Optometrists are a joke - not a threat

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vanessh

Vaness
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To all the ophthalmology docs, optometry can easily be dealt with through some patient education. Let your patient know that optometrists are not eye physicians, do not hold a medical license, and are basically good lense fitters. I think ophthalmology is being too passive. Start an advertising campaign, and please change the name of your profession: Eye Physician and Surgeon is an excellent idea.

Next, support the growth of opticians. Watch how your physician wanna bee optomerists squirm when optician scope of practice increases.

The era of cooperation in healthcare is over, its time to stick to your guns. We can't let a bunch of people: NPs, optometrists, audiologists...skip medical school to just start treating medical conditions and think they can dupe the public. There is one track to doing medicine...it is called medical school. Ofcourse, some people are too lazy to put the effort, but still want the qualifications. It is hilarious how some people are like, "optometry is a doctorate" or... "audiology is now starting a doctorate - AuD" or "NP is now a doctorate - DrNP."

Having a frieking doctorate doesnt give you the qualifications to being a medical physician. What a joke.

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vanessh said:
Next, support the growth of opticians. Watch how your physician wanna bee optomerists squirm when optician scope of practice increases.


Let me make sure that I'm reading this right. You are in favor of limiting the scope of practice in non-physician providers, I'm assuming on patient safety grounds. Yet you want to increase the scope for opticians who spend less time in school than ODs (who you clearly don't think have done enough time). So, you want increased scope for health care providers with even less medical education?

vanessh said:
It is hilarious how some people are like, "optometry is a doctorate"

OD school is 4 years, medical school is 4 years. At the end of either, you can be addressed as doctor. This seems reasonable to me. Now, granted, after med school there is still at least 3 years of schooling before you can really practice medicine. Though I don't know of anyone who's ever done this, if you get through med school and don't do a residency, you are still entitled to be called doctor, right?


vanessh said:
The era of cooperation in healthcare is over

Ignoring the scope battles in all these areas, I suspect that most MDs would have misgivings about getting rid of many of the professions you spoke of. Do you really think ENTs want to spend their days doing everything that a audiologist does? Orthopedic surgeons certainly have better uses of their time than seeing diabetic foot all day long. As a contact lens wearer, I'd much rather go to my OD for any problems there but let the MD handle my cataracts in my later years.

Its quite alright to disagree with scope of practice expansions, and by all means fight for what you think is right. But don't you think what you're suggesting is a bit much?
 
VA Hopeful Dr said:
Let me make sure that I'm reading this right. You are in favor of limiting the scope of practice in non-physician providers, I'm assuming on patient safety grounds. Yet you want to increase the scope for opticians who spend less time in school than ODs (who you clearly don't think have done enough time). So, you want increased scope for health care providers with even less medical education?

At least Opticians would not kill people with their lack of experience or schooling if they were to increase their scope. Optometrists trying to do surgery WILL endanger people's lives due to the lack of training. :)

It not necessarily just time spent in school. It is the the depth and quality of training that matters, which usually takes more time.
 
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vanessh said:
To all the ophthalmology docs, optometry can easily be dealt with through some patient education. Let your patient know that optometrists are not eye physicians, do not hold a medical license, and are basically good lense fitters. I think ophthalmology is being too passive. Start an advertising campaign, and please change the name of your profession: Eye Physician and Surgeon is an excellent idea.

Part of the problem is that OD's are generally the gate keepers for referring patients to ophthalmologists. Therefore, many ophthalmologists don't want to piss off the people who are referring them patients. Although, I agree that we need to educate patients on the differences b/w OD's and MD's. After the OK bill was passed, a lot of ophthalmologists have gone from not taking the any threat from OD's seriously to literally freaking out. Therefore, I think a lot of the changes you recommended may actually come to pass.

vanessh said:
Next, support the growth of opticians. Watch how your physician wanna bee optomerists squirm when optician scope of practice increases.

I think that allowing opticians to use automatic refractors is a great idea. If a patient doesn't like their rx, then they can go see an optometrist or ophthalmologist. Regardless, it's not a big deal (like having complications from surgery would be).
 
I2I said:
VA Hopeful Dr said:
At least Opticians would not kill people with their lack of experience or schooling if they were to increase their scope. Optometrists trying to do surgery WILL endanger people's lives due to the lack of training. :)

Yeah seriously, what's the worst thing that can happen if somebody's glasses prescription is a bit off? Maybe they'll get a headache when they read, and have to get their prescription changed? While that's not ideal, it's nothing compared to the complications of surgery.
 
"Let me make sure that I'm reading this right. You are in favor of limiting the scope of practice in non-physician providers, I'm assuming on patient safety grounds. Yet you want to increase the scope for opticians who spend less time in school than ODs (who you clearly don't think have done enough time). So, you want increased scope for health care providers with even less medical education?"

The fact is that opticians will never pretend to be physicians and fundamentally speaking, the work of opticians and optometrists is benign and doesnt threaten the health of patients. What indeed threatens the health of patients is when ODs want to play medical physician and want to start treating medical problems. If optometrists stayed within their scope - fitting lenses...there wouldnt be a problem. Yet the fundamental problem is greed and a cheapening of healthcare. Optometrists want to do surgery....but dont want to go to medical school. They defend their use of scalpels and claim...oh we just want to remove warts from eye lids...etc etc. This is bullcr@p and is just an attempt to introduce gradual changes such that 10 yrs from now, they will want to remove cataracts as well. This isn't time for cooperation anymore. Ophthalmologists should fight back and support opticians and educate the public about the difference between lense fitters and physicians/surgeons. If optometrists want to play games, MDs can play it too.

"OD school is 4 years, medical school is 4 years. At the end of either, you can be addressed as doctor. This seems reasonable to me. Now, granted, after med school there is still at least 3 years of schooling before you can really practice medicine. Though I don't know of anyone who's ever done this, if you get through med school and don't do a residency, you are still entitled to be called doctor, right?"

This isnt about being called doctor, its about being a medical physician. I can get a doctorate in social studies, but that doesnt make me qualified in treating medical diseases. Any organization can start a 4 yr doctorate in whatever they want, and churn out doctors with diplomas from that school...it doesnt make them physicians. The medical education of medicine is not equivalent as optometry.

"Ignoring the scope battles in all these areas, I suspect that most MDs would have misgivings about getting rid of many of the professions you spoke of. Do you really think ENTs want to spend their days doing everything that a audiologist does?"

Ofcourse ENTs dont want to be bothered by the everyday work of an audiologist. I think ENTs feel doing simple tests is a waste of time. But I suggest that you go to the association of audiologists website and then tell me what you think. ENTs are upset when audiologists make claims like: "we are primary care providers" when it comes to hearing problems. Don't you see how silly that is? So basically if someone comes with a hearing problem, audiologists would like to decide if a medical referral is needed...they will refer to an ENT as needed. Which is just hogwash. Audiologists also advertise that their members should make "professional relationships" with primary care physicians (Family docs and internists) for the purpose of referrals. Well obviously I dont think that is much of a concern for ENTs, because any qualified internist understands that a hearing problem should be referred to an ENT.

Yet audiologists are now starting doctorates in their profession: AuD...another gimmick like the DrNP (doctorate of nurse practitioner degree). Now they will say, "oh we just want to be doctorates in our profession." The real reason is to bring confusion in healthcare. To the lay person a Audiologist sounds like a medical physician. Now with a Dr., it makes that confusion even more likely. It is all about greed and money. For example, I went to the University of Nebraska's website, for info on their audiologist program. On this site it tells prospective applicants how much money they can make in their lifetime if they became audiologists. Show me one ENT residency program that lists the expected income they can make as an ENT surgeon. I guarantee you that you wont find one - because it is cheap. Sure many medical websites will list incomes, but lifetime wealth isnt stated on a residency admissions website. If it did, it would look so cheap. Regardless, it just tells you the mentality these pseudo-docs are coming from. Its a huge inferiority complex. The same is for optometrists. If you browse through optometry websites you will find articles that focus so much on the injustice of why do ophthalmologists get paid more than optometrists, and how can we as optometrists narrow the gap in incomes with ophthalmologists...etc. These people delude themselves with the word Dr and feel they can be physicians. Its a huge inferiority complex. I bet many optometrists wished they had the dedication and work ethic to go into medical school. Yet, instead of being content with their respectable job as an optometrist. They would rather play dirty and bribe congressmen to increase their scope of practice and play physician and surgeon.

"Orthopedic surgeons certainly have better uses of their time than seeing diabetic foot all day long."

oh i agree. but even with podiatrists...now they just dont want to treat diabetic toes...they want to treat ankle problems as well. The scope of practice of a podiatrist 20 yrs ago has changed drastically to what it is now.

"As a contact lens wearer, I'd much rather go to my OD for any problems there but let the MD handle my cataracts in my later years."

oh i agree. but ODs want to do lasix, and diagnose and treat medical problems with the eyes and do eye surgery. I go to ODs too for my glasses, but i dont want them playing physician/surgeon.

"Its quite alright to disagree with scope of practice expansions, and by all means fight for what you think is right. But don't you think what you're suggesting is a bit much?"

It isnt a bit much. Physicians and surgeons, are beginning to realize how much a danger this is to the health profession. Its time for MDs to go with all guns blazing and become as determined as these allied health people when it comes to defending our interests. If it means playing dirty in congress, then we will do it. In this respect, I feel the AMA has been a dead medical organization. If this organization truly took a strong stand for the 500,000 + MDs in this country, things wouldnt have become as crazy as it is today.
 
vanessh said:
What indeed threatens the health of patients is when ODs want to play medical physician and want to start treating medical problems. If optometrists stayed within their scope - fitting lenses...there wouldnt be a problem. Yet the fundamental problem is greed and a cheapening of healthcare.

Treating many medical problems of the eyes is something that ODs have been at for some time. I hardly think its greedy and cheapening healthcare for an OD to want to treat glaucoma with medications, use punctal plugs, or prescribe some Patanol when spring allergies hit. It makes no sense for an OD to do an exam, find out that a patient would feel 100% better with a few days of Elistat, but then have to send the patient to an MD just to get those drops. Nor, I think, do many MDs have too much of a problem with this. I don't know enough yet to have an informed opinion on ODs doing surgery, so I'll leave that argument to others; but, I think ODs medically treating eye conditions is acceptable.

vanessh said:
If you browse through optometry websites you will find articles that focus so much on the injustice of why do ophthalmologists get paid more than optometrists, and how can we as optometrists narrow the gap in incomes with ophthalmologists...etc. These people delude themselves with the word Dr and feel they can be physicians. Its a huge inferiority complex. I bet many optometrists wished they had the dedication and work ethic to go into medical school.

Having not been to optometry school, I certainly can't comment on how hard it is, but I doubt its not all that different all the time. At many of the OD schools, students take the exact same classes as MDs and DDSs. So, for the first two years at least, OD students and MD students don't differ all that much. Perhaps an OD can step in and detail what their clinical experience has been like, since I don't know much about it. The point I'm trying to make: I don't think there's all that much of a difference in the dedication and work ethic between MD students and OD students. And yes, I'm sure there are some OD students who wanted to be MDs but couldn't pull it off. However, I'd wager that they are few and far between.


vanessh said:
It isnt a bit much. Physicians and surgeons, are beginning to realize how much a danger this is to the health profession. Its time for MDs to go with all guns blazing and become as determined as these allied health people when it comes to defending our interests. If it means playing dirty in congress, then we will do it. In this respect, I feel the AMA has been a dead medical organization. If this organization truly took a strong stand for the 500,000 + MDs in this country, things wouldnt have become as crazy as it is today.

As I mentioned in a previous post, the AMA has too many vastly differing specialties to defend. They can't take the time and money needed to protect all branches of medicine.
 
VA Hopeful Dr said:
Having not been to optometry school, I certainly can't comment on how hard it is, but I doubt its not all that different all the time. At many of the OD schools, students take the exact same classes as MDs and DDSs. So, for the first two years at least, OD students and MD students don't differ all that much.

Yeah right! Do you really think optometry students learn the entire body's anatomy, physiology, pathology, etc in as much detail as med students? It would be interesting to see how OD students would do on a Step 1 exam!

VA Hopeful Dr said:
Perhaps an OD can step in and detail what their clinical experience has been like, since I don't know much about it.
Go ask around, you'll find it's quite different from med school.

VA Hopeful Dr said:
The point I'm trying to make: I don't think there's all that much of a difference in the dedication and work ethic between MD students and OD students.
Oh please, literally half of the optometrists I've talked to have said that lifestyle was a big reason why they chose to pursue optometry over other areas. I'd say there is a significant difference in work ethic b/w your average med student and your average optometry student.
 
Do you seriously believe that there is no creditentialing board for optometrist? Do you honestly believe that an optometrist does not require a state lisence? No they are not ophthalmologist but they do not run free either!

Yes optometrist can perform complete and very accurate eye exams! I really hate to say this, but in my town, I actually prefer to see an optometrist because around here, get this, if I visit an ophthalmologist, and RN does my exam, no kidding!! RN does complete exam and then when finished the MD/DO comes in and says "everything looks great!"

I don't think you need to worry, optometrist are not going to be any threat to an MD/DO. Simply put, optometrist just cannot perform surgery (except in OK).

Now I do understood how this whole "OK movement" has made DM/DO's nervous, and I can't blame you for that. But really, if for some reason all 50 states were to allow OD's to perform surgery, there would have to be some kind changes made in their training, there would just have to be!
 
Sledge2005 said:
Yeah right! Do you really think optometry students learn the entire body's anatomy, physiology, pathology, etc in as much detail as med students? It would be interesting to see how OD students would do on a Step 1 exam!

I think that if an OD is in the EXACT SAME CLASS as an MD then yes, said OD student would learn that subject in as much detail.


Sledge2005 said:
Oh please, literally half of the optometrists I've talked to have said that lifestyle was a big reason why they chose to pursue optometry over other areas. I'd say there is a significant difference in work ethic b/w your average med student and your average optometry student.

I think that the lifestyle decision is based more upon lifestyle after they complete their education. I hardly think that OD education is so much easier (which has yet to be shown) that students will decide to go to OD school just to make the next 4 years a little easier.
 
VA Hopeful Dr said:
I think that if an OD is in the EXACT SAME CLASS as an MD then yes, said OD student would learn that subject in as much detail.

Dear VA Hopeful: I am asking this in the most sincere manner, what OD programs are you basing this comment on? For my own knowledge, I would really like to know which OD programs sit along medical students and study gross anatomy from head to toe and the histology of every organ...then go on to learn the pathophysiology of and the basis of pharmacologic treatment for every organ system, all the while learning how to do a complete history and physical exam. I agree with you and expect that "said OD" could do as well as a medical student, but I would really like to know if and where this happens.
 
I think that the lifestyle decision is based more upon lifestyle after they complete their education. I hardly think that OD education is so much easier (which has yet to be shown) that students will decide to go to OD school just to make the next 4 years a little easier.[/QUOTE]

Again, are you speaking from experience as an OD who went to OD school? Just wondering where you perspective on all of this comes from.
 
vanessh said:
To all the ophthalmology docs, optometry can easily be dealt with through some patient education. Let your patient know that optometrists are not eye physicians, do not hold a medical license, and are basically good lense fitters. I think ophthalmology is being too passive. Start an advertising campaign, and please change the name of your profession: Eye Physician and Surgeon is an excellent idea.

Next, support the growth of opticians. Watch how your physician wanna bee optomerists squirm when optician scope of practice increases.

The era of cooperation in healthcare is over, its time to stick to your guns. We can't let a bunch of people: NPs, optometrists, audiologists...skip medical school to just start treating medical conditions and think they can dupe the public. There is one track to doing medicine...it is called medical school. Ofcourse, some people are too lazy to put the effort, but still want the qualifications. It is hilarious how some people are like, "optometry is a doctorate" or... "audiology is now starting a doctorate - AuD" or "NP is now a doctorate - DrNP."

Having a frieking doctorate doesnt give you the qualifications to being a medical physician. What a joke.


That's what their greed is driving them to. I fully agree with you, as I have started myself my own propaganda against OD's.

Believe me, patients learn after you explain them the HUGE difference.
 
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vanessh said:
To all the ophthalmology docs, optometry can easily be dealt with through some patient education. Let your patient know that optometrists are not eye physicians, do not hold a medical license, and are basically good lense fitters. I think ophthalmology is being too passive. Start an advertising campaign, and please change the name of your profession: Eye Physician and Surgeon is an excellent idea.

Next, support the growth of opticians. Watch how your physician wanna bee optomerists squirm when optician scope of practice increases.

The era of cooperation in healthcare is over, its time to stick to your guns. We can't let a bunch of people: NPs, optometrists, audiologists...skip medical school to just start treating medical conditions and think they can dupe the public. There is one track to doing medicine...it is called medical school. Ofcourse, some people are too lazy to put the effort, but still want the qualifications. It is hilarious how some people are like, "optometry is a doctorate" or... "audiology is now starting a doctorate - AuD" or "NP is now a doctorate - DrNP."

Having a frieking doctorate doesnt give you the qualifications to being a medical physician. What a joke.


Your comments are foolish and unprofessional. Optometrists are primary care eye doctors---I work with 2 of them and shadow an Opthalmologist---they work together. The OD I work with writes scripts for corticosteroids, beta-blockers, anti-virals (If you don't know about this--I have had pharmacology and can help you out), etc......treating things like open angle glaucoma is not a benign thing and the OD I shadow manages this medically with his patients every day. I will be doing a residency in ocular disease with either the VA or an eye institute--a 2 year one. Your comment about a lense fitter is a joke. Schools like Nova Southeastern University College of Optometry have an interdisciplinary program----many of the basic science courses of the first two years are shared by the Osteopathic Medical students, Optometry Students, Dental Students, and Pharmacy students----including classes like Biochemistry, Pharmacology, Medical Microbiology, and so on. Optometrists and Opthalmologists are both skilled doctors and surgeons respectively. Optometry does 75% of the primary eye care in this country while opthalmology does 99% of surgery---oklahoma has some surgery for OD's---lol. Do your research before you make an uninformed comment that makes you look foolish. Just a word of advice---behave professionally--becoming an allopath or osteopath is a great accomplishment (so is becoming an optometrist) start acting like it.
 
rubensan said:
Dear VA Hopeful: I am asking this in the most sincere manner, what OD programs are you basing this comment on?

At UAB, OD students take biochemistry and I believe pathology with medical students. OD students do not take gross anatomy with the med students, but I think the OD students get to make use of the cadavers after the med students are done with them.

rubensan said:
Again, are you speaking from experience as an OD who went to OD school? Just wondering where you perspective on all of this comes from.

I'm in med school, just with some optometry leanings. As far as my perspective, it all varies. Some of it is common sense (not being forced to send allergic conjunctivitis patients to OMD when OD works just fine), some of it is from the optometry forum (UAB classes), and some of it from doctor's I've gone to/worked for (lifestyle).
 
VA Hopeful Dr said:
I think that if an OD is in the EXACT SAME CLASS as an MD then yes, said OD student would learn that subject in as much detail.
But they're NOT in the EXACT SAME CLASSES . . . duh! You claim that optometry students in one specific school take a few classes with med students. First of all, the classes you mentioned make up about less then 1/3 of the first two year's curriculum. Second of all, thats only in one freakin optometry school. Finally, and most important, I'd be very interested to see if the optometry students are actually in the exact same boat as the med students in these classes. Do the optometry students take the same tests and get graded on the same curve as the med students? Or do they have their own curve?

VA Hopeful Dr said:
I think that the lifestyle decision is based more upon lifestyle after they complete their education. I hardly think that OD education is so much easier (which has yet to be shown) that students will decide to go to OD school just to make the next 4 years a little easier.

Are you on crack? The education part of becoming a doctor (premed, med school, and then residency) is one of the biggest factors that discourages people from applying to med school. OD school doesn't have anything like trauma surgery rotations and internal medicine sub-I's. Plus, in med school, after four years you aren't done, then it's several more years of very difficult work. Regardless, b/c of what a long road medicine is, on average med students have harder work ethics then most other professions (including optometry).
 
bustbones26 said:
Do you seriously believe that there is no creditentialing board for optometrist? Do you honestly believe that an optometrist does not require a state lisence? No they are not ophthalmologist but they do not run free either!

Maybe I wasn't clear. What I meant was that optometry students would never do very well on the USMLE step 1 due to the fact that they don't learn all the same material that med students do in the first two years of medical school. I imagine optometrists have their own exams. The point was that optometry students don't learn the same stuff med students do.
 
VA Hopeful Dr said:
At UAB, OD students take biochemistry and I believe pathology with medical students. OD students do not take gross anatomy with the med students, but I think the OD students get to make use of the cadavers after the med students are done with them.



I'm in med school, just with some optometry leanings. As far as my perspective, it all varies. Some of it is common sense (not being forced to send allergic conjunctivitis patients to OMD when OD works just fine), some of it is from the optometry forum (UAB classes), and some of it from doctor's I've gone to/worked for (lifestyle).


I just wanted to make a quick comment regarding the optometric curriculum. I want to make sure that the facts are presented. At UAB the curriculum is set up so that the Optometry students take Medical Neurobiology, which includes a neuroanatomy wet lab with the Medical students. In addition we take Histology, Physiology, General Pathology, Microbiology, General Pharmacology, Systemic Pathology among other classes with the dental students. Pretty much, for the vast majority of our “Basic Science” classes we are taught in Volker hall (outside the school of optometry) either alongside medical and dental students or by the same professors.

The basic science classes that we have with the dental students, from what I understand, are very similar in content to those taught to the medical students. In fact we have often used the transcripts from the medical students to study rather than having our lectures transcribed. It is my understanding that the reason that they just do not dump all of the students Medical, Optometry, and Dental into one class is partially logistic in origin; there just would not be enough room for all of us (of course I am sure that is only part of the reason).

All of the basic science classes that have “eye specific” counterparts such as Physiology of the eye, Ocular pharmacology etc. are taught in the optometry school.

Our biochemistry class is titled “biochemistry of the eye” and while it is a general biochemistry class there is an emphasis placed on the eye and biochemistry of the visual process. It is in fact one of the very few basic science classes which is taught within the optometry school and not in Volker hall.

As far as anatomy is concerned, we take this class on our own, but it is taught by a medical school professor. The focus of the class like the one taken by the dental students is the head and neck. We do dissect cadavers in groups of about 4.

Going to school along side medical students, from what I can gather, the largest difference between our curricula is that they take classes in “modules” while our classes are divided up into quarters lasting about 9 weeks each. It is not uncommon for us to have 5-6 classes 30 some odd hours of didactic or lab a week. The medical school seems to focus intensely on fewer subjects in a shorter period of time. The optometry school seems to be much more concerned about attendance (it is mandatory) than the medical school where attendance is optional. I think often times the medical students feel that they can get more out of spending their time in the library reading transcripts rather than going to class (and sometimes I have to say I agree with them.)
 
futuredoctorOD said:
Your comments are foolish and unprofessional. Optometrists are primary care eye doctors

I agree that some of the comments about OD's just being lens fitters are incorrect (although there are some OD's who do mainly glasses), but OD's aren't exactly that honest about their scope themselves.

futuredoctorOD said:
I will be doing a residency in ocular disease with either the VA or an eye institute--a 2 year one.

This is a good example of the dishonesty of OD's about their training. Why is your two years of training called a "residency?" The term "residency" for physicians came about b/c orginally the doctors literally did live in the hospital and were residents there. Since then, it's been a pretty specific term used in healthcare to refer to specialized training that physicians do after medical school. Then optometry decides they'll try and confuse people by calling their different training by the same name.
 
Sledge2005 said:
Do the optometry students take the same tests and get graded on the same curve as the med students? Or do they have their own curve? /QUOTE]
For Medical Neurobiology we did take the exact same tests as the medical students. As I recall we were not graded on the same curve as the medical students, as the medical students do not get A’s B’s etc. but rather are graded by purely by percentile rank. (Which, by the way, I think is unfortunate because it fosters an environment of hostile competition and puts an emphasis on getting the best grade possible rather than learning. There had been cases of books being hidden in the library just so that others in the class would not do as well.) We on the other hand were assigned letter grades. The absolute cut off for a passing grade was the same though.

In the classes we had with dental students we were graded on the same curve, if there was one.
 
Sledge2005 said:
Maybe I wasn't clear. What I meant was that optometry students would never do very well on the USMLE step 1 due to the fact that they don't learn all the same material that med students do in the first two years of medical school. I imagine optometrists have their own exams. The point was that optometry students don't learn the same stuff med students do.

I would imagine that we would do much better on the USMLE than a medical student would do on the NBEO part 1. Dental students take and pass the USMLE for OMFL programs; I imagine we would perform similarly seeing as we (at UAB) take most of our basic sci classes with them. Of course at this point that is not an option for us so it really does not matter.
 
Why are you guys so hell-bent on trying to prove that your MD or DO education is so much better than an OD's education? You say that an OD couldn't pass USMLE Step 1, so what? An MD student couldn't pass NBEO Part 1 either, probably because they're different material. And throughout the whole argument you guys continually maintain we're the ones with the inferiority complexes? Give me a break!
 
futuredoctorOD said:
Your comments are foolish and unprofessional. Optometrists are primary care eye doctors---I work with 2 of them and shadow an Opthalmologist---they work together. The OD I work with writes scripts for corticosteroids, beta-blockers, anti-virals (If you don't know about this--I have had pharmacology and can help you out), etc......treating things like open angle glaucoma is not a benign thing and the OD I shadow manages this medically with his patients every day. I will be doing a residency in ocular disease with either the VA or an eye institute--a 2 year one. Your comment about a lense fitter is a joke. Schools like Nova Southeastern University College of Optometry have an interdisciplinary program----many of the basic science courses of the first two years are shared by the Osteopathic Medical students, Optometry Students, Dental Students, and Pharmacy students----including classes like Biochemistry, Pharmacology, Medical Microbiology, and so on. Optometrists and Opthalmologists are both skilled doctors and surgeons respectively. Optometry does 75% of the primary eye care in this country while opthalmology does 99% of surgery---oklahoma has some surgery for OD's---lol. Do your research before you make an uninformed comment that makes you look foolish. Just a word of advice---behave professionally--becoming an allopath or osteopath is a great accomplishment (so is becoming an optometrist) start acting like it.

I think this post brings up some excellent points. Becoming an MD is an accomplishment (I have 4 weeks until graduation, but Step II still looms over my head...and I still have around 5 years of training left). I also believe that becoming an OD is an accomplishment as well. THis guy has his facts right, OD's do 70-80% of the primary eye care in this county and serve as major referring entities for us, the eye physicians and surgeons. In fact, some of the most successful ophthalmology practices utilize and incoporate ODs into their practice and everyone gets along well...because everyone's job description is well defined, the ODs deliver excellent primary eye care and the MDs do excellent cataract/refractive/glaucoma/etc surgery.

But let's not equate the 2 by suggesting that OD and MD education is equivalent just because OD students at UAB take classes like Physiology and Head and Neck Anatomy.

I believe that we should continue to advocate, by many different means that eye surgery should be done exlusively by MDs, however, I do not believe that the way to do this is by advocating or implying that optometrists are a "joke."

Ruben
 
futuredoctorOD said:
Your comments are foolish and unprofessional. Optometrists are primary care eye doctors...I will be doing a residency in ocular disease with either the VA or an eye institute--a 2 year one. Your comment about a lense fitter is a joke. Schools like Nova Southeastern University College of Optometry have an interdisciplinary program----many of the basic science courses of the first two years are shared by the Osteopathic Medical students...Just a word of advice---behave professionally--becoming an allopath or osteopath is a great accomplishment (so is becoming an optometrist) start acting like it.

This forum is becoming less about real scope of practice issues and more about who has the larger ego... Permit me to bring some more perspective into the discussion (aka add feul to the fire). I'm finishing my 4th year at NSU and am currently shadowing an opthalmologist. I've not only taken classes with the ODs but also work with quite a few of them while on primary care rotations through the NSU clinic. There is indeed an interdisciplinary curriculum at NSUCOM; this idea of a team approach to health care spills over into the clinical realm as well. What is interesting is that ODs and DOs do take some of the exact same classes. While slugging through neuroanatomy, it was not uncommon to hear comments like:

"I don't understand why the DO students complain so much... we take the same classes.."
or
"We do the same things as the DOs for the first two years.."
or
"We have the same exams as the medical students.."

On paper, this is correct. In actuality, however, subtle differences exist. The OD students sit through similar lectures. Specifically, they take the head and neck anatomy with the medical students. Their written and practical examinations are different as is their 'wet lab' requirement. They are not required to prosect and do not take histology or pathology with the medical students. Does this make them any less prepared for primay care of the eye? Absolutely not! While they may not share the 'exact same classes' as the DO students, I'm sure they spend much more time on optometric-specific subjects. The job of the future OD is quite different from the career of the future osteopathic physician, and the discipline-specific curriculum reflects these necessary differences.
Trying to argue which curriculum is more intensive is an endeavor in futility. I don't think any optometrist would argue which professional is better suited to manage a brittle diabetic with chronic renal failure. Similarly, I find it hard to believe that a generalist osteopath or allopath would think themselves better qualified to medically manage glaucoma patients.
Its clear that tensions rise when the debate turns to the controversial issues of practice scope. Since optometrists are eye physicians (for lack of a more agreeable term), it makes sense that their professional societies want to ensure future viability and growth. As specialists in the field, opthalmologists will understandably be concerned over potential territory disputes.
In clinical practice, I've seen few if any professional disagreements over referrals or appropriate diagnosis and treatment. I'm shadowing a glaucoma specialist. He gets patients from ODs, DOs, MDs, and emergency rooms. His practice depends on a good working relationship between the professions. As physicians, everyone has an ethical obligation to act in the patient's best interest. I would guess that everyday clinical practice bears this out. Indeed, many ophthalmologists partner with ODs to expand their practice base.
I would hope that future scope of practice regulations take each profession's expertise and curriculum into accout. Patients need lens fitters, primary care docs, eye surgeons, and eye physicians. It seems that ODs and MDs/DOs will work together for the forseeable future. As inevitable colleagues, it seems prudent to stay away from disparaging each others education and instead shift the focus to more pressing issues like arranging a mutally beneficial working relationship.
If that doesn't pan out, then there's always these entertaining and lively mud-fests here on SDN.

-Pushinepi2
 
pushinepi2 said:
Similarly, I find it hard to believe that a generalist osteopath or allopath would think themselves better qualified to medically manage glaucoma patients.


Yes and No. The "medical treatment of glaucoma" typically involves drops that not only have an effect within the eye but I seem to remember one of my pharmacology profs stating that they have an effect on other important organs like the heart, correct? A few drops in the eye is many times more potent than some PO meds, correct?

I think what a lot of people on this forum are trying to say is that whoever is writing the prescription or doing the surgery better be prepared to deal with the consequeces of the therapeutic misadventures of these interventions. Case in point, I was once in a phaco surgery where the patient went into cardiac arrest. It was not the CRNA who started down the ABCs and ACLS algorithm nor was it me (a 3rd year medical student at the time) who knew what to do. It was the 3rd year ophtho resident who got things started and brought out the defibrillator before the code team even got there. Although this is a rare occurence during cataract surgery, I can say that this patient probably lived because there was an MD in the room who ran a few codes during his internship year and knew what to do.

Don't misunderstand me, I am not saying that ODs have any less potential to act in a similar manner. My point of all of this is to pose the question regarding whether OD education and training is sufficient to justify having surgical priveledges and being faced with complicated scenarios. I'll be the first to admit that I am naive with respect to OD education, so I invite you to enlighten me.

pushinepi2 said:
I would hope that future scope of practice regulations take each profession's expertise and curriculum into accout. Patients need lens fitters, primary care docs, eye surgeons, and eye physicians. It seems that ODs and MDs/DOs will work together for the forseeable future. As inevitable colleagues, it seems prudent to stay away from disparaging each others education and instead shift the focus to more pressing issues like arranging a mutally beneficial working relationship.

Absolutely, I could not have said this better myself! And I think you make some excellent points! :thumbup: :)

Ruben
 
rubensan said:
Yes and No. The "medical treatment of glaucoma" typically involves drops that not only have an effect within the eye but I seem to remember one of my pharmacology profs stating that they have an effect on other important organs like the heart, correct? A few drops in the eye is many times more potent than some PO meds, correct?

I think what a lot of people on this forum are trying to say is that whoever is writing the prescription or doing the surgery better be prepared to deal with the consequeces of the therapeutic misadventures of these interventions. Case in point, I was once in a phaco surgery where the patient went into cardiac arrest. It was not the CRNA who started down the ABCs and ACLS algorithm nor was it me (a 3rd year medical student at the time) who knew what to do. It was the 3rd year ophtho resident who got things started and brought out the defibrillator before the code team even got there. Although this is a rare occurence during cataract surgery, I can say that this patient probably lived because there was an MD in the room who ran a few codes during his internship year and knew what to do.

Don't misunderstand me, I am not saying that ODs have any less potential to act in a similar manner. My point of all of this is to pose the question regarding whether OD education and training is sufficient to justify having surgical priveledges and being faced with complicated scenarios. I'll be the first to admit that I am naive with respect to OD education, so I invite you to enlighten me.

Ruben

I can't enlighten anyone on OD education, I was simply talking about how optometrists can sit in some of our lectures on head and neck anatomy. Your point about the medical management of glaucoma is well taken. Ophthalmic drugs most certainly have systemic effects. I think I've been told a cautionary tale (or two) about cardiac arrest possibly secondary to timolol administration. The only point I was trying to make was about family physicians or other physician generalists treating eye disorders. This forum has revolved around purported differences in education and not about substantive issues like the one you've just pointed out. When I'm in the ED performing a slit lamp exam on someone with an ocular complaint, there's no question that my patient will be discharged with instructions to see an eye doctor. Whether the patient follows up with an optometrist or an ophthalmologist will probably be a question of insurance and accessibility. The ODs and MD/DOs that I've worked with all have varying opinions on appropriate referrals to eye professionals. The antecedent debate, besides diaparaging the education of ODs in general, has done little to answer these inquiries.

-Pushinepi2
 
bolus jones said:
Why are you guys so hell-bent on trying to prove that your MD or DO education is so much better than an OD's education? You say that an OD couldn't pass USMLE Step 1, so what? An MD student couldn't pass NBEO Part 1 either, probably because they're different material. And throughout the whole argument you guys continually maintain we're the ones with the inferiority complexes? Give me a break!

You just don't get it do you? The point is that optometry students don't learn all the same things as med students do during the first two years. And yes, med students don't learn all the same things optometry students learn either. Although I feel that the first two years of med school are probaby harder then the first two years of optometry school, that's besides the issue.
 
Sledge2005 said:
You just don't get it do you? The point is that optometry students don't learn all the same things as med students do during the first two years. And yes, med students don't learn all the same things optometry students learn either. Although I feel that the first two years of med school are probaby harder then the first two years of optometry school, that's besides the issue.


I just looked at my post again...didn't mean for it to be so abrasive (must have been in a bad mood last night). Anyway, yes I agree we don't learn exactly the same things in our first two years. However, I also know that we learn everything we need to learn about being able to be a primary eye care doctor. Yes, you heard it here..PRIMARY care. That is not to say that we learn everything we need to know to perform surgery, which is why I personally do not advocate optometrists doing surgery (there also is no need for a program that would train optometric surgeons but that's beside the point). My point is that by the time we're done we will be able to safely and effectively diagnose and treat all of the eye-related medical problems that we will need to as a primary care optometrist. This includes prescribing the meds to treat these conditions. We can refer other cases out when the need arises. So, although it will do no good as I've posted similar things before, here it goes again:

WHY DON'T WE ALL JUST GET ALONG...OPTOMETRISTS CAN HANDLE PRIMARY CARE OF THE EYES(NOT JUST LIMITED TO PUSHING LENSES) AND OPHTHALMOLOGISTS CAN DO THE SURGERY...EVERYONE COULD JUST BE HAPPY!!!

By the way, I am in optometry school just so you guys know where I'm coming from.
 
bolus jones said:
I just looked at my post again...didn't mean for it to be so abrasive (must have been in a bad mood last night). Anyway, yes I agree we don't learn exactly the same things in our first two years. However, I also know that we learn everything we need to learn about being able to be a primary eye care doctor. Yes, you heard it here..PRIMARY care. That is not to say that we learn everything we need to know to perform surgery, which is why I personally do not advocate optometrists doing surgery (there also is no need for a program that would train optometric surgeons but that's beside the point). My point is that by the time we're done we will be able to safely and effectively diagnose and treat all of the eye-related medical problems that we will need to as a primary care optometrist. This includes prescribing the meds to treat these conditions. We can refer other cases out when the need arises. So, although it will do no good as I've posted similar things before, here it goes again:

WHY DON'T WE ALL JUST GET ALONG...OPTOMETRISTS CAN HANDLE PRIMARY CARE OF THE EYES(NOT JUST LIMITED TO PUSHING LENSES) AND OPHTHALMOLOGISTS CAN DO THE SURGERY...EVERYONE COULD JUST BE HAPPY!!!

By the way, I am in optometry school just so you guys know where I'm coming from.

sorry, but ophthalmologists are now referring to themselves as "Eye Physician and Surgeon" (as opposed to the seemingly ambigous name of ophthalmologist, which sounds far too similar to optometrists for most patients)... looks as though we have both fields covered quite well... i find it amazing to think that optometrists and OD students can even consider themselves on an equal playing field as medical physicians and surgeons... by the way, attempting to tell US what we SHOULD do is not going to get optometrists anything... how about a little perspective, eh?
 
brendang said:
sorry, but ophthalmologists are now referring to themselves as "Eye Physician and Surgeon" (as opposed to the seemingly ambigous name of ophthalmologist, which sounds far too similar to optometrists for most patients)... looks as though we have both fields covered quite well... i find it amazing to think that optometrists and OD students can even consider themselves on an equal playing field as medical physicians and surgeons... by the way, attempting to tell US what we SHOULD do is not going to get optometrists anything... how about a little perspective, eh?

1.)In no way did I try to say that we are equal to surgeons

2.)I did not try to tell anyone what to do

3.)Sorry that you're so stuck on yourself that you can't realize there are professions out there other than ophthalmology

4.)Why does someone always have to come along and turn a constructive thread into a name calling contest?
 
As the first to reply to this thread, I'd like to try and get back to where this all started. I don't think anyone is actually denying that OMDs know eyes, and certainly no one is trying to force them into just doing surgery. The whole point of my interest in this thread was the original poster's direct insults to optometry. I think Ruben said it best...

rubensan said:
I believe that we should continue to advocate, by many different means that eye surgery should be done exlusively by MDs, however, I do not believe that the way to do this is by advocating or implying that optometrists are a "joke."

It is entirely possible to disagree with ODs about surgery; but, is it so difficult to do so in a respectful way? Is it all that hard to "play nice" the rest of the time?
 
UABopt said:
I just wanted to make a quick comment regarding the optometric curriculum. I want to make sure that the facts are presented. At UAB the curriculum is set up so that the Optometry students take Medical Neurobiology, which includes a neuroanatomy wet lab with the Medical students. In addition we take Histology, Physiology, General Pathology, Microbiology, General Pharmacology, Systemic Pathology among other classes with the dental students. Pretty much, for the vast majority of our “Basic Science” classes we are taught in Volker hall (outside the school of optometry) either alongside medical and dental students or by the same professors.

As a med student at UAB, The only class opt students take with us is Neuroscience with a limited wet lab of about 2 days. Their tests are graded separately from Med students according to a different scale. I have heard this from the professors themselves. The rest of the classes they take with Dental students. I have heard that the OPt students even bring their class average down, since they are not graded on a different scale. These classes even taught by some of the same professors are not near as in detail as we have. If that were the case, we would take these classes together since we have an auditorium that can house around 500 people. (Lec room A). It would save time and money.

PS. Not only is using medical transcripts that you have not paid for illegal, your wasting your time learning extra details that you WILL NOT be graded on. :rolleyes:
 
Sledge2005 said:
Maybe I wasn't clear. What I meant was that optometry students would never do very well on the USMLE step 1 due to the fact that they don't learn all the same material that med students do in the first two years of medical school. I imagine optometrists have their own exams. The point was that optometry students don't learn the same stuff med students do.

Sledge,
Dude, I couldn't agree with you more. The average StepI score at columbia is 230 and the average for ophthalmology matriculants to residency is 228 (or something close). This is about a standard dev above the mean for the boards and that shows us just how competitive the field is. Remember this is in medical school for which only the best of the undergrad got in.

Now optometrists are welcome to take the exam but unless they take a year or two to study and learn lots of new material and to a greater depth they will do horribly on the test. I am not doubtful of this... also I still don't get why progressive optometrists didn't just go to medical school to do surgery. (Does anyone else have commentary on whether they have the same basic science years as us... it doesn't seem like it from what we have heard)

Another thing medical school tests for is your ability to understand and assimilate vast quantities of information quickly. If you can't get into the field through medical school then you didn't pass the bar. There are no margins for error here and people don't want some guy that learned how to do a few procedures to work on them... they need someone w/expertise and clinical decision making skills.


-ra
 
I2I said:
As a med student at UAB, The only class opt students take with us is Neuroscience with a limited wet lab of about 2 days. Their tests are graded separately from Med students according to a different scale. I have heard this from the professors themselves. The rest of the classes they take with Dental students. I have heard that the OPt students even bring their class average down, since they are not graded on a different scale. These classes even taught by some of the same professors are not near as in detail as we have. If that were the case, we would take these classes together since we have an auditorium that can house around 500 people. (Lec room A). It would save time and money.

Well you "heard" wrong, my classes average was always on par, or better than that of the dental students. I was just trying to make the point that optometry school is far from being a joke.
 
I think that educating patients is the right way to go. I have no idea how rigorous the OD education is, nor do I really care. They are not medical doctors and are not trained for surgerical intervention. Since the public has trouble discerning the difference sometimes, it is our duty to show them the difference. The same goes for CRNA's, Psychologists, and other mid-levels looking to expand due to our own apathy and lack of patient knowledge. I was not aware of the numerous expansion of scope issues until midway through medical school. Nowadays, I try to make it a point to educate anyone I encounter during my clinical rotations whenever relevant. I know many of my classmates (especially those going into anesthesia and psych) are doing the same. For example, I can barely go a day or two without encountering a diabetic patient. During my H&P, I always ask them if they see an eye doctor yearly. I then ask if they see an ophthalmologist or optometrist, and if they don't know the difference, I use the opportunity to explain the difference in an objective manner. I know that if i (or more importantly...a family member) needed surgery, I'd go to (or recommend) an ophthalmologist who had an anesthesiologist (not a crna). I think the general public deserves to know enough about the difference between the different degrees in order to make a wise and educated decision.

By the way, I do not believe in slinging mud or calling OD's names. I just believe in being honest...something that OD's should have no problem with at all.
 
Buck Strong said:
I think that educating patients is the right way to go. I have no idea how rigorous the OD education is, nor do I really care. They are not medical doctors and are not trained for surgerical intervention. Since the public has trouble discerning the difference sometimes, it is our duty to show them the difference. The same goes for CRNA's, Psychologists, and other mid-levels looking to expand due to our own apathy and lack of patient knowledge. I was not aware of the numerous expansion of scope issues until midway through medical school. Nowadays, I try to make it a point to educate anyone I encounter during my clinical rotations whenever relevant. I know many of my classmates (especially those going into anesthesia and psych) are doing the same. For example, I can barely go a day or two without encountering a diabetic patient. During my H&P, I always ask them if they see an eye doctor yearly. I then ask if they see an ophthalmologist or optometrist, and if they don't know the difference, I use the opportunity to explain the difference in an objective manner. I know that if i (or more importantly...a family member) needed surgery, I'd go to (or recommend) an ophthalmologist who had an anesthesiologist (not a crna). I think the general public deserves to know enough about the difference between the different degrees in order to make a wise and educated decision.

By the way, I do not believe in slinging mud or calling OD's names. I just believe in being honest...something that OD's should have no problem with at all.

:thumbup: :thumbup: Now we're talking!
 
futuredoctorOD said:
Your comments are foolish and unprofessional. Optometrists are primary care eye doctors---I work with 2 of them and shadow an Opthalmologist---they work together. The OD I work with writes scripts for corticosteroids, beta-blockers, anti-virals (If you don't know about this--I have had pharmacology and can help you out), etc......treating things like open angle glaucoma is not a benign thing and the OD I shadow manages this medically with his patients every day. I will be doing a residency in ocular disease with either the VA or an eye institute--a 2 year one. Your comment about a lense fitter is a joke. Schools like Nova Southeastern University College of Optometry have an interdisciplinary program----many of the basic science courses of the first two years are shared by the Osteopathic Medical students, Optometry Students, Dental Students, and Pharmacy students----including classes like Biochemistry, Pharmacology, Medical Microbiology, and so on. Optometrists and Opthalmologists are both skilled doctors and surgeons respectively. Optometry does 75% of the primary eye care in this country while opthalmology does 99% of surgery---oklahoma has some surgery for OD's---lol. Do your research before you make an uninformed comment that makes you look foolish. Just a word of advice---behave professionally--becoming an allopath or osteopath is a great accomplishment (so is becoming an optometrist) start acting like it.

Look who is talking again. Not even in optometry school.
 
modemduck said:
. also I still don't get why progressive optometrists didn't just go to medical school to do surgery. (Does anyone else have commentary on whether they have the same basic science years as us... it doesn't seem like it from what we have heard)



-ra

For very good reason. Let us imagine for a moment that you are 100% certain that you want to be an ophthalmologist. But, you were born with a strabismus, and although it was surgically corrected by, ironically enough, an ophthalmologist, you know have a lazy eye and thus there is no way you could have good hand eye coordination. I ask you, do you have any business handling a scalpel for any reason?

What if you had a tumor in your skull base and now have visual field deficits? Again, do you have any business handling a scalpel for any reason?

What if you had multiple sclerosis and now have weakness in your hands and have suffered optic neuritis in your past? Do you have any business handling a scalpel?

Let's face it, if you had any medical condition preventing you from becoming a surgeon, yet you were dead set of doing eye care, you'd have no choice but to become an optometrist.



Its very simple! If a person desires to do eye care but does not want to do surgery, and is incapable of doing surgery, they really do not have a choice, optometry is all they have!!

Lastly, we all know how competitive ophthalmology really is. Nothing upsets me more than a bunch of FP residents that hate their job and did FP as a stepping stone to something more competitive like ophthalmology. Maybe those people just don't want to take the chance and settle for optometry. Why suffer through four years of MD/DO school if all you really want to do is routine non-surgical eye care?

I can't stress this enough but some people just don't want to be surgeons, can't be surgeons if they tried for multiple reasons, or ultimately, just don't have th epersonality to be surgeons. And ultimately, in the world of MD/DO, there just is not any residency/training program aimed toward eyecare that is non-surgical, your only choice is optometry school.
 
UABopt said:
Well you "heard" wrong, my classes average was always on par, or better than that of the dental students. I was just trying to make the point that optometry school is far from being a joke.
I don't believe it is a joke...it just not like medical school training.
 
Buck Strong said:
For example, I can barely go a day or two without encountering a diabetic patient. During my H&P, I always ask them if they see an eye doctor yearly. I then ask if they see an ophthalmologist or optometrist, and if they don't know the difference, I use the opportunity to explain the difference in an objective manner.
Hardly objective. These threads are always entertaining to say the least. Let's forget about the expanded scope of practice issue for a moment. I hope you are not suggesting that OD's are not qualified to manage diabetic patients. I see approximately 2-4 diabetic patients a day. Believe it or not, a lot of them are referred by their MD to see me. OD's are qualified to handle primary care patients. Just like general OMD's send diabetics to the retinal specialist for laser when needed, so do OD's.

Just a side note for those that seem to hate OD's. I hope you like university settings. Since OD's provide the majority of the eyecare in the US, your attitude towards optometry will make it very hard to get those surgical referrals. In my town, the only OMD's that get referrals for cataracts, retina, glaucoma, plastics, etc are those that are friendly to OD's. There are plenty of co-management centers that have learned in order to stay busy, you have to play nice. A lot of them even testify in front of our state legislators on our behalf.
 
Ben Chudner said:
Hardly objective. These threads are always entertaining to say the least. Let's forget about the expanded scope of practice issue for a moment. I hope you are not suggesting that OD's are not qualified to manage diabetic patients. I see approximately 2-4 diabetic patients a day. Believe it or not, a lot of them are referred by their MD to see me. OD's are qualified to handle primary care patients. Just like general OMD's send diabetics to the retinal specialist for laser when needed, so do OD's.

Just a side note for those that seem to hate OD's. I hope you like university settings. Since OD's provide the majority of the eyecare in the US, your attitude towards optometry will make it very hard to get those surgical referrals. In my town, the only OMD's that get referrals for cataracts, retina, glaucoma, plastics, etc are those that are friendly to OD's. There are plenty of co-management centers that have learned in order to stay busy, you have to play nice. A lot of them even testify in front of our state legislators on our behalf.

Ben, I think you make some excellent points in the last paragraph, but perhaps you could explain why you don't feel Buck's method of patient education is not objective. Did I misunderstand Buck? I think he said that if someone needs eye surgery he would send them to an ophthalmologist.

Ruben
 
bustbones26 said:
For very good reason. Let us imagine for a moment that you are 100% certain that you want to be an ophthalmologist. But, you were born with a strabismus, and although it was surgically corrected by, ironically enough, an ophthalmologist, you know have a lazy eye and thus there is no way you could have good hand eye coordination. I ask you, do you have any business handling a scalpel for any reason?

Let's face it, if you had any medical condition preventing you from becoming a surgeon, yet you were dead set of doing eye care, you'd have no choice but to become an optometrist.

Not true. Some of the best strabismus surgeons had strabismus themselves! In fact, a former faculty at Iowa has strabismus.

Also, there is a surgeon in India (famous one too) who suffers greatly from rheumatoid arthritis with deformed hands. He too is a great surgeon.

These examples support the notion that surgery requires the mental discipline gained through medical school and residency in additition to requiring the manual dexterity.

http://myhero.com/myhero/hero.asp?hero=Venkataswamy
 
rubensan said:
Ben, I think you make some excellent points in the last paragraph, but perhaps you could explain why you don't feel Buck's method of patient education is not objective. Did I misunderstand Buck? I think he said that if someone needs eye surgery he would send them to an ophthalmologist.

Ruben
Maybe it was me that misunderstood, but it looked like Buck was refering to the education of non-surgical diabetic patients. It has been my experience that most MD's believe that all patients should be seen by OMD's. I believe that primary care patients are well served by both professions. It was not my intention to put words in Buck's mouth.
 
Ben Chudner said:
Hardly objective. These threads are always entertaining to say the least. Let's forget about the expanded scope of practice issue for a moment. I hope you are not suggesting that OD's are not qualified to manage diabetic patients. I see approximately 2-4 diabetic patients a day. Believe it or not, a lot of them are referred by their MD to see me. OD's are qualified to handle primary care patients. Just like general OMD's send diabetics to the retinal specialist for laser when needed, so do OD's.

Ben,

The training of ODs are so variable. I don't know your training, so I can't comment. However, I've worked with very "good" ODs who have watched severe non-proliferative diabetic retinopathy turn into proliferative disease with vitreous hemorrhage and CSDME before referring for laser. This is poor "primary care". Once ODs detect diabetic changes, then referral is needed.

General ophthalmologists do retina laser and don't always refer out. Your comment is a generalization. The limiting factor is the cost of maintaining a laser and having enough patients to support the laser. This may change for general ophthalmology in the near future! Read below-

Do you want to see optometrists really worry? Faculty at Iowa are working on technology (tele-medicine screening program) to help ophthalmologists work with the MDs that refer to optometrists directly to use telemedicine to screen diabetic patients. We want the primary care doctors to work with ophthalmologists directly. Currently, through this tele-medicine screening program, ophthalmologists screen the fundus and detect patients who need an evaluation by ophthalmology (physicians who can do lasers and really help).

Here's the exciting fact for members of this forum. This technology can be automated with software that is MORE sensitive than the human eye in detecting exudates, hemorrages, and other diabetic changes! This means we will need less "eye doctors" for normal diabetic screening examinations and more surgeons for the evaluation to laser patients. This may be the technology needed to help ophthalmologists regain control. Medical doctors want to refer directly to medical doctors. I am very excited about this tele-diagnosis/screening because it develops a radiology-like sub-specialty for ophthalmologists.

http://webeye.ophth.uiowa.edu/dept/News/2005/0412Telediag.htm

http://webscreen.ophth.uiowa.edu/
 
Andrew_Doan said:
Here's the exciting fact for members of this forum. This technology can be automated with software that is MORE sensitive than the human eye in detecting exudates, hemorrages, and other diabetic changes! This means we will need less "eye doctors" for normal diabetic screening examinations and more surgeons for the evaluation to laser patients. This may be the technology needed to help ophthalmologists regain control. Medical doctors want to refer directly to medical doctors. I am very excited about this tele-diagnosis/screening because it develops a radiology-like sub-specialty for ophthalmologists. QUOTE]

Hey Dr. Doan,

Pretty cool. Will aspects of this technology be presented at ARVO?

Ruben
 
I thought we had progressed past anecdotal evidence. Since I was wrong, I'll throw in my own little story. An OD where I'm from sends in a patient to a general ophthalmologist with diabetic retinopathy who needs lasering. That was why the OD sent this patient in, so that the OMD could zap those blood vessels. Instead, the MD decides to watch the patient for awhile and make sure that he really needed treatment. This patient, who was seeing somewhere in the neighborhood of 20/30 best corrected, now on good days can make out at 20/400. Everyone makes mistakes, until anyone can find good, statistically significant evidence of ODs screwing things up, let's not generalize. As for general OMDs not sending out retina laser work, no they certainly don't have to. However, if there is a retina specialist in the area who can see this patient quickly, why not refer? It is no slight to suggest that the fellowship trained retina guy is better at retina work than the general OMD.

I'd also like to add my own little bit onto what Ben said. Where I'm from, there are about 8 general OMDs. Of those 8, 7 of them don't co-manage and say some very nasty things about the local ODs to their state Congressmen. Those 7 are lucky to do 3 cataracts in a week. Number 8, on the other hand, co-manages and doesn't have the anti-OD attitude that we see on these boards every so often. He does anywhere from 30-45 cataracts in a week. In the private world, playing nice gets you patients.
 
Sledge2005 said:
Yeah seriously, what's the worst thing that can happen if somebody's glasses prescription is a bit off?

Amblyopia.
 
Sledge2005 said:
I agree that some of the comments about OD's just being lens fitters are incorrect (although there are some OD's who do mainly glasses), but OD's aren't exactly that honest about their scope themselves.



This is a good example of the dishonesty of OD's about their training. Why is your two years of training called a "residency?" The term "residency" for physicians came about b/c orginally the doctors literally did live in the hospital and were residents there. Since then, it's been a pretty specific term used in healthcare to refer to specialized training that physicians do after medical school. Then optometry decides they'll try and confuse people by calling their different training by the same name.

I will preface my comments by saying that you seem like an intelligent person. There are many residency programs I can give you the links to for optometry.

http://www.nova.edu/optometry/residency/residency.html

this is just one link from NOVA.....look at it..... The residency programs in this field help better prepare OD's for Pediatrics, Geriatrics, Ocular Disease Management, Sports Vision, Vision Rehabilitiation, Primary Care, Pre-Post--Opterative Management, and so on. I shadow on OD right now whose primary responsibility at the Eye Institute he works at is treating Glaucoma----he works hand in hand with OMD's there and they never question a script he writes....
 
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