Do patients speak MD/DO/OD?

[mdkurt]

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This is my first post, but I've been reading the threads regarding OD scope of practice with interest. Lots of good opinions from both side of the fence.

My question is this. It seems that patients, legislators, and the general public have a tough time telling between optometrists and ophthalmologists. This isn't too hard to understand, considering that optometrists rarely identify themselves as ODs. Generally, their signs say "Dr. Johnson" without any initials afterwards. Personally, I don't know of any MDs or DOs that don't affix their initials to their names so they can be properly recognized by the community. In an age when the government tells me that I can't buy a bag of chips without first having the opportunity to read about every single ingredient contained within, I think our patients have the right to be able to identify their treating doctor. We need a law mandating that doctors identify themselves by degree in advertisements, letterhead, and signage. The more the public can identify which doctors provide which care, the easier it will be to define scope of practice.

 

[Andrew_Doan]

In an age when the government tells me that I can't buy a bag of chips without first having the opportunity to read about every single ingredient contained within, I think our patients have the right to be able to identify their treating doctor. We need a law mandating that doctors identify themselves by degree in advertisements, letterhead, and signage. The more the public can identify which doctors provide which care, the easier it will be to define scope of practice.

Welcome to the forum! Thanks for your post. You make an excellent point. 😉

 

[johnstoner]

I think that is why it is important that ophthalmologists try to let the public know the difference. Optometrists have tried so hard to call themselves EYE DOCTORS that it confuses the hell out of even me before i started med school

 

[maxwellfish]

I think that is why it is important that ophthalmologists try to let the public know the difference. Optometrists have tried so hard to call themselves EYE DOCTORS that it confuses the hell out of even me before i started med school

Let me be naive, if optometrists are not eye doctors, what are they?

 

[mdkurt]

I think the point is that they prefer to use the ambiguous "eye doctor" to the more accurate "optometrist". Neglecting to add their credentials to the end of their names certainly doesn't help clarify the issue. Flip through the phone book, and you'll see what I mean.

 

[Sir Jun]

You are absolutely right. I addressed the "Dr. Smith" vs. "E. Smith, OD" in a different thread a few days ago and someone noted my reference as being "weird," but it is definitely a real phenomenon. I think ophthalmologists should be referred to as Eye Surgeons, or Ophthalmic Surgeons, or something of the like. ENT's have started doing this. No one says, "Hi, I'm Dr. SMith, an otorhinolaryngologist." They have started saying Head and Neck surgeon, which is plain English that anyone can understand. Ophthalmology should do the same; I think it would enhance the public's understanding of the scope of practice.

 

[mdkurt]

Good point--in my clinic, I take some pains to identify myself as an ophthalmologist, an eye surgeon, and explain that I went to medical school. I just think that patients flipping through the phone book should be able to identify every provider's name with MD/DO or OD. I would argue that many of these patients schedule visits with an "eye doctor", assuming (sometimes incorrectly) that they're getting a doctor who went to medical school. For a lot of patients, their care can go on for years before they realize that this is not the case.

 

[cpw]

I don't think I've EVER seen an OD office where it's just said "Dr so and so" on the door. Every office I've seen says: So and So, OD (and sometimes FAAO)

I also say I'm an eye doctor BECAUSE people have no idea the difference between ODs and OMDs. When I said I was an optometrist people ran the gamit from asking me which company I made glasses for to what number did they call for me to laser their eyes. The public has no earthly clue. Therefore, it's much easier in a casual setting for me to say I'm an eye doctor. That's all.

 

[mdkurt]

Optometrists and opthalmologists are going to refer to themselves as eye doctors in conversation with patients because otherwise it's a mouthful. That's not my point. My experience has been different from CPW's in that I find the majority of optometrists are not using OD after their name. Just to be sure, I checked the phone book again. Then I looked in the paper, where the optometrist down the street only says that he's "Dr. Strangelove, specializing in surgical comanagement". I don't think this is fair to patients who may not understand that these doctors didn't go to medical school. For me, this falls under the umbrella of full disclosure.

 

[maxwellfish]

but he is specializing in surgical comanagement... seems alright to me... not everyone is looking for a medical doctor

 

[Andrew_Doan]

but he is specializing in surgical comanagement... seems alright to me... not everyone is looking for a medical doctor

And patients know what surgical comanagement is?

 

[Mr Reddly]

And patients know what surgical comanagement is?

Shoot, before my strabismus surgery in college, I didn't even know what an opthalmologists was! Went to a hand full of "Eye docs" and looked through countless prisms before one of them (Optometrists) gave me the name of an opthalmologist. If not for that, my vision would probably still be messed up.

As for "do patients speak..." My guess would be no. Everybody wants to tweak their title this way or that so that there's no way a patient can know... PhDs (and porn stars) who list themselves as Dr. Soandso. , nurses with 10 different letters, symbols, and abreviations after their name... My god, you need an advanced degree just to figure out who is who and what is what!

 

[maxwellfish]

And patients know what surgical comanagement is?

well its a heck of a lot more descriptive then "eye doctor"

 

[exmike]

well its a heck of a lot more descriptive then "eye doctor"

Dr. X... Surgical Comanagement Specialist is a blatant and obvious attempt to throw in the word "surgical" and Doctor into the optometrist title, clouding in the consumers mind the difference between an optometrist and an eye surgeon.

I am willing to bet 90% of the general public has no clue what "surgical comanagement" means. I'll go further as to say the optometrist using that title is only doing to to mislead the public into thinking his is somehow associated with surgery and thus a real "doctor".

 

[maxwellfish]

Ha.. that "real doctor" thing makes me laugh everytime. It may be confusing but I bet 90% don't know the difference between optometrist and ophthalmologist, in the first place.

I was just stating that its more descriptive since the OD itself is confusing and most agree that "eye doc" is ambiguous... so by saying Dr. Smith surgical comanagement specialist, he is stating two important facts 1) He is a doctor and 2) He specializes in surgical comanagement.

Nowhere does it say that someone HAS to go to an ophthalmologist and if they don't they should BEWARE because they are seeing an optometrist instead.

 

[GlaucomaMD]

OCCUPATIONS CODE

CHAPTER 104. HEALING ART PRACTITIONERS
? 104.003. REQUIRED IDENTIFICATION.
(a) A person subject to this section who uses the person's name on a written or printed professional identification, including a sign, pamphlet,
stationery, or letterhead, or who uses the person's signature as a professional identification shall designate as required by this section the healing art the person is licensed to practice.

(b) A person who is licensed by the Texas State Board of Medical Examiners and holds a doctor of medicine degree shall use:

(1) physician or surgeon, M.D.;
(2) doctor, M.D.; or
(3) doctor of medicine, M.D.

(c) A person who is licensed by the Texas State Board of Medical Examiners and holds a doctor of osteopathy degree shall use:

(1) physician or surgeon, D.O.;
(2) osteopathic physician or surgeon;
(3) doctor, D.O.;
(4) doctor of osteopathy;
(5) doctor of osteopathic medicine;
(6) osteopath; or
(7) D.O.

(d) A person who is licensed by the State Board of Dental
Examiners shall use:
(1) dentist;
(2) doctor, D.D.S.;
(3) doctor of dental surgery;
(4) D.D.S.; or
(5) doctor of dental medicine, D.M.D.

(e) A person who is licensed by the Texas Board of
Chiropractic Examiners shall use:
(1) chiropractor;
(2) doctor, D.C.;
(3) doctor of chiropractic; or
(4) D.C.

(f) A person who is licensed by the Texas Optometry Board shall use:
(1) optometrist;
(2) doctor, optometrist;
(3) doctor of optometry; or
(4) O.D.

(g) A person who is licensed by the Texas State Board of
Podiatric Medical Examiners shall use:
(1) chiropodist;
(2) doctor, D.S.C.;
(3) doctor of surgical chiropody;
(4) D.S.C.;
(5) podiatrist;
(6) doctor, D.P.M.;
(7) doctor of podiatric medicine; or
(8) D.P.M.

 

[mdkurt]

The Texas law from GlaucomaMD is exactly what I think we need nationwide. Patients deserve to have the opportunity to identify exactly who is treating them, even if they don't care. The general public might not know the difference between OD or DO/MD, but a good way to help everyone catch on is to mandate that every doctor properly identify themselves. If optometrists continue to only identify themselves as "doctor", then I think Exmike is correct and that the public is being deceived. Whether this is what the optometrist intended or not probably isn't important.

 

[Andrew_Doan]

BTW, is that your new baby GlaucomaMD? Congrats! 😀

 

[GlaucomaMD]

Born April 28th!

7 lb 14 oz!

😀 😍

 

[NEATOMD]

As a future MD, I am personally ashamed of those whom I will be associated with once I obtain that title. Heck, I'll avoid using it whenever possible. Some of you people make me sick. I'm talking about the ones who think MD's are the only real doctors out there. You people have to get over your ego's. Have you really worked that much harder than those pesky "inferior" optometrists? Optometrists deserve the title doctor every bit as much as any ophthalmologist does. Maybe they don't introduce themselves, "I'm Dr. Joe, Optometrist, which really isn't nearly as good as if I were an ophthalmologist, who by the way are real M.D.'s, unlike myself" But, if they did, the appointment would be half over by they time they got through the spiel. Also, I don't see any opthalmologists walking around spitting out the extent of their credentials to everyone they meet. Maybe those of you with such ego's do though. At some point, I hope you'll mature enough to treat other professionals with the same respect that you feel like you've earned.

 

[Andrew_Doan]

As a future MD, I am personally ashamed of those whom I will be associated with once I obtain that title. Heck, I'll avoid using it whenever possible. Some of you people make me sick. I'm talking about the ones who think MD's are the only real doctors out there. You people have to get over your ego's. Have you really worked that much harder than those pesky "inferior" optometrists? Optometrists deserve the title doctor every bit as much as any ophthalmologist does. Maybe they don't introduce themselves, "I'm Dr. Joe, Optometrist, which really isn't nearly as good as if I were an ophthalmologist, who by the way are real M.D.'s, unlike myself" But, if they did, the appointment would be half over by they time they got through the spiel. Also, I don't see any opthalmologists walking around spitting out the extent of their credentials to everyone they meet. Maybe those of you with such ego's do though. At some point, I hope you'll mature enough to treat other professionals with the same respect that you feel like you've earned.

You're missing the point of our discussion to distinguish titles. Because you feel the optometrists have worked "so hard", then go to Oklahoma for your cataract surgery. Actually, because you're an MD with future $$$, you'll pick the best cataract MD surgeon to do your surgery and will likely ignore the fact that state papers or Medicare patients must go to optometrists for their surgery. Thus, for me, the battle against optometric scope expansion, is about patient care, not titles.

I respect your opinion, but apathy like yours is what allows scope expansion in Oklahoma to happen.

How would you like nurse practitioners to call themselves Doctors? They go to school and train almost as long as Optometrists do now. In fact, in some states, nurse practitioners can set up shop like any family practice doctor. This has occurred because of aggressive legislation.

I'm not refuting the fact optometrists are 'doctors'. I think they should be called 'doctors'. However, I think the term 'physicians' really blur the lines for patients. BTW, in Oregon, they are 'optometric physicians'. On the other hand, I also understand the reasoning behind this thanks to Jenny's explanation; however, I also feel there is more to it for some optometrists to call themselves 'physicians'.

In the world of medicine, titles are everything. When I do cataract surgery on my patients, they want to know that: 1) I'm a 'doctor' & 'surgeon'; 2) Resident vs Staff; 3) How many years I've done surgery.

It's not about egos here, but about representing yourself accurately to patients. The public ONLY knows titles. No one cares about your educational history of going to Harvard undergrad, UCLA med, Hopkins residency, etc... They want to know if you're a 'doctor', which equates to MD in 99% in our patients.

Another example is if you needed law advice from a lawyer, do you want a 'real lawyer' or a paralegal who calls him/herself a lawyer? Wouldn't you be angry if you lost your malpractice case because a paralegal misrepresented himself/herself?

Isn't it hypocritical for you to use an id like NEATOMD if you didn't care about 'titles'? I'm only pointing out a fact and not attacking you. 😉

 

[NEATOMD]

You're missing the point of our discussion to distinguish titles. Because you feel the optometrists have worked "so hard", then go to Oklahoma for your cataract surgery. Actually, because you're an MD with future $$$, you'll pick the best cataract MD surgeon to do your surgery and will likely ignore the fact that state papers or Medicare patients must go to optometrists for their surgery. Thus, for me, the battle against optometric scope expansion, is about patient care, not titles.

I respect your opinion, but apathy like yours is what allows scope expansion in Oklahoma to happen.

How would you like nurse practitioners to call themselves Doctors? They go to school and train almost as long as Optometrists do now. In fact, in some states, nurse practitioners can set up shop like any family practice doctor. This has occurred because of aggressive legislation.

I'm not refuting the fact optometrists are 'doctors'. I think they should be called 'doctors'. However, I think the term 'physicians' really blur the lines for patients. BTW, in Oregon, they are 'optometric physicians'. On the other hand, I also understand the reasoning behind this thanks to Jenny's explanation; however, I also feel there is more to it for some optometrists to call themselves 'physicians'.

In the world of medicine, titles are everything. When I do cataract surgery on my patients, they want to know that: 1) I'm a 'doctor' & 'surgeon'; 2) Resident vs Staff; 3) How many years I've done surgery.

It's not about egos here, but about representing yourself accurately to patients. The public ONLY knows titles. No one cares about your educational history of going to Harvard undergrad, UCLA med, Hopkins residency, etc... They want to know if you're a 'doctor', which equates to MD in 99% in our patients.

Another example is if you needed law advice from a lawyer, do you want a 'real lawyer' or a paralegal who calls him/herself a lawyer? Wouldn't you be angry if you lost your malpractice case because a paralegal misrepresented himself/herself?

Isn't it hypocritical for you to use an id like NEATOMD if you didn't care about 'titles'? I'm only pointing out a fact and not attacking you. 😉

Sadly enough, I realized even before I typed that message that it was quite likely that someone would point out the fact that my id is NEATOMD 😛 I also want to point out that I HAVE been paying very close attention to the scope of practice battles that have been so prevalent lately in medicine. One thing I find strikingly interesting is that fact that PA's were created by MD's for MD's benefit, and today they are in the process of reducing their need for MD authorization to practice. ie: they no longer need a physicians signature to write a prescription. Getting back to optometrists, I don't feel that they should be using scalpels. As I understand it, most optometrists don't even want to. While surgeries do generate money, most realize that it doesn't make sense for them to purchase expensive equiptment, pay increased insurance rates, and go to extra schooling, just for a few such surgeries a year. I do, however think that it does make sense to allow optometrists to prescibe topical and oral medications related to the treatment of eye related diseases. In order to prescibe those medications, optometrists ARE taught how to use them through the same methods as MD/DO's are. Also, keep in mind that they do have a limited set of medications as their scope of practice is limited by what they are trained to use through their schooling. With regards to going to Oklahoma to get cataract surgery: if there is so much money to be lost by optometrists performing those surgeries there, then why aren't Ophthalmologists out there doing it? I also just want to say that I wouldn't go to the "lowest bidder" but instead the best trained. When it comes to specialist such as this I still won't care so much what he/she calls him/herself, but instead I will ask, "How many surgeries like this do you perform in a year and with this staff and equiptment?" "How much training did you recieve for this type of operation?", "What are your patient success rates?", "How old is the equiptment being used?", "Where were you trained?". Unfortunately, most elderly patients don't seem to ask alot of these questions. Like you said, they just care that you are a doctor. On the other hand, I have found that younger generations have been taught to look into these things alot more. So, maybe the solution does not involve limiting other professionals such as optometrists, but instead instilling principles into the public that encourage them to ask these sorts of questions.

 

[mdkurt]

As a future MD, I am personally ashamed of those whom I will be associated with once I obtain that title. Heck, I'll avoid using it whenever possible. Some of you people make me sick. I'm talking about the ones who think MD's are the only real doctors out there.

The point of this discussion is that SOME (not many) optometrists are not identifying themselves to patients, and that this borders in some cases on outright deception. I'm not trying to make a statement re: the relative merits of either degree.

 

[Mirror Form]

As a future MD, I am personally ashamed of those whom I will be associated with once I obtain that title. Heck, I'll avoid using it whenever possible. Some of you people make me sick. I'm talking about the ones who think MD's are the only real doctors out there. You people have to get over your ego's. Have you really worked that much harder than those pesky "inferior" optometrists? Optometrists deserve the title doctor every bit as much as any ophthalmologist does. Maybe they don't introduce themselves, "I'm Dr. Joe, Optometrist, which really isn't nearly as good as if I were an ophthalmologist, who by the way are real M.D.'s, unlike myself" But, if they did, the appointment would be half over by they time they got through the spiel. Also, I don't see any opthalmologists walking around spitting out the extent of their credentials to everyone they meet. Maybe those of you with such ego's do though. At some point, I hope you'll mature enough to treat other professionals with the same respect that you feel like you've earned.

Maybe you really are a med student, but I can't just take your word for it b/c for some reason there have been a few people posting on this whole MD / DO debate that have pretended to be something they weren't. You could very well just be some troll. That said, once you get anywhere near graduation from med school (assuming you're a real med student, which you might not be) that question above: "Have you really worked that much harder than those pesky "inferior" optometrists?" will be very easy to answer. Yes, on average MD's work much harder then OD's in order to complete their training.

However, the "inferior" part seems to be something you made up yourself. Optometrists are not inferior to MD's, they are simply a different type of professional with a different type of training. Optometry training does not adequately prepare one for surgery. That's the issue, not about who's better then who. This is especially problematic b/c many uninformed people assume OD's are actually MD's that specialized in the eye. Therefore, it's one more less then honorable method that optometrists have used to broaden their scope of practice.

 

[CNU2020]

Hey all,

I'm a real O.D. in training. In addition, my very immediate family is loaded with both a single O.D. and three M.D.'s (soon to be four). I have friends who are M.D.'s as well. With those credentials, I thought I'd try to add some thoughts to this thread from a different angle. (hope they're welcome-- let me know if you feel they're not and I'll consider retracting my discussion.)

I can honestly say that as an Optometry student, nearly everyone I talk to feels that there is NO desire, and/or need to "invade" Ophthalmology's scopes of practice further. We're not trained for major surgery. True. Fact is, I , nor most of my peers have any desire to do this either. In fact, you may be surprised to find that when an interviewy talks to our admissions people about the possibility of Optometrist doing the surgeries in the future, that person is ussually red-flagged and denied admission. Why? Simple. We don't want people in this profession who are Ophthamology/ MD/DO wanna-bes (doing this, because they just couldn't make the M.D. cut.) On a side note, I know many M.D.'s are aware that there are many students at Optometry schools, such as myself (chose of the basis of lifestyle), who chose O.D. school on reasons other than the mere fact that they didn't make the cut. I/we appreciate that respectful acknowledgement.
In any case, when both O.D.'s and O.M.D.'s hear "Optometrist" and "surgeries" in the same sentence we all get alarmed. Thus, I thought that sharing what I've been reading in the literature may also be helpful/ set your wary minds at ease: Regarding Oklahoma -- I believe some of the "surgeries" discussion regarding OK is actually due to poor semantics on the state legislature. Again, from my understanding, what most, if not all, Optometrists there were trying to do, is something they (and O.D's across the country) have been doing for a long time; simple foreign object removal in the anterior most segment (I.E. metal flake in bulbar conj. or cornea) and eyelid margins. Whether you feel O.D. should be doing such things as this may concern you as well, but if not hopefully that may clarify. Again, no intellegent O.D. would attempt cataract surgery, not in any state, nor does organized optometry stand by any efforts to do so.
In my opinion, (which may not be welcome) in all our arguments about who should be doing what, we sometime neglect to think about the big picture. In the U.S. today there is an enormous generation of people who is about to hit the age where their eye just start to flat out fall apart. For example, as you may all be aware, corneal cataracts and other such diseases are all (100%) emminent with increase age on even the most healthy eyes. I don't think that our over saturated market concerns will be of much concern in the near 30 years. Sure, there will be a competition to find the hot spots where the money is, such as extremely well-off communities.
Finally, concerning what may be the true theme of the thread -- O.D.'s improper identification of themselves: Again, I've spent a lot of time in private practice settings of O.D.'s and M.D.'s. From what I've seen and heard, patients are rarely choosing a doctor due to title, nor do they care that the person they see has been through M.D./D.O. training. Instead, the often chose their doctor by things such as aquaintance's recommendations. Then, they return based upon how they felt their needs were met. For instance, I saw a study last week, (which I think was by the CDC?) that said that only 2% of patients went to an office because they saw a listing in a telephone book/online listing. Furthermore, another extremely small percentage went to a specific office because they just happened to see it there listed at the location: "Mr. Smith -- EYE DOCTOR." And, the only place that is happening is an enemy to us both, corporate eye care facilities. From my impression, the general public is very aware that "eye doctors" are not, in fact, the same as their internist (M.D.) But, in that same fashion, they knowingly choose to go to an O.D. for reasons such as; aquaintance's recommendation, that's where their family has always gone, and etc. This works the same as with dentist. The public is also very aware that they didn't go to the same school as the M.D. Frankly, noone really cares. It's understood and excepted. Knowing full well, we trust that their training is suffice to meet our needs. In truth, Jo America doesn't often go to their eyecare specialist with what they feel is a major concern. In fact, they feel that going to a Ophthamologist who is, in fact an M.D., would be a mistake because they associate M.D.'s with large bill$ or may feel that they would be over qualified to treat their small needs. (I.E. don't go to a neurosurgeon first for a slight headache). I must say, this works to the O.D.'s advantage in that if they are satisfied, they will return to that same doctor with larger problems, because they are comfortable with that person. A lot of times, a patient will come in and tell O.D.'s a variety of concerns because they know we can't do much about it. Especially males will resist going to the doctor, but who can continue basic function without proper vision. It is in ways such as this that it is possible that having an M.D. behind your name might detract from your patient base. Ergo, I say, I'm all for letting them know I never went to "medical school." Furthermore, I'd welcome a law that required me to state that I was simply an O.D... heck, I'd almost follow it with, "nope, never went to a true med school."

Hopefully this was welcome insightful into the mind of an O.D.

 

[Andrew_Doan]

Regarding Oklahoma -- I believe some of the "surgeries" discussion regarding OK is actually due to poor semantics on the state legislature. Again, from my understanding, what most, if not all, Optometrists there were trying to do, is something they (and O.D's across the country) have been doing for a long time; simple foreign object removal in the anterior most segment (I.E. metal flake in bulbar conj. or cornea) and eyelid margins.

Thanks for posting! I love these discussions.

First, I think you should study what's going on in Oklahoma. Some of your optometrist leaders have different plans than the one you outlined for us.

In 1998, Oklahoma optometrists (WITHOUT TRAINING) passed a law via a bill rider to allow them to do PRK. Is PRK a standard procedure for optometry CNU2020? I hope you realize that Oklahoma is the ONLY state allowing optometrists to do PRK surgery.

Second, this same bill allows them to do yag capsulotomies. Are Yag lasers part of your training? I hope you realize that Oklahoma is the ONLY state allowing optometrists to do PRK surgery.

Third, this same bill allows them to do argon laser trabeculoplasties and iridotomies. Are trabeculoplasties and iridotomies part of your training? Again, Oklahoma is the ONLY state allowing ANY optometric laser surgery.

I work with many lawyers, and with my recent launch of my corporation, I know first hand that contracts, legal documents, and laws are not drafted overnight. They are carefully written and analyzed. They are written with the purpose of getting what their clients want. Your leadership, although they may be few, do plan to include intraocular surgery in the optometric scope of practice. Setting precedence is the key to gaining more scope of practice. Oklahoma is optometry's first step into surgery.

Until I see you lobbying against the few who are leading optometry into surgery, your lack of action is supporting the few who are leading your profession into a battle with ophthalmology in regards to optometric surgery.

Consider the following
_____________________________________________
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.

 

[JennyW]

Thanks for posting! I love these discussions.

First, I think you should study what's going on in Oklahoma. Some of your optometrist leaders have different plans than the one you outlined for us.

In 1998, Oklahoma optometrists (WITHOUT TRAINING) passed a law via a bill rider to allow them to do PRK. Is PRK a standard procedure for optometry CNU2020? I hope you realize that Oklahoma is the ONLY state allowing optometrists to do PRK surgery.

Second, this same bill allows them to do yag capsulotomies. Are Yag lasers part of your training? I hope you realize that Oklahoma is the ONLY state allowing optometrists to do PRK surgery.

Third, this same bill allows them to do argon laser trabeculoplasties and iridotomies. Are trabeculoplasties and iridotomies part of your training? Again, Oklahoma is the ONLY state allowing ANY optometric laser surgery.

Personally, I hate these discussions.

In April of 2004, the AAO and it's Oklahoma affiliate quitely tried to have the ability of ODs to perform ANY AND ALL 60000 series procedures removed. And they were successful. Only through the hard work of ODs in that state where they able to win back the right to do procedures that they had safely and proficiently been doing since the 70s and 80s.

In my home state of New York ODs treated glaucoma safely and effectively for a number of years. When Xalatan came out, OMDs immediately sued to block ODs from not only using Xalatan but from treating glaucoma all together. The argument was made that since the original formulary did not include "prostaglandin analogs" then ODs should not use Xalatan. Then the argument was made that since ODs couldn't use the "latest treatment options" then they should be prohibited from using any.
A judge agreed and for three months, ODs could NOT write prescriptions for glaucoma medications until the legislature reconvened and the wording was changed to "any and all topical medications for the treatment of glaucoma." Now wasn't that just a waste of everyone’s time?

OMDs also won an injunction a few years back in New York restricing ODs from performing foreign body removals because that was "surgery" even though ODs had successfully removed thousands throughout the state. It wasn't a coincidence that the state court judge who issued this injunction happend to have a brother-in-law who was an OMD. It was eventually overturned after 6 months, but for those 6 months, many patients were denied care from the doctor of their choice, for a problem that their doctor could easily have taken care of.

A quote from the presdient of the AAO at a press conference following teh OK Board of Examiners in Optometry public hearing was as follows:

"Optometrists play a valuable role in providing eyeglasses and contact lenses for the public."

I guess we all know now how the AAO views ODs.

The issue is not who should be allowed or not allowed to perform surgical procedures. The issue for ODs is who is going to control optometric scope of practice? In OK, the OMDs would have it such that unlike any other allied health professional, optometric scope of practice be regulated not by the board of examiners in optometry, but rather by the state medical board. Why dont' we just eliminate all dental, podiatric, nursing licensing bodies and just leave it up to the state medical society? Cmon.

Jenny

 

[futuredoctorOD]

👍 👍 Bravo! 👍 Your attitude reminds me of my dad...who is an MD In the last 20 years I have heard him say MD when referring to himself in a professional setting---maybe 2 times...Cardiologist suffices nicely......

As a future MD, I am personally ashamed of those whom I will be associated with once I obtain that title. Heck, I'll avoid using it whenever possible. Some of you people make me sick. I'm talking about the ones who think MD's are the only real doctors out there. You people have to get over your ego's. Have you really worked that much harder than those pesky "inferior" optometrists? Optometrists deserve the title doctor every bit as much as any ophthalmologist does. Maybe they don't introduce themselves, "I'm Dr. Joe, Optometrist, which really isn't nearly as good as if I were an ophthalmologist, who by the way are real M.D.'s, unlike myself" But, if they did, the appointment would be half over by they time they got through the spiel. Also, I don't see any opthalmologists walking around spitting out the extent of their credentials to everyone they meet. Maybe those of you with such ego's do though. At some point, I hope you'll mature enough to treat other professionals with the same respect that you feel like you've earned.

 

[futuredoctorOD]

Dr. Doan.....I just read that Optometry had to sue, state by state, from 1972 to 1997 to get prescription rights in 50 states. Do you think that this along with other legal battles Optometry has had with medicine might be a point of contention in states like Oklahoma? If someone is keeping you down for a long time and you have an opportunity to strike back with force do you think that you would not take the opportunity? I believe in professions respecting each other but reality points to numerous problems. I am going to do more research like you said on history...Optometry and Opthalmology. 🙂

Thanks for posting! I love these discussions.

First, I think you should study what's going on in Oklahoma. Some of your optometrist leaders have different plans than the one you outlined for us.

In 1998, Oklahoma optometrists (WITHOUT TRAINING) passed a law via a bill rider to allow them to do PRK. Is PRK a standard procedure for optometry CNU2020? I hope you realize that Oklahoma is the ONLY state allowing optometrists to do PRK surgery.

Second, this same bill allows them to do yag capsulotomies. Are Yag lasers part of your training? I hope you realize that Oklahoma is the ONLY state allowing optometrists to do PRK surgery.

Third, this same bill allows them to do argon laser trabeculoplasties and iridotomies. Are trabeculoplasties and iridotomies part of your training? Again, Oklahoma is the ONLY state allowing ANY optometric laser surgery.

I work with many lawyers, and with my recent launch of my corporation, I know first hand that contracts, legal documents, and laws are not drafted overnight. They are carefully written and analyzed. They are written with the purpose of getting what their clients want. Your leadership, although they may be few, do plan to include intraocular surgery in the optometric scope of practice. Setting precedence is the key to gaining more scope of practice. Oklahoma is optometry's first step into surgery.

Until I see you lobbying against the few who are leading optometry into surgery, your lack of action is supporting the few who are leading your profession into a battle with ophthalmology in regards to optometric surgery.

Consider the following
_____________________________________________
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.

 

[mdkurt]

Personally, I hate these discussions.

In April of 2004, the AAO and it's Oklahoma affiliate quitely tried to have the ability of ODs to perform ANY AND ALL 60000 series procedures removed. And they were successful. Only through the hard work of ODs in that state where they able to win back the right to do procedures that they had safely and proficiently been doing since the 70s and 80s.


Jenny

Jenny, I usually respect your opinion, but I really don't want to hear any more about the poor downtrodden ODs just trying to protect themselves against the mean old ophthalmologists. Optometrists are, with the possible exception of nurse anesthetists, the most aggressive lobby for expansion of scope of practice. I'm not getting this entirely from the propaganda fed to me by the AAO, either. All I need to do is open a few optometry journals and read a few editorials about the manifest destiny of the profession.

 

[NEATOMD]

blah blah blah...manifest destiny of the profession.

👍

 

[mill_z]

The word "doctor" really doesn't have anything to do with medicine, chiropractic, osteopathy, optometry, or opthamalogy. All "doctor" means is level of education. I think all health care professionals should use the initials after their name. Once a patient knows who you are, they can refer to you as "Dr. Smith" or whatever.

 

[Andrew_Doan]

I agree with Mill. The issue at hand is not who is a doctor. For goodness sake, I'm a doctor doctor... 🙄

Please focus on the issue of surgeon vs non-surgeon. And NO an optometric residency for 2% of the optometrists who want to do surgery is garbage. Make the 2% go to medical school. They should've thought about it before becoming a Doctor of Optometry... MDs knew they wanted to do surgery... why can't the ODs figure it out before investing in a $150K+ educational endeavor???

 

[PDT4CNV]

I don't think I've EVER seen an OD office where it's just said "Dr so and so" on the door. Every office I've seen says: So and So, OD (and sometimes FAAO)

I also say I'm an eye doctor BECAUSE people have no idea the difference between ODs and OMDs. When I said I was an optometrist people ran the gamit from asking me which company I made glasses for to what number did they call for me to laser their eyes. The public has no earthly clue. Therefore, it's much easier in a casual setting for me to say I'm an eye doctor. That's all.

You mean it is much easier to call yourself a "doctor" so people will continue to come and see you and not question your training and question whether or not they should be seeing someone else. Maybe, since you admit the public has not earthly clue, you should be honest and educate your patients.

 

[PDT4CNV]

👍 👍 Bravo! 👍 Your attitude reminds me of my dad...who is an MD In the last 20 years I have heard him say MD when referring to himself in a professional setting---maybe 2 times...Cardiologist suffices nicely......

Optometrist suffices nicely.

 

[cpw]

You mean it is much easier to call yourself a "doctor" so people will continue to come and see you and not question your training and question whether or not they should be seeing someone else. Maybe, since you admit the public has not earthly clue, you should be honest and educate your patients.

I am always honest with my patients. I don't have an inferiority complex about what I do.. and when a patient asks me the difference between an OD and an OMD I explain the differences in our training. End of story.

 

[mdkurt]

I am always honest with my patients. I don't have an inferiority complex about what I do.. and when a patient asks me the difference between an OD and an OMD I explain the differences in our training. End of story.

As the person who started this thread, I'd like to call it dead. I initially started it because I know of an optometrist who, when pressed by his patients to say what kind of eye doctor he is, would say "a glaucoma specialist". This is certainly not the norm in optometry, and it's hypocritical for MDs to point a finger at self-aggrandizing optometrists when there are so many cataract cowboys that start their own "eye institute" to bill their practice as an institute of higher learning. The bottom line is that there are some, not many, shmucks in both fields.