This is a frightening thread.
Lasix = furosemide (a diuretic that optometrists should not prescribe as they are not physicians)
LASIK = laser in situ keratomileusis (a surgery that optometrists should not perform as they are not surgeons)
What this really boils down to is a public safety issue. Physicians are licensed to practice medicine equally in all states. If you go to a physician in CA it is the same as going to one in OK or MI. You can be certain that they have gone through medical school, internship, residency, and perhaps even fellowship. More likely than not the physician is board certified in a specialty.
Optometry is another story altogether. All O.D.s are not created equal. In one state they may be permitted to practice a broader scope of services while in a neighboring state there may be a very limited scope. Most O.D.s do not complete residencies and there is no way for the public to know if their O.D. is well trained or just out of school. They have no way of knowing if their O.D. just moved from state A to state B, suddenly acquiring the "ability" and "right" to perform services they have not been trained for.
Although it may be true that most O.D.s have no desire to perform surgery or shoulder the responsibility of higher malpractice premiums and dangerous surgical complications, patients should not be subject to the greed of the select few O.D.s who delude themselves into thinking that, professionally speaking, they are equal to physicians. Just because there are O.D.s who made the mistake of choosing optometry instead of medicine, the nature of optometry as a profession should not be changed into something it is not to suit them.
Someone's example of osteopathic medicine's evolution as a profession is a poor example. The D.O. profession was developed by an M.D. at a time when allopathic medical treatments were "worse than the disease" as an attempt to treat patients more safely. It had a foundation in mainstream medicine with a different philosophical approach to patient care. During the short lifespan of its founder, osteopathic medicine focused mostly on manipulation to differentiate itself from allopathic medicine. Near the end of the founder's life, and after his death, osteopathic medicine reintegrated the improved allopathic principles into its practice to provide complete care with an additional tool for diagnosis and treatment. Optometry is not and was not ever a surgical or medical profession and it is wholly inappropriate to try to overlap itself into medicine and surgery.
Refraction is only part of what ODs do. They check pathology, remove forien bodies, treat glacoma, diabetic retinopathy,...the list goes on and on!
How do they check pathology? Do they complete fellowships in ophthalmic pathology? As far as I know only ophthalmologists and pathologists are permitted to complete said fellowship. If you mean they go to the fax machine and read what a pathology report says, sure, I guess they are capable of checking.
ER doctors remove foreign bodies all the time. This fact does not qualify them to perform ocular surgery. When the going gets tough the ER docs and optometrists send ophtho their patients because both are not trained to handle complicated cases.
I am still stunned that O.D.s treat glaucoma. Glaucoma is an acquired optic neuropathy. Optometrists are not qualified to treat neuroophthalmic disease or any disease they cannot spell such as "glacoma." What is next, requests for training in trabs, ALT, and SLT?
Diabetic retinopathy? O.D.s perform PRP, focal photocoagulation, and vitrectomies? Most general ophthalmologists send PDR patients to retinologists for said treatments, but you are saying instead they should be sent to the local mall for the optometrist to treat? Scary thought.
Someone was also talking about co-management with ophtho. Yes, ophthalmologists make much more money for a surgical procedure than the optoms that see them pre and post-op. Do the ophthalmologists laugh all the way to the bank? No. If something goes wrong it is entirely the responsibility of the surgeon to manage the complications and to face any resulting litigation. Optoms are shielded from this as they don't see the complicated patients until they are stable enough to be released to them and the patient isn't suing them. What are they going to do, sue the surgeon who sliced through their cornea or the optom who asked them "better one, or better two?"
As this forum is supposed to he helpful for students looking for answers to their career issues (or so someone implied) my PSA is this: Make sure you really want to be an optometrist if you go to optometry school. If you are secretly desiring to become a physician, go to allopathic or osteopathic medical school. If you love eyes and want to take care of them, do extremely well in medical school so that you might be able to get a spot in an ophthalmology training program. If you think that optometry will be a secret way to get around medical school and residency if you wait 6-7 years, don't count on it.
Patients deserve appropriate medical care from an ophthalmologist for primary eye care and surgery. Optometrists are great for refraction and contact lens fitting.
Why in the world would the government allow that when there is already a projected surplus of ophthalmologists?
