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All this Opto vs. Ophtho makes me rethink my career plans

Discussion in 'Ophthalmology: Eye Physicians & Surgeons' started by johnstoner, Apr 28, 2004.

  1. johnstoner

    johnstoner Ben Franklin on Hashish
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    I'm getting worried about all these heated animosities b/w the two professions and I'm worried that if i pursue ophthalmology as a career...i may get shafted by optometrists wanting to do procedures.

    I feel like this is kind of rediculous b/c if this is the case...it wouldn't make sense for any MD's to go into ophtho...and its so freaking competitive to get in.

    Its like...ok...you need a 3.4 gpa and whatever to get into optometry school after college but for ophthalmology you need to be in the top of your class for undergrad...then you need to be the top of your class for medical school and then do another 4 years of residency to practice ophthalmology.

    To have an optometry or optometrists degree equal that of ophthalmologist's degree sounds ludakris!

    It makes going into ophthalmology less attractive, have anxiety over too many providers, and lowers the opinions of others about the field.
     
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  3. johnstoner

    johnstoner Ben Franklin on Hashish
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    i was wondering what other fields of medicine come close to ophthalmology in terms of practice?

    I want to do procedures, preferably surgery sitting down (i have a really bad back problem), love new technology, and prefer to know a lot about something rather than a little about everything

    what i could come up with was

    ENT
    Ortho hand
    maybe laproscopic general surgery
    urology (i heard they do a lot of robotics now)

    I've seen retina surgery done and thought that was the most awesome sight i've ever seen (with those two tiny instruments in the globe)
     
  4. xmattODx

    xmattODx Senior Member
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    If optometrists ever gain the right to do retinal surgery I will be the first in line to turn in my optometry card. I don't think you need to worry that optometry will go down that road. If you can get an ophthalmolgy residency and eye care interets you please go for it. Our population can really use enthusiastic, caring eye care providers off all types. I have the utmost respect for surgeons. Surgery is something I could never do...
     
  5. Sir Jun

    Sir Jun Member
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    it's definitely not done sitting down; in fact you end up sometimes having to hold your back in weird angles because all of your moves of the end-effectors have to be transmitted around a fulcrum. with a bad back, I'd stay away from laparoscopic, although with the da Vinci robot this may change so that you could actually operate sitting down.

    As far as being concerned about the job-market of ophthalmology, I have this general opinion to offer to all: if you are the best at what you do, people will always come to you. It doesn't matter if there are 500,000 optometrists doing surgery. There will always be a demand for quality. Most of the attractive fields are starting to get a little crowded. To enter them, one must have the mindset of the aspiration to be one of the best, not simply competent to pass the boards.

    Just my two cents.

    Dan
     
  6. Andrew_Doan

    Andrew_Doan Doc, Author, Entrepreneur
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    Nicely stated! ;)

    Don't be discouraged about the recent OD vs MD fight. I want medical students to be informed before picking ophthalmology as a career. I encourage new residents and current residents to be ready for the future. We need to give $$$ to our PAC and be members of the AAO.

    I love this field, and it's worth all the pain and political battles! :thumbup:
     
  7. Yogi Bear

    Yogi Bear 2K Member
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    hmm....a century ago...it was the DO vs. MD fight. nowadays, DOs are pretty much integrated into the system and can do any MD residency as long as they've got the scores/record and have taken the usmles. Now, the OD vs. MD fight starts....hehe.

    I wonder what people would say if chiroprators (DC) lobbied to start doing surgical procedures and encroach upon orthopods; or audiogolists lobbied to do ear surgery/implants, etc....
     
  8. BeefyRedEye

    BeefyRedEye Member
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    This is not a valid comparison. DO vs MD is totally different from OD vs MD. DO's go through the same amount of training as MDs. ODs don't.
     
  9. DreamJob

    DreamJob Member
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    Yes, I totally agree. DO's go through the exact same curriculum and compete for the same residency positions as MD's. OD's don't, and therefore are less qualified (yes I said less qualified) then MD's and DO's.
     
  10. new-eye

    new-eye Junior Member

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    Lots of medical doctors have non-medical doctor competition. It has been going on in some areas than in others. For example:

    CRNAs vs Anesthesiologits (probably one of the oldest examples, with CRNAs performing some of the earliest anesthetic delivery)
    Podiatrists (some are doing surgery upto the knee with fellowships offered in plastics and vascular) vs ortho
    NPs vs GPs (some hospitals are strictly run by NPs only, no MDs)
    Midwives vs OBs (long history)
    PAs are doing some simple surgical cases.
    Emergency medicine vs PAs

    Opthalmology does a good job keeping its head above water with lots of advances in technlogy. I think the real enemy is in Washington, not your fellow optometrists. In the professional world, I have yet to meet a practicing ophthalmologist in a successful practice who doesnt think the area optometreists provide an invaluable service to the community.
     
  11. Visionary

    Visionary Medical Retinologist
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    I think you'll find most of those on the OMD side of the argument would agree with this statement. The issue is not whether ODs provide an invaluable service--they clearly do. The issue is whether they should be expanding that service to include surgery--they clearly should not.
     
  12. shredhog65

    shredhog65 Member
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    so, i rarely post here, but after reading all of this ophtho vs OD stuff i want to give my 2 cents.

    i doubt OD's will be given surgical privilages in our lifetime (if they do then disregard everything in this post!). i don't think most even care about having them. those that do are (and i think some post here) are trying to overstep their training and if they cared about their patients more than their own pride they would stop trying to obtain them. they would only be harming their patients by doing this, and i HOPE they eventually realize that.

    all in all, i think most OD's are happy doing what they do and that does not include surgery. if they wanted to do surgery and couldn't get into med school then they could have tried the DO route (i'm not trying to put down DO's here - please, i mean no offense by this) instead of OD school. most went to OD school to become optometrists, not an optomotrist with the intention of bucking the system and gaining all these new privilages. that said, if it does happen then i think the public will be much more aware of the difference between ophtho and OD's since there will be a much higher complication rate among procedures performed by OD's. like an excellent ophthalmologist i worked with once said - there will always be a large population that is smart and willing to go elsewhere and pay more for better, more compitent care.

    i guess my point is, i don't think ophtho's (that includes me) should be bashing OD's like this on this board. odds are that one day most of us ophtho's will have an OD working for them in their office and you'll probably be very happy that they're there to help you. 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.
     
  13. Andrew_Doan

    Andrew_Doan Doc, Author, Entrepreneur
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    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.
     
  14. MacGyver

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    You say that now, what about 15 or 20 years down the road? When OK first allowed ODs to do PRK, all the ODs said they werent interested in LASIK. Now, years later, they all want to do LASIK.

    Who says the ODs will stop there?
     

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