"Opticianry is ultimately defined by how well the eyewear makes
contact with the Patient, not by the number of Customers served.
Therefore, a conscious, precise, and personalized process of frame
selection, lens design, and in-place, hands-on fitting is required."

The Open Letter, which follows, presents a 'Bird's eye' view of a) the business model in use today by some Retail Optical Dispensaries; b) the conflicted relationship between experienced Opticians and some Retail Managers and Corporate Executives; c) the corporate practices, which have led to a steep and steady decline in the practical design and up-close-and-personal delivery of custom-fitted, prescription eyewear; d) practical remedies.

The genesis of this Open Letter occurred following an Optical Retailer's outreach to its Staff for ideas about creating "America's ‘Premier’ source for Vision Care." What follows is based in part on my written response* as a staff member, along with some additional observations.

The opinions and conclusions that follow are based first, on my direct observation and experience, and second, on the first hand testimonials of Patients with whom I 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. Note: An abbreviated version of the following letter appears in the November 2009 edition of Eye Care Professional Magazine.

A Special Note
From OpticiansForChange.com

"The eye care industry needs to strike a better
balance between sales goals and healthcare delivery."

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 OpticianryToday.com for more details, then contact us here.

Open Letter

To Whom It May Concern:

First, a brief personal history. My career as an Optician began following active duty with the U.S. Marine Corps and subsequent employment with an American Optical Company Branch Laboratory in early 1958. I spent more than 2 years in all phases of 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, i.e., Bausch and Lomb, labs dispensed eyewear to the public at the behest of eye care providers, i.e., MD's and OD's. See OpticianryToday.com for additional background.) I then became the Manager of an AO Branch Laboratory, and later a Sales Rep for American Optical lenses, frames, and ophthalmic instruments. Shortly thereafter, I returned to Ophthalmic Dispensing with an MD-OD joint practice. Although currently retired, I hold active Dispensing Optician licenses in Florida and Arizona. I am also American Board of Opticianry and National Contact Lens Examiners certified. I have experience as the owner of an independent, private-practice Ophthalmic Dispensary, and more recently as a Licensed Optician for an optical retail chain. Click here for an online profile. See notes below.

                                                                   Main Issues                                                                              

1) Many Optical Retailers are well positioned in the marketplace, but few are ready to be America's 'Premier' Vision Care Provider. Many of them employ a business model that works well for marketing general merchandise. But an Optical Dispensary is different. Like a Pharmacy or Health Clinic, an Optical Dispensary is a Healthcare Facility where prescription eyewear is designed, fitted and serviced. It is not a strictly mercantile sales facility. The comparison can be likened to the difference between a retail outlet where only stuff is sold to Customers versus a Health and Wellness Eye Care Service where prescription visual devices are designed and custom-fitted on Patients. (The concept lost in today's optical retail market: Opticians exist more for the purpose of Serving Patients than for Selling Stuff. See To serve is to succeed.)

"Once today's Retail Optical paradigm is upgraded to that of serving
Vision Care Patients, as opposed to serving just Retail Customers, an
Optician becomes a Healthcare Provider, as opposed to a Merchant."

An aspiring 'Premier' Vision Care Provider must focus on a) ongoing practical training of Staff, b) highest standards of care for Patients, c) inclusion of qualified Opticians in upper management positions, d) sensitivity to Patients' eye care needs, and e) realistic sales goals.

What level of professional healthcare in the delivery of
prescription eyewear could you expect to find here?

"When's the last time you saw or heard a retail optical
store promote the custom fitting of eyewear? Could this
be because they don't know how to custom-fit eyewear?
Could it be that the staff only knows how to sell glasses?"

2) There is an acute need for the Staff of many dispensaries to acquire expanded and ongoing training that includes practical, i.e., hands-on-the-Patient training, which includes a) the Full Discovery Lifestyle Interview; b) Customized Frame Fitting and Adjustment Techniques; c) familiarity with both the lensometer and a wide range of dispensing hand tools; d) a working knowledge of optical laboratory operations, e.g., Layout, Surfacing, Finishing and Final Inspection practices; and e) a working knowledge of the Ophthalmic Refraction.

"Many Retail Optical Executives and Managers have no
experience in Opticianry or Ophthalmic Dispensing. In one
organization, only 1 of 43 Regional Managers is an Optician.
In contrast, the CEO of Walgreens Drugs is a Pharmacist."

3) Some corporate Executives and Managers within the retail optical industry, some with MBA's as their only prior experience, tend to make decisions that adversely impact an acceptable standard of vision care. Some are focused too exclusively on their career advancement as Managers, while obsessively promoting unrealistic sales goals and requiring interminable amounts of paperwork and reports from subordinates. This in turn interferes with the practice of Opticianry, and the delivery of quality healthcare.

"The conflicted relationship between Professional Opticians
and Retail Management can be likened to the current relationship
between Medical Practitioners and Insurance Industry HMO's."

Retail Managers who are absent Opticianry skills need sufficient training, possibly even in-house certification, in subjects such as the Lifesyle Interview, Optics and Lens Design, and Custom Fitting and Delivery of prescription eyewear BEFORE they assume any policy-making or supervisory roles. Currently, most get on-the-job training only, and their actions and decisions reflect their inexperience to the detriment of acceptable service. Again, providing professional vision care, i.e., designing, measuring, and custom-fitting prescription eyewear ON PATIENTS requires much more technical expertise and people skills than what is required to service mercantile CUSTOMERS.

"The most perfect prescription can be compromised if the
eyewear does not provide comfort and long-term wear-ability."

Example: Newly purchased eyewear is routinely and casually handed over to Patients without any custom fitting of the frame directly ON the Patient.

                                   The number one Patient complaint                                                  

"Nobody adjusted my glasses.
They just handed them to me."

Every Patient deserves 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 example) behind each ear, all of these differ with each person. See Common Complaints and Causes. See also The Final Fitting.

"For many Consumers, the personalized fitting of eyewear
by a skilled, hands-on Optician is an unfamiliar experience."

Example: Experienced Opticians are required by inexperienced Managers to reduce or even by-pass the time necessary to conduct life-style interviews, design appropriate lenses, and custom-fit prescription eyewear directly on the Patient. See How To Manage An Optical Dispensary.

"Just as a Dentist cannot practice Dentistry without touching a Patient, an
Optician cannot practice Opticianry without direct contact with a Patient.
Some of today's Dispensers just hand over a Patient's prescription glasses."

Again, fitting a vision appliance on a Patient involves a different level of technical knowledge and people skills. Dispensing prescription eyewear includes many elements of craftsmanship, artistry, and Patient-Dispenser interaction along with significant technical skill and finesse in their application. All of these are key to the success of any Vision Healthcare Facility.

A well-known optical chain's list of expectations for
the purpose of recruiting dispensing staff members.

1) Greet Customers in a friendly manner and
ensure high quality Customer service.  
2) Maintain a continuous effort to obtain            
company objectives.                                              
3) Create and maintain a retail environment   
    that is fun, educational, and professional.
4) Ensure all visual merchandising is                   
implemented and maintained.                       
5) Ensure all Customer service complaints      
are handled effectively and efficiently.     
 6) Show and recommend frames and explain
             product features and benefits to Customers. 
                      7) Take optical measurements for Customer eyewear.
                 8) Meet and-or exceed pre-established sales goals.

From another well-known optical chain.

1) Drive profitable store sales by fostering a retail selling culture
by practicing and role-playing effective retail sales skills.    
2) Develop professional business relationship with other Staff.   
3) Fill ophthalmic eyeglass prescriptions and fit and adapt          
lenses and frames, utilizing optical prescription.                            

Notice that these Merchandisers rank Retail Sales over Skill whereby 'Customers' are the focus. In contrast, a Vision Healthcare Facility emphasizes Skill over Merchandising whereby 'Patients' are the focus, which produces higher levels of Patient satisfaction, fewer remakes and refunds, and subsequent profitability with increased referrals.

And here's a personal profile submitted
online by a latter day Licensed Optician.

"Licensed Optician focused on converting patients
with malfunctioning (structural integrity) and outdated
eyeglasses (quality of vision) into a sales opportunity.
Specialties: Sales, sales reports, sales goals, quality
control, insurance filing, insurance analysis, training, word
processing, building professional relationships with clients."

Again, the focus here is on a selling opportunity not a serving opportunity. Of course, merchandising is an important and necessary service, but all too often the healthcare delivery component of the Optician-Patient equation becomes secondary to the act of selling, i.e., in too many cases obsessive and unrealistic sales goals override the mission of providing professional healthcare, whereby personalized, custom fitting of eyewear is given only minor consideration, if any. The reality of this issue is clearly demonstrated by a steady albeit unfortunate number of unhappy Patients and the subsequent loss of revenue by way of return visits, remakes, refunds and fewer Patient referrals. See testimonials. See Common Complaints and Causes.

                              "Serve people first, and more will follow."                                    

Well trained, hands-on Healthcare Providers
make for satisfied and happy Patients.

Closing Words

Many Optical Retailers need to make significant changes if they hope to acquire anything like America's ‘Premier’ Vision Care title. Their business models and the services they provide fall short due to deficiencies in practical training and depth of dispensing experience. Much more investment in the training of people and in resources is needed.

Example: In-house training manuals lack the practical experience that direct hands-on-the-Patient tasks afford. For an eye care facility to rely on manuals for training a Dispenser is like trying to teach an aspiring Surgeon how to become skilled in surgical techniques in the absence of a Patient. In addition, many dispensaries lack adequate dispensing tools, and visual aids, as well as sufficient training in their use. For instance, nose pad replacement is a frequently requested service. Many unskilled Dispensers use a snipe nose pliers to replace nose pad screws. Using this pliers requires excessive time for such a simple procedure. A practical solution is a specially designed self-closing tweezers that reduces the task to a minimum of time. The use of this tool alone can save an amazing amount of time for both Dispenser and Patient.

We urge Retail Executives to support certification and licensing of Dispensers, the funding of training schools, and higher wages in order to retain a well-trained staff. Note: Senior Dispensing Opticians are available to assist in the practical training of Dispensers and to explore pathways to more profitability. Click here for free consultation.

*"Of the over 67,000 Opticians designing, manufacturing
and dispensing eyewear - less than half have any formal
certification or licensure." U.S. Department of Labor

Several well-known Retailers have a history of financially supporting all kinds of community activities and philanthropic gifts. Their investment in the ongoing training and advancement of their Opticians is a gift that will keep on giving.

"Due to their market share, the largest Optical Retailers are
in a unique position to lead the industry in the direction
of re-humanizing the deliver of eyewear to the public."