need me, and for those reading this: heed the warning! This is important.

    Warren

  4. #4
    Bad address email on file dfisher's Avatar
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    This has been an ongoing battle in many states for many years. In spite of the fact that removing licensure will also allow chain stores and independent optical establishments to employ unlicensed, untrained opticians they continue such pursuits even at their own peril. If someone can help me find a rational motivation for optometry to act in such a manner, please rattle my cage! The only reason I can think of for these actions is to attempt to discredit the professionalism of qualified opticians.

    The lettter to Dr. Ferguson attacks opticians for improving their knowledge and striving to learn new skills when optometrists have won the right to use diagnostic and theraputic drugs, in many states after only 100 hours of training. (And no, folks, those are not semester hours). Many states allow the insertion of punctal plugs, epillation, foreign body and rust ring removal, and perhaps even laser and minor surgery with similar levels of formal experience. Optometry is clearly making its move into the realm of ophthalmology and doing so with minimal training and maximum political effort. So why would optometry oppose phasing in required formal education for opticians? Is it perhaps it would give opticians legitimacy in lobbying to widen their scope of practice as well?

    It does take a great deal to get some opticians off their duffs and work for their profession, but I sincerely the Tennessee opticians rally around the cause for this one. They would certainly have a great leader for the cause in Dr. Ferguson.

    I strongly encourag any optician in the state of Tennessee who is not currently a member to join the TDOA (Tennessee Dispensing Opticians Association. To the opticians of TN, I'll quote the TDOA.org website:
    ALL LICENSED OPTICIANS SHOULD REMEMBER WHO IS FIGHTING TO MAINTAIN OUR LICENSE AND WHO IS PAYING THE MONEY. IT IS THE MEMBERSHIP OF THE TENNESSEE DISPENSING OPTICIANS ASSOCIATION

  5. #5
    Master OptiBoarder Joann Raytar's Avatar
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    dfisher said:
    So why would optometry oppose phasing in required formal education for opticians? Is it perhaps it would give opticians legitimacy in lobbying to widen their scope of practice as well?
    Scope of practice may be a big part of the issue but I am going to bet money is the other half. Educated employees mean more payroll dollars paid out. Current employees already request that their license fees be paid by employers; I am sure money for education would also be on their wish lists. There is also the issue of employee turnover. The more real education behind a title, the more marketable a person is; so much for cheap labor. Unfortunately, most folks don't understand that well trained, well educated personnel should increase the money taken in.

    On another track, why does the opposition always seem to ignore the fact that the reason there may be so few public complaints or disciplinary actions may be because the profession is regulated? Perhaps mandatory training has something to do with it? Perhaps losing your license and not being able to practice in a licensed optical shop has something to do with it?

    Each profession (all three O's) seems to want to put the other under the gun for something. Honestly, this really is starting to look like utter nonsense. It is unseemly and very unprofessional. It is no wonder the public sees no problem turning to such companies as 1-800 Contacts, not getting regularly scheduled eye exams and the like. What have the retail and professional ends of the optical fields really done lately to maintain the public's respect? If we all keep fighting within the field, all of us are going to loose whatever public respect is left.

    I should have become a dental hygenist.

  6. #6
    Cape Codger OptiBoard Gold Supporter hcjilson's Avatar
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    I'm glad I'm ending my career....

    I'm glad I'm ending my career not beginning it. I cannot believe the ignorance shown by me/dr odam. He sure must be hard up for some REAL topics for Optometry today.

    FNGAH! (Old Irish expression concerning to a part of the anatomy referred to elsewhere in these pages by the current member of the Month!)

    Done for the day!
    hj
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  7. #7
    Master OptiBoarder Joann Raytar's Avatar
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    Wait a minute ...

    I thought I've heard the gentleman's name before. He is a member of Tennessee's House of Representatives as well as being an Optometrist, GARY ODOM, D - Nashville, District 55 - Part of Davidson county. CSPAN comes in handy sometimes. There isn't going to be a conflict of interest on that vote now is there.

    I would suggest that the Opticians of Tennessee vote Republican in District 55 next term. I also hope that the Opticians of District 55 outnumber the members of the TOA.

    Hmmm. He has been given Legislator of the Year Awards from nurses, chiropractors, physicians assistants and physical therapists. All of these professions, except for chiropractors, are similar in nature to opticians and yet he wants to deregulate opticianry. I think the gentleman is obviously biased here.

  8. #8
    Bad address email on file dfisher's Avatar
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    Jo
    Thanks for the info. The political strategies of optometry are exactly what yielded them the broadened scope of practice they now have. Even when they cannot place an optometrist in state legislature their warchests are full of policital action monies to buy the votes they need to champion their cause.

    Opticians as a whole lack the political clout the optometrists enjoy. There was a time long ago when the OAA helped to overcome the advantage the optometrists held in imortant state issues. I certainly hope the "new" OAA will again take up the sword for the opticians cause.
    Last edited by dfisher; 03-14-2003 at 11:51 AM.

  9. #9
    Bad address email on file NC-OD's Avatar
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    Friends,

    Please don't link all OD's together. I am not privy to any state legislatures or state boards, but I have been racking my brain and can't really think of a good reason to prevent Opticians from becoming or maintaining licensure or gaining formal education. I don't think money is a very big factor.

    Personally, I think everyone should get as much education as they can put up with.......the more the merrier.

    There may be some good reason for preventing Optican licensing but I really can't think of any. If anyone can give me a few possibilites, I will be glad to "ponder" them. Hell, I would be happy if everyone from the clerk at McDonalds to my plumber got a college degree...........it can't hurt!

    I am really confused or must be missing something Somebody help me out. I mean, from my standpoint, what difference does it make one way or another?

  10. #10
    Master OptiBoarder chm2023's Avatar
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    Can someone explain the (short!) history of why there are 3 Os in the US, whereas in other parts of the world usually 2--e.g. Brazil has only MDs (the only ones who can refract and write an Rx) and opticians who fabricate the products; Europe has MDs and opticians who can refract and are closer to optometrists in terms of education, college plus 3 if I remember correctly. Just interested in why/how the US developed differently.

  11. #11
    OptiBoard Professional Dannyboy's Avatar
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    Opticians during sunset should try to introduce a bill reinforcing opticianry practice without expanding scope of practice. Afterward, opticians should talk with the OD group. Tell them that you will not attemp to expand the profession for an x amount of time if they support the bill that reinforces opticianry practice.

    If they decline then the fight must go on to another level. Find legislator that will modify the bill to bill expanding the scope of practice and join forces with the MDs..The ODs may have money but most likely there are more opticians...Mds on the other hand would love to see ODs sweat a little...Maybe Tennesee will be the first state to gain refraction.....trust me the MDs want to this.

    I strongly believe that MDs will support a model for refraction by opticians that is similar to the PA (Physician Assistant) model. Nothing wrong in getting in the door that way! Lets faces refraction will not make us rich but will certainly add more leverage.

    Unity and patience.....I see hundreds if not thousands of letters to the legislators......Maybe the guy who wrote the letter will have the tail in between the legs if the Opticians of Tennessee perform as good as the LDOs from Florida.

    Just a thought.


    Dannyboy

  12. #12
    Master OptiBoarder Joann Raytar's Avatar
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    Dannyboy said:

    Unity and patience.....I see hundreds if not thousands of letters to the legislators......Maybe the guy who wrote the letter will have the tail in between the legs if the Opticians of Tennessee perform as good as the LDOs from Florida.
    Unfortunately, the guy who wrote the letter is a legislator. Let's hope he doesn't have too many "friends" in TN House.

  13. #13
    Cape Codger OptiBoard Gold Supporter hcjilson's Avatar
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    To NC-OD,

    Thank you for reminding us not to paint with too broad a brush. I am positive most of us are aware that not all OD's feel as Dr Odam does. Frankly I don't really think Dr. Odam believes what he says.No one who insists that his barber have a license could be that stupid!

    Nice to see you posting again!
    hj
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  14. #14
    Master OptiBoarder Joann Raytar's Avatar
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    (I don't know if this is the best time on OptiBoard to post this but here goes.)

    Review of Optometry: Optometry Under Fire; Because the profession has gained so much, does organized medicine have optometry in its sights?
    Vol. No: 139:01Issue: 1/15/02

    A Cure for Fat Cat Syndrome
    “We suffered from the fat cat syndrome,” Florida’s Dr. Foreman explains. “We were doing reasonably well in our practices, and treating our patients properly.” So O.D.s became complacent and dropped their guard.

    “Florida optometrists almost had to learn the hard way the consequences of letting our guard down,” he says. “We cannot blame anybody else but ourselves for getting in that position.”

    But by introducing the comanagement bill, optometrists’ adversaries in Florida have made the mistake of waking them up, Dr. Foreman says. “They’ve regenerated and rejuvenated us. We’re so much better organized and funded now, it’s going to be very hard for them to take us on again.”

    Nevertheless, one threat the FOA is watching is the combined force of semi-practicing ophthalmologists and would-be refracting opticians. The association successfully defeated an opticians’ refracting bill before. That bill would have allowed opticians to refract specifically under the general supervision of an ophthalmologist, likely one who would reduce his privileges in anticipation of retirement. That ophthalmologist could have virtually an army of refracting opticians working under his supervision.

    That’s like fighting two allied enemies on two fronts (also known as a pincer attack, double envelopment, or “hammer and anvil,” in the theater of combat). “It’s a pretty scary scenario, but it could occur,” Dr. Foreman says.
    Review of Optometry: The Case for Supporting Your Legislator
    Vol. No: 139:01Issue: 1/15/02

    To gain the support of legislators, you need to support them. For the most part, that’s done by spending time. But it can also mean spending money.
    “We hear it a lot, that contributing to a campaign is buying votes. But in reality that’s not true,” says Peter Kehoe, O.D., AOA board of trustee liaison to the AOA’s advocacy center. “The contributions of time and money are really no more than to help [legislators] stay in office, get elected or get re-elected.”

    What really counts—historically as well as in the future—are the personal relationships that optometrists can forge with their elected officials, Dr. Kehoe says. And that’s where optometry’s strength lies.

    “Optometry has never outspent its opponents. It’s outworked them. It’s a grassroots organization that has succeeded due to these personal relationships,” says Jerald Combs, O.D., chair of the AOA’s state government relations center.

    “It takes every single optometrist to give either financial or general support to their legislators as well as to the association leadership so that as we move forward we speak as one voice,” Dr. Kehoe says. “And for over 30 years we’ve done a good job, and we need to continue that.”

    But optometrists have become complacent after legislation has gone their way. And, optometrists who’ve graduated into therapeutic privileges don’t consider that those privileges can be withdrawn.

    “Optometrists have to realize that political action is part of their overhead, that they have to give money and be politically active in order just to stay where they are,” says Jim Stephens, O.D., legislative co-chairman for the Florida Optometric Association.

    How can you get involved? Here’s what Drs. Kehoe and Combs suggest:
    • First, contact your local or state optometric association (even if you’re not a member) and find out what district you’re in, who your representative and state senator are. (You may have different legislators at home and at the office. Ask for the names of all of them.) Ask what kind of relationships other colleagues have built with these legislators.
    • Call the legislator’s office. Offer to help in any way—to work a phone bank, distribute fliers or lawn signs, or participate in a fund-raiser. Explain that you welcome any calls or questions the legislator might have about any health-care issue. “There isn’t a legislator out there who won’t call you when you offer to help,” Dr. Kehoe says.
    • Learn what the hot topics are in your district. Your thoughts on health-care issues will be respected when you can also speak intelligently on other issues.

    “You know you’ve reached the point where you’ve got a good relationship with a legislator when he calls you and says, ‘There’s a bill here on my desk … What do you think about it?’” Dr. Kehoe explains. “That’s the goal.” —J.M.
    It appears this is what Rep. Odam is trying to do.

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    Warren:

    ..I agree with Warren completely. You offered to help the Tennessee writer, too. What can I do to help? Be specific. Is this also something the OAA will be involved in to help TN opticians keep their license? They are here for us. The OAA is our legislative arm. If you are from the OAA, and you are reading this: HELP IS NEEDED IN TN NOW. Michael.

  16. #16
    Master OptiBoarder Joann Raytar's Avatar
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    Tuesday, May 13, 2003, House Bill 1456 will be considered in the House Government Operations Committee at 10:30 AM, Room 29 Legislative Plaza and the companion Bill, Senate Bill 0220 will be heard in the Senate Government Operations Committee on Wednesday, May 14, 2003 at 1:30 PM
    http://www.tdoa.org

    Click on Legislative Report News for the information.

  17. #17
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    Re: Warren:

    mjh said:
    ..I agree with Warren completely. You offered to help the Tennessee writer, too. What can I do to help? Be specific. Is this also something the OAA will be involved in to help TN opticians keep their license? They are here for us. The OAA is our legislative arm. If you are from the OAA, and you are reading this: HELP IS NEEDED IN TN NOW. Michael.
    Send e-mails and phone calls before Monday morning.

    I am posting an e-mail that Happy Moyer send out to some of us. I've sent e-mails to both the house representative, Mike Kernell, and Senator Thelma Harper. Each of you should do the same. Happy is right. It is like a domino effect.

    Diane

    Hello, All!

    Many of you will remember 2 years ago when the Dispensing Opticians of Tennessee had to fight to keep their state license to dispense eyeglasses. We need your help again!

    We have a bill in the House and Senate that will extend the Dispensing Opticians license for 6 years ( the normal extension for a government regulatory agency). Please help by sending an email and placing a phone call to the Chair of the House and Senate Government Operations Committees:

    ** Rep. Mike Kernell, Chairman rep.mike.kernell@legislature.state.tn.us
    VOTE YES for House Bill 1456 1-800-449-8366 ext.13726

    ** Senator Thelma Harper sen.thelma.harper@legislature.state.tn.us
    VOTE YES for Senate Bill 0220 1-800-449-8366 ext.12453

    Urge them to vote YES to extend the Board of Dispensing Opticians in order to protect the citizens of Tennessee by having licensed, trained and skilled Opticians dispensing prescription eyewear.

    Please send emails and make phone calls by Monday, May 12 so they will have time to get them before the committee meetings.

    This is important to all Opticians. Should Tennessee lose their license, it will be a domino effect across the country - everyone will lose!

    Thanks for your help. If you have any questions, please contact me.


    Opticians Help Tennes SEE!



    Many Thanks,
    Happy Moyer
    6194 Amber Brook Drive
    Chattanooga, TN 37343
    Anything worth doing is worth doing well.

  18. #18
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    I just sent my 2 emails to the Congressman and Senator and it is so important for everyone on this optiboard to do the same. Doesn't matter which of the 3 O's you are. Do this please for our friends in TN. I am not from Tennessee, but this is the right thing to do.
    Also, will those of you in TN please keep us updated when a decision has been reached? Thanks. Michael.

  19. #19
    Optiboard Professional Bill West's Avatar
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    Optometry a real PIA

    Roy,
    I knew the first time I heard you mention Opticians learning to refract in a seminar in North Carolina, you were going to open a big can of worms. I had also heard Dr. Mac. suggest the same thing.
    I don't really know why any good Optician would want to refract, when the good money is in selling eyeglasses.
    Play politics and lose big bucks. Leave it alone and keep your money and let the public decide where to spend their money.
    Last edited by Bill West; 11-08-2009 at 09:05 AM.

  20. #20
    Manuf. Lens Surface Treatments
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    Shame.........................

    [Quote]

    This is evidence that there is no strong public policy reason to license or regulate opticians. Contact with those states that do not license opticians indicates that there is no difference in the quality of optical services nor is there a proliferation of optical shops as the TDOA suggests.

    [/QOUTE]

    Which means the public can get cheated by opticians with no license, being a garbage collector one day and an optician the next.

    And the public has trust in you to fill a doctors prescription like they feel going to a pharmacy.

    The FDA controls the import of spectacle frames because they are a device.. They control and aprove anything that goes on glasses from hard coats to lens dyes because anything going on a prescription is a device.

    How come the FDA does not get involved by controlling the sale of devices to the publicas they are called. If you can be garbage collector one day and a device seller the next, the FDA should step in.

  21. #21
    OptiWizard
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    I'm an OD and am pro-licensure. I've a few comments, and some are anti-OD. (some OD's)

    Many OD's have a chip on their shoulder when it comes to Ophthalmologists and very much want to erode their domain or scope of practice. Yet those same OD's don't want opticians to progress into traditional optometry.

    If you are going to dish it out, be ready to take it.

    Many states are now requiring an OD's staff to be licensed opticians if they dispense, I think this is where the TN sunset thing is coming from. In the past the opticianry laws seemed to be geared only to the private opticians and the chains.

    Myself, I'd like to see the chain competition crash and burn, so no tears would be shed if my state dropped optician licensure. My staff is well trained and we are very good at being smug.

    Harry

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