shredhog65 said:
most of us will have very good relationships with optometrists and they will be a large referal base for us. our jobs our fairly safe from "OD's taking over". if you're worried about making a living, it's insurance and medicare reimbursments you should be worried about.
Thanks for your comments. For the most part, I agree with you and respect your desire to make peace.
I'm not attacking you, but using your comments as an example of how optometry as gained more scope of practice in the last 20 years.
I agree that both professions need to cooperate. I also agree that many optometrists are not interested in the expansion of their current scope of practice. However, as physicians, we cannot ignore what is happening at the VA hospitals and in Oklahoma.
The problem with your comments are:
1)
"It's not going to happen in our lifetime": I'm sure I'm
safe because I'll be a fellowship trained ophthalmologist, but I'm not here to solely watch my back. We're differentiating non-surgeons vs surgeons and non-physicians vs physicians for future generations. The attitude "it's not going to happen in our lifetime" only encourages apathy amongst the more established ophthalmologists. This is for the future of patients and young physicians.
2)
"Most of us will have very good relationships with optometrists and they will be a large referral base for us.": Optometrists outnumber ophthalmologist by 3:1. They know this. Do not become complacent because your practice is making money from referrals. This is dangerous. Did you know there are "Optometric Glaucoma Specialists" and "Optometric Retina Specialists"? They approach practices demanding to co-manage all the retina patients. This is pathetic. How do they claim to be a "Glaucoma or Retina Specialists"? They take weekend courses. Some even claim to be trained at a University by Dr. X after taking a few seminar courses. Please don't be complacent about this issue because physicians are "making money from a large referral base". Optometrists need us as much as we need them. Optometrists, as primary care providers, need to refer surgical and medical cases that are beyond their scope of practice.
3) It's more than about making money. This is about maintaining a high level standard of care. Because optometrists out number ophthalmologists 3:1, if given more privileges (medical and surgical), then insurance companies and HMOs will require patients to see optometrists first. As a result, ophthalmologists will only get patients that optometrists "refer". Some HMOs already demand that primary eye care be seen first by optometry. Even without the medical and surgical training, Oklahoma is on the verge of granting optometrists the right to prescribe
all medications by all routes and to peform
all surgical procedures, excluding retina lasers, but optometrists can perform any surgery deemed appropriate by their optometry board.
The question you should be asking is:
who do I want performing intraocular surgery on me and who do I want managing giant cell arteritis with prednisone?
From your post, the answer is ophthalmologists, but with the recent advancements in Oklahoma, you may not have this choice if you live in Oklahoma or other states that may grant more medical and surgical privileges to optometry. Insurance companies will demand who you can and can't see, and these companies care more about the bottom line than standard of care.
[Edit] - One last point. Society doesn't know the difference between OD and OMD. I was in Washington D.C., and the politicians do not know the difference in training. In addition, the policy makers care most about the votes. As ophthalmologists, we need to: 1) educate the public, 2) help the public know the difference between OD and MD, and 3) give money to our PAC so that lobbyists can work for ophthalmology to gain more votes to achieve our goals.
