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Thread: Ethics in today's opticianry...

  1. #26
    What's up? drk's Avatar
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    Our office may be smaller than yours. We all know what lenses we use, and we often discuss the individual case and I'll sometimes have a recommendation on a specific design, if it's not "typical". I saw the patient first. Sometimes it works in reverse, depending.

    So, it's not a turf war, right?

  2. #27
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    Turf war! NOOOOO! If it feels like that, it's time to go. Everyone should work together as a team. If you're all on the same page then it should be a smooth process. ODs are good at ODing and Opticians are good at opticianing. One should support the other and vice versa. Doing some CE meetings on both sides will help everyone to work together. ODs should know some of what's out there and what can help their patients and Opticians should know some stuff in exam rooms so they know what situations their products can help with.

  3. #28
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    And office size doesn't matter. I've worked in different size offices.

  4. #29
    What's up? drk's Avatar
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    I would imagine in a big ophthalmology office with a couple of ODs that they would be slammed doing ophthalmology and wouldn't have the time to keep up with optical.

    In my world view, though, a "true" optometrist practicing "true" optometry can do what an optician can.

    But more and more ODs are doing what I'd call "ophthalmology". I know I'm getting the demand for that kind of service in my private practice, BIG time. Half of what I do is ophthalmology.

    In my world view, a "true" optician pretty much practices optometry sans refracting. There's a ton of overlap between our professions. At least, there used to be. (That's why Barry hate him some optometry--he old skool.)

  5. #30
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    You're right about that. I've worked with many ODs that are wanna be Ophthalmologists. That being said, they should still have a clue! Most now don't want to even think about optical. I even had an OD that almost never refracted! He doesn't like it so most of the exams are turned into medical exams and refractions are skipped. It is not unusual for a patient to have refractions that are 6+ years old. Then they decide to get glasses and it becomes an issue. "I was just seen the other day!" and I have to explain that was a medical visit and no refraction was done. Ugh. I get that a lot of what the ODs do now is medical but I can't stand seeing the other stuff go by the wayside. I'm not saying the OD should know all of optical, but enough that they can perhaps recommend a some stuff and tell the patient to talk to the opticians about it. A small conversation like that only takes a minute. Same with opticians... we should understand some stuff to help the patient and then send them to the OD. There is definitely an overlap.

  6. #31
    Compulsive Truthteller OptiBoard Gold Supporter Uncle Fester's Avatar
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    Doing some CE meetings on both sides will help everyone to work together.
    Mandatory after hours on work/life balance are my favorite meetings.

  7. #32
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    Quote Originally Posted by mervinek View Post
    I love it when the ODs know what they're talking about and can make a suggestion of what to discuss with the optician, but then lets the patient know that the optician is the one who will know best about that stuff and can discuss it more thoroughly. Like maybe the OD can say the patient should discuss computer glasses or sunglasses with the optician and the optician can take it from there. I don't like it when the ODs start to get into the lens design by saying a specific lens for a patient. It gets weird and it makes the opticians look like they don't know what they're doing.

    I also don't like "selling in the exam room." I'm not a salesperson! I'm an optician. I educate my patients and help give them the best vision I can. I don't sell. If an OD educates a patient in the exam room, it does help. But not just "selling". Ugh
    You can call it whatever you want, recommending the best product that will help give patients/customers their best vision is sales. That is what we do. We aren't giving away what we believe is a flattering frame for their face, the best progressive lens, in the best material with primo AR for FREE. We SELL it to our customers. You can be a used car salesman, or you can sell more like you do through education. How we sell is on a spectrum. I believe it is much better to sell like you do than a used car salesman. I even said it in my first response to Fes that it's better to be honest with a customer that their Rx has not changed much than to sell to them anyway. But it is all still sales ¯\_(ツ)_/¯

  8. #33
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    Quote Originally Posted by mervinek View Post
    And office size doesn't matter. I've worked in different size offices.
    It's not the size of the office, but the motion of the ocean that matters...

  9. #34
    What's up? drk's Avatar
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    Quote Originally Posted by mervinek View Post
    you're right about that. I've worked with many ods that are wanna be ophthalmologists. That being said, they should still have a clue! Most now don't want to even think about optical. I even had an od that almost never refracted! He doesn't like it so most of the exams are turned into medical exams and refractions are skipped. It is not unusual for a patient to have refractions that are 6+ years old. Then they decide to get glasses and it becomes an issue. "i was just seen the other day!" and i have to explain that was a medical visit and no refraction was done. Ugh. I get that a lot of what the ods do now is medical but i can't stand seeing the other stuff go by the wayside. I'm not saying the od should know all of optical, but enough that they can perhaps recommend a some stuff and tell the patient to talk to the opticians about it. A small conversation like that only takes a minute. Same with opticians... We should understand some stuff to help the patient and then send them to the od. There is definitely an overlap.
    amen

  10. #35
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    Old school OD's took many more classes on optics, newer school OD's take more classes on medical issues. I have no problem with OD's going towards a medical model, just wish optometry schools would also teach optics to a higher standard as well. The doctors I like working with the best have a pretty good idea of what is going on with the optics of the glasses they are recommending. They were either opticians before or have owned their own finishing labs and worked in them.

  11. #36
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    Quote Originally Posted by NAICITPO View Post
    You can call it whatever you want, recommending the best product that will help give patients/customers their best vision is sales. That is what we do. We aren't giving away what we believe is a flattering frame for their face, the best progressive lens, in the best material with primo AR for FREE. We SELL it to our customers. You can be a used car salesman, or you can sell more like you do through education. How we sell is on a spectrum. I believe it is much better to sell like you do than a used car salesman. I even said it in my first response to Fes that it's better to be honest with a customer that their Rx has not changed much than to sell to them anyway. But it is all still sales ¯\_(ツ)_/¯
    I get it... it is still sales, but don't call me a salesman. I feel like educating the patient makes it a little different. I worked with an optician who sold whatever he could. -0.50 sph? You need 1.74! Everyone should get AR!...you're a mechanic? Who cares... I'm making the sale! I cringed listening to him. I provide the information to the patient and let them decide what to get. And you're right... if you're honest, they'll come back again and again. Patient loyalty makes a huge difference. They tell their friends and family and then you have a well established office. Instead of a place where you only see patients once. You made XXX off that patient once...but when you have a lifetime patient... you're making way more and you're doing good! You're helping them and providing them with goods and services they are happy with.

  12. #37
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    Quote Originally Posted by NAICITPO View Post
    Old school OD's took many more classes on optics, newer school OD's take more classes on medical issues. I have no problem with OD's going towards a medical model, just wish optometry schools would also teach optics to a higher standard as well. The doctors I like working with the best have a pretty good idea of what is going on with the optics of the glasses they are recommending. They were either opticians before or have owned their own finishing labs and worked in them.
    The best OD I worked with was the one who spent time learning about the different lenses. You could have a conversation with him if you had a patient who was having problems with their glasses. As they say... 2 heads are better than one! (There is always that one patient who has issues and sometimes it takes a village to figure out what to do with them). I find that a lot of the ODs that are the wanna be ophthalmologists are the ones that just look at you and say... the problem isn't the Rx, it's the glasses figure it out. And... you and the patient are dismissed.

  13. #38
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    Quote Originally Posted by mervinek View Post
    I get it... it is still sales, but don't call me a salesman. I feel like educating the patient makes it a little different. I worked with an optician who sold whatever he could. -0.50 sph? You need 1.74! Everyone should get AR!...you're a mechanic? Who cares... I'm making the sale! I cringed listening to him. I provide the information to the patient and let them decide what to get. And you're right... if you're honest, they'll come back again and again. Patient loyalty makes a huge difference. They tell their friends and family and then you have a well established office. Instead of a place where you only see patients once. You made XXX off that patient once...but when you have a lifetime patient... you're making way more and you're doing good! You're helping them and providing them with goods and services they are happy with.
    100% agree with you, the optician who sells 1.74 to a -0.50 sph customer is bad for business and bad for our profession. And I agree honesty is the best policy, again to go back to what this thread was on--I will check the VA of the new rx and if it hasn't changed even though the Rx did I will let them know. Then the conversation for me becomes about what else we can do to make their life better and use their vision insurance in the process? Do they want a 2nd pair of glasses to have a new look? When was the last time they updated their Rx suns? If they are on the computer for 8 hours a day have they considered a NVF pair?

    You get the picture... it is not about selling to sell, it's about selling to make their life better. We have solutions to helping people with visual issues see better, if they don't want what we have to offer that is fine. BUT, you should at least try! Too often in other practices I would see doctors bring their patient out and say they don't need new glasses without going through the process I just laid out. That's way too timid and the wrong approach because the customer doesn't know what they don't know. The "salesman" you mentioned, selling 1.74 to people who don't need it is way too far on the other end of the spectrum. There's a happy medium that should be optical sales.

  14. #39
    Master OptiBoarder OptiBoard Silver Supporter Barry Santini's Avatar
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    Why is that is all these multiple pair/need-based eyewear discussions, no one brings up style?

    Hmm.

  15. #40
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    Quote Originally Posted by Barry Santini View Post
    Why is that is all these multiple pair/need-based eyewear discussions, no one brings up style?

    Hmm.
    Quote Originally Posted by NAICITPO View Post
    100% agree with you, the optician who sells 1.74 to a -0.50 sph customer is bad for business and bad for our profession. And I agree honesty is the best policy, again to go back to what this thread was on--I will check the VA of the new rx and if it hasn't changed even though the Rx did I will let them know. Then the conversation for me becomes about what else we can do to make their life better and use their vision insurance in the process? Do they want a 2nd pair of glasses to have a new look? When was the last time they updated their Rx suns? If they are on the computer for 8 hours a day have they considered a NVF pair?
    I did mention it, and it was the first thing I mentioned in the list.

  16. #41
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    I always review previous rx or wearing rx, if the question is asked, I'll trial frame or hold loose lens over their wearing to show them the difference. I have had the "WOW so much better" with just a 0.25 change and the "I see no difference" with a 0.75 change. Then I look at the lens condition, frame condition and give my advise accordingly, I have had many patients follow me to my 3 different optical offices just for being honest and straight forward. May not get the sale today, but will get it eventually. I will always question the Doc if something doesn't look right, even if the Doc is from a different office. Our job is to provide the best product with the best knowledge.
    Roy W. Jackson, Sr. ABOC

  17. #42
    Master OptiBoarder OptiBoard Silver Supporter Barry Santini's Avatar
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    Quote Originally Posted by NAICITPO View Post
    I did mention it, and it was the first thing I mentioned in the list.
    A “new look” is not the same as being “styled.”

    B

  18. #43
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    I think it's important to make sure the patient's expectations are not too high. Our doc wants everyone in PALs even if they are 20/20 for distance, and I am happy to do that for patients who WANT to wear their glasses all the time and don't want to bother with using readers, but not every patient wants that. Especially if they could get away with an OTC reader versus spending hundreds. I will tell people if there isn't a meaningful RX change and let them decide. I just hate when there is nearly no change in script, and then they pick up the glasses and complain that the lenses are no better than the old pair. Well, duh.

    I am very grateful for our doctors making lens recommendations, don't get me wrong, but we still have to consider what the patient wants, needs, and will benefit from. I LOVE when a patient says the doctor recommended anti-glare or a freeform PAL or a therapeutic tint. Makes it easier to get the patient what will actually help them. They really take what a doctor says seriously, as they should.
    Krystle

  19. #44
    Master OptiBoarder OptiBoard Silver Supporter Barry Santini's Avatar
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    Quote Originally Posted by KrystleClear View Post
    …I LOVE when a patient says the doctor recommended anti-glare or a freeform PAL or a therapeutic tint. Makes it easier to get the patient what will actually help them. They really take what a doctor says seriously, as they should.
    Hmm. So close to it, many still don’t recognize the COI.

    B

  20. #45
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    Hmm. Who is "so close to it"?

  21. #46
    Master OptiBoarder OptiBoard Silver Supporter Barry Santini's Avatar
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    Quote Originally Posted by drk View Post
    Hmm. Who is "so close to it"?
    The staff who works under the doctor, and helps with the eyewear subsequent to the exam.

  22. #47
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    Who has the conflict of interest?

  23. #48
    Master OptiBoarder OptiBoard Silver Supporter Barry Santini's Avatar
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    The potential conflict resides in the prescriber’s name brand product recommendations

  24. #49
    What's up? drk's Avatar
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    Why is an optician exempt from conflict of interest, then?

    Are prescribers/physicians subject to conflict of interest regarding contact lenses, IOLs, insulin pumps, medications and diagnostic tests?

    Why pick on optometrists? Are we that low a breed of human?

    You've erected a castle in the sky, Barry.

  25. #50
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    When I was brand new in the industry, working in a wholesale lab we had an OD that constantly ordered Executive bifocals for kids: -.25 sph., with a +.50 add. Being young and naive, I asked our branch manager what he was trying to acomplish? The answer? "Profit."

    I've often wondered how the parents got the kids to wear glasses that did absolutely nothing for them. Must have been a never ended battle.

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