Welcome
to
"An
Optician's primary function is as a highly
PREFACE The opinions and conclusions that follow regarding the practice of dispensing prescription eyewear in America are based first, on our direct observation and experience, and second, on the first hand testimonials of Patients with whom we have had the opportunity of serving. And they are presented optimistically with the hope that owners and managers, whether they are private practitioners or corporate retailers, will resonate and be inspired and motivated to make appropriate changes to their business model in order to advance the status of Opticianry as a profession while enhancing their own objectives. Part I, Serving vs Selling, in addition to offering an educational experience to Ophthalmic Dispensers, is intended to be a consumer advisory and industry critique, as well as a primer and a plea to Optical Retailers who have failed to recognize or who have chosen to ignore the need for a) the resurgence of Hands-on Assessment, Design and Delivery of prescription eyewear, b) the resurgence of the Lifestyle Interview in the training of Opticians, these elements being increasingly absent in today's Ophthalmic Health and Wellness delivery system, c) the resolution of the conflicted relationship, which has subsequently developed between Professional Opticians and many Retail Managers, d) the reversal of the retail practices that have led to a steep and steady decline in the eyewear design process, and the delivery of custom-fitted eyewear, and e) numerous practical remedies. See OpticianryReview.com. "Many
Retail Optical Executives and Managers have no In addition, Serving vs Selling is presented with the hope of stimulating meaningful dialogue among ophthalmic industry leaders, private practitioners, and corporate retailers especially, with the idea of providing more comprehensive and ongoing practical training, especially for Managers and Opticians; training that goes beyond the usual on-the-job, learn-as-you-go training, reviewing testimonials and episodes of prowess in selling, or answering an array of test questions that have more to do with corporate sales goals and policy issues than they do with everyday Practical Dispensing; quality-over-quantity training that focuses on one-on-one, Dispenser-Patient Interview exercises, and especially the practical application of hands-on, in-place, on-the-face prescription eyewear assessment, design and delivery skills. Note: For free consultation on ways to improve the delivery of prescription eyewear and increase profitability, contact Opticians For Change. This section is also meant to encourage Consumers to become more vociferous in demanding higher standards of practice, and more personalized care in the delivery of prescription eyewear and services. See Guide to Optical Terms. "For
many Consumers, the personalized fitting of eyewear by a Part II, Back To Basics Frame Fitting Course, which follows this discourse, is a Free Knowledge Review Course for Dispensing Opticians. Major points, which are covered here, are given some additional attention therein. Whatever
happened to Old-fashioned,
OVERVIEW In an article appearing in the Orlando Sentinel, June 4, 2008, Harry Wessel reports that there's a generation gap in America's workplace that's serious enough to cause a big brain drain in coming years. According to Randstad USA, an Atlanta-based employment-services company: "U.S. businesses risk a shortage of skilled labor -- not because of the lack of manpower in the wake of retiring baby boomers, but because of the limited transfer of knowledge. According to a Harris Interactive survey, there is little interaction among the four Generations of U.S. employees. It defined the four Generations as the Mature Generation (those born before 1946), the Baby Boomer Generation (born 1946-1964), Generation X (born 1965-1979) and Generation Y (born 1980-1988). The different Generations rarely interact with one another and often do not recognize each other's skills or work ethic. Employers should help close the knowledge gap by instituting ways for each Generation to recognize the strengths and value of all colleagues." The four Generations share the same objectives but not the same experience. Their respective perceptions have to do with diversities in background and life experience. Thus each of the Generations must simultaneously appreciate the skills, and tolerate the shortcomings of all colleagues in order to move forward successfully. Dispensing
Opticians' "For
the truly skilled Optician, the standard of care must include It is apparent to many of today's Senior's and other industry observers that there's a big gap between the applied dispensing skills, i.e., hands-on assessment, design, frame adjustment (see example) and delivery techniques of "Mature Generation" Opticians and the practices of many of today's Retail Dispensers and Managers. See Opticians: Merchants or Healthcare Providers. Through no fault of their own due to the absence of multi-generational connections, some of today's Dispensers, especially Retail Managers, are seen to provide and-or oversee only the most casual delivery of prescription eyewear as if it were ready-to-wear clothing or over-the-counter general merchandise, with little or no attention being given to the all-important Full Discovery Lifestyle Interview, or to the subtler frame-fitting details as practiced by their hands-on skilled predecessors. Unfortunately, their attention is now preoccupied almost entirely with quantity-over-quality issues, such as daily sales goals, sales reports and other marketing efforts to the detriment of Patient satisfaction, which of course, adversely impacts sales as well as referrals. Consequently, some of today's Ophthalmic Retailers are chronically struggling with high rates of returns and refunds. "The
most perfect prescription can be compromised if the And if any frame adjustment is applied, it may amount to no more than a slight adjustment of the nosepiece and-or a sharp and short ninety-degree bend of the frame's temples at the junction of the ears. In other words, no reshaping of the temples to follow the lines of the skull occurs, in the belief that it is the temples-to-ears contact that holds the eyewear in place. Of course, it's the temples-to-skull contact, NOT THE EARS, that primarily holds the eyewear in place. See example here. In fact, many of today's Dispensers only require the delivered eyewear to look straight or "cool," never mind that it does not fit the asymmetric facial or cranial contours of the Patient. It's as if they are fitting a one-dimensional, flat-surfaced counter top instead of a multi-dimensional, contoured human face and skull. Some unskilled Dispensers have been known to go so far as to 'fix', i.e., remove, any previously applied skull-conforming configuration, albeit more comfortable for the Patient. "In
order to excel as a Dispensing Optician, one must first have Through no fault of their own, today's Dispensers are unaware of the decades-old decline of applied Hands-on-the-Patient fitting skills. This situation has produced at least two generations of Opticians, "Generation X" and "Generation Y," including some latter generation Board Certified Opticians, who have never witnessed a demonstration of these skills. (See example.) Furthermore, it's uncertain how many of today's Schools of Opticianry are teaching dispensing skills to this same degree. As a result, some latter day Dispensers have come to believe, after practicing a couple of years of their method of 'delivering' eyewear, that they are sufficiently skilled and are in need of no additional training in the art and craft of dispensing eyewear, and worse, that they have little to learn from more skilled, Mature Generation colleagues. "Of
course, merchandising is an important and necessary service,
but all too often the
A Too Common Testimonial As an example, a Patient recently reported their experience whereby they were handed their new eyeglasses at an Optometrist's office by a Dispenser with some 20 years of experience, whereupon no adjustments to the frame were made and the Patient was forced to seek the appropriate service elsewhere. The Patient subsequently reported that she felt fortunate to find an Optician having the skills to relieve her discomfort after spending a considerable amount of time searching. Unfortunately, similar episodes have become somewhat common throughout the retail optical industry. This leads one to wonder if board certification and-or licensing is really effective, since just about anybody can hand over a pair of eyeglasses or contact lenses and operate a cash register, as we see demonstrated in some of today's true-to-life TV ads, whereby the Patient and Dispenser never make direct contact. The Dispenser just hands the Patient their eyewear. The Patient puts the eyeglasses on, looks in the mirror, and leaves. This scenario is so commonplace today in the real world that many Patients never expect to have any form-fitting adjustments applied to a frame. (Question: When's the last time you saw or heard a retail optical store promote the custom fitting of eyewear? Can this be because they don't know how to fit eyewear? Could it be that the staff only knows how to sell glasses?) See Common Complaints and Causes. Should
an Optician act more as a
"Hands-on-the-Patient
dispensing is a soon-to-be lost art. If the trend Placing
The Frame Directly On
"By
placing the eyewear directly on the Patient, the Optician Some portion of the Opticians' Generation Gap is explicable due to the current focus on Dispenser training by way of on-the-job apprenticeship programs, some of which are devoid of adequate Full Discovery Lifestyle Interview training, and absent any Hands-on-the-Patient, assessment, design and adjustment of prescription eyewear as practiced by skilled Opticians. But this gap is equally a result of today's over-emphasis on the corporate retail paradigm whereby latter generation Dispensers especially tend to become more skilled at parroting slogans, giving testimonials about sales prowess, and answering questions about company policy, sales goals and promotions from company executives, all of which afford them no experience in conducting a lifestyle interview or effectively assessing, designing, and then fitting prescription eyewear directly on the Patient. Unfortunately some aspiring Dispensers tend to become merchants, peddling ready-made, over-the-counter merchandise, not skilled Opticians, dispensing customized, prescription eyewear.
"A
Surgeon must train for years in actual hands-on practice, In the eyes of some Consumers the up close and personal aspect of dispensing eyewear has become an exotic and unfamiliar craft, and the art has devolved to such an extent that many Consumers (even many Dispensers) now actually think that a hand-fitted frame is inferior to an off-the-board frame. For example, some Patients, having never seen or experienced a hands-on-the-Patient customized frame fitting, have been known to request that the skull conforming adjustments, having been applied by a skilled Optician of the hands-on-school, be removed from temple ends because "they don't look straight, flat and normal like other people's glasses." Unfortunately, the "other people's glasses" were more than likely never customized to fit either.
"When's
the last time you saw or heard a retail optical
"Just
as a Dentist cannot practice Dentistry without OPHTHALMIC DISPENSING is herein defined as those activities performed by a skilled Dispensing Optician, which include, a) the fullest discovery and maximum consideration of the Patient's visual needs, b) the assistance and advice to the Patient regarding the appropriate choice of lens design and frame selection, c) the duplicating, measuring, inspecting, and verifying of prescription lenses, and d) any subsequent Gross Frame Alignment and Subtle Frame Adjustments, including the Final Fitting.
HANDS-ON-THE-PATIENT DELIVERY is herein defined as those procedures, which involve eyewear adjustments performed by a skilled Dispensing Optician, which specifically include, a) the visual and 'touch and feel,' hands-on-the-Patient, tactile assessment of the frame, while it is in-place, on-the-face of the Patient, in order to determine any misalignment, and b) any subsequent multi-dimensional hands-on-the-Patient, tactile, 'touch and feel' handcrafting that is required to refit, align, adjust, reshape, bend, stretch, twist and sculpt the components of the frame in order to personalize the eyewear for maximum visual comfort and wear-ability. See example. "Where there's no touch, there's no hold." The highest level of customized frame fitting, aligning, and sculpting, is achieved mostly with handcrafting skill and the trained eye, along with the aid of hand tools. Hand crafted multi-dimensional adjustments, including tactile, hands-on, 'touch and feel' procedures such as reshaping the temple ends to make direct and full, but light contact with the mastoid area behind the ears, while simultaneously avoiding direct contact with the pressure-sensitive ears, is one of the single most important considerations for long-term comfort and wear-ability. Full contact, without pressure, on the bridge of the nose and on the skull BEHIND the ears, NOT ON THE EARS, are the two primary means of frame support and restraint. The ears act as only a secondary or 'last resort' means of restraint and stability. See more 'Hands-on' details here.
Common Complaints and Causes
"These are just some of the challenges that face dispensers every day on the front lines of ophthalmic dispensing. Ask yourself if you and all your dispensing staff members possess the ability to professionally and effectively “diagnose” the cause of these problems and effectively and efficiently correct them.
Furthermore, a successful multi-dimensional frame alignment and fitting can be achieved only when the Dispenser 1) visually assesses the eyewear in-place, on the face of the Patient, and 2) simultaneously uses the sense of touch to determine any anomalies between the frame's temples and the Patient's skull. In most cases, the Dispenser cannot remain seated. The Dispenser must get up, and get close to the face of the Patient, otherwise neither a proper evaluation or fitting can occur. In other words, the Dispenser must stand and lean over the seated Patient in order to make the required observations at different angles to the front and rear of the Patient's head. The fitting-adjustment procedure itself also requires the removal and re-placement of the eyewear directly on the Patient as many times as necessary to complete, and the entire evaluation and fitting process requires sufficient time to execute properly, i.e., it should not be rushed. Old-Fashioned
Multi-dimensional "The
temple-ends cannot hold an eyeglass frame in place Every
Patient deserves a sufficiently handcrafted,
"Today's
Ophthalmic Dispensing practices are There are some industry observers who see the devolution of Ophthalmic Dispensing as the result of an overall corporate strategy perpetrated by some industry members to eliminate any reliance on competent, Licensed Opticians in order to better manage their labor costs and enhance their profits. But the Profession is mostly the victim of the perpetual tension and struggle between opposing market forces; the Company's need for control of inventory and labor costs, and the Patient's desire for choice and comfort. What many corporations don't understand is that giving the Consumer more of what they want is best for everybody. The last century's most successful entrepreneur, Sam Walton, taught that the Company must always favor the Consumer, first. Ophthalmic Dispensing, within recent decades, has become so 'retail oriented' and subsequently dehumanized to the point that some Patients have been known to express a sense of surprise, even concern, at a skilled Optician's use of 'touch' while fitting their eyewear. This has occurred to the extent that some 'old school' Opticians now feel the necessity to request a Patient's permission before proceeding with any critical and necessary Hands-on-the-Patient adjustments, which require touching the Patient. Just
as nobody can order dentures from a mail-order source because
the Physicians and Dentists do not request permission to touch a Patient since it is an obvious necessity, and a long accepted practice to use their Hands-on Skills. Sadly, Ophthalmic Dispensing has devolved for such a period of time that the Dispenser's use of touch is now no longer acceptable or even associated with the dispensing of eyewear by some Patients. Unfortunately this has subsequently led some Patients to turn to mail-order eyewear, their experience or logic being that the customized fitting of their prescription eyeglasses is either insufficient or unavailable. "It
is how well the eyewear makes contact with the Ready-Made, Ready-To-Wear Gap Whereas corrective eyeglasses that are assembled in an optical laboratory are, as a final step in their inspection process, inverted on a flat surface and made to fit squarely at the four points of contact, ready-to-dispense, they are NOT ready-to-wear. Instead of assuming that newly made eyeglasses all require at least some minimal adjustment and realignment, today's unskilled Dispensers assume and-or hope, due to lack of adequate training and tools, that they need no additional alignment. They seem to apply the logic, "Well, the Patient has chosen this frame, so it must be the right size, and the lab has already made their 'four point' adjustments, so the glasses are good to go." This hands-off approach is out-of-touch with the comfort needs of almost every Patient. 3-Dimensional
Dispensing
"Successful
dispensing requires the careful and thoughtful
Some Refractionists, that is Optometrists and Ophthalmologists, make entries on their prescriptions such as "No-line Bifocals" or "Progressive Lenses," both of which refer to a Progressive Addition Lens or PAL. See below. Too many times this is a subjective entry on their part, which is made in the absence of any discussion with the Patient, and minus any explanation to the Patient as to why a Progressive Lens is better, or how the lens works, or what other options are available. Of course, these points are all better left to the Optician to give more complete coverage during a lifestyle interview, which too often never occurs in many instances. See video.
But any suggestions on the Doctor's prescription notwithstanding, many of today's Retail Dispensers promote No-line Bifocals without any notion of whether the Patient's visual circumstances require more practical alternatives. And many Dispensers assume that a PAL is the Patient's informed choice since the reference appears on the Doctor's Rx. This scenario all too often results in an unsatisfactory outcome for all parties, and it manifests by way of many unhappy Patients as well as high rates of unnecessary remakes and-or refunds.
"In
order to adequately fulfill the needs of the Patient,
A
Case In Point Each Patient is unique, and presents different visual needs. In order for the Dispenser to recognize and fulfill these needs an adequate lifestyle interview must occur whereby the Patient discloses any pertinent details. In other words, the successful design of eyewear requires that the Dispenser fully engage the Patient in a full discovery and disclosure interview, so that all aspects of the Patient's visual habits, vocational and avocational, are disclosed. For example, a presbyopic aircraft mechanic working under an aircraft engine or a presbyopic painter working on walls and ceilings, both of which require a fixed upward view for extended durations, will appreciate a Double D Multifocal (Double Bifocal) or even a Quadrafocal lens design. On the other hand, a Progressive Addition Lens, though preferred by a majority of Patients, or a regular bifocal, is most likely to be an inadequate lens design under such working conditions.
At the conclusion of the lifestyle interview, the Dispenser should advise the Patient of the widest range of lens designs, frame styles, and prices that most appropriately fit the Patient's needs. This may well include the consideration of multiple pairs of eyewear, which can include special lens types such as extra-wide streetwear or occupational bifocals or trifocals, sunwear and safety, or golfing and other athletic designs.
When a Patient goes to a Physician for medical treatment the Physician first interviews the Patient to discover all relevant issues before designing a treatment. Likewise, a Patient in need of prescription eyewear requires a 'discovery interview' to determine the design of their eyewear, especially the lenses. "The
proper and successful practice of the art and Hands-on
Assessment, "A
Patient's face and head are not Patients deserve a fully personalized design and fitting of their eyewear. The fact that the frame lies on a flat surface squarely should never preclude fitting the frame directly on the Patient. This becomes obvious when after fitting a Patient with facial anomalies, the frame no longer fits squarely on a flat surface. Facial structure, the positioning of each eye and ear, the mastoid-contour (see photo) behind each ear, all of these differ with each person. The proper and successful practice of the art and craft of Ophthalmic Dispensing "lies in the details." For example, some Patients have one EYE positioned higher than the other. Most of these Patients are unaware of this condition. How many Dispensers are aware of this somewhat common disparity? How many Dispensers compensate for this anomaly in their multi-focal lens design by vertically offsetting the respective reading segment along with an appropriate advisory to the Patient? Multi-focal lenses are ordered today with the reading portion placed at matching heights because vertically-equal eye symmetry is assumed to be the norm and-or "it looks better" when the segments can be observed as vertically and horizontally equidistant, and because vertical eye asymmetry is not considered as a design factor, even though its consideration is important for the Patient's visual balance and comfort at the near and intermediate points. In fact, some Retailers don't allow for any disparate bifocal segment height or seg inset in their lens design software. "The
eye care industry needs to strike a better Eyewear can be considered to be successfully dispensed and delivered only after 1) an in-depth, full discovery lifestyle interview by the Dispenser occurs, 2) an in-place, on-the-face eyewear assessment is made and the resultant measurements are noted, 3) the laboratory processing of the eyewear is completed, 4) all elements of the eyewear are inspected for accuracy and validated by the Dispenser, and 5) Gross Frame Alignment and any Subtle Frame Adjustments are applied by the Dispenser upon delivery of the eyewear to the Patient using the sense of touch. See the Final Fitting. PERSPECTIVE
"It's
necessary to recall the past Together with the decades-long corporate expansion of retail outlets, the marriage of eyewear to fashion, the expanded marketing of multiple pairs, the proliferation of lens types, add-ons, and frame materials, the dawn of the computer age and the resultant visual issues, the unfortunate advent of mail order contact lenses and eyeglasses, the scarcity of experienced practitioner-teacher Professionals with hands-on, in-place, on-the-face skills, together with more and more Dispenser training occurring online, and state licensing boards, some of which are absent adequately trained members, a steady decline in the art of fitting eyewear with applied Hands-on-the-Patient assessment and fitting skills has occurred almost to the point of its disappearance. These skills now reside mostly in the hands of a dwindling number of skilled Opticians.
During the first half of the 20th century the American Optical Company and Bausch and Lomb, dominated and actually monopolized almost all of the Ophthalmic Manufacturing, Wholesale Laboratory, and Retail Dispensing Industry. Most dispensing skills were literally and figuratively in the hands of AO and B&L Laboratory-Dispensing Opticians. After the government anti-trust break-up of AO and B&L in the early 1960's, which separated their manufacturing and laboratory operations from any dispensing activities, the Ophthalmic Industry began to take the form we see today. Prior to their break-up, AO and B&L dispensed eyewear directly to the public in what the government ruled was a monopolistic business, which exclusively served their wholesale laboratory clients, i.e., Opticians, Optometrists, Ophthalmologists and other Dispensers. After the break-up, the retail dispensary paradigm began to shift from one of Patient care, with the focus on Health and Wellness to that of merchandising. Thus, began the evolution from hands-on-the-Patient, 'healing' related, ophthalmic dispensing to today's highly discounted, dehumanized, over-the-counter, ready-made, hands-off merchandising. As a result, latter day Dispensers do not easily relate to the practice of hands-on dispensing nor does the retail optical industry as a whole. There's a big difference in the quality of service.
"Of
the over 67,000 Opticians designing, manufacturing Then, acting mostly in the interest of cost-efficiency, the Ophthalmic Industry itself accelerated the decline. For example, in the years preceding the 1970's, frames were made in a multitude of sizes, i.e., eye sizes, bridge sizes and numerous temple lengths and styles, in order to satisfy the diverse needs of Patients. Since then, Ophthalmic Manufacturers have gradually eliminated multiple sizes. This has resulted in the decline of the quality of ophthalmic services. Now, most frame styles come in one or two sizes at most. As a consequence we see many Patients with ill-fitting prescription eyewear to wit it is now even more important for Dispensers to be skilled in Dispensing Opticianry, i.e., skilled in custom fitting frames in order to accommodate the absence of variable frame sizes. Instead, each succeeding generation of Dispensers is less skilled, and the downward spiral of decline appears to continue unabated. Furthermore, today's frame manufacturers, which are now based mostly overseas, produce frame materials that are inferior to the products of yesteryears when gold filled metal, for instance, was the dominant material. Many of the plastics and metals used today are too brittle and do not respond well to heat or bending. Today's frames are not capable of being reshaped or adjusted quickly and easily, such as changing the length of temples or applying mastoid-fitting bends. And ophthalmic lens manufacturers no longer provide experiential visual aids such as Progressive Addition Lens demonstrator kits whereby a Patient can actually experience the advantages and disadvantages of advance design PAL's as they apply to their specific needs before finalizing their choice of lenses. Another indicator of the devolution of Dispensing Opticianry is the trend in the design of dispensing tables to wit Dispensers can just barely reach Patients. The design seen in most Dispensaries today actually discourages Dispenser-Patient contact since the proximity of the Patient to the Dispenser is well beyond arms length. Today's Dispensers are unfamiliar with the Dispenser-friendly tables of yesteryears, which positioned the Dispenser and Patient within easy reach and which affords the easier performance of custom, hands-on fitting. Today, as a result, hands-on Dispensers must stretch and strain or circumvent the use of the offending table altogether in order to do their thing. "An
overly aggressive emphasis on sales goals has Many important tools of the trade along with the knowledge of their use have disappeared due to the industry's shift away from sufficient emphasis on a lifestyle interview, relevant eyewear design, and hands-on, in-place, on-the-face dispensing-delivery skills. For instance, how many latter day Dispensers know how to lengthen or shorten and refit a plastic covered, metal temple end piece? How many have seen or even heard of numerous dispensing aids such as the distometer, hot salt-bead pots, zyl-bridge stretching or shrinking pliers, specially designed self-closing tweezers, nose pad removal pliers and Progressive Addition Lens demo kits? How many present-day Dispensing Opticians have any knowledge of, or experience with the custom designing of presbyopic golfers' glasses, which feature bifocal segments designed to the golfer's specifications, in either one or both lenses, which are placed anywhere the Patient prefers, for the purpose of avoiding interference while aiming their golf shots? How many current Dispensers are aware of the round segment bifocal, which is scarcely used anymore, but remains a first choice transitional lens design for some first-time, hard-to-fit, prospective Progressive Addition Lens wearers due to its ease of adaptation along with its cosmetic advantage of having a nearly invisible segment? (Albeit the sales leader for today's presbyopic Patient, the PAL may NOT be the first or ONLY lens of choice for these Patients.) And what about the trifocal lens, which is no longer considered an alternative to the PAL by many latter-day Dispensers because of its visible segment? Even when Patients are less concerned with the vanity aspect of the 'no-line' feature as opposed to the superior functionality that a trifocal offers over the PAL or Computer Continuum lens, in some visually challenging environments especially, the PAL is too often the only option offered to them.
The
Progressive Addition Lens (PAL)
Unfortunately, today we see too many Retail Managers who are experienced in marketing but under skilled in the art and science of Opticianry. Many of them are too fixated on policies and procedures and-or overly sales-aggressive to the point of obstructing the delivery of acceptable ophthalmic services. (Remember the AIG debacle where the overreach for profits and bonuses caused an eventual financial calamity?) For example, check out the subject of prescription wrap-around eyewear and the expertise required to fit this type of eyewear properly. Click here. "Success
always follows good service. Furthermore, the untrained optical store Manager who obsessively pushes a Dispenser for higher production of high-dollar sales, e.g., the universal promotion of high-end and more expensive Progressive, "No-line" Lenses, regardless of their demonstrable need, thereby affords less occasions for adequate eyewear design time and full consideration of the Patient's needs. At the same time inexperienced Managers unrealistically demand that customer satisfaction be maintained and minimal remakes or refunds be sustained. "Pushing
Patients into Progressive Addition Lenses without As a result of these conflicted goals, Dispensers are discouraged from conducting the appropriate Patient interviews. This results in more Patients becoming dissatisfied, while generating more returns, remakes or refunds, which leads to more frustrated Managers and Dispensers. It's as if nobody can figure out that this unfortunate cycle, along with its adverse karmic impact on the bottom line, will end only when the Patient's genuine needs are considered and fulfilled. "To
serve is to succeed. When it comes to dispensing eyewear, Now, after several decades of dealing with this conflicted and downward spiral, with its resulting focus away from previous generations' people friendly, 'take your time,' hands-on practice of dispensing to today's ready-made, one-size-fits-all, 'get them in, and get them out' attitude, and with bottom-line sales the industries' main goal in spite of much hype to the contrary, a litany of complaints from Patients, such as the following, are being heard with ever increasing frequency. "They just handed me my glasses and asked me, "How do they feel?" "She didn't take the time to fit my glasses." "They just told me to bend down and shake my head to see if they fit okay, but they never adjusted my glasses." "I told him my new glasses looked crooked and then he asked me what I wanted him to do about it." "I was told that I needed a progressive no-line bifocal instead of a regular bifocal, but they didn't explain why, or what the difference would be. Now, at work, I have to raise my head and bend my neck way back in order to see my computer monitor. These progressive lenses don't work for me. I want my money back." Sadly, optical dispensing has declined to the point that many Patients over the years have developed an attitude whereby they no longer have any expectation that their prescription eyewear can ever be fitted comfortably. Some Patients are even heard to express a sense of dread in making an eyewear purchase. And some Patients even describe their experience as akin to buying a new or used car, i.e., getting the big sales pitch, and then paying for the promised or implied high quality of service, none of which is received. The 'Booming' Eye Care Industry "Of
the over 67,000 Opticians designing, Furthermore, the eye care industry in America is booming. The rapid growth, fueled by the ageing "Baby Boom" generation, and the dwindling number of hands-on skilled Opticians has created what is becoming a shortage of adequately trained Opticians nationwide. This large segment of the population, those born between 1946 and 1963, are entering their fortieth year and beyond. At approximately age 40, corrective lenses for reading and other near vision activities are commonly prescribed. This condition, known as presbyopia, is a normal function of the ageing process and affects nearly the entire population. See Before and After photos. The result: an increasing number of people are requiring the services of Eye Care Professionals each year, a trend that will continue well into this century. According to a study conducted by the U.S. Department of Labor, the number of Opticianry jobs is predicted to increase by some 35% during this period of unprecedented growth. See before and after correction photos of Astigmatism, Hyperopia and Myopia here. SO, WHERE DO WE GO FROM HERE? The
industry's challenge is to upgrade "Once
the Retail Optical paradigm is upgraded to that of serving First, the Retail Optical Industry's attitude and business paradigm must be upgraded from its current Retail Merchant model to that of a true Healthcare Provider. The reality and importance of the Skilled Optician's role in the healthcare delivery system must be more clearly defined and nurtured. Second, Ophthalmic Industry Members must step up with their collective resources, to close the "knowledge gap" with the ways and means for each generation of Opticians to "recognize the strengths and value of all colleagues," to improve the quality of service at all levels, and to provide, protect, and preserve the increasingly rare Hands-on-the-Patient skills of "Mature Generation" Opticians in the interest of serving the health and wellness of their current and future base. To this end, a prospective model for an On-site, Hands-on-The-Patient Remedial Training Workshop for Dispensers follows. *Note: The Florida Board of Opticianry is an entity within the Florida Department of Health, which has jurisdiction over Florida Healthcare Providers. "The
conflicted relationship between Professional Opticians REMEDIAL
TRAINING "Let's get back to lifestyle dispensing." A) The Full Discovery and Disclosure Lifestyle Interview. B) Design and Delivery of Eyewear using in-place, on-the-face assessment and hands-on skills. C) Managing an Optical Dispensary as a Healthcare facility. D) Improving the Dispensary layout. Full
Discovery and Disclosure
The Dispenser will advise the Patient of ALL the available lens-frame options and costs, and concludes the interview with specific recommendations, whereby the Patient can make a fully informed decision as to their purchase. Note: It is the absence of such a lifestyle interview and its subsequent disclosures that results in many unnecessary complaints, returns, remakes and refunds, and the loss of the Patient's good-will referrals.
"You
are fitting a Patient for comfort,
Chronic
discomfort issues can be "Opticians
must touch and feel A well executed hands-on, in-place, on-the-face assessment, as well as a touch and feel frame fitting procedure obviously requires some direct physical contact along with the appropriate communications between the Dispenser and the Patient. A proper hands-on frame fitting involves the repeated removal and re-placement of the frame on and off the Patient by the Dispenser until such time as the fitting is completed, which depends of course on the experience of the Dispenser, any asymmetric features of the Patient, and the type and design of the eyewear. See example. The Dispenser must not rush the procedure. Much time is saved in the long run when the fitting is done with sensitivity and patience, thereby reducing the necessity for return visits. Click here to discuss a hands-on dispensing demonstration. Note: It is how well ophthalmic eyewear, whether it be eyeglasses or contact lenses, makes contact with the Patient that ultimately defines Ophthalmic Dispensing. "Just
about anybody can casually hand over a pair of How
To Manage An Optical Dispensary "Many
of today's Retail Optical Executives are skilled Merchandisers
"Once
the Retail Optical paradigm is upgraded to that of serving
"Due
to their market share, some Optical Retailers are Special Note: The emphasis herein with respect to the importance of Hands-on-the-Patient, in-place, and on-the-face, touch and feel delivery of ophthalmic services may seem somewhat overstated, but Patients who experience the results of such skilled service are known to make more referrals and give testimonials as to the improvement to their long-term visual comfort and frame wear-ability using words such as "significant," even "profound." This level of personal service has the power to transform any Ophthalmic Consumer into a life-long Patron. And complaints, remakes and refunds are significantly reduced, as well. (Thought for today: Opticians exist for the purpose of SERVING people, NOT SELLING things. See ToServeIsToSucceed.com for an example.) "Serve people first, and more will follow."
Whereas personal service can be defined as any human activity by which people's lives are made better, i.e., easier, happier and-or more comfortable, happy Customers are the very best way of advertising goods and services just as portrayed in the inspirational narrative of 'Johnny's Story.' Happy Patient's promote good will, and the serendipitous word-of-mouth-advertising is free! See more specific details. Improving The Dispensary Layout "Inadequate
equipment and tools contributes to
The floor plan and workspace of many of today's Dispensaries are laid out in such a way that they do not support or encourage qualitative dispensing practices or Patient comfort. We see too many Dispensaries in which the pace of activities is so fast, and the environment so noisy and unpleasant that it is difficult for us to associate them with the health and wellness industry. In this respect, the training of skilled Opticians, the functional performance of Dispensers, and especially the delivery of healthcare services to Patients, is adversely affected, even discouraged. Today, as mentioned previously (click here), we see dispensing tables that are not made with much thought of enabling close, direct contact between the Dispenser and the Patient. See Custom Frame Fitting here.
Hands-on-the-Patient dispensing is a soon-to-be-lost art. If we continue today's trends to the narrow and strictly retail approach to ophthalmic services, the marketing of ready-to-wear, over-the-counter eyewear will continue to flourish, hands-on dispensing skills and services will disappear, Patients will continue to suffer from substandard quality of service, eyewear will continue to be delivered by an increasing number of unskilled Dispensers, and everybody will lose something in the real value, quality and satisfaction of life. The current retail paradigm for dispensing eyewear needs to be overhauled. In Conclusion The
Golden Rule of Commerce
It is presumably the intention of all Ophthalmic Dispensers to conscientiously practice the art of dispensing and delivery of eyewear with the optimum of skill and service whereby both the gross and subtle aspects of fitting a frame are applied. But while the majority of today's Dispensers are familiar with Gross Frame Alignment, the subject of Subtle Frame Adjustment fails to resonate in conversations with many industry members to wit, a rather blank, even puzzled facial expression is often visible in response to the broaching of the issue. Hopefully, the views presented in this discourse will resonate with industry members as a call-to-action with the result that they will work to avoid or discontinue today's all too common practice whereby a Dispenser casually, and absent any skillful attention to details, hands over prescription eyewear, and concludes the occasion with a statement such as, "How do they feel?" or "Shake your head and see if they're loose!" Everybody deserves eyewear, which has been conscientiously personalized to their maximum benefit, comfort and satisfaction. -- Special note: It seems the term 'hands-on' has different meanings among members of the optical community. See our definition. For an example of what we call hands-on-the-Patient, old-fashioned design and custom fitting of prescription eyewear, click here. And for those who are otherwise looking to improve the delivery of prescription eyewear in America, please contact us here. About Hari S. Bird, LDO Experience: Mr. Bird's career as an Optician began following his active duty with the U.S. Marine Corps and subsequent employment with an American Optical Company Branch Laboratory in early 1958. He spent more than 2 years in all phases of AO Laboratory operations as a Lab Technician, including hand surfacing, hand stone and automatic edging, bench work, finishing, final inspection, and hands-on-the-Patient custom fitting. (At that time AO and B&L, Bausch and Lomb, labs dispensed eyewear to the public at the behest of eye care providers, i.e., MD's and OD's.) He became the Manager of an AO Branch Laboratory, and later a Sales Rep for American Optical lenses, frames, and ophthalmic instruments. Shortly thereafter, he returned to Ophthalmic Dispensing with an MD-OD joint practice and later his own private practice. Although currently retired, he holds active Dispensing Optician licenses in Florida and Arizona. He is also American Board of Opticianry and National Contact Lens Examiners certified. His history includes experience as the owner of a private-practice Ophthalmic Dispensary, and more recently as a Licensed Optician for an optical retail chain. Click here for an online profile. Goals: Mr. Bird is a passionate advocate of a) a resurgence of the Optician as a Healthcare Provider as opposed to today's Dispenser acting mostly as a purveyor of merchandise, b) a resurgence of the Full Discovery and Disclosure Lifestyle Interview and Design of prescription eyewear, c) the conscious Hands-on-the-Patient design and delivery of prescription eyewear, and d) more practical training of aspiring Opticians in the art of custom designed lenses and the custom fitting of eyeglass frames. A
Special Note As senior Ophthalmic Healthcare Providers, we are interested in sharing our experience as Dispensers of prescription eyewear. If you are a practitioner who recognizes the decades-old decline in dispensing skills, and you wish to share your experience and-or you need guidance in order to improve the profitability of your practice, please visit OpticianryReview.com for more details, then contact us here.
Grateful
appreciation is hereby expressed to Hari
Singh Bird, LDO
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The
glasses do not stay in place. (Temples spread too widely; temple
adjustment behind ears is too loose or incorrect; pads spread
too far; bridge too wide; doesn’t fit nose; eyeglasses
are too heavy.) 
Each Attendee, in the presence of a skilled hands-on Optician,
will participate in an alternating 'Dispenser' and 'Patient'
role-playing episode in which the all-important Full Discovery
and Disclosure Lifestyle Interview, is conducted. Full Discovery
and Disclosure means that the Optician conducts an interview
of the Patient in order to discover ALL aspects of the Patient's
visual habits and needs. 
