Expanded Scope of Practice in KY (close to becoming a reality)

[Mixin Marc]

http://www.wkyt.com/home/headlines/Eye_doctors_battle_over_proposed_legislation_116287759.html

The bill would let optometrists remove lumps and bumps and use lasers to treat a few specified conditions, although they could not perform Lasik corrective surgery or any other procedure requiring general anesthesia.

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[200UL]

Just read the bill. I will give a run down on what it will let you guys do. This is a serious post.

1. ALT, SLT, YAG capsulotomy, PRK, Laser lens extraction, + additional laser procedures
2. “Scalpel procedures” with some exceptions
3. Prescribe all medications except for narcotics/marijuana… Ability to deliver all medicines by any route (injection in or around the eye, IV, PO)
4. Provide any type of anesthesia except for general anesthesia

Not sure why you guys are not able to perform your own general anesthesia yet.

 

[Meibomian SxN]

http://www.wkyt.com/home/headlines/Eye_doctors_battle_over_proposed_legislation_116287759.html

The bill would let optometrists remove lumps and bumps and use lasers to treat a few specified conditions, although they could not perform Lasik corrective surgery or any other procedure requiring general anesthesia.

"Since 1998 in OK, 250,000 procedures performed with not a SINGLE complaint to the board" etc....

Wow, I wonder if ophthalmology could tout figures like that!

Its states like Kentucky and Oklahoma that make me feel that the profession is still alive and kicking.

 

[200UL]

This statement is implying that there has not been a single complication with these procedures ("we have been perfect in all 250,000 cases we have performed"). The guy that made it is at the level of a used car salesman.

I have worked with some of the most famous ophthalmologists in the world - no ophthalmologist would attempt to make such an implication - no surgeon in any field of medicine would make such a statement. I, like most surgeons, am humbled on a daily basis in the clinic and in the OR.

If optometry wants to create surgeons (with no actual training with surgery), it is about time they start teaching you how to talk like surgeons.

 

[Meibomian SxN]

This statement is implying that there has not been a single complication with these procedures ("we have been perfect in all 250,000 cases we have performed"). The guy that made it is at the level of a used car salesman.

I have worked with some of the most famous ophthalmologists in the world - no ophthalmologist would attempt to make such an implication - no surgeon in any field of medicine would make such a statement. I, like most surgeons, am humbled on a daily basis in the clinic and in the OR.

If optometry wants to create surgeons (with no actual training with surgery), it is about time they start teaching you how to talk like surgeons.

Implications? Duh, it was a scientific fact. Or do you dispute those too?

Used car salesman? Rather that than a smear salesman....

 

[thecgrblue]

Preface: I'm still a student and claim next to ZERO knowledge on surgery or the implications of the bill.

What are the educational requirements in OK (and potentially KY) for an optometrist to be able to perform these surgeries?

If the training were similar to a Dentist learning oral and maxillofacial surgery (with similar competition to get into such a program) I MIGHT (key) feel comfortable performing them. However, if it is just CE style courses you learn on the weekend I will 100% agree that we have no business doing such procedures.

 

[200UL]

Again, the bill would allow optometry to perform any surgery on or near the eye if the world laser is involved. The bill is comical to read because many of the things do not exist in 2011 and will not exist for the coming years (sorry enucleations will not be done with laser next year or even the year after that).

Yet your leaders are saying you are being trained to perform laser eye removal from the human body among many other things. Is this true - if true please share with the medical community.

It will also given you the ability to prescribe any medication you would like (bp meds, insulin, statins, chemotherapy, "epinephrine."..).

Again, I am stating the facts and I am not trying to smear optometry. Most of optometry does not expect to perform any of what is listed in the bill. Sorry ophthalmologists did not write the bill. Optometry did and the authors look like fools/frauds.

 

[thecgrblue]

Again, the bill would allow optometry to perform any surgery on or near the eye if the world laser is involved. The bill is comical to read because many of the things do not exist in 2011 and will not exist for the coming years (sorry enucleations will not be done with laser next year or even the year after that).

Yet your leaders are saying you are being trained to perform laser eye removal from the human body among many other things. Is this true - if true please share with the medical community.

It will also given you the ability to prescribe any medication you would like (bp meds, insulin, statins, chemotherapy, "epinephrine."..).

Again, I am stating the facts and I am not trying to smear optometry. Most of optometry does not expect to perform any of what is listed in the bill. Sorry ophthalmologists did not write the bill. Optometry did and the authors look like fools/frauds.

So to answer my question...what training is req'd of Optometrists in OK to do the current procedures that are allowed?

 

[200UL]

As a member of your profession, you should be able to articulate the training requirments to me and the entire country. After all, I took an alternate route to become an eye surgeon (MD + Ophthalmology Residency).

Ophthalmologists perform thousands of surgeries during their residency on actual humans. We have minimum requirements on humans in our training. We have actual surgeons mentoring us during these surgeries as well. If we do not meet the requirments we do not call ourselves ophthalmolosits. If our training programs cannot meet these requirments they are put on probation or even removed.....

I suppose it is just two different routes to become an eye surgeon.

One group cannot articulate what their training is in these procedures (half of the procedures in the KY bill are fiction). This same training plus the magical 6 hour pharmacology course lets them prescribe any medication available as long as it is not the so dangerous schedule 1 or schedule 2 medication ("only the real doctors prescribe these")

The other group can provide a very clearly stated set of requirments that must be met in order to perform surgery/prescribe medication.

I wonder what the public would would prefer if they understood the difference.

 

[thecgrblue]

Preface: I'm still a student and claim next to ZERO knowledge on surgery or the implications of the bill.

I could make stuff up for you.

 

[bobbio]

I hope legislation does not allow this bill to pass because, honestly, optometrists are not qualified to perform these types of procedures. Optometrists mainly perform refractions and screen for diseases. Optometry school coursework does not prepare one to become a surgeon by any means.
I dislike seeing bills like this, which tries to increase the scope of practice of a midlevel without taking into account the training of the midlevel - it's rampant in every field now (nursing, PA, optometry) and is not the best method to producing competent practitioners.

 

[CarolinaBlueEye]

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[CarolinaBlueEye]

Again, the bill would allow optometry to perform any surgery on or near the eye if the world laser is involved. The bill is comical to read because many of the things do not exist in 2011 and will not exist for the coming years (sorry enucleations will not be done with laser next year or even the year after that).

Yet your leaders are saying you are being trained to perform laser eye removal from the human body among many other things. Is this true - if true please share with the medical community.

It will also given you the ability to prescribe any medication you would like (bp meds, insulin, statins, chemotherapy, "epinephrine."..).

Again, I am stating the facts and I am not trying to smear optometry. Most of optometry does not expect to perform any of what is listed in the bill. Sorry ophthalmologists did not write the bill. Optometry did and the authors look like fools/frauds.

Although your posts are ill-informed, let's be clear, you are belittling our profession as well as our leaders.

You clearly did not read the bill carefully or you aren't seeing through your own smear campaign. I would think you, of all people, would understand the limitations of this bill.

Your posts above are incorrect. The bill specifically does not allow cataract extractions, PRK, or Lasik. It also does not expand prescriptive authority...at all.

What exactly IS your response to the fact that over 250,000 similar procedures have been performed by OD's in Oklahoma with ZERO complaints filed? Is this really about the care of the patient, or is this more about your kids' trust fund?

My understanding is that most of the "scalpel procedures" you're talking about are for growths that could be removed by driving to CVS, buying a chemical kit off the rack (with no prescription), going home, and doing it in your bathroom.

You know as well as I do that your profession has one of the strongest lobbies in the world. Kentucky is one state in which the medical profession doesn't have the legislature in an absolute strangle hold and the needs of its citizens can be better considered. If the bill doesn't pass, I'm sure there are some fantastic opportunities for Ophthalmologists in rural Kentucky. Are you going to serve those people?

Without knowing how the Optometry boards will govern this, it's hard to pass judgement on the decision. LEGALLY, you, as an Ophthalmologist, can perform open heart surgery. It's how the board governs that decides your scope of practice. Legally you can essentially do whatever you want. It's can vs. should - essentially how the Optometry drug laws are now.

 

[JaggerPlate]

not seeing through your own profession's smear campaign.

Smear campaign? Thus far, I've seen commercials from the Kentucky AOA, and dozens of irate posts from ODs and pre-ODs accusing eye physicians and surgeons of only caring about the money, lining their pockets, keeping other professions down, etc, without a single negative or defamatory remark from a DO/MD. The physicians seem genuinely concerned about patient welfare. These Ophthalmologists have spent years in surgical residencies honing and perfecting these techniques, and simply understand the skill and practice it takes to perform them adequately. It's discomforting to see a group seeking the same rights without any firm explanation of how they will make up the training hours. How is this a smear campaign?

Furthermore, someone pointed out in another thread that over $400,000 has been donated by OD interest groups to local legislators in the past several years, but only $500 from Ophthal DO/MDs. Additionally, this bill (according to the official new releases) was attached (clandestinely) to another, and taken through a very peculiar route that bypassed the Kentucky health and welfare committee.

Who's running the questionable campaign here?

What exactly IS your response to the fact that over 250,000 similar procedures have been performed by OD's in OK with ZERO complaints filed? Is this really about the care of the patient, or is this more about your kids' trust fund?

Not reported does not equal 100% perfect results. Even the most highly trained surgeons in the world don't have perfect track records. To claim that ODs have performed 250k procedures without a single, slightly adverse outcome is laughable (and you know it). Furthermore, where do these complaints get filed? I know where medical complaints, malpractice issues, and lawsuits would be handled and reported, but would the OD board report the same? If OK is the only state performing these procedures, I find it hard to believe that a clear system of filing and reporting would be in place.

Furthermore, your argument of physician greed is old and tired. Individual physicians opposing this bill has essentially nothing to do with lining their own pockets. If you want to comment on the PAC groups as a whole, then that's fine, but labeling individual physicians in this light seems very unfair and quite 'smear-ish' in and of itself.

Are you going to serve those people?

Do you have any statistics or evidence indicating that ODs are more likely than O-MD/DOs to open a practice and service individuals within rural communities? Are you basing this strictly on numbers of practitioners? Furthermore, do you think that the potential for adverse outcomes - i.e. performing surgical procedures without additional surgical training, is outweighed by simply getting 'care' to this individuals? Is this really service?

What is your opinion of the fear-mongering and slander coming from the medical field right now? There is an awful lot of misleading rhetoric belittling our entire profession to the public.

Can you provide sources? It seems like this bill was moved through the legislative process so quickly that groups haven't even had time to respond, and I'm positive the public is clueless as to what's happening. Again, the only official response I've seen has been from the Kentucky AOA.

Here is one very small, all to common example: "Optometrists do not attend medical school, but they do receive four years of optometry training after graduating from college and are trained to detect vision defects and prescribe corrective lenses."

Is this untrue? Do you attend medical school? After earning your OD, do you have unrestricted surgical and prescription rights in all 50 states? Does the department of labor recognize ODs as physicians/medical doctors like DO/MDs? Does medicare recognize you as physicians?

So, we don't treat disease or prescribe medications or anything? Isn't that cute? You could learn to refract in a weekend. Why do we go to school for 8 years? That comment forms the readers' opinion of our profession. Read the totally uninformed opinions at the bottom of that article. Good job.

I don't see any evidence of this in your quoted statement.

The general public can't see through it. If your name ends in "MD" you should not misuse the respect that title provides you to line your pockets. You should be ashamed.

The only focus here needs to be on patient safety and transparency. From what I'm hearing, this bill extends surgical, anesthetic, and prescription rights without any dedication to further training or concrete evidence that these practitioners are prepared to safely offer these services. What would be truly shameful is hurting unsuspecting patients. Keep this in mind before you start labeling individuals as greedy or egotistical.

 

[Meibomian SxN]

I hope legislation does not allow this bill to pass because, honestly, optometrists are not qualified to perform these types of procedures. Optometrists mainly perform refractions and screen for diseases. Optometry school coursework does not prepare one to become a surgeon by any means.
I dislike seeing bills like this, which tries to increase the scope of practice of a midlevel without taking into account the training of the midlevel - it's rampant in every field now (nursing, PA, optometry) and is not the best method to producing competent practitioners.

The bill passed already is awaiting the governor's John Hancock.

Even though you dislike seeing these types of bills, you'll understand more once you start your clinical years. So stop being a judas and be happy for the profession, we have enough haters as it is.

 

[Meibomian SxN]

Furthermore, someone pointed out in another thread that over $400,000 has been donated by OD interest groups to local legislators in the past several years, but only $500 from Ophthal DO/MDs...

Its called politics and everyone plays it to their advantage. I am pretty sure if you looked at other states, you would see MDs giving more than ODs.

Does the department of labor recognize ODs as physicians/medical doctors like DO/MDs? Does medicare recognize you as physicians?

Yes and yes. Optometrists are classified as physicians under Medicare. And in a court of law, we are considered physicians.

 

[bobbio]

The bill passed already is awaiting the governor's John Hancock.

Even though you dislike seeing these types of bills, you'll understand more once you start your clinical years. So stop being a judas and be happy for the profession, we have enough haters as it is.

I'm not hating at all - just being realistic. I'm aware of our limited education and I believe we shouldn't be trying to push for practice rights that's beyond our training. If you want to become an eye surgeon, great, there is medical school for a reason...but then again, you mentioned in one of the other threads that you can't invest another $250,000 + interest at this point in your life to get a medical degree. So I guess this is your solution to becoming an eye surgeon - through the back door?

I think the profession has lots to fix and pushing our practice boundaries into ophthalmologists territory shouldn't even be a priority. I'm happy with the scope of our practice at this point and I'll be happier for the profession when the AOA stops permitting new schools to open.

 

[JaggerPlate]

Its called politics and everyone plays it to their advantage. I am pretty sure if you looked at other states, you would see MDs giving more than ODs.

Well, yesterday it was serving rural communities and allowing individuals to practice to the full extent of their training, and now it's "just politics" Which is it?

Yes and yes. Optometrists are classified as physicians under Medicare. And in a court of law, we are considered physicians.

Your ignorance is beginning to bother me. You really think that ODs are physicians in the same vein as MD/DOs? Furthermore, you think the government (aka medicare, a court of law, etc) agrees with you. Let's see what they have to say:

Physicians and surgeons diagnose illnesses and prescribe and administer treatment for people suffering from injury or disease. Physicians examine patients, obtain medical histories, and order, perform, and interpret diagnostic tests. They counsel patients on diet, hygiene, and preventive healthcare.

There are two types of physicians: M.D. (Medical Doctor) and D.O. (Doctor of Osteopathic Medicine). M.D.s also are known as allopathic physicians. While both M.D.s and D.O.s may use all accepted methods of treatment, including drugs and surgery, D.O.s place special emphasis on the body's musculoskeletal system, preventive medicine, and holistic patient care. D.O.s are most likely to be primary care specialists although they can be found in all specialties. About half of D.O.s practice general or family medicine, general internal medicine, or general pediatrics.

Physicians work in one or more of several specialties, including, but not limited to, anesthesiology, family and general medicine, general internal medicine, general pediatrics, obstetrics and gynecology, psychiatry, and surgery.

http://www.bls.gov/oco/ocos074.htm

Optometrists should not be confused with ophthalmologists or dispensing opticians. Ophthalmologists are physicians who perform eye surgery, as well as diagnose and treat eye diseases and injuries. Like optometrists, they also examine eyes and prescribe eyeglasses and contact lenses. Dispensing opticians fit and adjust eyeglasses and, in some States, may fit contact lenses according to prescriptions written by ophthalmologists or optometrists.

http://www.bls.gov/oco/ocos073.htm

Funny, I didn't see Optometry listed up there with physicians and surgeons. The fact that you're misinformed on even the most basic issues and seem to crucify or make excuses for anyone who sees ANY potential consequences or negatives from this expansion is still quite shocking.

 

[JaggerPlate]

I'm not hating at all - just being realistic. I'm aware of our limited education and I believe we shouldn't be trying to push for practice rights that's beyond our training. If you want to become an eye surgeon, great, there is medical school for a reason...but then again, you mentioned in one of the other threads that you can't invest another $250,000 + interest at this point in your life to get a medical degree. So I guess this is your solution to becoming an eye surgeon - through the back door?

I think the profession has lots to fix and pushing our practice boundaries into ophthalmologists territory shouldn't even be a priority. I'm happy with the scope of our practice at this point and I'll be happier for the profession when the AOA stops permitting new schools to open.

Don't be bullied. You're being logical here. Unless the law states how ODs are planning on increasing their skill set to encompass this expansion of surgical rights, it's dangerous to patients. The fact that the bill also creates an untouchable optometry board that can define it's own scope at anytime only makes this issue worse.

 

[Princeod2583]

http://www.wkyt.com/home/headlines/Eye_doctors_battle_over_proposed_legislation_116287759.html

The bill would let optometrists remove lumps and bumps and use lasers to treat a few specified conditions, although they could not perform Lasik corrective surgery or any other procedure requiring general anesthesia.

I don't see what the big deal is in allowing OD's to remove skin tags, and lesions around the adnexa. It's not exactly rocket science. Obviously, training and practice are needed, but you are not putting the patient at harm by removing skin tags or lid lesions that often require no more then pen cautery to seal off the wound. Yag capsulotomy can be learned with proper training as well. It does not take 4 years of medical school to remove posterior capsular opacification. If optometrists can treat glaucoma, then again, SLT/ALT should be allowed along with LPI's. Again training is required for these procedures, but you are asking doctors to learn procedures that require dexterity, precision, and PRACTICE.
Like it or not, healthcare is changing right before our eyes. Either the high costs are brought under control by sharing the burden amongst ALL healthcare professionals, or we risk drowning in the rising costs of healthcare. As long as major surgical procedures are NOT included in this bill, i think it has substantial merit.

 

[JaggerPlate]

I don't see what the big deal is in allowing OD's to remove skin tags, and lesions around the adnexa. It's not exactly rocket science. Obviously, training and practice are needed, but you are not putting the patient at harm by removing skin tags or lid lesions that often require no more then pen cautery to seal off the wound. Yag capsulotomy can be learned with proper training as well. It does not take 4 years of medical school to remove posterior capsular opacification. If optometrists can treat glaucoma, then again, SLT/ALT should be allowed along with LPI's. Again training is required for these procedures, but you are asking doctors to learn procedures that require dexterity, precision, and PRACTICE.
Like it or not, healthcare is changing right before our eyes. Either the high costs are brought under control by sharing the burden amongst ALL healthcare professionals, or we risk drowning in the rising costs of healthcare. As long as major surgical procedures are NOT included in this bill, i think it has substantial merit.

I completely respect OD education and the role Optometrists play in the health service system, but it's one thing to say "I assume this training will occur" and "obviously training is needed" and a totally different thing to pass a bill that expands rights without taking this into account.

Even if the bill passes Monday, and OD schools in Kentucky revamp their curriculum on Tuesday, what happens to the thousands of other ODs who have already graduated, are in practice, have not received the additional training, but can now LEGALLY perform the operation???

 

[Princeod2583]

I completely respect OD education and the role Optometrists play in the health service system, but it's one thing to say "I assume this training will occur" and "obviously training is needed" and a totally different thing to pass a bill that expands rights without taking this into account.

Even if the bill passes Monday, and OD schools in Kentucky revamp their curriculum on Tuesday, what happens to the thousands of other ODs who have already graduated, are in practice, have not received the additional training, but can now LEGALLY perform the operation???

Good point, and I'd hope if the bill passes that od's wouldn't just start performing these procedures, that it would require certain practice rqrments to be filled through board certification similar to MD's. Any medical docs out there care to share the specific time frame you spent learning specific laser surgical procedures, mainly yag, slt/alt/lpi. How much importance did they place on these procedures throughout your training? If i were to guess, you guys spent far more time on invasive procedures like cataract extraction, and tarsorrhaphy. How do they break up your training regimen....?

 

[DiveMD]

First of all, it’s all about $$$. The whole access to care argument is just a smoke screen. I wonder which ophthalmologist in KY is going to see the complicated s/p YAG caps patient done by some OD that now has an RD or IOL dislocation? Or the SLT or PI with the IOP spike unresponsive to MMT or oral meds? Per some of those KY OD’s: “we are trained to do those procedures and know how to manage the complications”. I guess you can do the pneumatic retinopexy for the RD since you know how to do injections. Or an anterior chamber paracentesis since you know how to remove a foreign body. I guarantee you that none of those state senators would ever allow an OD to touch them with a laser. Yet, they pass a bill in complete disregard for their constituents merely because they were legally bribed with campaign contributions. This is morally wrong and disgusting.
Geez, most OD’s barely know how and when to use steroids…

 

[200UL]

Sorry to keep harping on this, but are you all not reading the bill? Everyone keeps saying "minor surgical procedures," "less invasive surgical procedures..." Read the bill it is ridiculous and beyond anything you do in your training.

This bill immediately gives optometry the ability to perform intraocular surgery including cataract surgery (laser lens extraction, laser intraocular lens placement). Who is going to come and place that suture in the cataract wound when it will not seal (or are you already learning microsurgical techniques year 3 of optometry school)? It does not exclude epi-LASIK so it also gives the opportunity to perform laser vision correction. The bill gives optometry the ability to provide their own anesthesia as long as it is not general (beyond where most of ophthalmology practices). It gives optometry the ability to remove eyes if laser can be used in some way – again I would love to see how you guys are removing eyes in this manner in optometry-perhaps we can learn from each other. Many of the surgeries listed are fictitious surgeries in 2011 (planning ahead for that “new curriculum” of yours where the next technology will be invented. In summary, the bill is beyond the scope where most ophthalmologists practice. On top of that only optometry can define future scope of practice.

Also, please don't say a tarsorrhaphy is an invasive surgical procedure that ophthalmology residents spend a lot of time training in (you obviously have no clue about our training). Such a statement also calls into question your overall understanding of eye diseases. If optometrists want to be surgeons, they must learn to speak like surgeons (ie don't say ophthalmology spends a lot of time learning the complex procedure tarsorrhaphy. That would be like saying the general surgeons spends a lot of time in their training learning to suture of skin incisions).

Our training is like any other surgical subspecialty. The ACGME comes and inspects our training programs and puts forward standards that must be met. We see lots of complex surgical patients in our clinics (optometry will never have access to this number of complex patients). We assist on surgical cases with world experts. We then do cases with the world expert watching (if we do not do the case start to finish, it is not counted in our surgical log). We have minimal requirements in our surgical log for each of the disciplines of ophthalmology. Also, to graduate as an ophthalmologist, our training programs must sign off on the fact that we can practice independently.

I cannot wait to see how you guys regulate this or even provide minimal training standards (ophthalmology training programs are placed on probation for a variety of reasons each year if requirements are not met, including high surgical numbers). Sorry, you are going to have a hard time convincing the public that actual surgery on patients is not needed in the training program (even if the lawmakers believe otherwise).

 

[geronamo26]

Someone obviously feels threatened.

 

[Princeod2583]

Sorry to keep harping on this, but are you all not reading the bill? Everyone keeps saying "minor surgical procedures," "less invasive surgical procedures..." Read the bill it is ridiculous and beyond anything you do in your training.

This bill immediately gives optometry the ability to perform intraocular surgery including cataract surgery (laser lens extraction, laser intraocular lens placement). Who is going to come and place that suture in the cataract wound when it will not seal (or are you already learning microsurgical techniques year 3 of optometry school)? It does not exclude epi-LASIK so it also gives the opportunity to perform laser vision correction. The bill gives optometry the ability to provide their own anesthesia as long as it is not general (beyond where most of ophthalmology practices). It gives optometry the ability to remove eyes if laser can be used in some way – again I would love to see how you guys are removing eyes in this manner in optometry-perhaps we can learn from each other. Many of the surgeries listed are fictitious surgeries in 2011 (planning ahead for that “new curriculum” of yours where the next technology will be invented. In summary, the bill is beyond the scope where most ophthalmologists practice. On top of that only optometry can define future scope of practice.

Also, please don't say a tarsorrhaphy is an invasive surgical procedure that ophthalmology residents spend a lot of time training in (you obviously have no clue about our training). Such a statement also calls into question your overall understanding of eye diseases. If optometrists want to be surgeons, they must learn to speak like surgeons (ie don't say ophthalmology spends a lot of time learning the complex procedure tarsorrhaphy. That would be like saying the general surgeons spends a lot of time in their training learning to suture of skin incisions).

Our training is like any other surgical subspecialty. The ACGME comes and inspects our training programs and puts forward standards that must be met. We see lots of complex surgical patients in our clinics (optometry will never have access to this number of complex patients). We assist on surgical cases with world experts. We then do cases with the world expert watching (if we do not do the case start to finish, it is not counted in our surgical log). We have minimal requirements in our surgical log for each of the disciplines of ophthalmology. Also, to graduate as an ophthalmologist, our training programs must sign off on the fact that we can practice independently.

I cannot wait to see how you guys regulate this or even provide minimal training standards (ophthalmology training programs are placed on probation for a variety of reasons each year if requirements are not met, including high surgical numbers). Sorry, you are going to have a hard time convincing the public that actual surgery on patients is not needed in the training program (even if the lawmakers believe otherwise).

You need to settle down. If you actually read what I wrote, I was merely asking how MD's perform their clinical surgical rotations. I ASKED you IF you spend a lot of time on these procedures. You obviously are ready to pick a fight on this board rather than explain and educate others about the PROCESS. READ the post. I AM ASKING YOU TO EXPLAIN HOW EACH ROTATION IS DIVIDED UP AND HOW or IF THESE PROCEDURES ARE WEIGHTED DIFFERENTLY TIME WISE. If I am misunderstanding how your rotations are run, then please explain them to me (us) rather than talk down to me and say that I don't understand ocular disease. I do understand ocular disease. Do I focus on ocular disease? NO. I never claimed to. But give me a break if you think that performing simple laser procedures like laser capsulotomy requires an MD degree. Get off your high horse.

 

[Meibomian SxN]

I'm not hating at all - just being realistic. I'm aware of our limited education and I believe we shouldn't be trying to push for practice rights that's beyond our training. If you want to become an eye surgeon, great, there is medical school for a reason...but then again, you mentioned in one of the other threads that you can't invest another $250,000 + interest at this point in your life to get a medical degree. So I guess this is your solution to becoming an eye surgeon - through the back door?

I think the profession has lots to fix and pushing our practice boundaries into ophthalmologists territory shouldn't even be a priority. I'm happy with the scope of our practice at this point and I'll be happier for the profession when the AOA stops permitting new schools to open.

Finish all 4 years first and then talk about what scope of practice you're happy with.

I do not care to become a surgeon, otherwise I would have went to medical school. But ODs are educated enough to perform some in-office procedures and that is what many ODs are fighting for. Not to enucleate, etc.

Did you know that removing a corneal foreign body is a surgical procedure? Lash epilation also?

Trust me, you'll appreciate the Kentucky bill when you graduate, then you yourself can decide what level of eye care you want to provide. Not some jealous ophthalmologist who knows nothing about the rigors of your optometric education

 

[JaggerPlate]

Someone obviously feels threatened.

Definitely ... patient safety. It still unnerves me that the automatic response from the OD community has been 'Ophthalmologists are money hungry bullies who are holding US down,' when no one, for a second, has considered that maybe these roadblocks and restricted access to surgery are put in place for patient safety, not to line someone's hypothetical pockets.

 

[JaggerPlate]

then you yourself can decide what level of eye care you want to provide. Not some jealous ophthalmologist who knows nothing about the rigors of your optometric education

You're letting your resentment cloud your judgment. Regulations are put in place for a reason. An RN who isn't allowed to perform neurosurgery shouldn't be caustic toward the Neurosurgeon who's jealous and holding her back, she should understand that certain restrictions and regulations are put in place to keep her from harming patients. The fact that no one from the OD community is even considering this aspect is frightening to me.

Demonstrate your equivalence (with facts, not anecdotes), explain where the additional training is coming from, prove you're qualified to perform surgical procedures without harming patients, and stop 'smearing' the DO/MDs as bullies who are simply holding you back.

 

[Meibomian SxN]

You're letting your resentment cloud your judgment. Regulations are put in place for a reason. An RN who isn't allowed to perform neurosurgery shouldn't be caustic toward the Neurosurgeon who's jealous and holding her back, she should understand that certain restrictions and regulations are put in place to keep her from harming patients. The fact that no one from the OD community is even considering this aspect is frightening to me.

Demonstrate your equivalence (with facts, not anecdotes), explain where the additional training is coming from, prove you're qualified to perform surgical procedures without harming patients, and stop 'smearing' the DO/MDs as bullies who are simply holding you back.

An OD in Oklahoma is performing SLT on one of their patients now as we speak. That is a fact.

RNs fought and can now administer anesthesia and deliver babies vaginally. That is a fact.

ODs do not have to demonstrate anything to an MD/DO. Nothing. We only have to demonstrate competence to those that matter; the patients.

 

[JaggerPlate]

ODs do not have to demonstrate anything to an MD/DO. Nothing. We only have to demonstrate competence to those that matter; the patients.

Then SHOW ME the objective PROOF as a hypothetical patient.

I'm a patient in Kentucky. I'm trying to decide whether or not to let an OD perform my eye surgery. Explain to me; PROVE to me that you're competent. Show me your residency training; map out how many times you performed this procedure before you were certified by a national board; explain the type of surgical training you received in Optometry school; show me the peer reviewed studies that state you're on par with the alternative (O-MD/DO); let me review any negative outcomes from the times you've performed this procedure in the past (every state medical board makes malpractice issues and negative marks on state medical licences a public matter).

Furthermore, just because other groups have pushed their way into new territories, doesn't mean it's a valid argument for you to do the same. Again, all it makes it sound like is that the ODs feel they DESERVE something, simply because everyone else is getting what they want, and so they'll do what it takes to legally smash it through without giving patients an iota of consideration along the way.

 

[Meibomian SxN]

Then SHOW ME the objective PROOF as a hypothetical patient.

I'm a patient in Kentucky. I'm trying to decide whether or not to let an OD perform my eye surgery. Explain to me; PROVE to me that you're competent. Show me your residency training; map out how many times you performed this procedure before you were certified by a national board; explain the type of surgical training you received in Optometry school; show me the peer reviewed studies that state you're on par with the alternative (O-MD/DO); let me review any negative outcomes from the times you've performed this procedure in the past (every state medical board makes malpractice issues and negative marks on state medical licences a public matter).

Furthermore, just because other groups have pushed their way into new territories, doesn't mean it's a valid argument for you to do the same. Again, all it makes it sound like is that the ODs feel they DESERVE something, simply because everyone else is getting what they want, and so they'll do what it takes to legally smash it through without giving patients an iota of consideration along the way.

I do not show patients residency training, world class recommendations, board scores or boy scout awards. My proof is my license hanging on the wall, period. I simply diagnose the problem and offer treatment options. If the patient is not satisfied with my diagnosis or comfortable with treatment performed by me, then they are free to get up and go elsewhere.

 

[JaggerPlate]

I do not show patients residency training, world class recommendations, board scores or boy scout awards. My proof is my license hanging on the wall, period. I simply diagnose the problem and offer treatment options. If the patient is not satisfied with my diagnosis or comfortable with treatment performed by me, then they are free to get up and go elsewhere.

Does your license mean that you're already previously trained in the type of surgery you're offering? Or does it mean that you graduated before a bill was passed that gives you the power to operate without technically having to undergo any additional training (as outlined by the bill)?

Also, I'm confused ... 20 minutes ago, your goal was to expand access to patients, especially those in rural and underserved areas, but now I'm asking some questions that will directly affect my wellbeing and you're showing me the door? It doesn't seem like this is about patients.

Furthermore, why can't you provide information about your residency training? Why can't you show me these recommendations? Oh, sorry ... the door; I get it, I get it. I'll leave. Thank you for expanding access and doing this simply to reach the potential outlined in your license. THANK YOU for 'convincing me as a patient.'

This is frightening.

 

[livingcrow]

I do not show patients residency training, world class recommendations, board scores or boy scout awards. My proof is my license hanging on the wall, period. I simply diagnose the problem and offer treatment options. If the patient is not satisfied with my diagnosis or comfortable with treatment performed by me, then they are free to get up and go elsewhere.

i have 6 years worth of optometric training from overseas. I am about to go thru optometry school again due to the practice requirments here. I love optometry and that is why i am still in this profession. However, i do not think the kentucky optometrists and the professional body as a whole is approching this the right way. Optometry has always been about refractive techniques and vision therapy as is evidenced in the name. The expansion in the field to include areas such as ocular diseases and theraputic agents are all allowances that have been made over the years by the health care community purely based on the need. Even in these instances, appropriate adjustments have been made at the optometry schools level to ensure didactic theoretical and clinical training that will ensure that the optometrist is ready for this. The same way, if we feel its time to widen the scope a bit further, training should come first and evidence of such extensive training at the optometry schools as well as evidence of competency of such skills should be instituted first before granting such rights legally. There is no doubt that optometry plays a primary care role and patients have more access to them than ophthalmologists. This does not necessarily mean we should go out there ill prepared to perform all sorts of procedures that we have no training in. I think the optometry schools should voice their opinions on how they are prepared for this just as the medical schools ensure 3 yrs of residency and 1 yr internship post medical school for ophthalmologist. I would love to see opometry expand its practice in the future with appropriate and time tested training and demonstation. The way things stand now, i would not go to a fellow optometrist in kentucky to have any form of surgical procedure done on me.

 

[Meibomian SxN]

Does your license mean that you're already previously trained in the type of surgery you're offering? Or does it mean that you graduated before a bill was passed that gives you the power to operate without technically having to undergo any additional training (as outlined by the bill)?

Yes, my license allows me to perform limited procedures in the state I practice in. If I applied for a license in Oklahoma then I would be allowed by law to perform other procedures which include laser since 1998.

Also, I'm confused ... 20 minutes ago, your goal was to expand access to patients, especially those in rural and underserved areas, but now I'm asking some questions that will directly affect my wellbeing and you're showing me the door? It doesn't seem like this is about patients.

You're confusing yourself. I never said that. I simply said patients should be free to choose who they want to perform a procedure on them. I never called myself an ophthalmologist. But I am not an "over seas trained" or "undertrained" OD either.

Furthermore, why can't you provide information about your residency training? Why can't you show me these recommendations? Oh, sorry ... the door; I get it, I get it. I'll leave. Thank you for expanding access and doing this simply to reach the potential outlined in your license. THANK YOU for 'convincing me as a patient.'

Optometrists do not need to do a residency because they specialize from the first day of class. Unlike MD/DOs who graduate with 4 years of no specialization, therefore they do a medical residency in order to practice. The same is with dentists and podiatrists, although podiatrists now have to do a mandatory residency which was not the case in years past. Their scope of practice increased to include more complicated procedures and specialties and so their curriculum made adjustments.

But if you were one of the patients who like to come in and ask "what school I went to" etc, then I point to the wall and show them my credentials; including the optional residency I did.

And if I were to buy an SLT or Allegretto laser etc; the certification would be posted on the wall the same way it is in the MDs office.

i have 6 years worth of optometric training from overseas....

Enough said, so basically you are not a US trained optometrist. Pass all 3 board exams and then proceed with an opinion.

 

[bobbio]

Finish all 4 years first and then talk about what scope of practice you're happy with.

I do not care to become a surgeon, otherwise I would have went to medical school. But ODs are educated enough to perform some in-office procedures and that is what many ODs are fighting for. Not to enucleate, etc.

Did you know that removing a corneal foreign body is a surgical procedure? Lash epilation also?

Trust me, you'll appreciate the Kentucky bill when you graduate, then you yourself can decide what level of eye care you want to provide. Not some jealous ophthalmologist who knows nothing about the rigors of your optometric education

I don't need to finish 4 years of schooling to determine what scope of practice I'm happy with because I decided the level of eye care I wanted to provide before applying - I went into optometry knowing what I can and cannot do. Likewise, if I wanted to become an eye surgeon I would have gone to medical school instead of relying on a bill to accomplish that for me.

Yeah, we are qualified to perform foreign body removal but the bill speaks of holding more than a forcep. I do not doubt the abilities and intelligence of optometrists but the limited scope of practice is there for a reason. That being said, I do not support a bill that appeases the handful of optometrists that are resentful of their career paths.

 

[Meibomian SxN]

Yeah, we are qualified to perform foreign body removal but the bill speaks of holding more than a forcep. I do not doubt the abilities and intelligence of optometrists but the limited scope of practice is there for a reason. That being said, I do not support a bill that appeases the handful of optometrists that are resentful of their career paths.

Exactly, but did you know that corneal foreign body removal or lash epilation are both considered surgical procedures?

Because of very strong MD lobbying organizations, the optometry laws sometimes have to be crafted in a 'political' way to pass; even if they sound 'weird.'

Whether you want to solely perform refractions, be a COVD specialist or you want to offer patients a laser procedure in office; the choice is yours. No one will hold that against you. But without these laws being in place, you will not have that option.

It was only 20 years ago that ODs were allowed to even use diagnostic eye drops (red caps). MDs fought hard against it. Contemplate that the next time you are in clinic dilating your patient...

 

[JaggerPlate]

Yes, my license allows me to perform limited procedures in the state I practice in. If I applied for a license in Oklahoma then I would be allowed by law to perform other procedures which include laser since 1998.

If the bill is signed into law in February 2011, how do I know you received any appropriate training as you obviously graduated before this date?

You're confusing yourself. I never said that. I simply said patients should be free to choose who they want to perform a procedure on them. I never called myself an ophthalmologist. But I am not an "over seas trained" or "undertrained" OD either.

LOL ... I'm not confusing myself whatsoever. I saw the Kentucky AOA commercial, I've heard the arguments (time and time again), this is poised as a position to expand access to care and practice within the full extent of training. However, the second one of these newly served or full extent patients questions your newly found position as an 'eye surgeon' you show them the door?

Additionally, if they are free to chose who performs a procedure on them, shouldn't the same apply to the freedom of information bestowed upon them. Shouldn't they know whether or not the surgeon attended medical school? If the practitioner went to Optometry and not medical school, shouldn't the patient, who is free to make a choice based on these decisions, be able to ask what type of surgical training the OD has to make up for the fact that their license does not say 'physician and SURGEON?' Shouldn't ODs, who claim they are prepared and well trained for this expansion, jump at the opportunity to explain themselves to patients? If this is the case, why would you show them the door?

Optometrists do not need to do a residency because they specialize from the first day of class. Unlike MD/DOs who graduate with 4 years of no specialization, therefore they do a medical residency in order to practice.

Specialize in what? Optometry, or eye surgery? If you say Optometry, I believe you. However, if you say you being training in what I believe should be considered the equivalent of an accredited Ophthalmology residency from day 1 of OD school, then you're lying.

But if you were one of the patients who like to come in and ask "what school I went to" etc, then I point to the wall and show them my credentials; including the optional residency I did.

How many surgical cases did you perform during this residency? Who accredited it? Since, according to you, ODs specialize (unlike DO/MDs) from day 1, why would you need an additional residency? Aren't you well prepared to perform these operations, since you specialize from day 1? Does this residency equate to specialization like the 'unspecialized' DO/MDs undertake during residency training?

And if I were to buy an SLT or Allegretto laser etc; the certification would be posted on the wall the same way it is in the MDs office.

Would you explain to the patient that this machine is available for usage (in your specific state) by both DO/MDs and ODs (i.e. the patient can have this procedure performed by a medical doctor who's specifically trained in eye surgery)

Enough said, so basically you are not a US trained optometrist. Pass all 3 board exams and then proceed with an opinion.

You're quite militant as to who does and does not get an opinion on what's best for the state of Optometry. Students, by your own admittance, don't get an opinion? Foreign trained ODs (with years of experience) don't get an opinion? Ophthalmologists don't get an opinion? So anyone who disagrees in the slightest with expansion doesn't get an opinion?

What were you saying about a smear 'campaign' earlier?

 

[JaggerPlate]

I do not support a bill that appeases the handful of optometrists that are resentful of their career paths.

If the shoe fits ...

Exactly, but did you know that corneal foreign body removal or lash epilation are both considered surgical procedures?

Yes, but the bill doesn't stop at allowing these procedures, does it?

Because of very strong MD lobbying organizations, the optometry laws sometimes have to be crafted in a 'political' way to pass; even if they sound 'weird.'

Strong MD lobbying? That's funny, because according to the information shared with this site thus far, every single member of the congress in Kentucky, save one, has received financial contributions from OD PAC groups. Additionally over $400,000 has been donated by the OD groups, compared to $500 from the O-DO/MD groups. Who has the strong lobbying power here? DO/MD lobbying power is notoriously weak.

Furthermore, don't pretend like passing this bill in a back door, shady political manner was done so because it was necessary to get it past the evil bullies. It was done so because it's a 'weird,' questionable bill, and it wouldn't have passed otherwise based upon it's own MERIT, not because of any other agenda that would have held it down.

If you explained to any rational human being that Optometrists, who have not attended medical school or completed a surgical residency, wanted to start performing surgeries on the eye and also create a board that could alter the scope of Optometry at any point in time, without input from another agency ... they would say you're crazy. However, pay a politician 400k ...

Whether you want to solely perform refractions, be a COVD specialist or you want to offer patients a laser procedure in office; the choice is yours. No one will hold that against you. But without these laws being in place, you will not have that option.

By this logic, RNs should have the option to perform neurosurgery. Dentists should be able to perform rectal exams. Podiatrists should be able to perform breast reconstruction ... restrictions and regulations are put in place for one simple reason - patient safety. All practitioners should NOT have the choice as to what they perform in their office if they haven't demonstrated the proper training and safety channels to do so.

This is COMPLETELY irresponsible and takes one thing into consideration - what the group feels they are entitled to. Not patient care, not the full extent of a license, etc. You feel like you DESERVE the ability to perform these operations (despite not going through the proper channels to do so - ie medical school and residency). Nothing more.

It was only 20 years ago that ODs were allowed to even use diagnostic eye drops (red caps). MDs fought hard against it. Contemplate that the next time you are in clinic dilating your patient...

No difference between eye drops and complicated laser eye surgeries, huh? Ad hominem.

Again, frightened and shocked.

 

[Meibomian SxN]

If the bill is signed into law in February 2011, how do I know you received any appropriate training as you obviously graduated before this date?

We do not have to explain or appease any MD/DO. The state makes the law, the state said ok. If the governor thinks it will harm the people then he will veto the law.

LOL ... I'm not confusing myself whatsoever. I saw the Kentucky AOA commercial, I've heard the arguments (time and time again)....?

And I have seen ophthalmologist interview with them shining the cobalt blue light at patients. They both serve the same purpose...

Additionally, if they are free to chose who performs a procedure on them, shouldn't the same apply to the freedom of information bestowed upon them. Shouldn't they know whether or not the surgeon attended medical school? If the practitioner went to Optometry and not medical school, shouldn't the patient, who is free to make a choice based on these decisions, be able to ask what type of surgical training the OD has to make up for the fact that their license does not say 'physician and SURGEON?' Shouldn't ODs, who claim they are prepared and well trained for this expansion, jump at the opportunity to explain themselves to patients? If this is the case, why would you show them the door?

That information is readily available to all patients. And visibly displayed in any office. This goes for nurse anesthesiologists, podiatrists and any other health professional.

Specialize in what? Optometry, or eye surgery? If you say Optometry, I believe you. However, if you say you being training in what I believe should be considered the equivalent of an accredited Ophthalmology residency from day 1 of OD school, then you're lying.

Why are you caught up on names and titles? Many doctors overlap with procedures. Dermatology is not a surgical profession, yet they perform some procedures. Competence is certified and then the procedure is performed. So yes, I am an optometrist. And yes, I can perform some eye procedures that are called surgical for billing purposes.

....why would you need an additional residency? Aren't you well prepared to perform these operations, since you specialize from day 1? Does this residency equate to specialization like the 'unspecialized' DO/MDs undertake during residency training?

Same reason why ophthalmologists have residencies in LASIK/refractive surgery. In order to further ones skills.

Would you explain to the patient that this machine is available for usage (in your specific state) by both DO/MDs and ODs (i.e. the patient can have this procedure performed by a medical doctor who's specifically trained in eye surgery)

Would an MD/DO explain that? Do midwives explain to their patients that they can also go to an OB/GYN?

 

[livingcrow]

Enough said, so basically you are not a US trained optometrist. Pass all 3 board exams and then proceed with an opinion.

Your hypocracy and double standards is laughable. Are u not the the same person who referred to a URL of internet spectacle sales to an optometry student in a thread on this forum (AKA To Recent Grads: How's the Job Market? and How's the Outlook? ). From this, everyone can tell that the main reason for the kentucky bill is to increase scope to buffer low income resulting from saturation in the profession. I think a lot of the young graduates do not understand what the profession is and are misled by the prestige they get from the "Dr" title. I still love optometry regardless and as i stated earlier i don't see anything wrong with an increase in scope as long as future professionals are appropriately trained.

 

[JaggerPlate]

We do not have to explain or appease any MD/DO. The state makes the law, the state said ok. If the governor thinks it will harm the people then he will veto the law.

If the legislators were not able to clearly read the law (their vision was blurred by the $400,000 they'd received from OD PAC groups) why would the governor do the same. I find it ironic that you campaign against these lobbying groups and political handshake deals when it's the DO/MD groups setting standards and regulations, but bank on it when backroom deals allow you to play surgeon.

His decision to sign or veto the law will be based on the same political chess game that got the bill to where it is in the first place. You know it, I know it, hell, the governor knows it.

Why are you caught up on names and titles? Many doctors overlap with procedures. Dermatology is not a surgical profession, yet they perform some procedures. Competence is certified and then the procedure is performed. So yes, I am an optometrist. And yes, I can perform some eye procedures that are called surgical for billing purposes.

Dermatologists and surgeons both went to medical school. Dermatologists and surgeons both have unrestricted medical and surgical licenses. You did not attend medical school, nor have you completed a medical or surgical residency, nor do you have an unrestricted license. This is why I'm 'caught up' in names and titles. Despite what midlevels and other groups clawing for what they feel they deserve believe, the hardwork and knowledge inherent within these titles actually means something ... and this translates into optimal care and safety for patients.

Same reason why ophthalmologists have residencies in LASIK/refractive surgery. In order to further ones skills.

Ophthalmology residencies exist for physicians (DO/MD) to specialize in eye surgery. Since you apparently specialize in this from day one, I'm still curious as to why you needed to complete a residency. In your residency, did you complete surgical cases like the ones that are now available to ODs via the Kentucky law?

Would an MD/DO explain that? Do midwives explain to their patients that they can also go to an OB/GYN?

Of course not, and you know why ... midwives understand that the care they offer is simple deliveries during uncomplicated births. If patients KNEW or were given the proper information explaining the difference in training between an OB and a midwife, the midwives fear this would affect their ability to obtain patients.

They don't claim to be equal and still rush to find the OB/GYN when complications occur. However, you are essentially saying that, through your training, you possess and can operate at the same surgical level. So unlike the individuals who feel the need to boast the differences between their profession and physicians and work with the uncomplicated cases, you shouldn't feel the need to fight the comparison, which is why I was curious as to whether or not you could clearly explain it.

Furthermore, I don't know if you want to throw your hat in the ring with groups like midwives, NPs, CRNAs, etc. These aren't doctoral level clinical degrees (in 99% of cases), so following their path to getting what you want doesn't bode well for your group in general.

 

[Meibomian SxN]

Your hypocracy and double standards is laughable. Are u not the the same person who referred to a URL of internet spectacle sales to an optometry student in a thread on this forum (AKA To Recent Grads: How's the Job Market? and How's the Outlook? ). From this, everyone can tell that the main reason for the kentucky bill is to increase scope to buffer low income resulting from saturation in the profession. I think a lot of the young graduates do not understand what the profession is and are misled by the prestige they get from the "Dr" title. I still love optometry regardless and as i stated earlier i don't see anything wrong with an increase in scope as long as future professionals are appropriately trained.

No, that was not me. And again, once you have passed the US standards of being an OD (3 NBEO boards + degree) then I we can talk.

... and this translates into optimal care and safety for patients.

Accolades for you. In the mean time, ODs are progressing and you are still screaming about why I did not go to medical school. While you argue, Kentucky ODs will begin providing expanded care and procedures to their patients, the only ones that matter here.

 

[livingcrow]

No, that was not me. And again, once you have passed the US standards of being an OD (3 NBEO boards + degree) then I we can talk.

its funny i went to that thread now and u are online, have the same status, join date, and number of posts. Is that what u do to ur patients? And i have not attained my license and passed all 3 parts of NBEO yet but u have talked to me twice already.

 

[Meibomian SxN]

its funny i went to that thread now and u are online, have the same status, join date, and number of posts. Is that what u do to ur patients? And i have not attained my license and passed all 3 parts of NBEO yet but u have talked to me twice already.

Sorry, I have seen 35 patients today (not including f/u's) and argue/debated with a medical student online....

That was in relation to a traditional brick & mortar style OD offices that almost solely relies on glasses frames for income. For these types of doctors, their future looks bleak because it is increasingly hard to compete with the internet. Not impossible though.

These procedures will not "buffer" the income. If you are not comfortable performing them, then so be it. But do not condemn others who have the will, skill and certification to do so.

 

[JaggerPlate]

Mei,

I'm definitely not 'screaming' about you not attending medical school, but I am 'screaming' about the need to make sure surgical procedures are performed by those who are trained, prepared, and certified, which in nearly all cases means a surgeon, aka MD/DO.

At this point in time ... I think we've said all we can here. I'm not going to change your point of view, and you aren't going to change mine. If I can be completely frank, I think you have a bit of a chip on your shoulder when it comes to what ODs do, what they should be allowed to do, and how you feel MD/DOs 'hold them down.'

I truthfully hope you don't see his expansion as something to quell your irritation with the current establishment and nurse this insecurity without giving an appropriate amount of consideration to what it could do to unsuspecting patients. If it's state law, it means that every OD, whether they should or shouldn't, can perform these procedures. It would just be a shame to see patients suffer because of this.

Ciao.

 

[netmag]

I think only people who can spell "requirement" properly should be allowed to perform surgery on others.

Just kidding, however, it's apparent to anyone strolling by that this is making the eye physicians feel really threatened. Just be honest about it. What is the point of coming onto a Optometry forum and whining like this? What are you expecting to happen? Do you think Optometrists and Optometry students are going to go out of their way to march against expanded capabilities in their profession because it might hurt you? What is the ultimate goal then? To convince them to dislike themselves and their leaders?

As someone said above, it mostly comes down to money and anyone who spins it otherwise is either delusional or lying. Why would an Optometrist care if more monetary opportunities shifted their way than yours? You do know what country we're living in right?

I'm not saying the legislation is right or wrong though. I can completely see where you guys are coming from, but your method of expressing yourselves (especially considering you're posting in an Optometry forum) doesn't make you come off so well.

Seriously though if such legislation became more widespread, it could be a problem for Ophthalmologists. So from your end, you should do your complaining to the powers that be instead of just spinning your wheels trying to be condescending on an Optometry forum. That's really going to get you nothing unless you just have a lot of time to burn. There are obvious biases on both sides so there's really no point to argue here in this arena.

 

[JaggerPlate]

I think only people who can spell "requirement" properly should be allowed to perform surgery on others.

Just kidding, however, it's apparent to anyone strolling by that this is making the eye physicians feel really threatened. Just be honest about it. What is the point of coming onto a Optometry forum and whining like this? What are you expecting to happen? Do you think Optometrists and Optometry students are going to go out of their way to march against expanded capabilities in their profession because it might hurt you? What is the ultimate goal then? To convince them to dislike themselves and their leaders?

As someone said above, it mostly comes down to money and anyone who spins it otherwise is either delusional or lying. Why would an Optometrist care if more monetary opportunities shifted their way than yours? You do know what country we're living in right?

I'm not saying the legislation is right or wrong though. I can completely see where you guys are coming from, but your method of expressing yourselves (especially considering you're posting in an Optometry forum) doesn't make you come off so well.

Seriously though if such legislation became more widespread, it could be a problem for Ophthalmologists. So from your end, you should do your complaining to the powers that be instead of just spinning your wheels trying to be condescending on an Optometry forum. That's really going to get you nothing unless you just have a lot of time to burn. There are obvious biases on both sides so there's really no point to argue here in this arena.

I actually think, if it went wider - which it won't, that it would be a far, far bigger issue for patients than it would be for Ophthalmologists. Frankly, my guess is that it's extremely expensive to purchase one of these lasers and that you'd have to either have substantial volume or a healthy income from other areas of your practice to support it.

O-MD/DOs are likely to have this volume (probably from lots of referrals from local FM, IM, etc) docs, and will also generate more revenue in other areas of the practice compared to an OD. What I'm getting at is it's probably a lot easier for a DO/MD to buy one of these lasers safely than it is an OD, because volume, word of mouth, and referrals are likely to be sparse in the beginning. I don't think it will really hurt the DO/MD's business. Frankly, call me naive, but I don't think that is the DO/MD agenda at all ... I think they're concerned because they know how much practice, skill, and knowledge it took to get them to the point of performing these operations, and they're concerned about the outcome when others (who haven't completed these residencies) want to do the same.

Also, there is absolutely nothing wrong with defending one's position or career on these forums. In my opinion, it wouldn't 'come off well' if they didn't. Why put 12 years of your life into something (undergrad, med school, residency) and then not defend it and the patients you worked so hard to serve?

 

[socal2014]

lol at this damn thread.


What's the conclusion here folks? Can't be bothered to read every post.

 

[Meibomian SxN]

....Also, there is absolutely nothing wrong with defending one's position or career on these forums. In my opinion, it wouldn't 'come off well' if they didn't. Why put 12 years of your life into something (undergrad, med school, residency) and then not defend it and the patients you worked so hard to serve?

Absolutely agree.