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Mr. MAGEE. I am not twisting or distorting anything. I read their letter.
Mr. Sisk. I did, too.
Mr. MAGEE. I think the form is quite plain, and I think that they are asking to diagnose an eye condition, and I say they are not qualified to do it, sir. This is what the school doctor wants, a medical pathological report of the child's eye condition, not that he needs to be fitted with glasses, that isn't proper. They want to know medically what is wrong with the child.
Mr. Sisk. I am as familiar with doctors' referrals as you are, Mr. Magee.
Mr. MAGEE. Yes, sir.
Mr. SISK. It is taking place by the thousands in my State and in my hometown. It is done as a regular thing. And a child may go to an optometrist, or may go to an ophthalmologist, but in either case they are practitioners of the art of eye care and checking the eyes. So this is all that is being requested here, under the letter you have read from the State of Virginia.
Mr. MAGEE. My position is, sir, that the letter asks for a field in which these gentlemen are not qualified to operate in, because they say this: "detection of ocular diseases.” This is to be done by an optometrist, I think this is clearly the practice of medicine, sir.
Mr. HARSHA. Mr. Chairman, we can argue back and forth on the same point. I think we will have to weight the letter and each member decide for himself.
Mr. MAGEE. I have left the letter here so it won't be misinterpreted.
Mr. Sisk. Does the gentleman from North Carolina have any further questions?
Mr. WHITENER. Mr. Magee, I think in fairness to Mr. Kohn, who as general counsel represented the American Optometric Association here, that some of the questions that have been raised by you are ones that Ir. Kohn has agreed need to be rewritten. Mr. MAGEE. I wasn't here when Mr. Kohn was.
He is a very learned gentleman.
Mr. WHITENER. I don't think we are going to have any argument between him and the bar association and you on the proposition of the qualifications of an expert witness.
Mr. MAGEE. A learned profession.
Mr. WHITENER. I think we can work out something about the agencies of the District government accepting the test of visual acuity, I believe was the term. Some of the things we are taking a lot of time with, I don't believe there is much difference of opinion about, since we have had an opportunity to look at the bill together here in the committee room.
I certainly appreciate your giving us the benefit of your views about it, and I know with the different skilled attorneys we have had and will have testifying, that some of these little legal nubs will be knocked off the bill, and we will straighten them out. Then the proposition you mention is one of philosophy, which makes it pretty difficult for you folks ever to find any area of agreement, and that will be our job to try and do that.
Mr. MAGEE. We appreciate the opportunity to be here. I might say that I have represented, I not only represent the Medical Society, I am general counsel for the American Psychiatric Association, the
American Diabetes Association, the Association of American Clinics, and I have been working with medicine since I left the Department of Justice in 1938. And, gentlemen, I do this on an honorarium basis. I am not paid any fantastic fees at all, because I have always considered it a privilege and pleasure to work with medicine, and I feel medicine has given more to the American public than any other calling or profession in the United States. And I say this with sincerity, and that is why I am proud to represent them here.
Mr. Sisk. Thank you, gentlemen, for appearing. We appreciate your testimony.
The Chair would like to have the record note that in addition to the bills that have been introduced which we have referred to, I would like to add H.R. 13821, introduced by the gentleman from Minnesota, Mr. Nelsen, as being under consideration. It is identical to the other bills before us.
The Chair would like to inquire now if the next witnesses to be heard represent the Guild of Prescription Opticians of America, and the Guild of Prescription Opticians of Washington, D.C., and we have Mr. J. A. Miller, Mr. Charles White, Mr. M. Cook Barwick, Mr. Frank Jones, Mr. Alfred Teunis, and Mr. Frank Harris.
Are all these gentlemen here? (There was a show of hands.)
Mr. MILLER. I am Jerry Miller. Mr. Barwick is not here. He was here yesterday, expecting to testify. He is from Atlanta, Ga., and had to leave town.
In his place we will have Mr. Joseph Stoutenburg.
Mr. MILLER. We have two people to make statements, actual statements. The others may have few comments.
Mr. Sisk. I think what we will do here, will be to proceed for another half hour or so, and the committee proposes to sit this afternoon. We have permission to sit during general debate, so I think we will proceed now.
Mr. Miller, if you want to take the chair, we will recess for lunch a little bit later. If you wish, take the stand, and have accompany you those whom you would like to have with you.
STATEMENT OF MR. JERRY A. MILLER, ON BEHALF OF THE GUILD
OF PRESCRIPTION OPTICIANS OF AMERICA, AND THE GUILD OF PRESCRIPTION OPTICIANS OF WASHINGTON, D.C., ACCOM. PANIED BY CHARLES WHITE, NEWPORT NEWS, VA., CHAIRMAN, VIRGINIA STATE BOARD OF OPTICIANS; JOSEPH STOUTENBURG, SPECIAL COUNSEL; FRANK JONES, PRESIDENT, DISTRICT OF COLUMBIA GUILD; ALFRED TEUNIS, OPTICIAN, WASHINGTON, D.C.; AND FRANK HARRIS, OPTICIAN, WASHINGTON, D.C.
Mr. Miller. My name is J. A. Miller. I am the executive secretary of the Guild of Prescription Opticians of America, with offices at 1250 Connecticut Avenue NW., Washington, D.C.
I have here Mr. Frank Harris, who is a director of the National Guild of Prescription Opticians; Mr. Alfred Teunis, who is an optician
in the District of Columbia; Mr. Frank Jones, who is president of the Washington, D.C., guild, even though he practices in Silver Spring; and to my left is Mr. Charles White, who is chairman of the Virginia Board of Opticians; and to my right, Mr. Joseph Stoutenburg, who is special counsel for the guild.
The Guild of Prescription Opticians is a national nonprofit membership corporation representing skilled and ethical dispensing opticians throughout the United States, including the District of Columbia.
The Guild of Prescription Opticians of Washington, D.C., is our affiliated organization in the District of Columbia.
So far as this bill is concerned, we understand that Congress will be sitting as the legislature for the District of Columbia. Normally, therefore, our national organization would have a secondary interest. However, since a national association has admitted to be a coproponent of this bill, we can only assume that the proponents want to use this bill if enacted to establish a national pattern.
We have asked for this opportunity in order to make known that both our organizations are opposed to H.R. 12937 and its companion bills.
While there are literally dozens of passages in this bill which make it objectionable, there are three reasons why this bill should not be allowed to pass. They are:
1. This bill will substantially change the traditional patterns of visual care in this city;
2. This bill will put out of business many opticians in the District of Columbia; and
3. This bill will work to the detriment of the public. Permit me to comment on these three objections.
The first being, the proposed bill is designed to change-to upset, in fact—the traditional pattern of eye care.
What is this traditional pattern of eye care?
The oldest practitioner in the field is the optician, for whoever made the first pair of eyeglasses was, in reality, the first optician. By 1483 opticianry was developed sufficiently to warrant the formation of a Guild of Master Spectacle Makers in Nuremberg.
Initially, the optician helped those in need of visual correction by a trial and error method. He simply let his customer try on different pairs of glasses. This process was carried on first by spectacle peddlers, who dragged their carts through the streets, and later in the optician's shop.
In the middle of the 19th century scientific means of testing vision were developed. As this vision testing--or refraction was developed, opticians naturally took an interest in these new methods and learned how to test eyes. Physicians, who had played a leading role in the development of refraction, were also testing eyes.
As the medical men took more of an interest in sight testing, one group of opticians continued to do their own sight testing. The other group chose to make and fit glasses prescribed by the physician. The two groups of opticians were known respectively as refracting opticians and dispensing opticians.
Around the turn of the century, the refracting opticians, that is, those who chose to continue testing eyes, took the name of optometrist in the United States. Those who chose to continue making glasses for physicians and to let the physicians do the testing became knownand are known today—as dispensing opticians.
The optician, in the tradition of his forebears, continues to provide optical services, exclusive of sight testing, to the public-primarily upon the authorization of the physician. Because of this relationship between dispensing opticians and physicians for more than a century, it is not surprising that opticians and ophthalmologists are opposed to this bill.
Today, therefore, there are two types of practitioners providing optical services in this city, the optician and the optometrist—with the unique difference between the two of them being that optometrists test sight and prescribe-opticians do not.
I might add, as an aside, that Franklin and Co., Inc., a member of our organization, has been functioning as opticians without interruption in this city for 111 years—years before the scientific development of sight testing and 50 years before the use of the term optometrist.
We had in our audience yesterday, I don't know whether he is here today or not, the grandson of the founder of that business, and the present owner and manager of it.
The third practitioner serving the needs of the public's vision is the ophthalmologist or oculist. He is a physician, a doctor of medicine, who specializes in the care of the eye and all its related structures. He is the only person legally and professionally qualified to diagnose and treat all eye disorders. He uses eye drops, eye ointments, and other medications, if necessary, in the examination and, treatment of the eye. He prescribes whatever eve treatment is necessary, including eyeglasses, contact lenses, optical aids for the partially sighted, and eve exercises.
Traditionally, and most especially in the District of Columbia, the ophthalmologist does not provide the eyeglasses and other optical aids which he prescribes, but relies upon the services of the dispensing optician.
What will this proposed legislation do to this traditional pattern of eye care?
First, it will move the optometrist, by legislative action, to the level of professionalism.
Second, it will make the traditional functions of dispensing opticians part of the practice of optometry.
Third, it extends the practice of optometry into the field of medicine and ophthalmology by allowing optometrists through legislative action to diagnose departures from the normal.
Our second reason is that this proposed bill will put opticians out of business.
It is true that the bill purports to give certain exemptions to persons who fill prescriptions-spelled out in section 9(c)—but the definition of optometry creates a virtual monopoly of optical services when it includes the use or furnishing of lenses, prisms, or frames * * * the fitting or adaptation of contact lenses. The dispensing optician has traditionally dispensed lenses, prisms, and contact lenses upon the prescription of a physician-or optometristand has provided frames, frame repair, and lens duplication service without the necessity for a prescription.
By the inclusion of these services in the definition of the practice of optometry, the services of a dispensing optician are defined as the practice of optometry. Though section 9(c) gives an exemption, that exemption is so confining that it will put out of business many optical stores in the District of Columbia.
This bill would require the optician to have a written prescription in order to make lenses. In other words, I carry in my pocket a copy of my physician or my prescription for my eyeglasses. It is not signed by the physician, it is an exact copy. And if I need emergency repair, I cannot get that repair on the basis of the actual prescription I have written in my pocket. It requires a written prescription to duplicate lenses from existing lenses, a written prescription to repair broken frames, a written prescription to sell sunglasses, a written prescription to put old lenses in a new frame. All these are services traditionally rendered for the benefit of the public by dispensing opticians.
Mr. HARSHA. May I interrupt?
Mr. HARSHA. Aren't you required to have a written prescription to make lenses?
Mr. MILLER. I am not familiar with the practice in the District of Columbia, but in some areas this may be done by telephone, rather than by a prescription, so presumably a physician or an optometrist could give the prescription over the telephone.
Mr. HARSHA. How is it done here in the District?
Mr. MILLER. I will have to ask one of the District opticians, Mr. Teunis.
Mr. TEUNIS. We can in the District, as one of your constituents, as we have done on many occasions for Members of this House, If you have an emergency and break a lens, if you have a large enough piece intact, we can take a reading from the lens and we would duplicate it without a prescription.
If the lens cannot be duplicated, we will immediately try to contact by telephone or telegraph that person's eye doctor or optometrist, whoever is needed to prescribe. Either that, or they have a copy of the prescription, otherwise we have to get an examination.
Does that answer your question?
Mr. Miller. Not only must the prescription be written, the prescription must be signed by a physician or an optometrist licensed in the District of Columbia.
By prohibiting opticians from performing such services without a written prescription, the proposed legislation forces patients of ophthalmologists to go to optometrists-which is contrary to the interests of the public, the ophthalmologists, and the opticians.
This proposed legislation prohibits the optician from doing the mechanical and technical work in dispensing contact lenses to patients who have had a complete medical eye examination for contact lenses and who hold a prescription for contact lenses. The optician performs this function only on the written prescription of an opthalmologist or an optometrist and has done go traditionally.
Now, our time is much too short to go into the optician's role in the fitting of contact lenses, but I ask the chairman's permission to submit at this time a statement for the record which outlines the optician's original contributions to this field and describes the role which opticiais play in dispensing contact lenses upon prescription.