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The
American Optician
Where Do We Go From Here? |
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This is the first of a series of articles that will focus on the role of the American Optician in the eye care delivery system. The profession is evolving, but no one seems to know how and in what direction. Opticians across the country look and do different things... .have different levels of professional responsibility, and this lack of consistency is causing some concern. The marketplace is seemingly the arbiter of the role Opticians will be playing in the new, technologically-based eyecare delivery system of tomorrow. To some, that is exactly how it should be. But to others, there is a definite lack of concerted effort of behalf of the leadership of the profession that could carve out the Optician's role, rather than allowing market forces or one of the other Os to do it for us. I only have 1200 words or so to complete this task per edition, so I will attempt to present an objective view of the issues based on research, and hope we can stir some discussion and dialogue within the professional organizations that affect where we go from here.
The American Optician is a professional with roots tracing back to the early days of this country (Stimson, 1951). Throughout history, many outstanding Americans can be counted as early pioneers in the field, including Captain John Smith of Virginia who founded the glass industry in 1607, and Benjamin Franklin, considered being the inventor of bifocal lenses (Epting & Morgret, pp 10-21; 122). Opticians are found in nearly every city and town in the country, and the profession of Opticianry has a major impact on the well being of those who need vision correction. As the nation grows, the need for vision correction is expected to increase causing an increase in the demand for professional Opticians, who design manufacture and fit and dispense optical appliances used in the correction of vision.
As a practicing Optician for many years, this author felt that there was a significant void in training and education requirements for Opticians, and possibly a lack of understanding of the valuable services a competent Optician provides in the eye care market place. Eye care is changing, however. New technology may require a new level of education for the future Optician, allowing them to expand their scope of practice to include refraction services, low vision or advanced contact lens services, or make things so simple to do that they would no longer be necessary as stand-alone professionals. Or the simplified technology of today may allow for lesser-trained technicians to provide similar levels of service in the eye doctor's office. The purpose of the initial study from which this series is developed was to predict what future role the Optician will play in the eye care delivery system in the United States, to evaluate the current status of the American Optician, including current strengths and weaknesses of the education and training of contemporary Opticians, and to assess the Optician's preparation and readiness to utilize new technology in the field. The effort could be utilized to provide a roadmap for the future development of the profession, and an indication of the required education and training to safely practice in the future.
Background Statement
Opticianry as a profession is rapidly changing. Opticians in the United States may be under-trained and under-educated according to state Opticianry leaders in recent resolutions to the by-laws of the Opticians Association of America (2002). Apprenticeship is the primary training mode for Opticians in most jurisdictions in the country, according to the American Board of Opticianry (2002), which may not provide the needed background for tomorrows Optician. Some states, such as New York, Florida, North Carolina and others, require a state license to practice with prerequisite education prior to sitting for the mandatory board examinations (Opticians Association of America, 2002). In other states, there are no existing regulations. Coupled with the lack of training in some states is an increase in new technology that may demand a higher level of understanding and knowledge of optics and vision care. Several emerging issues have a significant effect on Opticians. They include:
Advances in Technology
Optical research has provided many widely recognized advances in recent years in spectacles, vision testing and contact lenses. Examples of those advances include a new specialty contact lens designs, such as Paragon's CRT. Several new devices to test refractive error that are specifically designed for use by technicians allow for accuracy in assessing vision have recently been introduced for use by vision care professionals. Even more advanced spectacle lenses that are based on complicated computer models provide the wearer with superior vision, as well as a more cosmetically appealing lens generally require advanced knowledge by the Optician if they are to be adequately utilized in practice.
What level of education and training is needed for Opticians to safely and effectively utilize these new technologies in practice?
Changing Practice Roles
Practice styles have changed over the years (Drew, 1990). 20 years ago, most Opticians had a goal of becoming independent practitioners. It was unethical for physicians to sell eyeglasses, and the relationship that naturally developed between the Ophthalmologist (a physician specializing in the eye) and the Optician was a natural one. Today, the optical landscape has changed dramatically. Most Ophthalmologists dispense glasses from their offices, and large chain operations have rapidly become the primary market competitor. Optometrists, once the professional adversary of Ophthalmology, co-manages much of the medical care of post surgical patients with Ophthalmologists and have the right to treat many diseases once the realm only of the physician.
Licensure/Certification Requirements
Only twenty-two states require a specific state license to practice Opticianry. One other (Texas) recognizes a voluntary registry, but do not require it to practice (American Board of Opticianry, 2002). The rest have little or no restrictions placed on the sale of prescription eyeglasses. Pass rates on state and national boards vary according to training and education of the student (McDonald, 1987; North Carolina State Board of Opticians, 1995). As the test material for state and national becomes more complicated, it may require an increase in the level of education required to sit for the examinations (South Carolina State Board of Opticians, 2002). However, if Opticians will only serve under the supervision and direction of other professionals, should additional education be required prior to sitting for state board or national certification examinations, or are those examinations even necessary to serve the public as an Optician?
Controversial? The issue will probably be described as such, but it not intended that way. I admit up front that I am an Optician and believe strongly that the profession needs to move forward. How and in what direction is what I will attempt to describe. Follow along for the next few months and let's look at this issue in depth. We will look at Opticians from other countries and compare and contrast their training and education, as well as professional scope. We will evaluate licensing and certification, and attempt to look at other professionals view on the future role of the American Optician. I am looking forward to it very much, and hope you enjoy the ride. |
