O.D. should equal Doctor of Optometric Medicine

[Lonman06]

So how do all those reckless and wacky dentists and podiatrists learn how to do the surgical procedures that they do without a medical degree?

While podiatrists don't go to "medical school", in 6 out of the 8 schools they take their classes with MD/DO students. All podiatrists are now required to do a 2 or 3 year surgical residency. Then you are considered eligible to sit for the boards after submitting 50 surgical cases for review.

So I would say in my opinion that podiatrists are more than qualified to do surgery on the foot. Think of it this way, Orthopedic surgeons have 6 weeks of training on the foot and they do foot surgery too!

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[Dr.Millisevert]

While podiatrists don't go to "medical school", in 6 out of the 8 schools they take their classes with MD/DO students. All podiatrists are now required to do a 2 or 3 year surgical residency. Then you are considered eligible to sit for the boards after submitting 50 surgical cases for review.

So I would say in my opinion that podiatrists are more than qualified to do surgery on the foot. Think of it this way, Orthopedic surgeons have 6 weeks of training on the foot and they do foot surgery too!

Podiatry too isn't a great analogy.. because not as many orthos are doing feet, and even the ones who do.. it is not always a huge proportion of their practice.

Yes, an optometrist could do a residency, but what would they learn to do that isn't already covered by ophthalmology? If you could think of some low paying procedures that only make up 2% of ophthalmology practice.. you could maybe say "hey guys, ODs will pick up these procedures".. and then create a residency to train ODs in these.. but again.. you're going to have a hard road ahead of you if you want to jump in and take over the bread and butter ophthalmology procedures. I don't think ophthalmologists are going to let that happen.

 

[IndianaOD]

Ditto.

The way I see it, the bottom line here is: If you want to do surgery so badly, why aren't you going to medical school? I personally have no desire to ever do surgery. If you (not you personally eyestrain, "you" in general) are an optometrist and are fighting to do surgery, you might have entered the wrong profession. Just my .02

I disagree. People can change their minds as they learn more. I don't want to do surgery either, but OD students should be able to change their minds. Heck med students often end up in something different than they first thought.

 

[KHE]

Good review article on ophthalmology. I completely agree with the points. Eventually the "comprehensive OMD" will become rare as an integrated OD/MD delivery system emerges. Also states what I knew to be true...the most successful OMDs are those that work closely with ODs.

The only way that that situation works with respect to optometry is if the optometrists remain independent, autonomous and have the ability to form true business partnerships with decision making abilities. 98% of the "integrated OD/MD delivery systems" that I see involve ODs working in ophthalmology offices as W2 employees and essentially super-teching. Is that what we want for the future of the professoin?

http://www.osnsupersite.com/view.asp?rID=27881

 

[KHE]

While podiatrists don't go to "medical school", in 6 out of the 8 schools they take their classes with MD/DO students. All podiatrists are now required to do a 2 or 3 year surgical residency. Then you are considered eligible to sit for the boards after submitting 50 surgical cases for review.

So I would say in my opinion that podiatrists are more than qualified to do surgery on the foot. Think of it this way, Orthopedic surgeons have 6 weeks of training on the foot and they do foot surgery too!

Ok, but what about the other 2 schools? And to be fair, there are optometry schools where students sit in the same classes as MD/DO students as well.

I'm not advocating for optometric surgery but the point I'm making is that there are ways to train a competent "surgeon" that don't involve traditional allopathic medical school.

 

[Dr. Dai Phan]

Hello,

You do not need medical education to perform surgeries as long as the education (DDS,DPM,OD, DC or whatever) adequately train the students to do such procedures. Dental students are exposed to oral surgery in second year of school and for oral surgeons, many had gone through OS interships and excelled in them followed by another 4-6 year hopital based surgical residency before they become oral and maxillofacial surgeons. Podiatrists also have gone through 3 year hospital surgical training after graduation. True, neither have gone through medical school but the curriculum is surgically oriented for both dentists and podiatrists from the beginning followed by years in residency. In optometry, such post graduate training does not exist ( I am aware of the 1 year post grad).That is why the wacky DDS/DPM can enjoy the surgical freedom which ODs don't have. The rationale of "hey, these guys don't go to med school and still can do surgeries so I as an MD without going to dental school can take out teeth too, right?" won't fly in court. First, ODs curriculum is not surgically based, there is no surgical residency and in my opinion, the school training does not prepare them for the surgical rights now they are seeking. I believe that if there are complications from eye surgeries that are done by an OD (that can happen from anybody) , the legal hassles are more than it is worth. If I was to do any kind of surgeries in the eye no doubt I would do med school and be done with it unless there is a surgical residency available for OD grad now. DP

 

[KHE]

Hello,

You do not need medical education to perform surgeries as long as the education (DDS,DPM,OD, DC or whatever) adequately train the students to do such procedures. Dental students are exposed to oral surgery in second year of school and for oral surgeons, many had gone through OS interships and excelled in them followed by another 4-6 year hopital based surgical residency before they become oral and maxillofacial surgeons. Podiatrists also have gone through 3 year hospital surgical training after graduation. True, neither have gone through medical school but the curriculum is surgically oriented for both dentists and podiatrists from the beginning followed by years in residency. In optometry, such post graduate training does not exist ( I am aware of the 1 year post grad).That is why the wacky DDS/DPM can enjoy the surgical freedom which ODs don't have. The rationale of "hey, these guys don't go to med school and still can do surgeries so I as an MD without going to dental school can take out teeth too, right?" won't fly in court. First, ODs curriculum is not surgically based, there is no surgical residency and in my opinion, the school training does not prepare them for the surgical rights now they are seeking. I believe that if there are complications from eye surgeries that are done by an OD (that can happen from anybody) , the legal hassles are more than it is worth. If I was to do any kind of surgeries in the eye no doubt I would do med school and be done with it unless there is a surgical residency available for OD grad now. DP

This is EXACTLY the point I've been trying to make for years now.

 

[JMU07]

I disagree. People can change their minds as they learn more. I don't want to do surgery either, but OD students should be able to change their minds. Heck med students often end up in something different than they first thought.

Well, that's true. It's one thing if you suddenly realize "wow.. I don't think this is what I want to do. Maybe I'll try med school." but it's another if you want to do surgery from the very beginning.

I don't see anything wrong with wanting to expand or modify our scope of practice. Optometry is constantly changing, just as any other profession. I just don't agree with surgery.

 

[IndianaOD]

Well, that's true. It's one thing if you suddenly realize "wow.. I don't think this is what I want to do. Maybe I'll try med school." but it's another if you want to do surgery from the very beginning.

I don't see anything wrong with wanting to expand or modify our scope of practice. Optometry is constantly changing, just as any other profession. I just don't agree with surgery.

So if someone is interested in eyecare and goes through OD school (makes sense, eyes - program trains you for eyes) they shouldn't have any options if they get interested in ocular surgery on rotations during their fourth year? Their only option being repeat hours of the same classes in med school, starting from scratch?

I wouldn't doubt most med students have never touched a BIO or fundus lens. Again, there is nothing in it for me, I just think people deserve options. Heck have a 1 year pre-OMD residency to prepare you if need be. I'm done beating the horse.

 

[VA Hopeful Dr]

So if someone is interested in eyecare and goes through OD school (makes sense, eyes - program trains you for eyes) they shouldn't have any options if they get interested in ocular surgery on rotations during their fourth year? Their only option being repeat hours of the same classes in med school, starting from scratch?

Yes, they would. If I graduate medical school and then decide to become a dentist, I would have to do my 4 years of dental school. Likewise if I wanted to do optometry. Yes, there is that 3 year program at NECO but that's more self study and just goes faster - same material as regular OD students.

 

[Oculomotor]

Guys, like I stated earlier, Oklahoma's Optometry School (Northeastern States University) already trains its students to do surgical procedures! Just expand on that and make that uniform as part of optometric education......Add the 3-4 year post Doc residency and bam-------you have it.

 

[Dwight Schrute]

Team, arguing that ODs should do surgery is pointless. Let's establish a uniform scope of practice acrosss all states at our current level of training and strive to access as many medical plans as possible. That's something that's going to benefit every optometrist, not just some tiny minority that thinks we should start slicing and dicing. Once this is accomplished then maybe, just maybe, we can talk about minor surgeries. Until then, I'd strongly suggest using our energies to face reality.

 

[IndianaOD]

Team, arguing that ODs should do surgery is pointless. Let's establish a uniform scope of practice acrosss all states at our current level of training and strive to access as many medical plans as possible. That's something that's going to benefit every optometrist, not just some tiny minority that thinks we should start slicing and dicing. Once this is accomplished then maybe, just maybe, we can talk about minor surgeries. Until then, I'd strongly suggest using our energies to face reality.

I'd rather decrease the graduation rate if we want to help ODs. I agree the things you mention are more important, but not the direction the discussion was going.

 

[Dwight Schrute]

I'd rather decrease the graduation rate if we want to help ODs. I agree the things you mention are more important, but not the direction the discussion was going.

I'd rather do that too, but as we all know, that would be a huge violation of our nation's current anti-trust laws . Although I didn't progress the surgical discussion, I'd just like to see more of my optometry student colleagues having discussions on more realistic things that could benefit us all. It's obvious that the tenacity is there but too many of us are hung up on image and "should theories" which ultimately gets us nowhere.

 

[eyestrain]

Team, arguing that ODs should do surgery is pointless. Let's establish a uniform scope of practice acrosss all states at our current level of training and strive to access as many medical plans as possible. That's something that's going to benefit every optometrist, not just some tiny minority that thinks we should start slicing and dicing. Once this is accomplished then maybe, just maybe, we can talk about minor surgeries. Until then, I'd strongly suggest using our energies to face reality.

Thank you, thank you, thank you. +1,000,000. We've managed to devote five pages to something that will benefit almost no one.

 

[Oculomotor]

Dr. Schrute,

I agree with you that we do have to "walk before we can run" and states like Florida, New York, and Maryland are among the 5 left that don't even have oral medications! Talk about the optometric "dark ages" lol. How do you propose (at a national--AOA level) to reach this "uniform scope of practice" as every state is legislated at state level with our wonderful friends in medicine there to make that really fun!!? We have had tremendous victories BUT how do you propose to help those states that the AOA classifies in its Subjective Rankings of Scope of Practice as tier 5-7 (5 of these dont have orals, and about 8 states don't have narcotics for ocular pain nor oral steroids, some don't have oral glaucoma treatment, only 10 states have "real injectable authority"--while 32 states have epinephrine for anaphylactic shock. About 42 states have all topical ophthalmics,most orals, oral steroids, narcotics, and oral glaucoma treatment. Tennessee has a law that states that an optometrist can prescribe any drug necessary to treating ocular disease (this includes orals topicals, and injectibles). This is what the entire country should have in a uniform scope of practice.

 

[VA Hopeful Dr]

Dr. Schrute,

I agree with you that we do have to "walk before we can run" and states like Florida, New York, and Maryland are among the 5 left that don't even have oral medications! Talk about the optometric "dark ages" lol. How do you propose (at a national--AOA level) to reach this "uniform scope of practice" as every state is legislated at state level with our wonderful friends in medicine there to make that really fun!!? We have had tremendous victories BUT how do you propose to help those states that the AOA classifies in its Subjective Rankings of Scope of Practice as tier 5-7 (5 of these dont have orals, and about 8 states don't have narcotics for ocular pain, and some don't have oral glaucoma treatment.

The same way anything gets done - money and some effort. With enough cash and work, you can get most anything done (see Oklahoma).

Honest question here: what oral meds do you use for glaucoma?

 

[Oculomotor]

Actually VA, Oral CAI's such as acetazolamide or methazolamide should be used in certain cases of extreme elevated intraocular pressure (e,g, angle closure glaucoma). I have read recommendations in optometric pharmacology guides (such as the Review of Optometry--Clinical Guide to Ophthalmic Drugs 2008
http://www.revoptom.com/drugguide/pdf/drugguide2008.pdf ) that every O.D.'s office should have two unexpired 250 mg tablets of acetazolamide to help patients in a "crisis" situation.

 

[Oculomotor]

Per Indiana OD's comment,

Why doesn't the AOA, ARVO, or whoever, "sack up" and mandate some kind of limitation on the #of overall optometric grads? Those of us who are graduating between 2010-2020 don't want to be practicing in an artificially saturated market where the supply of OD's exceeds the demand of patients. This ant-trust excuse is nonsense.

 

[Dwight Schrute]

Just as VA mentioned, you just gotta throw time and money at it. Problem is, I don't think enough docs are trying because they're perfectly content with the current scope or they just don't care. We need strength in numbers. You'd be surprised that a lot of docs are oblivious to the world outside their practice. For example, last time I went to my eye doc, I asked him what he thought of the new schools and he replied: "there's new optometry schools?"

 

[KHE]

Per Indiana OD's comment,

Why doesn't the AOA, ARVO, or whoever, "sack up" and mandate some kind of limitation on the #of overall optometric grads? Those of us who are graduating between 2010-2020 don't want to be practicing in an artificially saturated market where the supply of OD's exceeds the demand of patients. This ant-trust excuse is nonsense.

Well, many of you are going to be graduating in saturated markets. What are you going to do to prepare for it. The anti-trust issue is not non-sense. It's very real. There is nothing that the AOA can do to arbitrarily reduce the supply of graduates. The AOA has been in anti-trust trouble in the past, though not over that issue.

What they CAN do however is issue a position paper that no new schools are needed and that current optometric supply more than meets demand. Stating an opinion is NOT anti-trust.

 

[KHE]

Actually VA, Oral CAI's such as acetazolamide or methazolamide should be used in certain cases of extreme elevated intraocular pressure (e,g, angle closure glaucoma). I have read recommendations in optometric pharmacology guides (such as the Review of Optometry--Clinical Guide to Ophthalmic Drugs 2008
http://www.revoptom.com/drugguide/pdf/drugguide2008.pdf ) that every O.D.'s office should have two unexpired 250 mg tablets of acetazolamide to help patients in a "crisis" situation.

See again.....in my entire career, the number of times I have had to use oral CAI on someone is exactly...........once.

This is why your constant desire to expand expand expand scope of practice is misguided. There is no demand for the services you are seeking to be licensed to provide. There are so many more issues facing the profession that need our political and economic capital. Why do you refuse to see this?

I take that back...I know why....because you're starting your second year of optometry school and don't have a frame of reference. But please....I'm begging you....just trust me on this one.

 

[Oculomotor]

Understood KHE,

That said, it is still nice to have an Oral CAI if faced with an emergency angle closure situation---most states have oral glaucoma drugs like that......Hell my luck it would happen to me the first week of my practice in the future!--Murphy's Law is a big part of my life!lol I like to have every tool available to me contrary to what the ridiculous MD lobby has to say about it. Most literature I have read recommends that EVERY OD have oral CAI's in their office on hand in case of an emergency--I tend to follow the evidence based literature and what is proactive. I agree with you though that we need to address the insurance-economic issues, have a uniform scope of medical ophthalmic practice for optometry nationwide, and then later address potential surgical residencies etc.......

 

[Richard_Hom]

See again.....in my entire career, the number of times I have had to use oral CAI on someone is exactly...........once..."

KHE,

I see acute glaucomas probably 1-3 per month. What primary care optometrists (if there is such a term) can do is not necessarily do tertiary activities. There are still a significant amount of these kinds of patients out there. I think equipping the optometrist for that level of competency is critical

 

[aphistis]

Understood KHE,

That said, it is still nice to have an Oral CAI if faced with an emergency angle closure situation---most states have oral glaucoma drugs like that......Hell my luck it would happen to me the first week of my practice in the future!--Murphy's Law is a big part of my life!lol I like to have every tool available to me contrary to what the ridiculous MD lobby has to say about it. Most literature I have read recommends that EVERY OD have oral CAI's in their office on hand in case of an emergency--I tend to follow the evidence based literature and what is proactive. I agree with you though that we need to address the insurance-economic issues, have a uniform scope of medical ophthalmic practice for optometry nationwide, and then later address potential surgical residencies etc.......

I don't think you can claim Murphy's Law when, secretly, it's something you desperately want to happen.

 

[KHE]

KHE,

I see acute glaucomas probably 1-3 per month. What primary care optometrists (if there is such a term) can do is not necessarily do tertiary activities. There are still a significant amount of these kinds of patients out there. I think equipping the optometrist for that level of competency is critical

Dr. Hom,

Let's be honest here. Your mode of practice is incredibly unique, and incredibly rare. Perhaps it will become more and more commonplace in the future, and that may well be a laudable thing but right now, 99.99% of ODs out there are not seeing 1-3 acute glaucoma cases a month.

I agree with you. Students should be taught the treatments and practitioners need to be knowledgeable about what to do when those situations arise, even though they are rare.

But the point I'm making is this.....let's say you practice in a state where ODs are not permitted to use oral glaucoma agents. I'm willing to bet $5000 that in those states, there are at least a dozen issues facing optometry that are far faaaaar more critical in resolving than the issue of oral CAIs. So...what do we spend our economic and political capital on? The dozen important issues.....or the oral CAIs.

That's why our friend Oculomotor is can be such a frustrating person. He's missing the important things and unfortunately, all of his heated rhetoric on here is actually doing more harm to his cause than good. It's unfortunately that he doesn't see that.

 

[Richard_Hom]

Dr. Hom,

Let's be honest here. Your mode of practice is incredibly unique, and incredibly rare. Perhaps it will become more and more commonplace in the future, and that may well be a laudable thing but right now, 99.99% of ODs out there are not seeing 1-3 acute glaucoma cases a month.

I agree with you. Students should be taught the treatments and practitioners need to be knowledgeable about what to do when those situations arise, even though they are rare..."

Dr Elder,

I concur with you that there are many practical issues that need to be overcome first, but new models of optometric practice help educate all practitioners of optometric competency and relevance in modern health care.

 

[Oculomotor]

KHE,


Heated Rhetoric? Expressing different viewpoints is what forums are all about---in real life I am very measured and calculated in person. Wow there are quite a few students I know that agree with most of what I say! Are we all radicals? lol Professions evolve and there are early adopters, late adopters, and non-adopters. As I stated earler, a uniform scope of practice, economic issues, and insurance issues trump any idea of surgery.........I did say that......gimme a little credit.

 

[200UL]

Oculomotor - I find you crazy (in a funny way). I am not sure if you are serious on all your statements, but they can be very entertaining. By the way - what year of student are you?

On a more serious note, I really doubt the average optometrist wants to fill their clinic with glaucoma patients dependent on oral CAIs - would anyone? (Even glaucoma specialists cringe at this). In addition to the possible side effects, conditions that require oral CAIs are heading toward surgery.

Much has been said on this link about the lack of lawsuits against ODs. An OD using oral CAIs on a frequent basis is a quick way to raise this rate. If I were you, I would call the MD to prescribe the CAI - even in angle closure. Putting the responsibility on the EyeMD would be in your best interest. If a patient had a poor outcome, it would not look good if an OD (or MD) was treating an obvious surgical case medically.

 

[IndianaOD]

Oculomotor - I find you crazy (in a funny way). I am not sure if you are serious on all your statements, but they can be very entertaining. By the way - what year of student are you?

On a more serious note, I really doubt the average optometrist wants to fill their clinic with glaucoma patients dependent on oral CAIs - would anyone? (Even glaucoma specialists cringe at this). In addition to the possible side effects, conditions that require oral CAIs are heading toward surgery.

Much has been said on this link about the lack of lawsuits against ODs. An OD using oral CAIs on a frequent basis is a quick way to raise this rate. If I were you, I would call the MD to prescribe the CAI - even in angle closure. Putting the responsibility on the EyeMD would be in your best interest. If a patient had a poor outcome, it would not look good if an OD (or MD) was treating an obvious surgical case medically.

I don't think you understand the use of an oral CAI in angle closure. The quicker you break the attack the better. ODs are much more accessable in many cases. I'm sure most OMDs would rather it be stabilized first then see the patient at a more convenient time.

I would be insulted to call an MD to use acetazolamide. Lets get real.

I have broken 2 acute closures in the last year. Both were successful with topicals, but it was nice to know I had the orals if need be.

 

[KHE]

KHE,
Wow there are quite a few students I know that agree with most of what I say! Are we all radicals? lol

No...you're not radicals. You're students lacking a frame of reference for what you are advocating for.

As I stated earler, a uniform scope of practice, economic issues, and insurance issues trump any idea of surgery.........I did say that......gimme a little credit.

Good....then start working on that instead of trying to convince every medical student and 1st year ophthalmology resident on here that "dentists do surgery so so should ODs" because they are pretty much just as lacking in their frame of reference as well. All that your rhetoric does is inflame people needlessly. It would be mildly comical and somewhat entertaining if it wasn't so damaging to your ultimate cause.

There used to be a book that was quite popular a while back called "How to
Win Friends and Influence People." I think it was written by Dale Carnegie. Let me make a suggestion......start with that. You might think that all your "passion" is getting you somewhere but you're actually doing more harm to your cause than good.

 

[200UL]

I don't think you understand the use of an oral CAI in angle closure. The quicker you break the attack the better. ODs are much more accessable in many cases. I'm sure most OMDs would rather it be stabilized first then see the patient at a more convenient time.
I would be insulted to call an MD to use acetazolamide. Lets get real.

I have broken 2 acute closures in the last year. Both were successful with topicals, but it was nice to know I had the orals if need be.

I don't think you understand acute angle closure! What do you do with the patient once you break the angle closure? Do you just sit on these patients and treat them medically? I feel it would be malpractice for an OD/MD to allow a patient to go in and out of acute angle closure with nothing more than oral/topical medicines tried. Therefore, you may have broken these cases successfully, but what have you done to provide definitive treatment?
Definitive treatment is LPI - yes use of topicals and oral CAIs can make this possible in the setting of a cloudy cornea. If there is a large phacomorphic component, the LPI may do little - in this situation the patient may need cataract surgery. Glaucoma surgery may also be needed.

Just as important - the fellow eye needs to be assessed and treated appropriately. It would also be malpractice if a patient had angle closure recognized by an OD/MD in one eye to be followed by angle closure in the second eye IF NO TREATMENT OF THE SECOND EYE WAS OFFERED TO THE PATIENT UPON THE RECOGNITION OF ACUTE ANGLE CLOSURE IN FIRST EYE.

Also - Acute angle closure is a true ocular emergency (every graduating US medical student should know this - a frequent USMLE step 2 and step 3 question). If I were you, I would not refer any patients to comprehensive/glaucoma eyeMDs who think of it as less because they are too incompetent / busy to care for these types of patients (sad thing). Any MD who wants to see this at a "convenient time" does not deserve your referrals.

 

[fonziefonz]

Can't we all just get along?

P.S. POST 500!!!

 

[KHE]

I don't think you understand acute angle closure! What do you do with the patient once you break the angle closure? Do you just sit on these patients and treat them medically? I feel it would be malpractice for an OD/MD to allow a patient to go in and out of acute angle closure with nothing more than oral/topical medicines tried. Therefore, you may have broken these cases successfully, but what have you done to provide definitive treatment?
Definitive treatment is LPI - yes use of topicals and oral CAIs can make this possible in the setting of a cloudy cornea. If there is a large phacomorphic component, the LPI may do little - in this situation the patient may need cataract surgery. Glaucoma surgery may also be needed.

Just as important - the fellow eye needs to be assessed and treated appropriately. It would also be malpractice if a patient had angle closure recognized by an OD/MD in one eye to be followed by angle closure in the second eye IF NO TREATMENT OF THE SECOND EYE WAS OFFERED TO THE PATIENT UPON THE RECOGNITION OF ACUTE ANGLE CLOSURE IN FIRST EYE.

Also - Acute angle closure is a true ocular emergency (every graduating US medical student should know this - a frequent USMLE step 2 and step 3 question). If I were you, I would not refer any patients to comprehensive/glaucoma eyeMDs who think of it as less because they are too incompetent / busy to care for these types of patients (sad thing). Any MD who wants to see this at a "convenient time" does not deserve your referrals.

I don't think that you understand optometric training. Even the dimmest of optometry students knows the protocol for handling an acute angle closure as well as the urgency that these cases require.

I'm not going to speak for IndianaOD, but I am willing to bet money that when he says a "more convenient time" he's not talking about 2 weeks from now.

There are plenty of areas of the country where the nearest ophthalmologist may be more than a day away. Having ODs have the ability to at least stabilize these people until they can get the care they need is of great benefit to public health. No one is talking about medically managing angle closure beyond the time frame of getting them to the ophthalmic surgeon, which you'll find once you're out of your academic environment is sometimes more difficult than just paging the on call doctor whos upstairs at the big teaching hospital you are at.

 

[IndianaOD]

I don't think that you understand optometric training. Even the dimmest of optometry students knows the protocol for handling an acute angle closure as well as the urgency that these cases require.

I'm not going to speak for IndianaOD, but I am willing to bet money that when he says a "more convenient time" he's not talking about 2 weeks from now.

There are plenty of areas of the country where the nearest ophthalmologist may be more than a day away. Having ODs have the ability to at least stabilize these people until they can get the care they need is of great benefit to public health. No one is talking about medically managing angle closure beyond the time frame of getting them to the ophthalmic surgeon, which you'll find once you're out of your academic environment is sometimes more difficult than just paging the on call doctor whos upstairs at the big teaching hospital you are at.

Agreed, 200UL, please do some reasearch on Optomeric training. Just because some ODs sell themselves to commercial doesn't mean they didn't have great training. You do know its a 4 year DOCTORAL program following undergraduate do you not? You think an angle closure patient will go blind if they don't have an LPI in 5 minutes? KHE is right, things do not happen immediately in the real world.

 

[WoodyJI]

There used to be a book that was quite popular a while back called "How to Win Friends and Influence People." I think it was written by Dale Carnegie. Let me make a suggestion......start with that. You might think that all your "passion" is getting you somewhere but you're actually doing more harm to your cause than good.

I think the book's still popular.

 

[Oculomotor]

OD's are trained extensively to have an excellent understanding of pharmacology in general and safely Rx these types of drugs to treat ocular disease:

• All topical ophthalmic drugs
  

• Oral Anti-glaucoma drugs (including CAI's 200 UL)
  

• Oral Antibiotic drugs

• Oral Antiviral drugs

• Oral Antifungals (although this is not a primary eye care circumstance)
• Oral Antiprotozoals (again--not a primary eye care situation)

• Oral Analgesics (including narcotics)

• Oral Anti-Inflammatory drugs (including oral steroids)

• Oral Anti-Allergy drugs

 

[Richard_Hom]

I don't think you understand acute angle closure! What do you do with the patient once you break the angle closure? Do you just sit on these patients and treat them medically? ..."

200UL,

I think you are a bit off base on this post in "teaching" us on this forum about your philosophy in managing acute glaucoma. Your intent and attitude clearly indicates to me that you are a bit out of touch of what typical eye practice is. Frequently, ophthalmologist-in-training are divorced from the realities of community eye practice where the stabilization or preliminary of acute glaucomas are often done by non-ophthalmologists.

 

[gochi]

Ditto.

The way I see it, the bottom line here is: If you want to do surgery so badly, why aren't you going to medical school? I personally have no desire to ever do surgery. If you (not you personally eyestrain, "you" in general) are an optometrist and are fighting to do surgery, you might have entered the wrong profession. Just my .02

The point of this whole debate is that OD's should have the option to do surgery, without having to go to medical school. It's not fair that one has to go through unnecessary and more so repetitive education in order to do surgery, for which there is only a single dedicated school for.

 

[Dr.Millisevert]

You do know its a 4 year DOCTORAL program following undergraduate do you not?

So is physical therapy and Nurse practitioner training and Audiology and chripractic and naturopathy.. the list goes on.. All American health professional programs have switched to calling their degrees "doctorates". However, a physical therpist who graduated with a BSPT degree 15 years ago has the exact same scope of practice and license as someone who graduated with a DPT degree last year. At the end of the day.. you're still a physical therapist.

Also, doctors who graduate in the UK graduate with a "Bachelors of Medicine and Surgery".. yet that degree is equal to a US MD degree... and are licensed as such if they work in the US.

I'm not saying anything against optometry training.. (I think it is stellar!)
I'm just saying... regardless of what field you're in.. People shouldn't get so wrapped in this idea that since their degree has the word "doctor" in it that it means that much. All American Health professional degrees: DPT, MD, DO, DPM, ND, DNP, DDS, AuD, OD, etc are all entry-level degrees to that profession. (aka: first professional degrees). The only degrees that are truly academically classified as a true doctorate are PhDs and DSc degrees.

 

[ProZackMI]

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.

Oh, Jesus, here it is again!

1) DVM and DPM do have medicine in their title; they are medical degrees.
2) DO = Doctor of Osteopathy (Not Doctor of Osteo Med); it's not DOM
3) DMD = Dr of Dental Medicine, true, but DDS does not mean this.

Optometry is NOT medicine. Do you feel PT should earn a Doctor of Physical Medicine and psychologists should earn a Dr. of Psychological Medicine? Arguably, you could say that they are practicing medicine just as much as an OD.

Quit being a tool and stop.

 

[ProZackMI]

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.

IndianaOD, no optometry curriculum anywhere has MORE hours of pharm than any allo/osteo program. This statement borders on ludicrous; it's like the chiro saying they have more clinical hours of anatomy than allo/osteo med students. Most ODs couldn't figure out anything beyond DPA and TPA. Don't even try to compare apples to oranges here. Let this stupid ass thread die! Jesus.

 

[ProZackMI]

So is physical therapy and Nurse practitioner training and Audiology and chripractic and naturopathy.. the list goes on.. All American health professional programs have switched to calling their degrees "doctorates". However, a physical therpist who graduated with a BSPT degree 15 years ago has the exact same scope of practice and license as someone who graduated with a DPT degree last year. At the end of the day.. you're still a physical therapist.

Also, doctors who graduate in the UK graduate with a "Bachelors of Medicine and Surgery".. yet that degree is equal to a US MD degree... and are licensed as such if they work in the US.

I'm not saying anything against optometry training.. (I think it is stellar!)
I'm just saying... regardless of what field you're in.. People shouldn't get so wrapped in this idea that since their degree has the word "doctor" in it that it means that much. All American Health professional degrees: DPT, MD, DO, DPM, ND, DNP, DDS, AuD, OD, etc are all entry-level degrees to that profession. (aka: first professional degrees). The only degrees that are truly academically classified as a true doctorate are PhDs and DSc degrees.

Actually, DNP and DPTs are 3-years, full-time, post bachelor's. Many DPT programs allow for direct entry after only 2-3 years of undergrad, like some OD and PharmD programs.

Lawyers also earn a post undergrad professional doctorate (JD) as do some clergy (DMin), vets (DVM), public health professionals (DrPH), and many others who earn professional doctorates. Most professions are "pufffing" their professional degrees for increased status, increased scope of practice, or...maybe it's just "cool" to be a "doctor". For whatever reason, so? It has little or no impact on professional service.

 

[eyestrain]

Let this stupid ass thread die! Jesus.

With all due respect, it WAS dead. You were the one who revived it with no less than THREE new posts.

 

[aphistis]

With all due respect, it WAS dead. You were the one who revived it with no less than THREE new posts.

Agreed. Closing.

 

[cpw]

Thanks, Bill. I got away for three days of CE and this place became a fun-house.