THE NEXT CENTURY:
Are Opticians Ready for
a Change? Part II
Last month we discussed the changing face of Opticianry as a profession. This month, we continue that discussion.
Redefining the Profession
To adequately understand the role that Opticians may fill in the future, a clear picture of the profession as it currently exists must be presented. The profession is currently ill defined due to the varied role Opticians play in different regions of the country. In many states, Opticians are licensed health care providers with the right to fit contact lenses and other visual appliances. Those states require an examination, state licensure and varied levels of education and training.
On the other hand, some states require no training at all. For example, Nebraska has no licensing requirements, but the author’s home state of North Carolina has an extensive 2-day examination (North Carolina State Board of Opticians, 2002). However, 78% of the US population does get their eyewear from a licensed Optician. This disparity causes obvious problems in defining a future role, but the emergence of new technology could provide a measurement for what the profession feels will be the level of education and training needed to safely and efficiently practice in the future. This new technology may expand the need for better-trained practitioners or eliminate the need for them completely. The technology may be good enough that technicians trained at a very basic level could do the tasks that Opticians do today.
A review of the education and training requirements for Opticians in the United States was conducted that will provide a foundation on which the profession can base its educational and training need for the future. Key to the research is the fact that this is the first effort in Opticianry to study the educational and training requirements of Opticians, and an effort to predict the future status of the profession. It will provide a picture of what current Opticians feel is important to practice safely and effectively in the future and what role Opticians may play in the eye care delivery system ten years from now. Technology is potentially a key component for Opticians in the future.
Public Perception of Opticians
The public perception of the Optician is important. In the view of many patients, the Optician is the person who answers the questions patients don’t get to ask the doctor. The questions the doctor may not have time to answer thoroughly or patients forget to ask. Only one study could be found on this issue and it provides some insight into how the public generally perceives Opticians.
Gerardi and Woods (2000) completed the only known research study found that discusses Opticianry from an academic perspective. Entitled Public Attitude towards Opticianry Education as Human Capital, this study asked several key questions related to this research.
Does the public feel apprenticeship is sufficient training for an Optician?
In the public’s opinion, is a college educated Optician a better professional?
In the public’s opinion, what level of education should the Optician obtain?
This report is based on a New York City Technical College study that randomly sampled patients from a large New York optical firm and evaluates the level of education most people perceive Opticians as having. The authors wanted to find out: (a) what level of education and training patients thought Opticians had completed, and (b) what level the public felt was necessary to competently practice. The study found that 100% of those patients polled stated that they would have more confidence in a college trained Optician, and they were surprised to find that Opticians could be trained via apprenticeship. The overwhelming majority felt that at least an associate degree should be required, and 81% felt the bachelors’ degree was a necessary prerequisite.
The data also suggests that the apprenticeship program is perceived by the public to be a “relic of the past” and should be eliminated. The study selected a 10% random sample of over 1500 patient files in a large New York City firm. It was scientifically designed and clearly points to a public perception that Opticians need more education, and in fact the public felt that the level of education already completed was significantly higher than actually obtained. Interestingly, 81% felt a bachelor’s degree should be required as the entry-level educational credential.
This study indicates that the public has a higher perception of the Optician’s level of education and training than actually exists. Interestingly, there is little additional evidence of information related to this subject.
Historical and Political Perspectives
Historical perspectives of Opticianry are interesting and point to many changes within the profession over the years. Eye exams were self-administered by trial and error in many cases, and the Optician was the only source of vision correction. Medicine had little interest and there were no Optometrists yet. The Optometric profession has roots that trace back to its origin in Opticianry, as described below.
Classé (1989) discussed the early development of Optometry, a profession which evolved from Opticianry in the early part of the twentieth century. Refracting Opticians, as early Optometrists were called, saw a need to form an independent profession separate from organized medicine that would test vision and also provide optical services. This group became increasingly disenchanted with their current professional role, and saw that they could better serve their patients if they could do independent eye examinations.
Organized medicine, a formidable foe, did not support such a move towards independence for these “Refracting Opticians” and caused a slowdown of the movement from the early 1900s to the first legislative recognition of Optometry back in the late 1940s in Minnesota. This profession saw new developments that would allow them to expand beyond their present scope of practice, and developed educational programs to allow them to do so. Once educated they sought legislation for state licensure, which they have currently in every state and have attained a status to rival physicians in most areas of the country.
Today the Optometrist is a medical professional with comparable scope of practice to the physician, without the ability to do surgical procedures and with limited pharmaceutical rights. The Optometrist has the right to prescribe some pharmaceutical agents and has a significant level of income as described later in this study. The growth and development of Optometry is a model for other professions.
The Opticians Association of America (OAA) is the recognized national organization representing Opticians politically. Leaders of that organization support a change in the education and training requirements for the profession as noted in multiple resolutions, and established 2001 as the date for requiring formal education as the entry into the profession. But that move to formal education has moved slowly. Historically, Opticians have trained via apprenticeship in a field that was handed down from generation to generation. Movement away from traditional thinking is controversial to say the least.
A review of the OAA resolutions passed at recent national professional meetings indicates that similar feelings exist today regarding the expansion of scope of practice. In resolution 2-1 adopted June 1973 and revised as late as June 1984, the OAA General Assembly stated that the dispensing and refraction functions of eye care providers need to be separated, in a similar fashion to medicine and pharmacy. Today, however, the later resolutions beginning in June 1990, call for the independence of Opticians, and the adoption of formal education standards that includes the process of refraction and state licensure for all Opticians (Opticians Association of America, 2002). More next month!
References on request