by any state or institution; second, that referring patients to opticians by a physician should be deprecated because it is not only exposing them to the risk of incomplete diagnosis and unnecessary suffering, but is aiding and abetting men who have no medical education, in their acknowledged and open efforts to enter on an important field of special medical practice." The New York Ophthalmological Society recently passed resolutions of protest against these laws. The oculists have shown more activity in opposing the extension of this optometry legislation because the unfortunate results are so frequently met with in their work; this opposition should not be confined to them but the situation appreciated by the profession in general, who should be able to realize what it may mean to their patients to refer them to opticians and approve optometry laws. DISCUSSION. DR. E. TERRY SMITH (Hartford): Mr. President and Members of the Society I wish to thank Dr. Ring for his instructive, timely, and very interesting paper; and also for coming up here in 1905 and 1911 to speak before the legislature and attempt to prevent the passage of laws that would have been a menace to the eyes of the community. If you saw, as men who practise ophthalmology see every day, the results of the advice of incompetent opticians, you would realize the danger to the community and the need for not giving your approval to their practice. When the principal claim of many so-called optical colleges is the fact that their diploma is the largest and most gorgeous printed by any college on eyes; and when, if you do not care to take the course for seven dollars and a half, you can buy a set of test lenses and have the diploma thrown in, I think it is time to protest. Until these men are more careful in appreciating their limitations, I think that the State should withhold its approval of their work; and the only way of preventing the State from giving them its approval is for the medical profession to use its influence to keep state laws from being passed in their interest. DR. HENRY S. MILES (Bridgeport): I also am very glad that Dr. Ring has again brought this subject to the attention of the medical profession of Connecticut. The opticians have been deceived, mostly by a few active leaders, into believing that they can properly examine and treat eyes without any medical training. They, in turn, have deceived the public and, I regret to say, some doctors. They have proved to be good poli ticians, and have deceived legislatures into passing laws creating commissions to examine men in subjects that they themselves do not understand. This is a mistake; but because twenty-five of these United States have made this mistake, there is certainly no reason why Connecticut should do so. They have deceived the authorities of Columbia University, and have gotten them to try a course in so-called optometry, which, considering the characteristics of their professors, will not be of long duration, in my opinion. Dr. Bossidy, of the American Medical Association Committee appointed to investigate this whole matter, says that if physicians will work, no more states will recognize the opticians in their efforts to become licensed to do that for which they have no qualifications. It is not beneath the dignity of physicians to protect people against themselves; and to prevent this evil, as well as all other evils, is much better than to have to cure it, as several states have found. Whenever uneducated men or women try to enter any branch of medicine, we should all fight to keep them out. That opticians have been permitted to continue their peculiar methods so long, is equally the fault of laymen and of physicians. Many people, especially in the country, pay little attention to their eyes until someone comes to tell them to do so. Then they usually pay more for improper glasses from an ignorant tradesman or pedler than a trip to an oculist and correct diagnosis and treatment would have cost; but the former is often supposed to be less trouble. The need for thorough and proper treatment is greater than the supply. This has just been emphasized to us by Dr. McCormack. We should have more oculists, and our medical schools should pay more attention to this department of medicine. DR. WILLIAM HENRY CARMALT (New Haven): I supposed, Mr. President, that I had done with this subject. I have done little in the way of ophthalmological work for many years, that I am not in very close touch with it; but I cannot forget the amount of mischief that I have seen done in previous years by exactly these men in attempting to do what they want now to get the legislature to legalize. Not only do they know nothing concerning ophthalmology, but in one breath they claim that they do not care to know anything about diseases of the eye, and in the next they advertise that they give diplomas for attending a course of lectures given on diseases of the eye! Not only do they not know this subject; they do not even know how to fit glasses ordinarily. As I have just said, in former times I was constantly rectifying the mistakes of the opticians; and I have no doubt that the men now at work in that line are doing the same thing. I must, however, say, to my regret, that the physician is as much to blame for this as others. We constantly hear of physicians recommending patients to some one advertising that he is fitting glasses. Then, again, there is another statement that perhaps I may be excused for quoting, although Dr. Ring has probably heard me say it before: that is, "that professional opinion not paid for is not worth a damn." If the opticians give examinations free, they must make something out of it in another way. They must sell a pair of spectacles, in order to make up for the loss of their time; and, right or wrong, they will do it. Sometimes they charge seven dollars for a pair of plain lenses. That is the best thing that they could do. More frequently, however, they sell entirely incorrect glasses. They give a concave lens, cylindrical or spherical, as the case may be, to a patient with hypermetropia or with plus astigmatism. This is a mistake that we in the profession have to be on guard against all the time, and we have to use drugs in order to overcome the trouble; and yet, in one of the clauses of their argument, they claim not to use drugs. They could not do the work if they did not use drugs. The next thing, they want to use them. Altogether, it is the most inconsistent way of arguing possible; and I hope that the profession will learn to be conscious of the mischief that they are doing when they recommend a person to go to an optician and get fitted for glasses. The fact that the opticians do occasionally fit these accurately, does not prove anything. It simply gives them an opportunity to do it incorrectly another time. DR. FRANK K. HALLOCK (Cromwell): I think that we should all like to hear from Dr. McKnight as to what has happened to the optometrists. DR. EVERETT JAMES MCKNIGHT (Hartford): I thought that I was through with this business for two years. Do you want to know what happened to them? Well, I have not seen one for two months. I do not know whether they will try it again or not, but I should think that the two defeats that they have had in this state would deter them from trying it again. I believe that this agitation will gradually die out. The states that have enacted these laws will probably continue to let the optometrists practise under them; but I doubt whether they can get such laws passed in any more states. I think that one of the best pieces of campaign literature ever published was the Veto of Governor O'Neal of Alabama. I should advise you all to read it. I think that it was printed in the Journal of the American Medical Association, and it certainly is a very able article. It would be a very good one for you all to read. I stated this morning that the two optometry bills, the Senate and the House bill, were both rejected without any opposition at all. I think that one gentleman, a man whom I supposed to be very much opposed to the bill, did say in the House that the optometrists ought to be given a little chance. This was practically no vote, and the bill was rejected practically without a negative vote. I want to thank the physicians of the state who helped us out so nicely, responding to every call made by the Chairman of the Legislative Committee, and who did such excellent work. It was only by combined effort that we were able to accomplish what we have this year. I want, Mr. President, to emphasize what Dr. Smith has said, and to thank Dr. Ring for coming here during the last two sessions, and appearing before the Committee. It was difficult to get ophthalmologists to appear. When our Committee officially invited one man, he would not come because he felt that it was not the ophthalmologists' business to appear. It is their duty to do so, and I want to thank Dr. Ring for doing it. DR. FRANK K. HALLOCK (Cromwell): I suggest that we all stand up and give a rising vote of thanks to Dr. Ring and Dr. McKnight, and also to Dr. Carmalt. (This was done.) DR. HENRY W. RING (New Haven): Mr. President and Members of the Society-I certainly deserve no rising vote of thanks for what little aid I gave in trying to defeat these bills. I had the same convictions that the other ophthalmologists had in coming up to oppose them. Of course, it is rather natural for the unthinking public to say: "This is a matter of your own interest"; but I am honestly telling you that the income of the average practising oculist would not have been changed one way or the other by the passage of these bills. There would, however, be the feeling on the part of the public that our motives were not entirely altruistic; I had considerable hesitation in coming for that reason. Regarding the last attempt, I would say that I had a different experience from Dr. McKnight. One of the leaders of the optometrists came to my office and asked me to compromise. I said that I did not see anything to compromise about; for I had no personal interest, one way or the other. What induced me to write the paper was the statement that I quoted in the early part of it: that out of eleven hundred and thirty reply postal cards sent to physicians in the State of Wisconsin, asking their endorsement of the bills, ten hundred and fifty replies endorsing them had been received by the opticians. That is the reason that it occurred to me to come up here and talk to you. I thought that if the physicians of any state in the Union would endorse a law like that, there might be a certain proportion of those in Connecticut who would do so. I did not think that it would be necessary before; but when I saw that statement, it seemed to me that it might be wisdom to be forewarned. |