By Cheryl G. Murphy, OD
July 20, 2016
Whether or not an optometrist is considered a dispensing or non-dispensing OD, they need to be aware of the latest lens options in order to prescribe what’s best for each patient.
Is it possible that you are a non-dispensing optometrist in a practice that dispenses glasses? Is this best for your patients?
After practicing optometry for 12 years I think it is safe to say at this point that I consider myself a non-dispensing OD. It is my understanding that a “dispensing OD” dispenses glasses and performs many of the measurements and tasks that some practices choose to reserve for the optician. Dispensing ODs are more likely to be found in a practice that has made the decision not to have a licensed optician. I ran across one of these practices when I graduated from optometry school and was looking for my first job as an OD.
The optometrist I interviewed with at one practice had chosen not to have an optician because his father had founded the practice and had enjoyed the opticianry aspect of eyecare as much as the optometry. When the torch of the practice was passed, the son also decided not to hire an optician and to take a patient through the entire appointment himself. That meant he did the case history, pre-testing and the eye exam. Then he would bring the patient out to the optical to help them select frames and get measured for the lenses. This was repeated for each patient.
This dispensing OD told me the way he practiced was “true optometry.” In other words, if I accepted the position there that I would be using all of the opticianry skills that I had been just trained to do in optometry school, as well as the skills I needed for the exam room. I appreciated the way the OD ran his practice, but I ended up selecting another position with a different practice. However, a couple of things that happened recently got me thinking about the distinction between dispensing versus non-dispensing ODs and whether or not there even is an official distinction.
The ophthalmology practice where I work currently has an opening for an optician due to their optician having to leave suddenly. I was asked to serve as optician (as well as continuing to see patients as an optometrist) until they hired someone else. Although I can’t quite pinpoint why this makes me anxious, it does. The main reason is probably because it has been a long time since I have measured a patient’s PD or seg height. It’s also been a while since I adjusted a frame, aside from my daughter’s, or my own, when it gets out of whack. So, I lack the confidence to do these tasks on the spot in a hurried manner in front of a waiting patient with watchful eyes. I told the practice owner that, though I was licensed to take measurements, adjust frames and dispense glasses, it is something I don’t normally do since I consider myself a non-dispensing OD. I explained that I was out of practice. This resulted in confusion on the ophthalmologist’s part, to say the least.
The second thing that made me recently start thinking about dispensing versus non-dispensing ODs was the fact that I was asked to write an article for an optometric trade journal that had to do with lenses and technology (L&T.) The article was slated for publishing, but at the last second, ended up on the cutting room floor. I think it was decided that it should not be published for a number of reasons, but one of them was that my “voice,” or explanations of certain things, seemed to be not needed or deemed obvious.
One of the statements I was trying to make in the article was that there are a lot of new designs for progressives out there that optometrists may not know about, and that they should familiarize themselves with these designs by talking to opticians, fellow ODs and reps, or by educating themselves through CE or at trade shows. I was told that optometrists already know there are hundreds of progressives out there and that ODsdon’t need to be told that. Don’t they?
I can’t speak for other optometrists–nor would I try–but I personally fall into a prescribing rut at times. When asked by patients, I tend to recommend a certain brand of progressives from a few of the trusted designs that I know have worked well for patients in the past, and not much else. Obviously, I am aware that there must be “hundreds of different progressives out there,” but my prescribing habits fail to reflect that.
For example, I wasn’t aware that there are progressives that are designed with a little area of distance power at the bottom of the lenses to help people see clearly while stepping off of a curb or walking downstairs. It was only after conducting interviews and doing some research for the article that I learned of this design. So, what about the ODs who aren’t writing for magazines or interviewing other ODs or lens companies? How are they learning about the latest in lens designs and innovations? And do they even care?
It was then that I realized how important it is for ODs (whether they consider themselves to be dispensing or non-dispensing optometrists) to stay current with developments in lenses and technology. We as ODs have to actively seek education through our peers, opticians, reps, CE and at trade shows so that we know when “new” solutions (like the Essilor progressive with Ground View Advantage, for example) have been developed to help us solve problems that we have heard patients gripe about (like stepping off a curb or walking downstairs as a new wearer of progressives.) Learning about this, and other developments in lenses, treatments, tints and measuring technologies can only help us prescribe better for our patients.
Much of the focus and excitement in continuing education for optometrists is on eyecare and health. I think that many ODs feel that staying current in that part of optometry can benefit them the most. However, when we rev our engines eager to learn about the latest diagnostic equipment and technology to measure and help manage disease, are we leaving optometry’s optical-driven past behind in the dust?
The best thing that all ODs can do for the profession and our practices is to force ourselves to have “our hands in everything.” Now, I know what you are probably thinking, “jack of all trades, master of none,” however, it is important for our patients’ sake that we keep up with at least the knowledge of new lens designs and treatments so that we can prescribe them from the exam room chair to better ensure that the patient will follow through with our recommendations in the optical.
In doing so, we may be able to help the patient who was told by the optometrist down the block that if they didn’t like peeking outside of the frames, or dropping their chin to their chest when walking downstairs, that they should consider switching out of progressives. A few weeks ago, before I learned about the new Ground View Advantageprogressive lens design, and others like it, that “optometrist down the block” may have been me. Don’t let it be you. Keep up with the latest in L&T.
Is there such a distinction betweena dispensing andnon-dispensing OD, or should optometrists be expected to jump into the role of optician on the spot if required? How confident are you in your opticianry skills? What sources do you use to keep up with the latest in L&T? Has optometry’s focus shifted so much toward eyecare that it is neglecting eyewear, or are we just letting the professionals best trained for that job (opticians) do it?