Keep current scope.

[planex]

Is there concern among others on this forum about the possiblity of other professions encroaching on what we do as optometrists?
For instance:

http://www.senecac.on.ca/parttime/pip-refracting_optician.html

And...just a couple of years ago...

As reported in the September 2004 State Legislative Report from the American Dental Association, the leadership of the American Dental Hygiene Association has decided to move forward with a policy supporting the creation of a drastically altered workforce model by moving to create an “advanced dental hygiene practitioner.” This self-described “mid-level” practitioner would “assist in the delivery of primary oral health care to a greater number of people.” Hygienists and/or assistants are already licensed as an independent group in some jurisdictions. And, in some, they have been authorized by the legislature to provide certain services independently.

These developments can easily be viewed as a precursor to what could become the future agenda for: 1) opticians, 2) paraoptometrics, and/or 3) certified ophthalmic techs.

---

Members don't see this ad.

 

[Northerner]

Take a gander at the debate in the Ophthalmology Forum about optometrists lobbying (successfully in Oklahoma) to expand their practice rights into ophthalmology. Or the "optometric physician" debate in this forum.

 

[orangezero]

www.optiboard.com is filled with opticians, a very vocal minority (probably, maybe a majority) of which feel they should be able to refract separate from the examination. Who gets to decide to change the paradigm of eyecare in the US?

I think it brings up a bigger issue of how to deal with persons that are very talented at their craft, and dont' want to be limited by silly things such as laws. This applies to anyone, ODs, opticians, OTs, PTs, nurses, etc..... There is usually a debate as to the "real" reasons for the laws being in place, ie public safety vs. legalized monopoly vs. public need for services.

Any type of legalized "profession" has the potential for that monopoly to be taken away at any time.

Is there such a shortage of optometrists and ophthalmologists that the public needs opticians to refract? Is there enough of a shortage of ophthalmologists that the public needs optometrists to perform surgery? Do we need more dental providers?

I think its a shame we have certain segments actively supressing knowledge because another group uses it as justification for future scope expansion.

Interesting questions. I think there is a line (somewhere) between being the best you can be in your profession because of your "extra" knowledge and practicing without a license. Having the knowledge of surgical techniques, refrative techniques, and dental techniques to better serve patients is one thing, but actually using them is another.

 

[orangezero]

just looked at the page you linked originally. I'd feel a little hesitant paying money for that knowing another optician in Canada just got fined $1 million for practicing without a license.

I don't want to look down on teaching institutions (both my parents were teachers, and lots of cousins, etc.) BUT they are in the business of making money and not so much looking out for the best interests of any profession.... something to ponder..

 

[Schroder79]

Take a gander at the debate in the Ophthalmology Forum about optometrists lobbying (successfully in Oklahoma) to expand their practice rights into ophthalmology. Or the "optometric physician" debate in this forum.

This term "optometric physician" never made sense to me as a seperate entity. In Oregon the optometric group is the Oregon Optometric Physicians Association or OOPA. Would you consider optometrists in Oregon more trained or with a broader practice oportunity than other states? Actually the scope of practice is bigger here but I hate to split the title of optometrist.

 

[orangezero]

This term "optometric physician" never made sense to me as a seperate entity. In Oregon the optometric group is the Oregon Optometric Physicians Association or OOPA. Would you consider optometrists in Oregon more trained or with a broader practice oportunity than other states? Actually the scope of practice is bigger here but I hate to split the title of optometrist.

I think the title of physician was added mostly for semantic issues. The "optometrists" were not eligible to be reimbursed for some medical plans that only allowed "physicians" as providers, hence optometric physicians enter the picture and actually get paid for doing exams. I'm sure there could be ODs that have other feelings on this as well.

 

[Eyeswideopen]

This term "optometric physician" never made sense to me as a seperate entity. In Oregon the optometric group is the Oregon Optometric Physicians Association or OOPA. Would you consider optometrists in Oregon more trained or with a broader practice oportunity than other states? Actually the scope of practice is bigger here but I hate to split the title of optometrist.

"Optometric Physician," is pure puffery. If not, what should the OD title become when selling glasses and contacts - doesn't "Optometric Retailer," seem appropriate.

ODs earner 60% of their revenue from huckstering optical goods, about 32% from basic refraction, and 8% or less from "Optometric Physicianing."

Them's the facts folks.

 

[luckyfool]

"Optometric Physician," is pure puffery. If not, what should the OD title become when selling glasses and contacts - doesn't "Optometric Retailer," seem appropriate.

ODs earner 60% of their revenue from huckstering optical goods, about 32% from basic refraction, and 8% or less from "Optometric Physicianing."

Them's the facts folks.

I'd like to see some references on those facts. Thanks.

 

[PBEA]

"Optometric Physician," is pure puffery. If not, what should the OD title become when selling glasses and contacts - doesn't "Optometric Retailer," seem appropriate.

ODs earner 60% of their revenue from huckstering optical goods, about 32% from basic refraction, and 8% or less from "Optometric Physicianing."

Them's the facts folks.

Facts? Clearly you are a pathetic troll. Not the brightest bulb on the tree either, given your grammar. You and I can have a discussion about how dumb you are, if you like. That is if you can stomach the thrashing I'm about to give you. Why dont you start with with where you got your stats from?

 

[PBEA]

I think the title of physician was added mostly for semantic issues. The "optometrists" were not eligible to be reimbursed for some medical plans that only allowed "physicians" as providers, hence optometric physicians enter the picture and actually get paid for doing exams. I'm sure there could be ODs that have other feelings on this as well.

You are correct. This is precisely the spirit in which the "optometric physician" moniker was created. I dont use it (I dont have to), but if I had to (in order to join a provider panel) I would not hesitate to use it.

 

[PBEA]

www.optiboard.com is filled with opticians, a very vocal minority (probably, maybe a majority) of which feel they should be able to refract separate from the examination. Who gets to decide to change the paradigm of eyecare in the US?

I think it brings up a bigger issue of how to deal with persons that are very talented at their craft, and dont' want to be limited by silly things such as laws. This applies to anyone, ODs, opticians, OTs, PTs, nurses, etc..... There is usually a debate as to the "real" reasons for the laws being in place, ie public safety vs. legalized monopoly vs. public need for services.

Any type of legalized "profession" has the potential for that monopoly to be taken away at any time.

Is there such a shortage of optometrists and ophthalmologists that the public needs opticians to refract? Is there enough of a shortage of ophthalmologists that the public needs optometrists to perform surgery? Do we need more dental providers?

I think its a shame we have certain segments actively supressing knowledge because another group uses it as justification for future scope expansion.

Interesting questions. I think there is a line (somewhere) between being the best you can be in your profession because of your "extra" knowledge and practicing without a license. Having the knowledge of surgical techniques, refrative techniques, and dental techniques to better serve patients is one thing, but actually using them is another.

Dear Orangezero--

Are you training in ophthalmology right now? If so, then maybe you have yet to encounter "opticianry" in its common form. Opticianry (as you may know already?) is largely a trade position, not an academically trained profession. Requiring little to no education (save a high school diploma or GED). They are trained "on the job" mostly to handle the the "material" aspects of eyeglasses (ie fabricating lenses, adjusting frames). Some may act as a technician for the doctor, and some actually have some limited contact lens experience (although this is rare and varies state by state). It should be abundantly clear that opticianry is much farther removed from clinical eyecare, than optometry (and obviously ophthalmology). Having said that I think your comments probably reflect some confusion (on your part) as to whether a refraction should be separated from an ocular health assessment. Let me answer that one for you (its an easy one). Refraction should not, and obviously is not an adequate substitution for a comprehensive evaluation of the eye. It is absurd to think otherwise.

 

[PBEA]

Is there concern among others on this forum about the possiblity of other professions encroaching on what we do as optometrists?
For instance:

http://www.senecac.on.ca/parttime/pip-refracting_optician.html

And...just a couple of years ago...

As reported in the September 2004 State Legislative Report from the American Dental Association, the leadership of the American Dental Hygiene Association has decided to move forward with a policy supporting the creation of a drastically altered workforce model by moving to create an “advanced dental hygiene practitioner.” This self-described “mid-level” practitioner would “assist in the delivery of primary oral health care to a greater number of people.” Hygienists and/or assistants are already licensed as an independent group in some jurisdictions. And, in some, they have been authorized by the legislature to provide certain services independently.

These developments can easily be viewed as a precursor to what could become the future agenda for: 1) opticians, 2) paraoptometrics, and/or 3) certified ophthalmic techs.

I think the fear regarding opticians refracting is unfounded. While I am aware of canadas foray into this nonsense (mostly due to access issues), I think/know that there is not enough demand to sustain additional "refractionists" from entering the market. There are already too many ODs and OMDs providing this service, with more on the way (3 more OD schools, WTF!?!?).

 

[orangezero]

Dear Orangezero--

Are you training in ophthalmology right now? If so, then maybe you have yet to encounter "opticianry" in its common form. Opticianry (as you may know already?) is largely a trade position, not an academically trained profession. Requiring little to no education (save a high school diploma or GED). They are trained "on the job" mostly to handle the the "material" aspects of eyeglasses (ie fabricating lenses, adjusting frames). Some may act as a technician for the doctor, and some actually have some limited contact lens experience (although this is rare and varies state by state). It should be abundantly clear that opticianry is much farther removed from clinical eyecare, than optometry (and obviously ophthalmology). Having said that I think your comments probably reflect some confusion (on your part) as to whether a refraction should be separated from an ocular health assessment. Let me answer that one for you (its an easy one). Refraction should not, and obviously is not an adequate substitution for a comprehensive evaluation of the eye. It is absurd to think otherwise.

Actually, I am an optometrist. I was not revealing any of my own opinions in my previous posts but rather stating the fact that there a great many other people who have differing opinions on this subject. As optometrists we should be careful that our own words aren't used for good in one debate and then prove to be our undoing in another. Ie, not allowing refracting because opticians dont' know enough and at the same time being refused admittance to ophthalmology meetings because we'll learn too much. Not exactly related but its an interesting point. Personally, I think we should be able to intelligently win both battles, but more is needed besides namecalling, whining, etc.

There is no confusion on my end in regards to refractions and their separation from health and even visual performance evaluations. My point for posting on here was not to imply that there should be separation, but to make everyone think about why they should be integrated. And to have justification for it besides, "thats the way its been and thats what we were taught in optometry school..."

As far as opticians, I guess I can agree with you in part. The term "optician" is so far reaching its laughable. Opticians are those teenages pulled out of the garden department because someone got sick. They are also the untrained or poorly trained "frame stylists" in retail and yes even private offices. However, there are opticians that fit specialty contact lenses, ocular prosthetics, etc and have been doing so since before I was born. There are opticians that work in GP labs that know more than I'll ever know about lens materials and GP fitting. There are tests that can be taken to get certified (and we could argue about their appropriateness) in opticianry and contact lenses. Some have advanced masters degrees; they are not all high school dropouts. Being further away from patient care does not automatically make them less intelligent. I think we could argue about the proportion of skilled to unskilled, but generally its moving in the direction of unskilled rather quickly. Unskilled at all levels, from the frame selecting to the lab workers. Even the highly skilled elder opticians lament the changes in education and testing, mostly to lower standards... I dont' think I am confused about opticianry.

Just yesterday I was discussing with some opticians about how they "mildly alter" the Rx when they feel its necessary. How? Well, by doing trial frame refractions, JCC, and whatever else they learned "who knows where." I brought this up in another forum. Despite the legal or medical risks (which they neither see, agree with, or fully understand), this goes on a lot more than we are led to believe. There are places in texas where opticians refract under the authority of an ophthalmologist that is not at that location.... Once again, I'm not condoning these things, but at least pointing them out to people that may not be aware...

Did you hear how long it took them to finally deal with the "great glasses" thing in Canada? $1 million fine, and those stores are still open!!!

I don't think its entirely a "the sky is falling" mentality that makes people think opticians could one day be refracting. Who is actually going to be on the side of optometrists if this ever would get a political wind behind it? Walmart, Luxottica, PCPs, ophthalmologists, the general public? On a realistic level though, I do think the total lack of real need for more refractionists is what is going to decide this for quite some time.

 

[sethuel1]

Facts? Clearly you are a pathetic troll. Not the brightest bulb on the tree either, given your grammar.

you mean grammer

 

[Schroder79]

Wow! I think that this is well written and appreciate the comment. Please stay on this forum.

Actually, I am an optometrist. I was not revealing any of my own opinions in my previous posts but rather stating the fact that there a great many other people who have differing opinions on this subject. As optometrists we should be careful that our own words aren't used for good in one debate and then prove to be our undoing in another. Ie, not allowing refracting because opticians dont' know enough and at the same time being refused admittance to ophthalmology meetings because we'll learn too much. Not exactly related but its an interesting point. Personally, I think we should be able to intelligently win both battles, but more is needed besides namecalling, whining, etc.

There is no confusion on my end in regards to refractions and their separation from health and even visual performance evaluations. My point for posting on here was not to imply that there should be separation, but to make everyone think about why they should be integrated. And to have justification for it besides, "thats the way its been and thats what we were taught in optometry school..."

As far as opticians, I guess I can agree with you in part. The term "optician" is so far reaching its laughable. Opticians are those teenages pulled out of the garden department because someone got sick. They are also the untrained or poorly trained "frame stylists" in retail and yes even private offices. However, there are opticians that fit specialty contact lenses, ocular prosthetics, etc and have been doing so since before I was born. There are opticians that work in GP labs that know more than I'll ever know about lens materials and GP fitting. There are tests that can be taken to get certified (and we could argue about their appropriateness) in opticianry and contact lenses. Some have advanced masters degrees; they are not all high school dropouts. Being further away from patient care does not automatically make them less intelligent. I think we could argue about the proportion of skilled to unskilled, but generally its moving in the direction of unskilled rather quickly. Unskilled at all levels, from the frame selecting to the lab workers. Even the highly skilled elder opticians lament the changes in education and testing, mostly to lower standards... I dont' think I am confused about opticianry.

Just yesterday I was discussing with some opticians about how they "mildly alter" the Rx when they feel its necessary. How? Well, by doing trial frame refractions, JCC, and whatever else they learned "who knows where." I brought this up in another forum. Despite the legal or medical risks (which they neither see, agree with, or fully understand), this goes on a lot more than we are led to believe. There are places in texas where opticians refract under the authority of an ophthalmologist that is not at that location.... Once again, I'm not condoning these things, but at least pointing them out to people that may not be aware...

Did you hear how long it took them to finally deal with the "great glasses" thing in Canada? $1 million fine, and those stores are still open!!!

I don't think its entirely a "the sky is falling" mentality that makes people think opticians could one day be refracting. Who is actually going to be on the side of optometrists if this ever would get a political wind behind it? Walmart, Luxottica, PCPs, ophthalmologists, the general public? On a realistic level though, I do think the total lack of real need for more refractionists is what is going to decide this for quite some time.

 

[Ben Chudner]

I think the fear regarding opticians refracting is unfounded. While I am aware of canadas foray into this nonsense (mostly due to access issues), I think/know that there is not enough demand to sustain additional "refractionists" from entering the market. There are already too many ODs and OMDs providing this service, with more on the way (3 more OD schools, WTF!?!?).

I am not entirely sure why you feel this fear is unfounded. In Washington State, we narrowly defeated a refracting opticians bill a couple of years ago. This issue has absolutely nothing to do with access and if you honestly believe that refracting opticians won't be busy, you are kidding yourself. I predict that if a refracting optician bill ever passes, which I believe is very dangerous for several reasons, Wal-Mart, Costco, LensCrafters, PearleVision, Sear's, JC Penny's, Target, etc, will gladly decrease the amount of space dedicated to their independent optometrists to a tiny refracting lane and hire an optician. This would mean more retail space in the store, which means more potential revenue, and they no longer have to worry about an OD wanting to do more than refractions. A refracting optician would have no problem seeing 6 or more patients an hour for a quick Rx check so that they could buy glasses without the hassle of an eye exam. Next time a bill comes up, take a look at who the sponsors are. I bet if you look close enough you will see several familiar names that have a lot more money to support the bill and a lot more to gain if it passes.

 

[cpw]

you mean grammer

no... he means GRAMMAR !! (look it up)

 

[sethuel1]

no... he means GRAMMAR !! (look it up)

i was kind of making fun of the other guy

 

[PBEA]

I am not entirely sure why you feel this fear is unfounded. In Washington State, we narrowly defeated a refracting opticians bill a couple of years ago. This issue has absolutely nothing to do with access and if you honestly believe that refracting opticians won't be busy, you are kidding yourself. I predict that if a refracting optician bill ever passes, which I believe is very dangerous for several reasons, Wal-Mart, Costco, LensCrafters, PearleVision, Sear's, JC Penny's, Target, etc, will gladly decrease the amount of space dedicated to their independent optometrists to a tiny refracting lane and hire an optician. This would mean more retail space in the store, which means more potential revenue, and they no longer have to worry about an OD wanting to do more than refractions. A refracting optician would have no problem seeing 6 or more patients an hour for a quick Rx check so that they could buy glasses without the hassle of an eye exam. Next time a bill comes up, take a look at who the sponsors are. I bet if you look close enough you will see several familiar names that have a lot more money to support the bill and a lot more to gain if it passes.

If you are saying that these corporations are the "underwriters" of this type of legislation, then the AOA had better buck up and shut that crap down at every turn. My own anecdotal experience has been that opticians only ever deal with frame adjustment. (I have worked with well over 100 different opticians). Having shown that opticians essentially receive no didactic or clinical training, whatsoever, Ill just add that the only motive for performing a refraction only exam is to make money, a self-serving benefit, not helpful to society at large. I know you already know this, but I also feel this obvious common sense explains my unfounded comment.

 

[planex]

I am not entirely sure why you feel this fear is unfounded. In Washington State, we narrowly defeated a refracting opticians bill a couple of years ago. This issue has absolutely nothing to do with access and if you honestly believe that refracting opticians won't be busy, you are kidding yourself. I predict that if a refracting optician bill ever passes, which I believe is very dangerous for several reasons, Wal-Mart, Costco, LensCrafters, PearleVision, Sear's, JC Penny's, Target, etc, will gladly decrease the amount of space dedicated to their independent optometrists to a tiny refracting lane and hire an optician. This would mean more retail space in the store, which means more potential revenue, and they no longer have to worry about an OD wanting to do more than refractions. A refracting optician would have no problem seeing 6 or more patients an hour for a quick Rx check so that they could buy glasses without the hassle of an eye exam. Next time a bill comes up, take a look at who the sponsors are. I bet if you look close enough you will see several familiar names that have a lot more money to support the bill and a lot more to gain if it passes.

These are the thoughts that I mirror. It has been stated several times that there is not the demand for more refractions. The demand is already in place-with the corporate optometry venues accross the country. Just as was well said above, the corporations would certainly be pleased to employ refracting opticians. Refracting opticians would then charge less(as they only refract), see more appointments and will allow for more sales for the optical.
Those who are not corporate practicing optometrists will be affected as well.
Think for a moment of just one state passing a law to allow for opticians to refract. The optometrists will be replaced in many of the commercial settings of that state. Creating a large flux of formerly commercial practicing ODs looking for employment, or doing the start-up practice they have been considering in the same or another state. Fees would flater through competition as well.
I just hope that I am not alone in the understanding of the consequences, as well as hope that with all the current concerns of the AOA PAC- this is still kept fresh on the burner.

 

[cpw]

i was kind of making fun of the other guy

ah... sorry

 

[Ben Chudner]

If you are saying that these corporations are the "underwriters" of this type of legislation, then the AOA had better buck up and shut that crap down at every turn. My own anecdotal experience has been that opticians only ever deal with frame adjustment. (I have worked with well over 100 different opticians). Having shown that opticians essentially receive no didactic or clinical training, whatsoever, Ill just add that the only motive for performing a refraction only exam is to make money, a self-serving benefit, not helpful to society at large. I know you already know this, but I also feel this obvious common sense explains my unfounded comment.

I have no proof that the big boxes sponsored legislation in Washington State or any of the other states where the refracting opticians bill was introduced. I believe there were three other states. I will say that from what we know about the optician association in our state, there is no possible way they could have come up the amount of money they needed to lobby as effectively as they did. We do not know who underwrote their lobbying efforts, but I have my own theories. As for the AOA getting involved, I think they are too concerned about getting sued to get involved in a state matter. The AOA expects the state associations to handle this, and that is what we did. The reason why I fear this type of legislation is that in the hearings, one of the state legislators had recently needed a new pair of glasses. Her Rx was expired and so the optical shop wouldn't fill it and instructed her to see an eye doctor. The doctor did an exam and noted that there was a small change in her Rx (I don't know where she had the exam). The Rx was updated and filled. Somehow she got the impression that all she needed was a small change (and not a health assessment) and it would have been easier if the optician could have just done it during her initial visit to the optical shop. Fortunately, our state organization was very good at explaining the potential health risks of allowing stand alone refractions. This is a classic example of how common sense when it comes to this matter may not be that common.

 

[Ben Chudner]

Refracting opticians would then charge less(as they only refract), see more appointments and will allow for more sales for the optical.

It may be worse. If opticians gain the right to refract and the bill does not specifically state that they cannot be employees of a non-medical corporation, a place like Wal-Mart could hire one for $12 an hour and not even charge for the refraction. I am sure they would have patients lining up around the corner for a free refraction with purchase of eyewear. I guarantee those patients won't feel they will need another eye exam as long as Wal-Mart will keep updating their Rx.

 

[PBEA]

As optometrists we should be careful that our own words aren't used for good in one debate and then prove to be our undoing in another. Ie, not allowing refracting because opticians dont' know enough and at the same time being refused admittance to ophthalmology meetings because we'll learn too much. QUOTE]


Your example is wrong on both accounts.

First: Opticians dont get any formal training at all?? So what the fvk are you talking about?. If they are not trained to perform a complete eye assessment then they cant actually do it, now can they? There are two sides to the "curve" of an exam. Assessment is first, treatment is second. If you cant assess then you cannot treat. Opticians cant do the first so they obviously cant do the second.

Second: Learn to much? We already know to much. Ophthalmology's refusal to admit ODs to some of their meetings represents nothing more then misguided attempts by their leadership to pretend optometry is not integral to providing competent, proven treatment to millions of people. Comparing ODs quest for uniform scope is NOT the same as opticians trying to perform "eye" exams so that they (big box store?) can sell the glasses quicker.

 

[Northerner]

Ophthalmology's refusal to admit ODs to some of their meetings represents nothing more then misguided attempts by their leadership to pretend optometry is not integral to providing competent, proven treatment to millions of people.

That doesn't sound right. It sounds bitter, hostile, and downright wrong. I recommend inviting opticians to "your meetings" and maybe, when they're eventually fighting for the right to do your job, you'll realize why it was a mistake to give them the ammunition to believe they're just as competent as you. No one thinks optometry isn't integral to providing competent treatment to millions of people. Everyone appreciates them, no one is discounting their role.

We also don't train nurses to do central lines. We train them to do IV's, why not central lines? Why not arterial lines? They're basically the same thing, surely there's some sort of seminar they could attend and get the gist of it...hopefully my point is made.

 

[exmike]

Your example is wrong on both accounts.

First: Opticians dont get any formal training at all?? So what the fvk are you talking about?. If they are not trained to perform a complete eye assessment then they cant actually do it, now can they? There are two sides to the "curve" of an exam. Assessment is first, treatment is second. If you cant assess then you cannot treat. Opticians cant do the first so they obviously cant do the second.

Second: Learn to much? We already know to much. Ophthalmology's refusal to admit ODs to some of their meetings represents nothing more then misguided attempts by their leadership to pretend optometry is not integral to providing competent, proven treatment to millions of people. Comparing ODs quest for uniform scope is NOT the same as opticians trying to perform "eye" exams so that they (big box store?) can sell the glasses quicker.

Thousands (millions?) of opticians would be offended at the notion that they are not an intergral part of providing competent eye care. Its interesting to watch you hedge your position between OMD and opticians with such discomfort. Do you really think you can have it both ways? Encroach upon the OMD's territory while denying the opticians expansion of practice? I have yet to hear an argument that justifies expanding OD scope of practice without justifying allowing Opticians to expand scope of practice.

What if opticians created their own accreditation authority that certifies Opticians to be trained in refracting, taught the exact same techniques and courses that ODs and OMDs used to learn refracting. Then would be okay for Opticians to refract? Or maybe a one year Optician fellowship where they learn refracting and basic diagnosis. And why does this proposal sound eerily similar to something else? hmm...

 

[PBEA]

That doesn't sound right. It sounds bitter, hostile, and downright wrong. I recommend inviting opticians to "your meetings" and maybe, when they're eventually fighting for the right to do your job, you'll realize why it was a mistake to give them the ammunition to believe they're just as competent as you. No one thinks optometry isn't integral to providing competent treatment to millions of people. Everyone appreciates them, no one is discounting their role.

We also don't train nurses to do central lines. We train them to do IV's, why not central lines? Why not arterial lines? They're basically the same thing, surely there's some sort of seminar they could attend and get the gist of it...hopefully my point is made.

It is right, and it is bitter and it is hostile. Are really going to sit here and say your political leadership has done anything besides degrade optometry's role in delivering competent, evidence based eyecare? Your assoc have used fear-mongering by claiming ODs have used ophthalmology meeting to advance their scope, what a crock. The only thing ive used ophthalmology meeting for (and optometry meetings for) are to refresh my knowledge and build upon it. The only thing ODs use to justify its attempts at uniform scope is its already excellent training. Which by its very nature allows for some absorption of new technologies and treatments into its fold. Im not talking surgery, and neither are any of the ODs I know of, either in the periodicals or personally. I would "blame" any current optometric surgery expansion issues on the fact that for the last 30 years, your AAO has basically tried to ignore optometry and limit their role, by claiming ODs are not "real" doctors, all the while claiming a non-ophthalmic MD, or nurse, or PA, or whatever is better able to properly assess AND treat eye conditions, what a joke. Nothing more then hypocritical self-serving nonsense. If you wont listen then I guess we will have to go in our own direction. Dont kid yourself, ODs might very well push to setup our own "surgical" residencies, I may not agree with it, but it might happen if your colleagues continue to ignore optometry's capabilities.

Also opticians AND ophthalmologists are always allowed at our meetings (at least to my knowledge). They are listed and invited on any of the curriculum Ive ever seen. Again, comparing opticians attempts at performing refraction is not the same as optometry's quest for uniform scope. You seem to subscribe to the idea that it is ok to separate refraction from a comprehensive eye exam? If so then perhaps you might like to review the myriad of cases that I see daily, which while a "refraction" did improve the vision, doing just that would have overlooked a whole stew of asymptomatic eye disease. I mean am I missing something, you are aware that many eye conditions are asymptomatic right? Glaucoma is called the "thief" of sight isnt it? Of course it is, but I guess you think an optician can blast away with an "air puff", and if the pressure is high then they can just refer to you right? Oh wait, what about LTG, or pigment dispersion? Geee, seems like it isnt that simple after all. Lets face it examining the eye is a dynamic process that doesnt do well with a "one size fits all" approach. And if you think that an optician, or PCP, or nurse, or PA, etc can learn that process, by having some "ophthalmology" rotations then you are misguided.

 

[PBEA]

Thousands (millions?) of opticians would be offended at the notion that they are not an intergral part of providing competent eye care. Its interesting to watch you hedge your position between OMD and opticians with such discomfort. Do you really think you can have it both ways? Encroach upon the OMD's territory while denying the opticians expansion of practice? I have yet to hear an argument that justifies expanding OD scope of practice without justifying allowing Opticians to expand scope of practice.

What if opticians created their own accreditation authority that certifies Opticians to be trained in refracting, taught the exact same techniques and courses that ODs and OMDs used to learn refracting. Then would be okay for Opticians to refract? Or maybe a one year Optician fellowship where they learn refracting and basic diagnosis. And why does this proposal sound eerily similar to something else? hmm...

I may have to start posting in red again. Maybe my words will burn deeper into your retinas, so that we can communicate effectively. I never stated opticians are not integral to eyecare? I know that I would have a heck of a time without mine. My point (the one you misinterpreted) is that while anyone, including opticians, can be taught the mechanics of a refraction, the real problem with this is that refraction itself cannot be separated from a comprehensive exam. If you disagree with that fact then I would be more then happy to destroy any argument you have to the contrary.

Also, I know you are trying to parallel my arguments with OD surgery, but you are talking to the wall. I know without a shred of doubt that I cant do the highly invasive procedures that constitute the bulk of eye surgery (I can understand the entire process, but I have no experience in actually performing them). Your argument therefore does not apply to me, its a nonstarter.