O.D. should equal Doctor of Optometric Medicine

[futuredoctorOD]

I have thought about this one for a long time. Among the Dentists, Podiatrists, Optometrists, and Osteopathic Physicians, we are the only degree that leaves out the term "medicine" when describing our degree.

Currently you have,

Doctor of Podiatric Medicine (DPM)
Doctor of Dental Medicine (DMD)
Doctor of Osteopathic Medicine (DO)

I think at this point in 2008 when we are a profession that diagnosis and treats disease with medications, functions as THE primary eye care doctor for most people most of the time, we should add the term "medicine" to the end of our degree:

O.D. = Doctor of Optometric Medicine


When the term "doctor of optometry" was created OD's didn't treat any eye diseases or prescribe any medications! IT IS 2008 In reality all of the fields of Dentistry, Podiatry, and Optometry respectively are practicing a "form" of medicine. When a Ophthalmologist prescribes Travatan Z he is practicing medicine, when a Doctor of Optometry prescribes Travatan Z he is practicing optometry, when family practice physician prescribes a pain medicine for TMJ he is practicing medicine, when a Dentist prescribes a pain medicine for TMJ he is practicing dentistry! These practitioners are all practicing medicine in some shape or form!


I know there is going to be "firestorm" from some of the old-timers on here but if Dentistry and Podiatry which are "limited license doctors" in the same sense of the word as optometrists have this designation in their degree, I think it is time for optometry to move forward.

---

Members don't see this ad.

 

[eyestrain]

Well, here's one of the "old-timers" who has been out of school for ONE year. I have never seen a group of people who are so obsessed with titles semantics as the people who post on this board. Everyone wants to add some kind of title so we can be more like "real" doctors. Get over it. What exactly do you hope to accomplish by adding the word "medicine" to our degree or "physician" to our title? More respect? From whom?

 

[futuredoctorOD]

Well for starters, Dentistry and Podiatry which are analagous to optometry already have the "medicine" designation in their degree. Optometry should to----it is more "accurate" and better describes what we are capable of doing. And I know that an OD is a "real doctor" maybe you don't Eyestrain?





OD's need to get more stones

 

[KHE]

Well for starters, Dentistry and Podiatry which are analagous to optometry already have the "medicine" designation in their degree. Optometry should to----it is more "accurate" and better describes what we are capable of doing. And I know that an OD is a "real doctor" maybe you don't Eyestrain?





OD's need to get more stones

Just for the sake of clarification futuredoctorOD, please post where you are in your training process. Pre-optometry? Optometry student? Practicing Optometrist?

Also, in what way is podiatry and dentistry analogous to optometry other than the fact that all 3 of those programs are 4 years in length and none of them end with the MD degree?

 

[aphistis]

Well for starters, Dentistry and Podiatry which are analagous to optometry already have the "medicine" designation in their degree. Optometry should to----it is more "accurate" and better describes what we are capable of doing. And I know that an OD is a "real doctor" maybe you don't Eyestrain?





OD's need to get more stones

The problem is that your premise is flawed. For good or ill, dentistry and podiatry aren't encumbered by the same limitations as optometry. If somebody has a problem in the oral cavity or maxillofacial region, dentists (whether GP's or specialists) are able to definitively treat it. If somebody has a problem with their foot or ankle, podiatrists are able to definitively treat it. If somebody has a problem with their eyes, on the other hand...odds are fair to good that they'll need an opthalmologist on board, because an optometrist, alone, won't be able to definitively treat it.

I post this respectfully, and I ask that you not skewer me simply for suggesting your comparison is flawed.

 

[futuredoctorOD]

Well I respectfully disagree,

As IndianaOD has so eloquently stated, OD's can treat most of the eye care issues when it comes to primary ocular care...so you are in error about this one.

In all 50 States can:

1) Diagnose eye diseases and disorders
2) Diagnose systemic diseases and refer to the appropriate practitioners.
3) Prescribe ocular medications for the treatment of eye diseases
4) Perform minor surgical procedures (ie, FB removal, punctal plugs, etc).


In 42+ states OD's can:

1) Rx systemic medications to treat eye diseases (including narcotics for ocular pain)


So in regard to "primary ocular care" the optometrist can do 99% of it.

 

[362.04]

Well I respectfully disagree,

As IndianaOD has so eloquently stated, OD's can treat most of the eye care issues when it comes to primary ocular care...so you are in error about this one....


In 42+ states OD's can:

1) Rx systemic medications to treat eye diseases (including narcotics for ocular pain)


So in regard to "primary ocular care" the optometrist can do 99% of it.

aphistis has a point but to add to that, optometry is flawed because its scope of practice is legislated. It is by nature not recognized uniformly. I believe that "medicine" or "physician" titles for an optometrist is superfluous at this time.

I believe this discussion is rather unproductive and hope that it goes nowhere.

 

[aphistis]

Well I respectfully disagree,

As IndianaOD has so eloquently stated, OD's can treat most of the eye care issues when it comes to primary ocular care...so you are in error about this one.

In all 50 States can:

1) Diagnose eye diseases and disorders
2) Diagnose systemic diseases and refer to the appropriate practitioners.
3) Prescribe ocular medications for the treatment of eye diseases
4) Perform minor surgical procedures (ie, FB removal, punctal plugs, etc).


In 42+ states OD's can:

1) Rx systemic medications to treat eye diseases (including narcotics for ocular pain)


So in regard to "primary ocular care" the optometrist can do 99% of it.

That's my whole point. "Most of" isn't "all", and that's just in the limited sphere of primary care stuff. As soon as you expand the question to include more complex problems, "most of" no longer even enters the discussion. By your own admission, in almost 20% of the country you aren't permitted to prescribe medications in your own area of expertise.

Don't misunderstand me, please. I'm not speaking at all to whether I think the limitations are right or wrong. All I'm saying is that they do exist, and as long as they continue, "optometry" and "medicine" will not, for better or worse, become interchangeable terms. Good luck in your career, and have a nice day.

 

[362.04]

Dear futuredoctorOD,

I think your argument is misdirected. Until optometrists can be reimbursed, paid or become members of medical panels or be free to become paid by ERISA plans, that should be the larger battle. I don't believe a change in title will give optometry that kind of access.

 

[SarahNC]

Frankly, who cares if OD = Doctor of Optometry or Doctor of Optometric Medicine? You are the minority here, the rest of us aren't obsessed with titles and I don't think it makes a difference which it is. You are not going to introduce yourself as either to your patients or anyone else, you are going to say you are an Optometrist.

But I did have one thing to say about the being able to treat "most" things. Podiatrists and Dentists can not treat EVERYTHING either, they have to refer to other specialists as well. This shouldn't be a battle of who can treat more or less, but Optometrists aren't nearly as limited as some may think.

 

[200UL]

Well I respectfully disagree,

As IndianaOD has so eloquently stated, OD's can treat most of the eye care issues when it comes to primary ocular care...so you are in error about this one.

In all 50 States can:

1) Diagnose eye diseases and disorders
2) Diagnose systemic diseases and refer to the appropriate practitioners.
3) Prescribe ocular medications for the treatment of eye diseases
4) Perform minor surgical procedures (ie, FB removal, punctal plugs, etc).


In 42+ states OD's can:

1) Rx systemic medications to treat eye diseases (including narcotics for ocular pain)


So in regard to "primary ocular care" the optometrist can do 99% of it.

If you can prescribe narcotics, then you must have the ability to care for most ocular conditions. Really?

Regarding prescription right of OD's... The difference between an MD prescribing medications and an OD prescribing the same medicine is that an MD understands (has witnessed in clinical practice) that many medications can have serious side effects. For example, we take care of patients that die due to reactions to medications in our training (systemic antibiotics, b blockers, aspirin....).

ODs have pushed and continue to push for "narcotics" rights. MDs find this funny because narcotics are rarely used in our practices (even in post trauma/post surgical cases). Getting these rights is a good move on the part of ODs as I believe it will help expand your scope or practice in the future. Law makers, who know very little about medicine, and the general public are always impressed with "narcotics."

In summary, use the "narcotics" argument when you speak to lawmakers. Do not use it when you speak to other medical professionals – especially if they have had clinical pharmacology experience (not just a lecture/test). For many reasons Tylenol #3 is more benign than timolol - in both the hands of an OD or MD.

 

[qwopty99]

O.D. = Doctor of Optometric Medicine

Shouldn't OMD = Doctor of Optometric Medicine?

Are you also suggesting we change the letters of our degree?


I think optometry is a field. It is the field that comprises that which we do as optometrists. As the most educated in "this" field, we are doctors of this field, and hence, Doctors of Optometry.


Medicine still doesn't comprise nearly enough of what we do for us to make any demand for a meaningful shift towards appropriating the term "medicine" into our title. At least not yet. Whether that changes at some point in the future is anyone's guess.


But hey - I'm glad I'm the expert at refraction and helping patients optimize their vision. Isn't that what you're in optometry for?

 

[362.04]

Dear 200UL,

Let's not confuse the issue. Your post borders on inflammatory. I wonder why you posted here at all

If you wanted to make a positive contribution to the discussion, you could have made your point in one paragraph. Instead, you launched into some kind of diatribe. Let's be more concise and try to restrain ourselves from creating a "thus agains them" thread.

 

[qwopty99]

ODs have pushed and continue to push for "narcotics" rights. MDs find this funny because narcotics are rarely used in our practices (even in post trauma/post surgical cases). Getting these rights is a good move on the part of ODs as I believe it will help expand your scope or practice in the future. Law makers, who know very little about medicine, and the general public are always impressed with "narcotics."

It is certainly the case that most lobbying done by optometrists is merely political, and not for clinical purposes. What I mean is, optometrists basically want to say they can do "X Y and Z", but that the number of times they actually will or do do it, is very small. There are exceptions of course. There exists medically-minded optometrists who practice full scope, but I think the number of these folks who are basically on par with general ophthalmologists in terms of what they do day-to-day is relatively few.


So the point is, most optometrists want to be able to claim to their patients and on their websites that they do treatment for X Y and Z, but the amount of actual times they (optometrists as a whole) do X Y and Z, is very small.


I saw a statistic once - what was it - like 5% of all medical eye scripts in Massachusettes was done by ODs? The rest were done by OMDs.

 

[200UL]

Dear 200UL,

Let's not confuse the issue. Your post borders on inflammatory. I wonder why you posted here at all

If you wanted to make a positive contribution to the discussion, you could have made your point in one paragraph. Instead, you launched into some kind of diatribe. Let's be more concise and try to restrain ourselves from creating a "thus agains them" thread.

I apologize. But earlier it was pointed out that narcotics are part of the ODs toolbox when talking about primary eye care. ODs having the ability to give many of the topical meds means more to me (and maybe it means more to you too?). In many patients I am more worried about writing a timolol script than giving a few pain pills (although, I can envision few scenarios where faced with this).

 

[qwopty99]

Well, here's one of the "old-timers" who has been out of school for ONE year. I have never seen a group of people who are so obsessed with titles semantics as the people who post on this board. Everyone wants to add some kind of title so we can be more like "real" doctors. Get over it. What exactly do you hope to accomplish by adding the word "medicine" to our degree or "physician" to our title? More respect? From whom?

I just want to add here...

What is wrong with the term "Optometry"?

What is wrong with the term "Optometrist"???




Why the need to shift towards "Optometric Physician", or "Optometric Medicine"?

If you graduated from an optometry school, you are an optometrist. Why is that so difficult to comprehend?

As Forrest Gump said, "An optometrist is what an optometrist does."

If that means prescribing meds, then fine. If that means doing surgery, then fine. But you're still an optometrist!!


Signed in an ironic manner,
Qwopty, Optomologist.... (haha)

 

[362.04]

I apologize. But earlier it was pointed out that narcotics are part of the ODs toolbox when talking about primary eye care. ODs having the ability to give many of the topical meds means more to me (and maybe it means more to you too?). In many patients I am more worried about writing a timolol script than giving a few pain pills (although, I can envision few scenarios where faced with this).

Thanks. I wanted to keep this thread as clean as possible.

 

[362.04]

I apologize. But earlier it was pointed out that narcotics are part of the ODs toolbox when talking about primary eye care. ODs having the ability to give many of the topical meds means more to me (and maybe it means more to you too?). In many patients I am more worried about writing a timolol script than giving a few pain pills (although, I can envision few scenarios where faced with this).

I agree that prescribing oral analgesics including narcotics are not what I call main stream optometry. I practice in a hospital and screen or manage most of the eye patients coming from the Emergency Department and from primary ambulatory medicine and practically all of the uveitis, abrasions, moderate corenal ulcers do not require narcotics. I think of the last 100, I think I prescribed only about 2 cases.

 

[eyestrain]

I just want to add here...

What is wrong with the term "Optometry"?

What is wrong with the term "Optometrist"???

Why the need to shift towards "Optometric Physician", or "Optometric Medicine"?

If you graduated from an optometry school, you are an optometrist. Why is that so difficult to comprehend?

As Forrest Gump said, "An optometrist is what an optometrist does."

If that means prescribing meds, then fine. If that means doing surgery, then fine. But you're still an optometrist!!


Signed in an ironic manner,
Qwopty, Optomologist.... (haha)

I do not understand the point of any of that. Yes, I know I'm an optometrist. No, I have no problem with the terms "optometry" or "optometrist". Do you care to explain to me what you're trying to say here?

 

[qwopty99]

I'm agreeing with you. It's a continuation of the line of thinking expressed by your post.

 

[eyestrain]

I'm agreeing with you.

You should have quoted the OP, then i would have understood. My bad.

 

[KHE]

So in regard to "primary ocular care" the optometrist can do 99% of it.

What is primary ocular care? Many people throw around the terms "primary care" and "primary eye care" very easily, but I think that many people have never really thought what the terms actually mean.

Do most of you students think that the term "primary eye care" means "any eye care that isn't surgery?" Is that your definition of "primary eye care?"

 

[qwopty99]

Why stop at medicine? Why not:

OD: Optometric Physician and Surgeon?

 

[IndianaOD]

I figured we were due for another one of these threads. Unless you are an MD resident/MD with OD after your name you are not qualified to comment on the significant training of an OD.

If it was up to me, MDs (non OMDs) could NOT prescribe ophthalmic medications. Honsestly, and I'm tired of being PC, you don't know crap about the eye. All most MDs ever due is unnecissarily dump crappy antibiotics on red eyes. Yes, there are plenty of incompetant MDs and ODs.

As far as narcotics, you do know that the cornea has the greatest nerve density of any tissue in the body? I have had patients who couldn't even walk because their eyes hurt so bad.

ODs have plenty of pharmacology, more actual class wise than MDs. Around here PAs and NPs prescribe at will with a blank check from MD bosses. How much pharmacology do they have?

BTW I don't care if I have medicine after my name. I'm a doctor of optometry and proud of it. No-one does primary eye care (everything short of invasive surgery) better than a good OD.

 

[eyestrain]

I figured we were due for another one of these threads. Unless you are an MD resident/MD with OD after your name you are not qualified to comment on the significant training of an OD.

I think this works both ways.

Oh, and ditto to primary care docs, NPs and PAs giving antibiotics (usually sulfacetmide) to every red eye that they see. Why don't OMDs put up a fuss about that? Maybe they have and I've just missed it.

 

[aphistis]

As far as narcotics, you do know that the cornea has the greatest nerve density of any tissue in the body?

I presume you're disregarding the brain and spinal cord as tissues of the body?

 

[362.04]

Dear IndianaOD,

I think it is incumbent upon us to remember our scope of responsibility which is the ocular health of the patient and ocular problems that are a consequence of systemic or functional conditions and problems.

But towards your post, it is true that physicians may have modest education, training or facility in eye care but most physicians are quite aware of their own knowledge base and easily defer to others. We must be aware that we also have a responsibility of doing the same.

In this regard, I think it is misdirected to argue whether we are or are not qualified to do something. It is a no-win argument. Neither you or I will be able to say anything on this forum to change minds.

To that end, most physicians will only comprehend the training of the optometrist through a working relationship. I think that if we use our opportunities to demonstrate our skill and knowledge through action and result, that will probably more helpful in increasing our acceptance by others. I fail to see to see how throwing missives at each other will do that.

 

[VA Hopeful Dr]

ODs have plenty of pharmacology, more actual class wise than MDs. Around here PAs and NPs prescribe at will with a blank check from MD bosses. How much pharmacology do they have?

You are completely wrong about this. Here, let me show you why.

NECO - 5.5 hours of pharmacology

UAB - 6 hours of pharmacology

SCO - 6 hours of pharm

UHCO - 7 hours of pharm

I tried to look up the curriculum for med school, but everyone seems to be going for either the organ systems approach or PBL. Consequently, I only found 2 schools that listed the actual hours (oddly enough, both here in SC).

MUSC - 9 hours

USC - 7 hours

Long story short, at the bare minimum y'all have the same number of classroom hours (and that's not even most of the OD schools out there). On the other hand, MUSC has 2-3 hours more pharm class then OD schools.

I did notice something interesting at your alma mater. You have 3 hours of ocular specific pharm, and then 10 hours of Systemic Physio-Pharm. I'll leave it up to you to give specifics as to how exactly that works, if you so choose, but it does appear that IU potentially has more pharmacology class time than at the least every other OD school and perhaps most med schools. But, as I said, this appears to be an aberration.

 

[362.04]

Like I said, IndianaOD, comparing with medicine on a point-by-point argument has always brought forth an endless repetitive argument of this and that. Let's stay on point about the topic and avoid the inflammatory rhetoric.

 

[KHE]

Regarding prescription right of OD's... The difference between an MD prescribing medications and an OD prescribing the same medicine is that an MD understands (has witnessed in clinical practice) that many medications can have serious side effects. For example, we take care of patients that die due to reactions to medications in our training (systemic antibiotics, b blockers, aspirin....).

That's fair enough....but dentists and podiatrists are prescribing narcotics at a much MUCH higher rates than ODs, just by the painful nature of tooth and foot care. I have prescribed narcotics MAYBE 3 times in the past year and all were for large corneal abrasions.

The question becomes then....how do dentists and podiatrists learn to use these medications safely if they aren't going through a traditional allopathic medical school program?

 

[WoodyJI]

Do most of you students think that the term "primary eye care" means "any eye care that isn't surgery?" Is that your definition of "primary eye care?"

I'd just like to drop in here that, as a current student, I am aware of the fact that "primary eye care" does NOT fit the simple definition of "any eye care that isn't surgery."

One easy example of this would come from Ohio's policy on oral steroids in optometry. Under the law, one section states that we can prescribe orals on the basis of an individual's particular episode of illness. Basically we don't manage chronic inflammation with orals...a patient needing that kind of management no longer qualifies as someone receiving "primary care." I think that makes good sense.

 

[daysend85]

You are completely wrong about this. Here, let me show you why.

NECO - 5.5 hours of pharmacology

UAB - 6 hours of pharmacology

SCO - 6 hours of pharm

UHCO - 7 hours of pharm

I tried to look up the curriculum for med school, but everyone seems to be going for either the organ systems approach or PBL. Consequently, I only found 2 schools that listed the actual hours (oddly enough, both here in SC).

MUSC - 9 hours

USC - 7 hours

Long story short, at the bare minimum y'all have the same number of classroom hours (and that's not even most of the OD schools out there). On the other hand, MUSC has 2-3 hours more pharm class then OD schools.

I did notice something interesting at your alma mater. You have 3 hours of ocular specific pharm, and then 10 hours of Systemic Physio-Pharm. I'll leave it up to you to give specifics as to how exactly that works, if you so choose, but it does appear that IU potentially has more pharmacology class time than at the least every other OD school and perhaps most med schools. But, as I said, this appears to be an aberration.

I can't comment on the other optometry schools, but I know that we have PLENTY of pharmacology lectures at PCO. We learn about meds for ALL SORTS of conditions, not just ocular conditions. We learn about ADRs and mechanisms of action, etc. and are tested on them. So before anyone puts a blanket on OD schools and says we learn nothing about pharmacology, get the facts straight. Do we have so-called pharmacology classes at PCO? No. The pharm info is integrated into the course work as it is deemed necessary. That's probably why you couldn't find any "hours of pharmacology" for PCO.

 

[Oculomotor]

Woody JI,

Yes the Ohio Optometry Code has limitations on Oral Steroids and Narcotics:

Within these drug classes there are NO LIMITATIONS and it is up to the OD to prescribe drugs with ocular indications

1) Any Ocular Medication (Topical Ophthalmic Drugs)
2) Any Oral Anti-infectives (Antibiotics, Antivirals, Antifungals, Antiprotozoals)
3) Any Oral Anti-Glaucoma Medications
4) Any Oral Anti-Allergy Medications
5) Any Oral Non-Narcotic Analgesic Medications
6) Any Oral Non-Steroidal Anti-Inflammatory Medications

Within these drug classes there are LIMITATIONS set forth by the Ohio State Board of Optometry:

1) A licensed optometrist, who holds a therapeutic pharmaceutical agents certificate is authorized to employ, apply, administer and prescribe schedule III controlled substances that are determined to be appropriate for use in the practice of optometry. Controlled substances may only be prescribed by an optometrist if the product's FDA approved labeling contains an indication for pain.

2) Oral Steroids may be used in the following circumstances:
(i) The drug is prescribed for use in allergy cases;
(ii) The drug is prescribed for use by an individual who is eighteen years of age or older;
(iii) The drug is prescribed on the basis of an individual's particular episode of illness;
(iv) The drug is prescribed in an amount that does not exceed the amount packaged for a single course of therapy.

And they can prescibe vision correction devices that deliver medications as well.

There is a significant amount of self-oversight for OD's when compared to their MD, DO, DDS, and DPM counterparts by the Optometry Board. It seems Ohio is similar to many states.

On the initial topic about OD=Doctor of Optometric Medicine........I like it. As long as the OD would be kept the same. I know that in the profession of Osteopathic medicine they kept the DO and went from Doctor of Osteopathy to Doctor of Osteopathic Medicine. Regardless, I like the way the degree is anyway.

 

[200UL]

I can't comment on the other optometry schools, but I know that we have PLENTY of pharmacology lectures at PCO. We learn about meds for ALL SORTS of conditions, not just ocular conditions. We learn about ADRs and mechanisms of action, etc. and are tested on them. So before anyone puts a blanket on OD schools and says we learn nothing about pharmacology, get the facts straight. Do we have so-called pharmacology classes at PCO? No. The pharm info is integrated into the course work as it is deemed necessary. That's probably why you couldn't find any "hours of pharmacology" for PCO.

I am sure all OD students get plenty of pharmacology LECTURES - maybe even more the MD students in some cases. Still, lectures and tests only provide a foundation. True understanding only comes with seeing the planned impact of medications first hand (and side effects). This starts in the 3rd and 4th year of medical school when students right medication orders for hospitalized patients and follow patients closely both day and night. It is taken to the next level during internship when the buck stops with the intern for all patient care. This is the "pharmacology training" all MDs depend on. It is also this experience the NPs and PAs depend solely on - you are probably right, however, that the lack of the same foundation in physiology and pharmacology should limit their prescription scope. I would argue that post pharmacology lecture learning is roughly 1000x more important than memorizing side effects and mechanisms for a given drug for a test during one's first year of professional school. One needs both.

For example, during my intern year I took care of 2 patients that died from complications related to side effects from oral antibiotics (one case was bactrim prescribed by a dermatologist, another antibiotic was prescribed by an internist). In the past 12 months our program has had 2 deaths and 3 other hospitalizations related to oral prednisone use for the treatment of giant cell arteritis (sure I memorized that GI bleed and psychosis could result from prednisone use, but seeing these cases first hand adds something - at least for me). We have all seen exacerbations of COPD from topical timolol.... These, along with many other experiences, are important in the patient care eye MDs deliver.

 

[362.04]

Daysend85,

I think you are over your head this one.

Although optometrists do have a wide exposure to the theoretical basis of pharmacology of the body, they are mainly focused on ocular effects and ocular consequences.

To say that an optometry student has the same wisdom as a physician even though their pharmacologic platform knowledge is almost similar is not being realistic.

Until you spend clinical rotations like medical students do to "practice" the pharmacology from the theory, the reality is that their practical knowledge of pharmacology outpaces optometry.

 

[IndianaOD]

I am sure all OD students get plenty of pharmacology LECTURES - maybe even more the MD students in some cases. Still, lectures and tests only provide a foundation. True understanding only comes with seeing the planned impact of medications first hand (and side effects). This starts in the 3rd and 4th year of medical school when students right medication orders for hospitalized patients and follow patients closely both day and night. It is taken to the next level during internship when the buck stops with the intern for all patient care. This is the "pharmacology training" all MDs depend on. It is also this experience the NPs and PAs depend solely on - you are probably right, however, that the lack of the same foundation in physiology and pharmacology should limit their prescription scope. I would argue that post pharmacology lecture learning is roughly 1000x more important than memorizing side effects and mechanisms for a given drug for a test during one's first year of professional school. One needs both.

For example, during my intern year I took care of 2 patients that died from complications related to side effects from oral antibiotics (one case was bactrim prescribed by a dermatologist, another antibiotic was prescribed by an internist). In the past 12 months our program has had 2 deaths and 3 other hospitalizations related to oral prednisone use for the treatment of giant cell arteritis (sure I memorized that GI bleed and psychosis could result from prednisone use, but seeing these cases first hand adds something - at least for me). We have all seen exacerbations of COPD from topical timolol.... These, along with many other experiences, are important in the patient care eye MDs deliver.

Yup I've Rx'd oral antibiotics several times. Also I would never give a topical beta blocker to an asthmatic or other. Never killed anyone yet. I can understand the drug interactions and precautions just as well as any MD. It isn't secret information. The safety profile of OD prescribing has been excellent.

Hey professor, without looking it up what is the glaucoma mechanism of action of topical timolol? How is it most effectively prescribed?

What training do MDs have that should allow them to Rx topical medications effectively? Many times I see patients that started up in the ER or other MD and the doc never even took a close look at the eye (per the patients recollection). Hey MDs are great and are very well trained. Please stop thinking its the only way to take care of patients. Personally does an MD with the same length of training deserve unlimited prescriptive authority? At least ODs are watched like a hawk.

 

[IndianaOD]

VA, I commonly respect your input. For IU you did not include the 3 hours of applied ocular therapeutics. This is all pharmacology and the use of pharmaceutical agents.

It would be great if medicine never got involved with eye care in history just like they have left dentistry alone. I am sorry, but I just get tired of MD students and residents thinking they know everything and are better than everyone else.

For all you other more humble and hard working MDs: well done!

You are completely wrong about this. Here, let me show you why.

NECO - 5.5 hours of pharmacology

UAB - 6 hours of pharmacology

SCO - 6 hours of pharm

UHCO - 7 hours of pharm

I tried to look up the curriculum for med school, but everyone seems to be going for either the organ systems approach or PBL. Consequently, I only found 2 schools that listed the actual hours (oddly enough, both here in SC).

MUSC - 9 hours

USC - 7 hours

Long story short, at the bare minimum y'all have the same number of classroom hours (and that's not even most of the OD schools out there). On the other hand, MUSC has 2-3 hours more pharm class then OD schools.

I did notice something interesting at your alma mater. You have 3 hours of ocular specific pharm, and then 10 hours of Systemic Physio-Pharm. I'll leave it up to you to give specifics as to how exactly that works, if you so choose, but it does appear that IU potentially has more pharmacology class time than at the least every other OD school and perhaps most med schools. But, as I said, this appears to be an aberration.

 

[Oculomotor]

Indiana OD,

No matter what you tell some of these "stubborn--MD's are Gods" types they are not going to listen to you. If you mention Dentistry (who get the same amount of pharmacology that we do--I take Pharm I and II with them) have very broad prescribing powers in their scope of practice and the last time I checked, they have a lower malpractice incidence rate than MD's, they have nothing to say about it. When I bring up malpractice rates for doctoral level professionals and point out that OD's have a very good track record of prescribing:

Listed below are the total numbers of malpractice payments made by carriers over the past 17 years, 7 months for the independent doctoral-level provider groups who are authorized by the state legislatures to prescribe drugs.
Medical Physicians 232,727
Osteopathic Physicians 14,733
Dentists 40,261
Podiatrists 6,618
Optometrists 580

This data, with only 580 reported malpractice payments made for optometrists in the past 17 years, 7 months, clearly shows the excellent, safe, and effective track record of the profession of optometry.

source: NPDB Website

They will just say, "you can't lump all MD's together with different levels of risk! that data means nothing." They don't want to see the fact that OD's do a very good job safely prescribing in general. They don't care to hear that. It is futile for some of these hubris laiden MD's to try to reason with them. Honestly it really pisses me off---hell even at the GYM I had to hear this unholy crap! lol I am working out and get into a discussion with an internist from a local hospital. I end up telling him what I am doing (My OD degree and residency) for the future and he asks some questions," So how long are you in school?---- Doctorate 4 yrs + 1 yr of residency I replied. After I told him what I planned on doing in the future, he says," Oh you OD's need to be really careful with medications.....Make sure you get good training and make sure you know what you are doing. Are ophthalmologists training you?" It was like he had no respect for my education, no knowledge of what OD's do or are capable of doing, and the worst part of it was--------------HE HAD NO IDEA HE WAS BEING DISRESPECTFUL TO MY EDUCATION AND OPTOMETRY IN GENERAL!!!!!!!!!
Now not all MD's exhibit this ignorance about optometry or professional hubris but it is really annoying when they do. All I know is that I am in a great field with great training and I am going to be really good at what I do.....period. (And yes I will prescribe medications for eye disease and take on some challenging cases within the best of my ability and limits)....REPRESENT!

 

[eyestrain]

When I bring up malpractice rates for doctoral level professionals and point out that OD's have a very good track record of prescribing:

Listed below are the total numbers of malpractice payments made by carriers over the past 17 years, 7 months for the independent doctoral-level provider groups who are authorized by the state legislatures to prescribe drugs.
Medical Physicians 232,727
Osteopathic Physicians 14,733
Dentists 40,261
Podiatrists 6,618
Optometrists 580

This data, with only 580 reported malpractice payments made for optometrists in the past 17 years, 7 months, clearly shows the excellent, safe, and effective track record of the profession of optometry.

source: NPDB Website

They will just say, "you can't lump all MD's together with different levels of risk! that data means nothing." They don't want to see the fact that OD's do a very good job safely prescribing in general. They don't care to hear that.

Wow, i can't believe you brought up this malpractice nonsense again. They reason they, and I, don't want to hear this is because you're comparing apples to oranges. Do you think that safe track record has a little to do with the fact there are still a whole bunch of ODs who don't treat ANYTHING? Or maybe the fact that we're not dealing with life and death situations regularly? Or the fact that there are many, many, many more MDs out there than ODs? Please find a better argument.

 

[Oculomotor]

Eyestrain,

You are MISSING The point. Based on "face value" the data points towards SAFE and EFFICACIOUS prescribing by optometrists. Your statement about "you know how many OD's won't treat anything" is speculative and totally anecdotal!---------Have you done a research study about that Eyestrain? Did you publish it in a peer reviewed journal? It is just your own opinion and those are just like buttholes------everybody has one! You understand the concept of proportionality right? Here look at this:

35,000 practicing OD's 580 claims
750,000 practicing MD's 232,727 claims

So What if there are more MD's? It is all about proportionality and relativity to the population you are studying. Did you ever take statistics? I took stat and differential calculus-------I can see the numbers and draw my own conclusions. How do explain dentists and podiatrists who have having lower numbers than MD's? Well back to the OD's-----I have two practice surveys from "peer reviewed journals" Eyestrain and this is what they say:


The Practice of Optometry: National Board of Examiners in Optometry Survey of Optometric Patients
MORT SOROKA, PhD, DAVID KRUMHOLZ, OD, AMY BENNETT, MPA,
and THE NATIONAL BOARD OF EXAMINERS CONDITIONS DOMAIN TASK FORCE

Conclusion. Ocular disease treatment was found to be an integral part of the optometrist's practice. Prescribing topical
medications, both legend and "over the counter," was a primary treatment option. The most common medications
prescribed were for glaucoma, with antibiotics, antiinflammatory, and antiallergy drops making up the remainder in
descending order.
(Optom Vis Sci 2006;83:E625–E636)
-----------------------------------------------------------------------------------------------------------------------------
2006 AOA Practice Survey

1. OD Written/Ordered Drug Rxs
During a 6 Month Period in 2006, Mean Number


Drug Category All Respondants/ OD's at 95 percentile
Topical anti-microbial drugs 65.9/ 220
Oral antibiotics 6.0 /25
Topical anti-inflam/steroids 50.4 /190
Oral anti-inflam/steroids 2.1 /10
Agents to treat glaucoma 40.0 /200
Anti-viral agents 2.7 /10
Anti-allergy agents 66.7 /200
Analgesics 6.0/ 25
Medication for dry eye 94.4/ 400
Vitamin therapy 37.9 /150
Punctal plugs 7.0 /25

Source: 2006 AOA Scope of Practice Survey

Gee don't let the facts get in the way of your point eyestrain! The fact is----just like Indiana OD (one of your fellow OD's that has some "stones"----that was funny when FuturedoctorOD said that) had previously stated, OD's have a verified, safe, track record with drug prescribing and that is fact supported by the data. I am part student, part scientist, and part old school brawler, so I will take hard facts over opinions of disgruntled optometrists like yourself........

 

[eyestrain]

Fine, you win. This argument is still beyond stupid, but it's obvious you'll never understand why.

 

[KHE]

Source: 2006 AOA Scope of Practice Survey

Gee don't let the facts get in the way of your point eyestrain! The fact is----just like Indiana OD (one of your fellow OD's that has some "stones"----that was funny when FuturedoctorOD said that) had previously stated, OD's have a verified, safe, track record with drug prescribing and that is fact supported by the data. I am part student, part scientist, and part old school brawler, so I will take hard facts over opinions of disgruntled optometrists like yourself........

The issue here isn't whether ODs can safely and effectively use the medications they use. The issue is whether we should be chaning our degree to "Doctor of Optometric Medicine" which to me, is quite lame. No one is going to afford you any more "respect" or deferrence if we do that. Not the public, and certainly not other health care providers.

I think a lot of you really need to calm the heck down. Most of the people who are full of the most piss and vinegar here are people who are barely into their second year of school. It's great to be all "passionate" and "excited" but the reality of the situation is that you are almost certainly doing more harm than good to your cause by acting the way that you act.

 

[Oculomotor]

KHE,

Fair enough......I try to substantiate my points with facts (ergo the two surveys I used and the NPDB Website that demonstrates the safety and effectiveness of optometric physician prescribing) rather than the heresay that is spewed on this site.......I do think that the Doctor of Optometry verbage is fine the way it is.

 

[prettygreeneyes]

How many times can we possibly rehash the same discussion? Will this pissing contest EVER get old? Does it really matter what we are called? Will having the title, "Doctor of Optometric Medicine" make us more respected within the healthcare field? Will that suddenly get us on medical panels or increase our scope of practice?

The answer is no. This constant battle is getting old, and I'm not even an optometrist yet. Some of you are so obsessed with what everyone else thinks of you. JUST LET IT GO!!! It doesn't matter who had more hours of pharmacology. Optometrists will never be MDs. Accept that fact. Embrace it. Find your own niche. If you aren't getting the respect that you think you deserve... if you don't have the title you think you should have - GO TO MEDICAL/DENTAL/PODIATRY SCHOOL!!! Life is too short to be miserable.

*sigh*

 

[IndianaOD]

How many times can we possibly rehash the same discussion? Will this pissing contest EVER get old? Does it really matter what we are called? Will having the title, "Doctor of Optometric Medicine" make us more respected within the healthcare field? Will that suddenly get us on medical panels or increase our scope of practice?

The answer is no. This constant battle is getting old, and I'm not even an optometrist yet. Some of you are so obsessed with what everyone else thinks of you. JUST LET IT GO!!! It doesn't matter who had more hours of pharmacology. Optometrists will never be MDs. Accept that fact. Embrace it. Find your own niche. If you aren't getting the respect that you think you deserve... if you don't have the title you think you should have - GO TO MEDICAL/DENTAL/PODIATRY SCHOOL!!! Life is too short to be miserable.

*sigh*

Some of us just want to put MDs in their place

MDs would do much better for their patients if they better respected and understood others with different training. I know my limitations and happily work with others when its in the patient's best interests.

Some examples:
Why do 99% of pediatricians send patients with eye turns to OMDs who will certainly do strab surgery when optometric vision therapy is safer (several children die each year in the surgery), and functionally superior in the literature.

Why don't more headache patients get referred to ODs? I see patients drugged up with all kinds of crap when really its an ocular etiology.

ADD commonly misdiagnosed when its a binocular vision problem. Nope most OMDs don't look for BV problems either.

Why do physicians treat red eyes when they don't know how or aren't equipped to make a proper diagnosis? (Sorry, but one MD gave a child with herpetic eye disease a benadryl shot mistaking it for poison ivy. If I wouldn't have seen the patient for a "routine" exam and initiated proper Tx the current disciform keratitis could have caused severe permanent vision loss)

We all need to realize that nobody is perfect. Amazing how much politics gets in the way of patient care.

 

[fonziefonz]

pissing

OMG, a mod said 'pissing' lol

 

[Jay12]

Amazing how much politics gets in the way of patient care.

 

[docrw]

I don't think all of the "politics" of MD's treating some of the eye diseases you think you are more qualified to treat comes from arrogance but more a lack of understanding of what you guys can do.

I can say personally as a medical student, I had no idea what optometrist do outside of corrected lens and fixing vision problems until becoming exposed to this forum. I also have learned more about the education of other health professions I previously had no experience of such as podiatrist.

I know I haven't been out in the real world to experience some of the frustrations you may deal with but perhaps you should take more time to educate others on what exactly you can do.

 

[KHE]

I don't think all of the "politics" of MD's treating some of the eye diseases you think you are more qualified to treat comes from arrogance but more a lack of understanding of what you guys can do.

I can say personally as a medical student, I had no idea what optometrist do outside of corrected lens and fixing vision problems until becoming exposed to this forum. I also have learned more about the education of other health professions I previously had no experience of such as podiatrist.

I know I haven't been out in the real world to experience some of the frustrations you may deal with but perhaps you should take more time to educate others on what exactly you can do.

Thank you Docrw, for pointing out one of the biggest problems of optometric education, and it's something that I, and especially Dr. Hom who also contributes to this forum have pointed out for years now.

Medical students and residents will work with and encounter virtually every other provider and specialty in the health care delivery team as part of their training with the EXCEPTION of optometry. As such, medical students and residents never even have a clue as to what services optometry is capable of providing and optometry is never even considered to be a viable referal option for physicians once they enter practice.

Any optometrist that a medical student encounters is likely confined to the ophthalmology department and in most cases their practice is limited to low vision or contact lenses within these departments. Certainly that's not always the case but it is more often then not.

At most physician training centers, optometry is regarded in one of two ways:

1) Benign indifference, in which optometry is never even really thought of.

2) Outright hostility, which generally occurs when 3rd med students may do a 6 week rotation through an ophthalmology department and have it drilled into them that if they refer ANY type of eye issue WHATSOEVER to ANYONE OTHER THAN AN OPHTHALMOLOGIST then the referring physician will be sued up the wazzzzzzooooooooooooooo.

Either way, it doesn't foster an adequate apperciation for what optometry is capable of offering patients. I can't really blame the physicians in the majority of the cases. As Docrw pointed out, they simply don't know any different. This is something that is really the fault of optometry, not the physicians.

 

[Oculomotor]

KHE has hit on to something,

What he says is true-----> OD students in general have very little exposure to medical students. I have always thought that instead of having a clinical medicine class like we do why not have 3-4 months dedicated to rotating through internal medicine at a hospital where we actually learn how to do general medicine rather than in a class or a textbook? God knows we get enough "theoretical optics/optometry" in school...lol That time could be replaced with a real clinical medicine experience (didactic and clinical). I am doing this on my OWN at my school with special permission because I want to learn more about this stuff. It would definitely expose OD students to MD/DO students in a clinical setting and they would have a much better idea of what optometrists are capable of doing rather than just working at Lens Crafters! lol