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Opticians assume many shapes and sizes across the depth and breadth of America. The landscape was at one time dotted with independent Opticians in most jurisdictions and they seemed to be quite successful.

One constant was that all Opticians, no matter the state or region, provided the basis for competition; we were the business side of eye care, filling Rx’s and participating in the dreaded “S” word, sales! Ophthalmologists were our “partners,” referring patients to us because the American Academy of Ophthalmology deemed it unprofessional to dispense the products they prescribed. We did most of the contact lens work for them as well. At the time that consisted of PMMA lenses only…….soft lenses did not come on the scene until the early to mid-seventies. ODs had not yet gained their new medical direction, and were not the force they have become today.

Changing Landscape
The landscape has dramatically changed for the profession. Ophthalmologists now dispense eyewear regularly as a replacement for reductions in reimbursement for cataract surgery and other services, and ODs and MDs work closely together in co-management relationships. ODs have generally become the primary eyecare providers in the country. While the ODs strategically planned to improve their lot by first educating themselves at a higher level, and then legislatively enacting laws that allowed a significant increase in their scope of practice, Opticians sat on the sideline and did little, if anything, to improve. Apprenticeship is still utilized as the primary training method, and the debate continues over the value of education. The independent has slowly slipped into oblivion in many places, and while market forces had a major role in that change, Opticians themselves could and should have played a primary role in a more controlled transformation. Now we find ourselves wondering about the future.

Where Do We Go From Here
What role will Opticians play, if any, in the future of the eyecare delivery system in the United States? Technological changes may completely eliminate the need to a “skilled” Optician, as many of my colleagues on a popular Internet discussion board, Optiboard, like to refer to themselves. Much of the skill level of the old Optician is now unnecessary with these new, advanced technological laboratory systems, and may eliminate the need for those who see the role of the Optician as only manufacturing a nice pair of spectacles. These new edging “systems” even drill and safety-bevel for you! While the superior skills of the Optician of the past still exist, they are slowly dying as these new kinds of technological innovations take hold on the market. Look in most newspapers, and ads for employment seek optometric assistants…..no experience necessary, will train, rather than seeking a “skilled” Optician. Ophthalmologists and ODs, for the most part, do not want to pay for an Optician when someone else can, perceptually at least, do the same work for significantly less money. Can you blame them?

New Roles
The Optician must improve to survive and seek new roles to play in the eye care delivery system. In the next few months we are addressing several of those roles. Last month it was contact lenses. This month, we will address management. All of Healthcare is seeking people with skills in management, and Opticians can assume the role of manager/administrator in eyecare facilities with their knowledge of eyecare and some additional coursework. A friend commented on this topic and thought Opticians would never be interested in administrative duties, but in reality, we have always been the catalyst for the “business” side of eyecare as we discussed in the beginning of this article. Is there support in the field for this new role? I can tell you resoundingly, yes! In a study we completed some time back, the study population overwhelmingly supported this role as something the Optician could and should do. We asked Opticians to respond to the following statement: 

Opticians Should Assume a Broader Role in Administration of Eye Care Facilities

The data indicated 80.5% agree with this statement, while 14.5% are neutral and 5% disagree. Support is indicated for this statement, with 80+% positively responding. As Opticians look for new roles, the administrative/management area is one that can be developed and is not medical in any way. Here is the actual breakdown of the respondents

Opticians Should Assume a Broader Role in Administration of Eye Care Facilities

A second related statement also received positive responses:

Coursework in Business/Management would be an Asset for Future Opticians

Data showed that 93.5% indicate a positive response to this question, with the mean value at a positive 1.28. This response further validates the profession’s evolvement into administration. The important thing to note here is that they did not say they would take courses, but thought the concept was good for future Opticians. Interestingly, 61.5% of the study population indicated that they already spend 2 or more hours on administrative duties daily. 

Coursework in Business/Management Would be an Asset for Future Opticians

To be effective in management and administration, Opticians must also gain additional expertise in general education and critical thinking. We asked our study group to respond to the following statement:

Eighty-seven point five (87.5%) support this issue while 6% did not. 6.5% were neutral. Statistically, this showed a mean response of 1.16, a very positive response to the statement. This is a huge response, and clearly indicates support for the statement. See the graph below for the actual breakdown.

Required Courses in General Education/Critical Thinking Skills Better Prepare Future 
Opticians to Deal with Patients/Customers

Interestingly, there is support from the field for educating our future workforce in administration and management. What needs to be done? First, we must look to the leaders of the profession to assist in developing a solid direction for the future. What will tomorrow’s Optician look like? That must include a significant review of the education and training of future Opticians. Courses that provide the background and skills needed to successfully manage an eyecare facility would be very helpful in establishing the Optician in that role. 

As a Professor of Health Administration, as well as an Optician, I can tell you that managing providers is a difficult task. It takes great negotiation skills, and an understanding of what makes them tick. We must learn to do proper scheduling of providers, along with the very important task of coding and billing. There are many other significant activities that make any practice, large or small, successful, and a good manager is worth their weight in gold! 

Conclusion
Administration and management is something to consider. As an Optician, there really are a lot of different roles you can play if you just look positively at the marketplace. Think about where you may fit in the eyecare delivery system of tomorrow. The corporate giants are looking for managers, and so are many medical and optometric practices. The future can be bright for Opticians if we begin to embrace the changes that have taken place around us, and prepare for those not yet here. I wish you all the best in your continuing careers, and want to see you flourish! 

References on request

Warren G. McDonald, PhD
Professor of Health Administration
Reeves School of Business / Methodist University