I've now read about as many posts as I can handle that read something similar to: "My (insert person of importance here) told me that (insert field of practice here) will be dead in a year due to (insert doom here)."

These are, of course, followed up by those who have chosen the particular field saying something like: "No way, couldn't/won't happen because (insert good reason here)."

How about recasting the debate? I'd like to hear from those who've ardently maintained that optho will never fall from grace, but try to come up with reasons it COULD be in trouble. Maybe this is just mental masturbation, but I think it's both a good exercise and might help everyone understand the field a bit better.

Looking forward to very few replies..... ;)

P

-Decreased reimbursement for procedures
-Legislators with no clue expanding privileges of OD
-Cheesy ophthos who advertise in comics/billboards, who also have sold their souls to the BOPTOMS and see their patients for the first and last times on the OR table
-O/W ophtho is sweet. Let the good times roll!

Gene therapy which will totally eliminate the need for all ophthalmologists and all other specialties, for that matter.

Computer programs will read blood samples, retinal photographs, slit lamp photos and imaging studies to make the diagnosis. These highly evolved computers will then select the appropriate gene therapy and tell the technician to administer it. This will start out as an "assistance" to the MD's aimed at lightening the work load. The developer of the technology however, had much broader applications in mind. The inventor of the technology will likely be a team of DO's, OD's, PA's, CRNP's and computer engineers.

In those cases where gene therapy is not available and operative intervention is required, robots that have highly refined technical ability will perform the surgery. These robots will be extremely evolved and adaptive based on input from surgeons that once performed the surgery. The technician will simply insert the micro-chip that contains the procedure the patient needs, and voila, the surgery is done much better than any human could possibly perform. The robots will operate around the clock, vastly improving access to care and decreasing cost. They will be highly mobile, thus allowing highly precise care to be brought to patients without boundary. They will be developed by Bill Gates, run on software developed by microsoft, and will compete unfairly against other companies. This will prompt congressional inquiry which will cause bill gates to "break up" his company by very wittingly renaming the different divisions. This will solve any concerns about trust laws being broken.

Apple will have a similar program and computer system, which Gates probably stole. Everyone will scoff at the akwardness of the Apple system. But the Apple systems will look much more stylish, thus appealing to the artists-types.

Ultimately the machines will treat disease and disability with much superiority to the MD's and DO's. Citing the un-necessary nature of MD/DO training and associated expense, Congress will dispose of residency training programs and slash reimburesements such that physicians cannot continue their practice. State legislatures will stop spending for MD schools, and redirect this money toward training technicians and buying the necessary robotic and computer equipment. The MD's and DO's will close their practices, become dependent on welfare, and eventually disappear from the earth.

Trauma cases, which are too unpredictable for the computer programs and robots to handle, will be handled by a new breed of surgical-technician, which will likely be recruited from PA, CRNP, and OD schools. They will be under direct supervision of the US Congress and ex-malpractice attorneys, which unltimately know best when it comes to surgical management of patients.

The trauma surgery-technicians will be paid accordingly, since they are the only humans in the medical system. Their income will be 100K per year, which at the time will be far more than the lowly MD's were making before the machines took over.

There will be but 4-5 MD's left in the world...and one day a prophet will tell there leader of a "chosen one." This chosen one will fight with great skill and almost pre-cognition reflexes to battle the machines....

HAHA