Optometric Physicians

[PLPrincess]

OMG, are all OD's as pathetic as you???? LOL

Is this guy for real?

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Members don't see this ad.

 

[CNU2020]

OMG, are all OD's as pathetic as you???? LOL

Thanks for proving my point.

Okay the name calling stops NOW !!!

P.S. "No name calling" includes you.

 

[rpames]

CNU2020 makes a great point. There are a couple, the minority, of OMDs in the area that don't seem to like ODs. But there are many who like to work with us. I'll give you one guess on who's practice is huge, and who's is not. Those who don't play nice, don't get to play.

 

[monstermatch]

Such acrimony between future ODs & OMDs - its really stupid. Unfortunately, a lot is a result of the overwhelming elitism among OMD's. I for one intend to proactively reach out to ODs once I finish my residency - other OMD's can wallow in their hostility, I'll be out there taking away their referrals one handshake at a time.

 

[cpw]

P.S. "No name calling" includes you.

I don't remember calling anybody a name.

We go in tides like this every year on this forum. But, when i start getting reported post complaints.. I have to step in. It's my job as a moderator.

 

[CNU2020]

I don't remember calling anybody a name.

We go in tides like this every year on this forum. But, when i start getting reported post complaints.. I have to step in. It's my job as a moderator.

CPdubbs-

My bad. Sorry, that was unclear. I was not meaning that you had been name calling. I pulled up your quote to refresh the memory of Valeno, who just 2 post later continued with the insults (especially to me.) I was refering to, "OMG, are all OD's as pathetic as you????" --Valeno

Sorry about the confusion... carry on with the discussion!

 

[futuredoctorOD]

Dear futuredoctorOD,

C'mon!!!!! My god....Have you read some of the comments by some of these malignants that are insulting the profession of Optometry?..You remark about none of my posts being constructive in nonsense...I am new to this forum and I am mortified by the kind of responses I have suffered thru from some of the insecure MD folk (a few--not all) that are directed at Optometry. And your little cut about "smart folk" I am not going to even give that a response ..I agree with you on being civil BUT I will stand up for myself and what I believe in...I believe in Optometry.

 

[futuredoctorOD]

Such acrimony between future ODs & OMDs - its really stupid. Unfortunately, a lot is a result of the overwhelming elitism among OMD's. I for one intend to proactively reach out to ODs once I finish my residency - other OMD's can wallow in their hostility, I'll be out there taking away their referrals one handshake at a time.

Five years from now when I am done with OD School and residency....I will give you a call . You are the kind of Optho I will associate myself with.

 

[vanelo]

There are a couple, the minority, of OMDs in the area that don't seem to like ODs. But there are many who like to work with us. I'll give you one guess on who's practice is huge, and who's is not. Those who don't play nice, don't get to play.

I like working with OD's. They serve good coffee.

 

[futuredoctorOD]

I like working with OD's. They serve good coffee.

Obviously you are probably a troll and not a real MD because your responses are reminiscent of a child........I know of no residents---by brother is a surgery resident that would respond with the lack of intelligence that you exhibit....I am growing dummer evertime I respond to you! (and my IQ is 160!) Goodbye Vanelo and good luck flipping burgers---because you are more likely than not a fraud........Now go get me a big mac with cheese and a cappuchino with it.

(I am not responding to you anymore)

 

[vanelo]

http://www.abqtrib.com/albq/cda/article_print/0,2558,ALBQ_19866_3517831_ARTICLE-DETAIL-PRINT,00.html

The Albuquerque Tribune

To print this page, select File then Print from your browser
URL: http://www.abqtrib.com/albq/op_commentaries/article/0,2565,ALBQ_19866_3517831,00.html
Commentary: No aye for eye
New Mexico legislators must defeat a bill that would allow optometrists, who do not have medical degrees, to perform eye surgeries. There's too much risk.

By Kathleen Blake
February 3, 2005

There are times when taking a shortcut makes sense. Almost everyone knows a quick back-road route to his or her home to avoid extra traffic lights. Weeknight dinner shortcuts to get food on the table in a flash? I'm all in favor.

But when it comes to providing medical care, shortcuts can mean a dangerous outcome for patients.

Our legislators are debating whether to take a shortcut in eye care for New Mexico residents. At hand is a proposal, House Bill 199, that would allow optometrists to perform procedures on the eye. These procedures would include surgeries with lasers, scalpels and needles, plus prescribing any oral or injectable drug.

On the surface, it can be confusing to sort out the differences between optometrists and ophthalmologists. But, in reality, it's quite simple.

Ophthalmologists are medical or osteopathic doctors and have 12 years of undergraduate and medical or osteopathic education and residency. They complete 9,000 to 12,000 hours of education and surgical training before operating unsupervised.

Optometrists must have some undergraduate education and a four-year optometry degree. They do not have a medical or osteopathic degree and do not take part in surgical internships or residencies.

Despite these profound differences, our legislators are considering House Bill 199.

This issue is not new to the state. When Gov. Gary Johnson considered a similar proposal in 1997 from the optometric lobby, he rejected it.

House Bill 199 would set a dangerous precedent for patient care in New Mexico. It would allow optometrists to:

Conduct invasive diagnostic tests on the eye that pose risks, including heart attacks.

Use lasers for eye surgeries, including the popular laser vision correction, which, if not executed properly, could cause irreparable damage.

Wield a scalpel to remove lesions around the eye that might be the manifestation of a dangerous form of cancer.

Optometrists are not trained to diagnose, manage or treat events that can arise from these types of treatments and procedures, nor are they trained to handle the complications of major surgery.
So what do patients have to gain if our Legislature passes House Bill 199? Nothing.

The lobbyists for the optometrists will try to convince our legislators that an optometrist is just as capable of providing high-level eye care as an ophthalmologist. They have no evidence to show that.

They will say that expanding "scope of practice" for optometrists will help ensure access to eye care for patients. There is no access problem for patients who want or need to visit an ophthalmologist.

They will say it's nothing but a petty "turf war" between two disciplines. That ignores the very real medical needs of patients, who are looking for safe and effective care.

They will say they aim to drive down costs. In fact, there is no evidence that costs for a specific procedure carried out by an optometrist will differ from that of an ophthalmologist; however the price of potentially compromising patient safety is immeasurable.

New Mexico's Legislature should not travel down this path. Gambling with patient safety when there is no pressing need is irresponsible and only serves the interests of those who seek to improve their bottom line.

It is now up to the Legislature to reject the demands of this special interest and put patients at the top of the priority list.

Blake is president of the New Mexico Medical Society.

Copyright 2005, The Albuquerque Tribune. All Rights Reserved.

 

[CNU2020]

Commentary: No aye for eye
New Mexico legislators must defeat a bill that would allow optometrists, who do not have medical degrees, to perform eye surgeries. There's too much risk.

Valeno, thank you for bringing that wonderful update to our attention! That about settles it for me; I am now dedicated to doing my part in lobbying for surgery rights for fellow OD's in New Mexico. In accordinance with the article, I had almost decided that OD's should not be taking part in surgeries. However, after having read your (Valeno) posts, in addition to that article, I now see the light. I've learned I'd rather have a 3 year old doing surgeries than OMD's such as Valeno. There's too much risk. Thus, in order to remove the public from the perils engendered by OMD's such as Valeno, I now strongly advocate OD's in surgery. Thus, several peers and I have decided to take some time this next week to do our part in drafting the appropriate documentation in support of OD surgery for the Governor of New Mexico.

Again, had you not pointed out that there was strong opposition, we might have been reluctant to get involved.

So, thank you for your support! Your aid in our cause will not go unmentioned when Ophthamology becomes extinct. Hope the welfare system is still going strong, because though I'd like to give you a job making the coffee at my office, I can't say I'd trust you to even maintain the "good service" rating. Hey, it's tough to make a good brew.
Well, I've got to go, I'm trying to figure out which LASER I want to purchase so I can get my LASIK skills underway.

EDIT: Enough was enough! Post handle at will.

 

[cpw]

one more attacking post and I start post-holding people.

 

[Kristene9]

I live in Oklahoma, the only state that allows optometrist to perform some laser procedures. There has not been a single lawsuit against an optometrist in the state of Oklahoma for malpractice or anything like it. So where is the proof that optometrist are endangering the public?

 

[futuredoctorOD]

LOL I second your notion--CNU2020.."United we stand divided we fall!"..A car in every garage, a turkey in every oven, surgical rights for optometrists in every state...lol This sounds very reminicent of 1972 when the AOA decided it was a goal to get prescription rights (for meds) in every state---25 years later and shaaabang--it happened. I guess in 25 years we will have optometric surgeons in every state...lol Maybe at that point the Optos and Opthos can have a big party and celebrate the joining of optometry and opthalmology into Opthaltometry.....! Just kidding Anyway,..from what I have been told we have a very effective lobbying organization....I don't want to participate in surgery personally but I will support a residency program for surgery proceedures for Optometrists....maybe like OMFS---something like that. I hope this email does not cause an explosion....lol

Valeno, thank you for bringing that wonderful update to our attention! That about settles it for me; I am now dedicated to doing my part in lobbying for surgery rights for fellow OD's in New Mexico. In accordinance with the article, I had almost decided that OD's should not be taking part in surgeries. However, after having read your (Valeno) posts, in addition to that article, I now see the light. I've learned I'd rather have a 3 year old doing surgeries than OMD's such as Valeno. There's too much risk. Thus, in order to remove the public from the perils engendered by OMD's such as Valeno, I now strongly advocate OD's in surgery. Thus, several peers and I have decided to take some time this next week to do our part in drafting the appropriate documentation in support of OD surgery for the Governor of New Mexico.

Again, had you not pointed out that there was strong opposition, we might have been reluctant to get involved.

So, thank you for your support! Your aid in our cause will not go unmentioned when Ophthamology becomes extinct. Hope the welfare system is still going strong, because though I'd like to give you a job making the coffee at my office, I can't say I'd trust you to even maintain the "good service" rating. Hey, it's tough to make a good brew.
Well, I've got to go, I'm trying to figure out which LASER I want to purchase so I can get my LASIK skills underway.

EDIT: Enough was enough! Post handle at will.

 

[Andrew_Doan]

Surgery is more than technical know how. Please read my blog on eyeOrbit:

http://www.eyeorbit.org/article.php?story=20050217025849528

 

[MPS]

The US has more than enough ophthalmologists per capita - what is the point of allowing optometrists surgical rights? To allow certain optometrists to attain "self-fulfilment"? To cut costs? There is already a defined path by which an optometrist can train in surgery – by going to medical school.

 

[Richard_Hom]

The US has more than enough ophthalmologists per capita - what is the point of allowing optometrists surgical rights? To allow certain optometrists to attain "self-fulfilment"? To cut costs? There is already a defined path by which an optometrist can train in surgery – by going to medical school.

Dear Dr. MPS,

Knowing you have a unique background in both optometry and ophthalmology I submit the following hypothesis.

The disclaimer here is that I do not belong to the American Optometric Association nor am I associated with any optometry school. These are my own personal hypotheses.

In my opinion, I think the expansion of scope is one of strategic planning. It is more of treatment delivery rather than actual practice. Let us suppose that glaucoma treatment, for instance, is more efficacious with non-drug medication but with laser, then optometrists would want to stay in this game by being "certified" or "licensed" or otherwise allowed to do this.

In any negotiative "game", one always asks for more then get down to the nitty gritty. In the past, optometry has learned quickly that ophthalmology has not negotiated necessarily in good faith on these issues.

Richard

 

[PBEA]

The US has more than enough ophthalmologists per capita - what is the point of allowing optometrists surgical rights? To allow certain optometrists to attain "self-fulfilment"? To cut costs? There is already a defined path by which an optometrist can train in surgery – by going to medical school.

I agree, with our current system, there is no reason to provide OD's with any of the majority of ocular procedures. The few caveats (as I see it) are 1) Access, this is not a problem in my neck of the woods, but it may be possible in other areas (I have never witnessed it). 2) Certain procedures are minimally invasive, or pose relatively low risk 3) Definition of "surgery" (don't cite Stedman's because it doesn't hold water in this case), and 4) Actual practical limitations on OD training.

Anyway, I think that the core issue isn't so much that OD's should be looking to create a second pathway for invasive surgery, but instead, should be looking to cooperate and coordinate with ophthalmology in creating a COMMON pathway for primary eye doctors, as well as, tertiary eye doctors. The current 2 pathways do the job well, but are weak in comparison. Talk about controlling our own destiny, for global and local eyecare delivery this is ideal. Every level of patient eyecare would be in harmony with the demand for services. I won't even mention the financial benefits of such a union. OK maybe I will, how bout higher reinbursement for core and critical surgeries? Greater control over, Ooops I goota go for now. Anyway you get the picture

 

[Andrew_Doan]

OK maybe I will, how bout higher reinbursement for core and critical surgeries?

How do we get higher reimbursements when Medicare is almost broke???

Insurance companies are pushing to pay less and less!

Perhaps a course in medical economics should be required before people start proposing financial and social advantages for optometric scope expansion.

 

[MDF614]

That actually was pretty funny, mdkurt! I am also quite impressed with the fact that phrases like "who do you think you are" and "you are no better then..." come mostly from OD posts.

That's because the MD's feel the need to belittle the ODs like they're on some school yard playground.

 

[JR]

That's because the MD's feel the need to belittle the ODs like they're on some school yard playground.

This was funny in the context of a discussion at that time. Your post is competely out of context and does not bring anything significant to this argument.

 

[PBEA]

How do we get higher reimbursements when Medicare is almost broke???

Insurance companies are pushing to pay less and less!

Perhaps a course in medical economics should be required before people start proposing financial and social advantages for optometric scope expansion.

I don't claim to know the answers to these questions, this an idealistic scenario and I am rambling on, and on. I have to try and not sound so declarative when typing.

I don't need an MPH (or a PhD) to do a rough supply and demand calculation! Greater control over practitioner #'s is what I was going to finish my last post with. There is an oversupply of OMD and OD's. You posted a study on potential future demand as being marginally increased, and we are pumpng out more and more new graduates. This can go on and on, but if you continue to view this as an "optometric scope" issue only then we are using semantics, or we are not talking about the same thing.

 

[samwY]

ah
is it me or is the word "optometric" weird to pronouce

doesnt sound smooth like optometrist

 

[nnjh]

Do opthamologist's get patient referrel's from optos? If so, wouldn't it be wise to have good relations?

(just a curious passerby from the dental forum)

 

[futuredoctorOD]

That's because the MD's feel the need to belittle the ODs like they're on some school yard playground.

I agree.....I am new to this forum--about a month ago and I tried to have a resonable discussion on the Optho forum about semantics (Optometric Physician vs Optometrist) or even suggest (just hypothetically) a sugery residency for the 2% or less of OD's who would want to venture down that road....The posts degraded into an ugly exchange! I like to play devil's advocate and talk about very controversial issues but I feel that they (meaning some of the MD's--OMD's) feel entitled and really feel (wrongfully so) that they are better than everybody else....I digress----back to worring about how I am going to get my OD and JD degrees in the next several years!

 

[Buck Strong]

I like to play devil's advocate and talk about very controversial issues but I feel that they (meaning some of the MD's--OMD's) feel entitled and really feel (wrongfully so) that they are better than everybody else....

Ok then, I suppose that you're in favor of giving opticians, who are interested in refracting on their own and giving eye exams, the ability to take a few courses and then opening shops? If I liked to play devil's advocate as much as you did (which I don't)...I'd say that a botched refraction is usually alot easier to fix than a botched eye surgery, and who's to say that an optician would do a much worse job refracting than an OD? Honestly, I think we'd all be better off if we stuck to the jobs that we're supposed to do, and best trained to do, instead of fighting each other for turf. Maybe you'd like to wait until you finish school and start working with MD's and opticians before you start generalizing a whole field as being elitist, insecure or entitled.

 

[vanelo]

I agree.....I am new to this forum--about a month ago and I tried to have a resonable discussion on the Optho forum about semantics (Optometric Physician vs Optometrist) or even suggest (just hypothetically) a sugery residency for the 2% or less of OD's who would want to venture down that road....The posts degraded into an ugly exchange! I like to play devil's advocate and talk about very controversial issues but I feel that they (meaning some of the MD's--OMD's) feel entitled and really feel (wrongfully so) that they are better than everybody else....I digress----back to worring about how I am going to get my OD and JD degrees in the next several years!

He's just mad because he got post-holded in the Ophthalmology/Surgeons Forum. Crybaby

 

[Furrball]

Being your typical soon to be newly minted MD, I can barely find the power switch for the slit-lamp. Refracting eyes is nearly magic to me. I came to this thread because I am generally interested in getting an idea about what it is that OD's do vs. OMD's. It isn't very clear for those of us on the outside. My curiosity was sparked by having a neuro resident during my neuro rotation who is an OD who praticed for about 10 years before going to medical school. I'll leave it at all of you ODs should feel very happy this guy is representing you. But the level of discourse and animosity I've read here is ridiculous. If I wanted to read vacuous name calling, I could find a post about PAs and NPs on the allopathic site. Note I respect both, have worked with both, and I am not suggesting that PAs or NPs are remotely like or related to ODs. Just that the level of discussion about these practitioners amongst MD/DOs is similar to what I've been reading here.

I'm signing off so if you want me to read any responses to my post send a PM.

 

[futuredoctorOD]

He's just mad because he got post-holded in the Ophthalmology/Surgeons Forum. Crybaby

I did not get post-holded my friend!!!!!!



Look at today's post....on the Optho forum (I was never post-held--pay attention)....Otherwise have a marvelous day my good friend.......


"can't we all just get along?"

 

[futuredoctorOD]

Ok then, I suppose that you're in favor of giving opticians, who are interested in refracting on their own and giving eye exams, the ability to take a few courses and then opening shops? If I liked to play devil's advocate as much as you did (which I don't)...I'd say that a botched refraction is usually alot easier to fix than a botched eye surgery, and who's to say that an optician would do a much worse job refracting than an OD? Honestly, I think we'd all be better off if we stuck to the jobs that we're supposed to do, and best trained to do, instead of fighting each other for turf. Maybe you'd like to wait until you finish school and start working with MD's and opticians before you start generalizing a whole field as being elitist, insecure or entitled.

I agree with some of your points....I just like to have constuctive conversations about what is going on in the professions....(look at New Mexicon and Oklahoma...as well as New Jersey). I actually have no interest in doing anything other than primary care......I never said the WHOLE field of Opthalmology is elitist or insecure rather I said that there are some out there that exhibit those traits----I have had personal experience as a witness! Optometry has worked hard an fought many legislative battles with medicine to get to the point it is at now (25 years of battles to get prescriptive rights for medicines in 50 states.) OD's are doctors of disease and vision not just refraction--but it took a hell of alot of work to get to this point.....Don't forget history my friend because it is crucial to know where you came from to understand where you are going.
We all need to work together......

 

[Andrew_Doan]

Let's work together then. Optometrists continue to deliver non-surgical care, and ophthalmologists continue to manage medically complicated cases and surgical ophthalmic cases!

 

[Richard_Hom]

Let's work together then. Optometrists continue to deliver non-surgical care, and ophthalmologists continue to manage medically complicated cases and surgical ophthalmic cases!

Dr. Doan et. al,

Sensible discussion, as Dr. Doan as suggests, always produces a better outcome than adversarial encounters. However, I believe that there isn't any single professional governing body that can "control" their profession.

Despite the general sense of "cooperation" that should prevail, there will always be segments which will turn a deaf ear to the leaders and proceed down a path that is fraught with controversy. This occurs on both sides of the optometry and ophthalmology issues.

Looking back at the scope of practice wars that have transpired, the optometric profession does seem to "grow" only through this path. It hasn't been easy. Having participated in these wars, I'm quite aware of the intricacies of this kind of behavior. The "no holds" bar approach on either side was inevitable because of the intransigence that is perceived by one or the other sides.

I hold out hope that 1:1 or "below the surface" relationships will continue to serve the patient better than our "loud shouting" and "fist pounding" actions that are seen in the posts of the ophthalmology forum.
Richard

 

[futuredoctorOD]

Let's work together then. Optometrists continue to deliver non-surgical care, and ophthalmologists continue to manage medically complicated cases and surgical ophthalmic cases!

You know....I agree with a lot of what you prescribe...There has got to be a half-way point where both professions can be happy. Please hear me out........I feel that if two things were satisfied maybe there would be less acrimony between two wonderful professions. In the case of states where there is battling between OD's and Medicine (Opthalmology, Allopathy) regarding scripts---your quote"Instead of fighting about this, we need moderators, for instance, who will allow optometrists to prescribe new glaucoma medications in NY. I think it's silly to prevent optometrists from prescribing travoprost when they can already prescribe latanoprost. Why waste energy and money in battles like this? Focus our money, efforts, and energy in defeating every surgical scope bill optometry tries to 'sneak' into law, but allow optometry to be primary eye care doctors" Actually I agree with a lot of what you say.....I spoke to my brother who is a Surgeon (MD) and he proposed something to me: Again PLEASE hear me out.....

If there are some Optometrists who have a desire to do limited surgery--(general ocular surgery) have a track developed for them this way.....

Have two optometry curriculums----One Primary care track
One----Surgery trackThe primary care track will get exposed to surgical procedures for the experience and to do "minor procedures in practice" nothing substancial.
The surgery track, at the end of the two years of basic science (QUALIFIED OD students) can go to a modified final two years where they do a great deal of the same rotations as medical students and following thier awarded ODS degree they do the same residency (1 year general medicine and 3 more years for general ocular surgery)---to get into an ODS program your NBOE scores have to be in the top 10%--not an easy task......One track--the primary care track would probably have 90% or so of the Optometry students while a minority would opt (no pun intended) for the surgery tract.....THIS WOULD NOT THREATEN OPTHALMOLOGY--rather compliment it with OD surgeons that have the proper medical training (in the eyes of Opthalmology.) This is a lot like OMFS or Podiatry--they have 4 yr programs that include surgical training.
My brother is a very good surgeon and felt that something like this would be a good solution because he thinks that doing it the way it was done in Oklahoma is WRONG.
2. point.....If you really want to mediate and help optometrists to become more effective primary care eye doctors then there should be a much more open formulary in all 50 states...One example in Ohio the formulary for oral drugs is: "Therapeutic pharmaceutical agent" means a topical ocular pharmaceutical agent or any of the following drugs or dangerous drugs that is used for examination, investigation, diagnosis, or prevention of disease, injury, or other abnormal conditions of the visual system or for treatment or cure of disease, injury, or other abnormal condition of the anterior segment of the human eye and is an anti-microbial, anti-allergy, anti-glaucoma, topical anti-inflammatory, or cycloplegic agent, or an analgesic:

(1) A topical ophthalmic preparation;

(2) Oral dosage of any of the following drugs:

(a) Acetazolamide;

(b) Astemizole;

(c) Dichlorphenamide;

(d) Diphenhydramine;

(e) Glycerin in a fifty per cent solution;

(f) Isosorbide in a forty-five per cent solution;

(g) Methazolamide;

(h) Analgesics that may be legally sold without prescription;

(I) Terfenadine;

(j) Ampicillin in a two hundred fifty milligram or five hundred milligram dosage;

(k) Cefaclor in a two hundred fifty milligram or five hundred milligram dosage;

(l) Cephalexin in a two hundred fifty milligram or five hundred milligram dosage;

(m) Dicloxacillin in a two hundred fifty milligram or five hundred milligram dosage;

Doxycycline in a fifty milligram or one hundred milligram dosage;

(o) Erythromycin in a two hundred fifty milligram, three hundred and thirty-three milligram, or five hundred
milligram dosage;

(p) Penicillin VK in a two hundred fifty milligram or five hundred milligram dosage;

(q) Tetracycline in a two hundred fifty milligram or five hundred milligram dosage.

(3) Any other oral dosage of a drug or dangerous drug that is listed by rule adopted by the State Board of Optometry under section 4725.09 of the Revised Code.

4725-16-02 Additional oral therapeutic pharmaceutical agents


A) Oral dosages of the following drugs:

(1) Amoxicillin up to and including five hundred milligram dosage;

(2) Erythromycin up to and including five hundred milligram dosage;

(3) Ibuprofen up to and including eight hundred milligram dosage;

(4) Loratadine;

(5) Naproxen up to and including five hundred fifty milligram dosage;

(6) Terfenadine with Pseudoephedrine Hydrochloride.

(7) Fexofenadine Hydrochloride

(8) Fexofenadine/Pseudoephedrine

(9) Amoxicillin/Clavulante Potassium

(10) Loratadine and Pseudoephedrine Sulfate

(11) Azthromycin up to and Including 250 milligram dosage

(12) Cetirizine Hydrochloride

(13) Clarinex

(14) Zyrtec D

(15) Acyclovir (consistent with paragraph B)

(16) Valacyclovir (consistent with paragraph B)

(17) Famciclovir (consistent with paragraph B)

(B) An optometrist who prescribes an antiviral agent shall consult with a physician licensed pursuant to 4731 of the revised code and shall advise the patient as appropriate based on that consultation. The optometrist shall include in the patient's record an entry specifying that the consultation and advice required was given.
This section was a compromise with the Medical Board to get the oral anti-viral meds in the Optometric formulary..They are just going to wait a couple years and get this (B)section removed as a qualifier......Things like this are confounding and unecessary------OD's can prescribe these Oral antiviral drugs with dilligence and safety...but again political compromise.....Would you be a proponent for allowing a larger formulary if OD's were Primary Care Eye Doctors's exclusively?


Maybe Optometry's agenda is to have a surgical scope?----look at Oklahoma, New Mexico, and now New Jersey. Wouldn't it be better to have a legitimate track for the very few OD's who would want this instead of having the political--legal--lobbying route and have to fight them state by state? If you remember a similar battle started in 1972 for prescription rights for medications and 25 yrs later ---50 states give OD's some prescriptive authority! You were probably right when you said Optometry wants surgery in 20 yrs---I am not in an Optometry organization so I really don't know...But wouldn't it be better to have the professions find a mutually reciprocal solution rather than fight each other?

Again I don't wish to be attacked for this---these are just thoughts.....Optometry and Opthalmology exist to help people--this should be the most important thing.

How would you make OD's more effective primary care eye docs? I am very interested in what you have to say.....

Thank you

 

[futuredoctorOD]

Dr. Doan et. al,

Sensible discussion, as Dr. Doan as suggests, always produces a better outcome than adversarial encounters. However, I believe that there isn't any single professional governing body that can "control" their profession.

Despite the general sense of "cooperation" that should prevail, there will always be segments which will turn a deaf ear to the leaders and proceed down a path that is fraught with controversy. This occurs on both sides of the optometry and ophthalmology issues.

Looking back at the scope of practice wars that have transpired, the optometric profession does seem to "grow" only through this path. It hasn't been easy. Having participated in these wars, I'm quite aware of the intricacies of this kind of behavior. The "no holds" bar approach on either side was inevitable because of the intransigence that is perceived by one or the other sides.

I hold out hope that 1:1 or "below the surface" relationships will continue to serve the patient better than our "loud shouting" and "fist pounding" actions that are seen in the posts of the ophthalmology forum.
Richard

I agree.....I really felt attacked when I just flurted with the idea of a Sugery Residency on the Optho forum...The irony is I don't want to do surgery myself! My comments were taken to be an attack on Opthalmology--by even suggesting a sugery track...I was just trying to discuss it not get into an ugly exchange.......

 

[cpw]

I think the AOA should concentrate on getting states with lower rights on the level with wider scope states like NC before gunning for other rights.

When I move to Florida I'll lose rights compared to what I can do in Texas. I can't write for oral antibiotics in FL, but can Rx an ocular beta blocker. And yes, I know antibiotics have side effects (so do all drugs), but we've been trained for that.

so weird how state laws work in our profession.

 

[xmattODx]

If there are some Optometrists who have a desire to do limited surgery--(general ocular surgery) have a track developed for them this way.....

Have two optometry curriculums----One Primary care track
One----Surgery trackThe primary care track will get exposed to surgical procedures for the experience and to do "minor procedures in practice" nothing substancial.
The surgery track, at the end of the two years of basic science (QUALIFIED OD students) can go to a modified final two years where they do a great deal of the same rotations as medical students and following thier awarded ODS degree they do the same residency (1 year general medicine and 3 more years for general ocular surgery)---to get into an ODS program your NBOE scores have to be in the top 10%--not an easy task......One track--the primary care track would probably have 90% or so of the Optometry students while a minority would opt (no pun intended) for the surgery tract.....THIS WOULD NOT THREATEN OPTHALMOLOGY--rather compliment it with OD surgeons that have the proper medical training (in the eyes of Opthalmology.) This is a lot like OMFS or Podiatry--they have 4 yr programs that include surgical training.

In all the posts that you've pushed for this additional training you've never stated, to my recollection, why we would need surgically trained ODs. Is there a shortage? Why wouldn't ODs so inclined to do surgery go to med school? Your idea may be sound but it isn't necessary. My optometry colleagues really need to stop pushing for expansion of scope.

 

[Kristene9]

In all the posts that you've pushed for this additional training you've never stated, to my recollection, why we would need surgically trained ODs. Is there a shortage? Why wouldn't ODs so inclined to do surgery go to med school? Your idea may be sound but it isn't necessary. My optometry colleagues really need to stop pushing for expansion of scope.

From what I've heard at my interviews there isn't a shortage, but "surgery" could mean something as simple as getting rid of an ingrown eye lash. I think the laws just need to be more defined not necessary changed. There is NO NEED for optometrist to do lasik, the market is very saturated with ophthalmologist doing that kind of stuff.

Of course I am coming from what I've heard from optometrist and professors at optometry schools. I've never heard a good argument from an ophthalmologist on why Oklahoma laws should be changed (I'm from Oklahoma and despite popular believe optometrist CAN NOT do lasik in Oklahoma, just some minor things with lasers)

 

[Andrew_Doan]

(I'm from Oklahoma and despite popular believe optometrist CAN NOT do lasik in Oklahoma, just some minor things with lasers)

It's more than defining what is surgery and not surgery. Nearly all ophthalmologists agree that epilation and FB removal does not constitute surgery.

Those "minor things with laser" that you refer to include PRK AND LASEK, which is LASIK without a flap. New Oklahoma laws include scalpel surgery too:

Oklahoma Governor Brad Henry Signs Optometric Scalpel Surgery Regulation

On October 29, Oklahoma Governor Brad Henry signed the Oklahoma Board of Examiners in Optometry?s recently approved regulation that will allow optometrists to perform lid and eye surgery using a scalpel. The regulation was sent to the governor for his signature after its approval on October 4, 2004. Ophthalmology testified during the hearing in opposition to the proposal and held a press conference the next morning condemning the regulation. In addition, a statewide radio news story and a TV ad were run, calling on the citizens of Oklahoma to call the governor. ASCRS joined with the AAO, the AMA and other physician organizations in calling on the governor to reject it and will continue to work with them to fight its implementation.

The language of the regulation is confusing because it primarily makes the statement in terms of exclusion and exception. Therefore, careful review is required to interpret its outline of optometric scope of practice. Some surgical procedures are specifically not allowed (such as current method utilized for cataract extraction). However, many surgical procedures, as well as injections, are allowed, including:

Laser Surgery
Laser capsulotomy
Laser iridotomy
Laser trabeculoplasty
Photorefractive keratectomy (PRK)
Phototherapeutic keratectomy (PTK)
LASEK (LASIK is excluded)
Laser ablation of vitreous strand

Incisional Surgery
Radial keratotomy
Astigmatic keratotomy
Pterygium excision without graft or flap
Chalazion incision and drainage
Entropion repair
Ectropion repair
Anterior chamber paracentesis for emergency IOP reduction

Injection Procedures
Periocular (no limitation as to drug type)
Intraocular (no limitation as to drug type)

Other Surgery
Retinal detachment repair by
scleral buckle,
injection of air, gas, or other substance

There is no exclusion for cataract removal by laser technology in the future.
NOTE: A one-word change in the Oklahoma guidelines to remove "retinal" exceptions to laser procedures would allow PRP, focal laser, and PDT.

 

[VA Hopeful Dr]

I think she was referring to the procedures allowed by an early 90s law that gave ODs the power to do Laser capsulotomy, Laser iridotomy, and Laser trabeculoplasty.

 

[JR]

This is absolutely amazing. LASEK, but not LASIK? What is the reasoning behind that??? All things being equal, LASEK is actually a more complicated procedure. Scleral buckles? Radial Keratotomy? This is an archaic procedure no one has done for decades.

All these are serious complicated procedures that take years to perfect. One wrong move, one unforeseen side effect, and you change someone’s life forever. How can someone even think of doing these without proper training?

 

[Andrew_Doan]

I think she was referring to the procedures allowed by an early 90s law that gave ODs the power to do Laser capsulotomy, Laser iridotomy, and Laser trabeculoplasty.

That law allowed ODs to perform LASEK/PRK in 1998. It was the stepping stone to this new law. http://www.crstoday.com/PDF Articles/1004/Brennan.html

Although we don't need more surgeons, particularly refractive surgeons. Optometrists will line up for the refractive surgery lessons if they were allowed to do it.

 

[futuredoctorOD]

That law allowed ODs to perform LASEK/PRK in 1998. It was the stepping stone to this new law. http://www.crstoday.com/PDF Articles/1004/Brennan.html

Although we don't need more surgeons, particularly refractive surgeons. Optometrists will line up for the refractive surgery lessons if they were allowed to do it.

As usual you are very perceptive. I just finished a research paper on eye disease for an upper level biology course and for reference I called several optometry schools. I like to fish for information on topics other than pathology so the conversations lead to some honest political/scope issues. I am not going to say who I talked to but many of the schools I called already have many different types of lasers and students are using these to "practice" to "better understand" opthalmic surgery. Obviously they are using models and not human eyes but you "get my drift." Some of the faculty I talked to felt that optometry has been "the" leading profession in refractive management and that refractive surgery is just another technological necessity. "What about a world in 15-20 yrs when refractive surgeries are much more routine and safer--we have a right with proper training (including surgery training in the OD program) to do these procedures---the battle ahead will be imense but it has to be fought. Optometry will have to figure out an effective way to win this battle. Refractive surgery is an extension of refractive management."-----this is what one OD at one of the schools I talked to said and this opinion is not an isolated one. They also mentioned how "automated" these surgeries are now so they are relatively easy. Lasers have been added to different schools curriculum. What if they add surgery training to OD education? The picture I got was that this is on the horizon and it is a matter of professional right. I can respect their points regarding refractive surgery being an extension of refractive management---in 30 yrs will there be a lot of people wearing contacts and glasses anymore when refractive surgery becomes a routine even mundane procedure? I can also see the other side--if I was an Opthalmologist how would I feel about this? There is going to be an ugly battle or some sort of compromise. Time will tell but after I read about legislative history on the profession I feel that attaining some procedures is enevitable for Optometric Medicine.

 

[JR]

They also mentioned how "automated" these surgeries are now so they are relatively easy.

.

Again, PROFOUND lack of basic understanding of the complexity of these procedures. They may look automated and "easy" to an untrained eye. Even though the complication rate is small, if something does go wrong it is devastating. Have you ever seen a case of severe endophthalmitis or a corneal perf post LASIK?

 

[vanelo]

Time will tell but after I read about legislative history on the profession I feel that attaining some procedures is enevitable for Optometric Medicine.

I feel pity for your future clients (since only MD's have patients). Your inflated ego will one day cause you to burst the bubble you live in.

 

[bolus jones]

I feel pity for your future clients (since only MD's have patients). Your inflated ego will one day cause you to burst the bubble you live in.

OK...I understand futureOD's comments are sometimes not grounded with any evidence, and that he appears to like to stir up trouble, but there is no need to belittle the rest of us with comments like "only MD's have patients"). I guess I just don't understand how such comments are in any way contributing to the educational purpose of these forums. Furthermore, I can't believe that you will get many referrals from OD's if this is the way that you treat them.

 

[bolus jones]

Also, I'd be interested to know what OD schools are teaching about laser surgery and how to perform it. We sure as heck don't do that here. (probably shouldn't give a location)

 

[Richard_Hom]

.

Again, PROFOUND lack of basic understanding of the complexity of these procedures. They may look automated and "easy" to an untrained eye. Even though the complication rate is small, if something does go wrong it is devastating. Have you ever seen a case of severe endophthalmitis or a corneal perf post LASIK?

Dear Dr JR,

1. It is true that the former poster who cites LASIK "easy" may also have been presumptive in the procedure due to a lack of familiarity to the subject matter at hand.

2. However, your response presumes that optometrists would only learn the procedure and none of the science and "medicine" behind the procedure or the relevance or efficacy of the procedure. I would doubt that such a presumption is accurate and your generalization may be indicative more of a generalized bias rather than an accurate rendition of the position.

3. What makes your response questionable is the multitude of invasive procedures done by FNP in Cardiology, PA's doing all kinds of procedures without direct supervision, etc. There is ample prior experience for scopes of practice for "non-physicians" and surgeons.

4. In addition, the inflammatory and outright distortions perpetuated by all organizations will only cloud the merits of the case. I believe that both sides are guilty to some extent although my view of the ophthalmology attacks seem more vitriolic than optometry responses.

5. In the end, "fright" tactics by opthalmomlogy may win the near term battle. There is ample evidence, though, that such tactics will "backfire" in the end and the only cost is the mounds of money that have been spent on each other's efforts.

6. Again, the positions that non-physicians occupy in the health care system weren't developed out of "thin air" or "whole cloth" but were from the minds and hearts of physician executives who are not as enamored by the emotional debate surrounding optometric scopes of practice.

7. I had hoped that your ascendency to the moderatorship of the ophthalmology forum might mean that you have a fairly "even-handed" approach to professional relations, but I may be wrong on that account. I look forward to your future approach on this subject in "bettering" rather "worsening" relations between the two professions.

Richard

 

[vanelo]

2. However, your response presumes that optometrists would only learn the procedure and none of the science and "medicine" behind the procedure or the relevance or efficacy of the procedure. I would doubt that such a presumption is accurate and your generalization may be indicative more of a generalized bias rather than an accurate rendition of the position.

Richard

Well, I know you would only learn the ocular procedure and none of the science and medicine behind since you didn't go to med school.

It is unbelievable that the only professionals that don't recognize the hard work (hardest of all) that med students go through are optoms.

I have many friends in other fields (law, dental, etc) and they all agree in that a medical career is the most sacrificed of all.

And then you try to believe that you would actually learn the science and "medicine" behind the procedure or the relevance or efficacy of the procedure in only optom school.

Believe whatever you want, but do not underestimate another person's hard work just because you want to justify an "unjustifiable" point (again:the science and "medicine" behind the procedure or the relevance or efficacy of the procedure cannot be learned by simply learning about the eye. The human body is a system much more complex than what you OD's try to trick others into believing)


P.S. JR is a GOOD MODERATOR

 

[cpw]

Well, I know you would only learn the ocular procedure and none of the science and medicine behind since you didn't go to med school.

this is where you are udderly and completely WRONG. You cannot make brash assumptions about my education without going through it yourself.