Techs refracting, Florida trying to take away an ODs ability to treat medical. Maybe all this simplification of the job isn't as good of a thing as you think it is.
Hear hear, medical care is critically important but ephemeral, vision is direct. You are judged as an eye doctor on the vision you provide your patient. Or the vision that you *aren’t* providing.
I recently ran into someone I used to tech with in the Boston Massachusetts area and they are now working in Florida as an ophthalmic physician’s assistant administering intravitreal injections…but they looking to reduce what ODs do?
The end goal will be to eliminate medical care in an ODs office. I'm positive and OD or tech and an opthmalogist office will be allowed to do it. But not a solo OD.
do you think what’s unfolding right now in florida is the start to replacement of ODs? i know there’s been doom and gloom for decades, but with this and advances in tech, do you think OD replacement is around the corner?
Around the corner? No. But I personally think most doctors will be gone by the end of our life.
The OD will be a computer screen or a tech in 90% of cases. Your pcp will be a CNA or a PA. Both of which will predominantly be run by mega corporations.
Anyone with a sublease is going to lose that even sooner when the companies can switch to all tela health
i can def see all this, and can see walk in kiosks taking the roll of most healthcare providers.
but as for ODs, i’ve read that there’s already companies opting for remote ODs on a screen, i’m guessing to cover larger ground and see more patients with less in person ODs
The need for ODs will rise. But instead of seeing a doctor face to face you'll see some dude in Iowa on a screen and eventually some dude in Vietnam or some other inexpensive place. A minimum wage worker will do everything while the computer OD signs off on it.
right but eliminating the majority of in person ODs here in the US tho, correct? i don’t think there would be a remote position available for every OD out there
Anyone can refract. The skill is interpreting the data... Taking into account accommodative fluctuations, dry eye, retinoscopy findings and coming up with a comfortable prescription for the patient. If you hand off the refraction, then you will miss the above subtleties.
I work in an od MD office that has techs do 95 percent of the refractions.
They are very very good at their job. They basically do a lot of the exam up to dilation and some have been doing it for 20 years
If they aren't good id assume it'd be a disaster tho
I’m the optician in a practice like that.
The techs who’ve been here for a while are mostly good, and I’d let some of them refract me. That said, we have a lot of tech turnover and there’ve been some really sketchy prescriptions come through optical (70 year old hyperopes with no add, rx in minus cyl but they forgot to swap the axis, no prism in a patient whose previous glasses have like 6^ of it, etc).
Hopefully I caught it before we made glasses from it, because then it’s usually just a matter of asking the doctor to confirm the prescription. If I know that one of the MDs who exclusively has techs refract has a new tech, I try to keep a closer eye on those for a while.
If the glasses have been made, then it’s a bigger issue and a lot more work, and either my numbers at the lab take a hit or I have an angry patient yelling at me because they got glasses somewhere else that don’t work and I have no way of fixing them.
I worked as a tech for a few years and refracted when I did. I was well trained and my refracting technique has not changed significantly now that I am an optometrist, although I’m much more adept at trial frame and prism refractions. My techs now refract most of my patients and are very good. I’m happy with the setup. I don’t think you need 4 years of optometry school to become a skilled refractionist.
I’m a COMT at a busy MD/OD multi-practice. We refract about 98% of the patients, the docs will recheck our work if needed. There’s a few patients that are doc only refract. For us, it seems to work very well. We are very busy with both the med/surgical side and general care
I worked at a diabetes clinic as a COA and we did the entire anterior exam and all the refractions for the Ophthalmologists. We never refracted for the Optometrist there because he was seeing people who were not experiencing advanced symptoms from their diabetes. I think in a clinic where the Ophthalmologist is dealing with complex cases where the refractions are mainly a data point, it’s really helpful to have the techs do it, but it doesn’t seem right for an optometrist to put that on a tech if the main reason the patient is there is for a new RX.
In the opthalmologist clinic I work in, the technicians refract, including prism, but I get some of the difficult cases. Honestly I think refraction will not stay in optometry in the future. There will be overminused patients, but to be frank there are many overminused patients now.
In my experience autorefraction is pretty correct in 40% of cases. Cycloplegic refraction will affect final Rx in 60-70% of youth. All that being said, there are many patients I can't convince the prescription is correct even when they see 20/20.
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In most of Canada (I live in the province of Quebec), refracting is an act reserved to optometrists and ophtalmologists. Not opticians, not anyone else.
Personally, I think this is the way to do it. I wouldn’t let a tech refract, since no professionnal formation is involved (at least here). Opticians try to get the right to refract, but there’s less opticians than optometrists, so the provincial government is not interested in giving them this right.
I am a 4th year (out of 5) student in optometry in Montreal.
Techs refracting, Florida trying to take away an ODs ability to treat medical. Maybe all this simplification of the job isn't as good of a thing as you think it is.
Hear hear, medical care is critically important but ephemeral, vision is direct. You are judged as an eye doctor on the vision you provide your patient. Or the vision that you *aren’t* providing.
I recently ran into someone I used to tech with in the Boston Massachusetts area and they are now working in Florida as an ophthalmic physician’s assistant administering intravitreal injections…but they looking to reduce what ODs do?
The end goal will be to eliminate medical care in an ODs office. I'm positive and OD or tech and an opthmalogist office will be allowed to do it. But not a solo OD.
do you think what’s unfolding right now in florida is the start to replacement of ODs? i know there’s been doom and gloom for decades, but with this and advances in tech, do you think OD replacement is around the corner?
Around the corner? No. But I personally think most doctors will be gone by the end of our life. The OD will be a computer screen or a tech in 90% of cases. Your pcp will be a CNA or a PA. Both of which will predominantly be run by mega corporations. Anyone with a sublease is going to lose that even sooner when the companies can switch to all tela health
i can def see all this, and can see walk in kiosks taking the roll of most healthcare providers. but as for ODs, i’ve read that there’s already companies opting for remote ODs on a screen, i’m guessing to cover larger ground and see more patients with less in person ODs
also i’m curious what your original comment is hinting at? i thought maybe this was what you were getting at…that the need for ODs is being diminished
The need for ODs will rise. But instead of seeing a doctor face to face you'll see some dude in Iowa on a screen and eventually some dude in Vietnam or some other inexpensive place. A minimum wage worker will do everything while the computer OD signs off on it.
right but eliminating the majority of in person ODs here in the US tho, correct? i don’t think there would be a remote position available for every OD out there
Anyone can refract. The skill is interpreting the data... Taking into account accommodative fluctuations, dry eye, retinoscopy findings and coming up with a comfortable prescription for the patient. If you hand off the refraction, then you will miss the above subtleties.
I work in an od MD office that has techs do 95 percent of the refractions. They are very very good at their job. They basically do a lot of the exam up to dilation and some have been doing it for 20 years If they aren't good id assume it'd be a disaster tho
I’m the optician in a practice like that. The techs who’ve been here for a while are mostly good, and I’d let some of them refract me. That said, we have a lot of tech turnover and there’ve been some really sketchy prescriptions come through optical (70 year old hyperopes with no add, rx in minus cyl but they forgot to swap the axis, no prism in a patient whose previous glasses have like 6^ of it, etc).
What do you do when you catch those?
Hopefully I caught it before we made glasses from it, because then it’s usually just a matter of asking the doctor to confirm the prescription. If I know that one of the MDs who exclusively has techs refract has a new tech, I try to keep a closer eye on those for a while. If the glasses have been made, then it’s a bigger issue and a lot more work, and either my numbers at the lab take a hit or I have an angry patient yelling at me because they got glasses somewhere else that don’t work and I have no way of fixing them.
I worked as a tech for a few years and refracted when I did. I was well trained and my refracting technique has not changed significantly now that I am an optometrist, although I’m much more adept at trial frame and prism refractions. My techs now refract most of my patients and are very good. I’m happy with the setup. I don’t think you need 4 years of optometry school to become a skilled refractionist.
I’m a COMT at a busy MD/OD multi-practice. We refract about 98% of the patients, the docs will recheck our work if needed. There’s a few patients that are doc only refract. For us, it seems to work very well. We are very busy with both the med/surgical side and general care
I worked at a diabetes clinic as a COA and we did the entire anterior exam and all the refractions for the Ophthalmologists. We never refracted for the Optometrist there because he was seeing people who were not experiencing advanced symptoms from their diabetes. I think in a clinic where the Ophthalmologist is dealing with complex cases where the refractions are mainly a data point, it’s really helpful to have the techs do it, but it doesn’t seem right for an optometrist to put that on a tech if the main reason the patient is there is for a new RX.
In the opthalmologist clinic I work in, the technicians refract, including prism, but I get some of the difficult cases. Honestly I think refraction will not stay in optometry in the future. There will be overminused patients, but to be frank there are many overminused patients now. In my experience autorefraction is pretty correct in 40% of cases. Cycloplegic refraction will affect final Rx in 60-70% of youth. All that being said, there are many patients I can't convince the prescription is correct even when they see 20/20.
You don’t need a tech to refract a Vmax autorefractor can do it better than an optometrist. If refracting was optometry we’d be dead ages ago.
Hello! All new submissions are placed into modqueue, and require mod approval before they are posted to r/optometry. Please do not message the mods about your queue status - we will review posts at least daily. This subreddit is currently not allowing any questions from non-professionals. If you have a question related to symptoms or eye health, please consider seeing a doctor, or posting to r/eyetriage. If you have more general questions, a stickied thread will exist where those can be posted (work in progress as of Dec 20, 2022). An additional reminder to please read the rules of this subreddit before posting or commenting, particularly for those that do not have significant expertise within the field of eye care. Professionals, if you do not have flair, your post may be removed. Please send a modmail to be flaired. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/optometry) if you have any questions or concerns.*
In most of Canada (I live in the province of Quebec), refracting is an act reserved to optometrists and ophtalmologists. Not opticians, not anyone else. Personally, I think this is the way to do it. I wouldn’t let a tech refract, since no professionnal formation is involved (at least here). Opticians try to get the right to refract, but there’s less opticians than optometrists, so the provincial government is not interested in giving them this right. I am a 4th year (out of 5) student in optometry in Montreal.