Future scope of practice

[JeffChou]

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I was about to revive a few threads but I thought this question would be best addressed in its own thread and not on the 4th page of some hundred reply thread.

What do you all think Optometry's scope of practice will be at in the next 10 or 20 years? We all know that there is a history of territorial dispute between optometrists and ophthalmologists which will likely continue into the future. There has also been mention of opticians in the ring with optometrists (refracting opticians, etc.).

Where does it end? Where will organized optometry draw the line (if we do continue to expand into increasingly medical practice)? Do you think refracting rights or certification programs is a viable avenue for opticianry?

I'm also curious to see what you all think is the impetus/justification for expanding scope of practice. Is the expansion into more medical procedures a result of or partly justified by the increased attention to medical treatment in the OD curriculum? Might it be to ease the strain of a changing patient demographic (higher demand for increasingly complicated ocular disorders?); has there been/will there be a change in ophthalmology's primary concerns and focus?

On the spectrum of eye-care management, where do you think the interface between opticianry/optometry and optometry/ophthalmology will or should be?


Please, lets not conflagrate a flame war, my flame suit is at the cleaners.

 

[IndianaOD]

It is impossible to really know. There are so many factors involved not the least is advances in technology. If optometry is threatened to the point that it is not a viable profession as it exsists then it will have to expand in scope. Nothing makes people fight harder than hungry children! The is absolutely no public benefit to refracting opticians. There are already 2 eye professions to choose from and clearly no shortage of providers. Many ODs already pimp out exams for next to nothing 😡 . I would like to see optometry and ophthalmology merge into the dental model of surgery. As far as scope, most ODs want nothing to do with intraocular or strabismus surgery. I could see injections and laser procedures in optometry's scope but little else for quite some time. There is little or no desire to do more, I think only loss of livelihood will cause a push for more.

 

[MacGyver]

There is a lot of hypocrisy on this board, just like all the other boards filled iwth people who want to practice medicine without going to med school.

You say opticians cant do what you do becasue they "dont have the training" yet in the same foul breath claim that you are capable of eye surgery.

BTW, lobbying for new legislation is an expensive process. The only way the OK and NM bills would have come up at all is because of massive lobbying done by the optometry PACS which cost a ton of money.

So dont give me this crap that "nobody in optometry wants to do surgery." Thats a load of crap, and your PACS prove it to be all lies. There are obviously hundreds if not thousands of optos who are supporting these PACs, otherwise they never would have gotten this far.

Dont piss on my back and tell me its raining. Nobody believes your lies anymore.

If any optos do feel that surgery is out of scope, then please write the NM congressmen and tell them to alter the language of the bill that gives optos specific surgical privileges. Somehow I doubt they will be getting any of those letters.

Secretly, deep down inside all of you want surgery. You want to call yourself an "eye surgeon." We all know it, your PAC efforts prove it. Just admit it and quit lying to everybody.

 

[Ben Chudner]

There is a lot of hypocrisy on this board, just like all the other boards filled iwth people who want to practice medicine without going to med school.

Well I guess it was too much to ask not to have a flame war.

You say opticians cant do what you do becasue they "dont have the training" yet in the same foul breath claim that you are capable of eye surgery.

If you want to make broad statements like this, leave them on the OMD forum. There are those of us that know OD's are capable of performing some surgical prcedures, such as YAG's and LPI's. I don't believe there is anyone on this board that is saying OD's are qualified to perform eye surgeries like cataracts, blephs, trabs, membrane peels, etc. If they are, they are not only way off base, but are not representative of our profession.

BTW, lobbying for new legislation is an expensive process. The only way the OK and NM bills would have come up at all is because of massive lobbying done by the optometry PACS which cost a ton of money.

So dont give me this crap that "nobody in optometry wants to do surgery." Thats a load of crap, and your PACS prove it to be all lies. There are obviously hundreds if not thousands of optos who are supporting these PACs, otherwise they never would have gotten this far.

There is no denying that lobbying is expensive, but a lot of OD's support their PAC blindly to ensure there is money to fight against legislation designed to reduce our scope of practice, for example removing glaucoma meds from our formularies. The PAC doesn't ask us how to spend the money, and as you can imagine, the people in charge of the PAC committee tend to be OD's that do want to push the scope envelope. That's why they take those committee positions. To assume that just because someone donates to their local PAC, they want everything the PAC wants is naive.

 

[MacGyver]

There are those of us that know OD's are capable of performing some surgical prcedures, such as YAG's and LPI's. .

Yes, and opticians are qualified to do simple refractions.

Again, its all about hypocrisy

 

[Ben Chudner]

Yes, and opticians are qualified to do simple refractions.

Again, its all about hypocrisy

There is no doubt that opticians are qualified to do simple refractions. The problem is that a refraction is not a stand alone procedure. It is a part of a comprehensive eye examination. Allowing a patient to simply have Rx checks for 10 years is unsafe. So if you want to have a discussion about hypocrisy, let's talk about how OMD's love to bring up patient safety in the laser debate but seem to look the other way in the refracting optician debate.

 

[KHE]

And they're off!!

Out of the gate its Optometrists Doing Surgery! Optometrists Doing Surgery starts out strong followed closely behind by ODs are Hypocrits and No We're Not. Yes You Are is in 4th place followed by PAC Money and Refracting Opticians on the outside. As they come past the quarter pole its YAGs are Easy and Only MDs Should Do Surgery making their moves! Only MDs Should Do Surgery takes the lead but OUT OF NOWHERE comes Dentists Do Surgery and Tropicamide Kills Patients! As they head into the back stretch its Bitching and Moaning, its Moaning and Bitching! Moaning and Bitching are NECK AND NECK. Working Together is dead last and OH MY GOD! Working Together has BROKEN DOWN! That horse will have to put down, Bob! What a tragedy! Up at the front of the pack Go To Med School is making a hard charge followed once again by I Took The Same Anatomy Class as Med Students and Yea So What is right in there again! As they round the far turn, its ODs Work at Walmart and I Know an OD Who Found a Brain Tumor Once and DOWN THE STRETCH THEY COME!

As they come down the stretch it's still a dead heat between Dentists Do Surgery and Go To Med School! Only MDs Should Do Surgery is pouring it on at the end along with ODs Work at Walmart and Go To Med School. As they come to the last quarter mile its YAGs are Easy and ODs are Hypocrits neck and neck and as they come to the finish line it's.......IT'S..........IT'S MORE WASTED BANDWIDTH BY A NOSE! ANOTHER STRONG FINISH BY MORE WASTED BANDWIDTH! I DON'T BELIEVE IT!! THE CROWD IS GOING WILD!!

7-1-8 Trifecta pays $432.12.

 

[prettygreeneyes]

There is a lot of hypocrisy on this board, just like all the other boards filled iwth people who want to practice medicine without going to med school.

You say opticians cant do what you do becasue they "dont have the training" yet in the same foul breath claim that you are capable of eye surgery.

BTW, lobbying for new legislation is an expensive process. The only way the OK and NM bills would have come up at all is because of massive lobbying done by the optometry PACS which cost a ton of money.

So dont give me this crap that "nobody in optometry wants to do surgery." Thats a load of crap, and your PACS prove it to be all lies. There are obviously hundreds if not thousands of optos who are supporting these PACs, otherwise they never would have gotten this far.

Dont piss on my back and tell me its raining. Nobody believes your lies anymore.

If any optos do feel that surgery is out of scope, then please write the NM congressmen and tell them to alter the language of the bill that gives optos specific surgical privileges. Somehow I doubt they will be getting any of those letters.

Secretly, deep down inside all of you want surgery. You want to call yourself an "eye surgeon." We all know it, your PAC efforts prove it. Just admit it and quit lying to everybody.

😱 😱 😱

Wow.... is this some kind of record? Thread to all out flame war in two posts flat?

Checking out your past posting history, I gather that you are nothing more than an obnoxious 3rd or 4th year medical student with an obvious axe to grind against any "mid level provider". The OP was hoping for responses based on experience, reason, and logic, not the rantings of someone who "drank the koolaid" on their ophthalmology rotation. Isn't there some "Should non-doctors be allowed to wear white coats?" thread that you can post on? 😴


Nice rematch race KHE!

 

[PBEA]

Yes, and opticians are qualified to do simple refractions.

Again, its all about hypocrisy

Forget about hypocrisy for a moment. Lets just consider competence for now. I especially like when any MD thinks they can treat a "red" eye (as if they new wtf they were talking about) and then come onto this forum and preach to us lowly "auxiliary" healthcare providers about what an OD is able to do. MacGyver you are WAYYY out of your depth, you maybe king shiit in your neck of the woods but TRUST ME, you dont know jack about the eye or what an OD or OMD is doing. So please before I proceed to eat your innards...buzzzz off.

 

[IndianaOD]

Forget about hypocrisy for a moment. Lets just consider competence for now. I especially like when any MD thinks they can treat a "red" eye (as if they new wtf they were talking about) and then come onto this forum and preach to us lowly "auxiliary" healthcare providers about what an OD is able to do. MacGyver you are WAYYY out of your depth, you maybe king shiit in your neck of the woods but TRUST ME, you dont know jack about the eye or what an OD or OMD is doing. So please before I proceed to eat your innards...buzzzz off.

I second that. I had an ER nurse in the other day. She told me 3x that MDs should not be treating eye conditions. Note this was not me saying that. All of us ODs have seen the consequences of this. I love the MD flamers that know nothing about optometry that come on here. Unless you've gone through OD school you have no idea what we are trained to do. The complication rate of OK ODs doing laser surgery has actually been lower than Ophthalmologists. Don't mistake laser surgery and simple anterior seg procedures for ODs wanting cataract surgery etc.

 

[CatsandCradles]

And they're off!!

Out of the gate its Optometrists Doing Surgery! Optometrists Doing Surgery starts out strong followed closely behind by ODs are Hypocrits and No We're Not. Yes You Are is in 4th place followed by PAC Money and Refracting Opticians on the outside. As they come past the quarter pole its YAGs are Easy and Only MDs Should Do Surgery making their moves! Only MDs Should Do Surgery takes the lead but OUT OF NOWHERE comes Dentists Do Surgery and Tropicamide Kills Patients! As they head into the back stretch its Bitching and Moaning, its Moaning and Bitching! Moaning and Bitching are NECK AND NECK. Working Together is dead last and OH MY GOD! Working Together has BROKEN DOWN! That horse will have to put down, Bob! What a tragedy! Up at the front of the pack Go To Med School is making a hard charge followed once again by I Took The Same Anatomy Class as Med Students and Yea So What is right in there again! As they round the far turn, its ODs Work at Walmart and I Know an OD Who Found a Brain Tumor Once and DOWN THE STRETCH THEY COME!

As they come down the stretch it's still a dead heat between Dentists Do Surgery and Go To Med School! Only MDs Should Do Surgery is pouring it on at the end along with ODs Work at Walmart and Go To Med School. As they come to the last quarter mile its YAGs are Easy and ODs are Hypocrits neck and neck and as they come to the finish line it's.......IT'S..........IT'S MORE WASTED BANDWIDTH BY A NOSE! ANOTHER STRONG FINISH BY MORE WASTED BANDWIDTH! I DON'T BELIEVE IT!! THE CROWD IS GOING WILD!!

7-1-8 Trifecta pays $432.12.

🙂 😀

 

[Ben Chudner]

7-1-8 Trifecta pays $432.12.

Pays almost as much as cataract surgery.

 

[MacGyver]

Will the national optometry associations and the opto boards in every state issue a decree declaring they will NEVER pursue invasive globe surgery? I dont think so.

Dont sell me this crap about how "we only want to do simple surgeries, not the real invasive stuff"

Thats a load of crap and you know it. I guarantee you within 10 years the Oklahoma optometrists will push to have their surgical scope expanded even further.

 

[still_confused]

I guarantee you within 10 years the Oklahoma optometrists will push to have their surgical scope expanded even further.

woot! go OKLAHOMA

 

[still_confused]

Will the national optometry associations and the opto boards in every state issue a decree declaring they will NEVER pursue invasive globe surgery?

will the national whatever MD eye surgeons associations issue a decree to stop being arrogrant? How about they declare to NEVER talk **** behind our backs to patients? Or stop letting opticians or just about anyone for minimum wage do what optometrist are suppose to do for under thier "supervision?"

Sure ODs and OMDs hate each other and will like nothing better then the other gone, but the reality is we are stuck in this situation. At least optometrist bother to pretend to try to work with those that hate us so much.

and you know what? you got great scores on your mcats and have a high gpa??? thats great, i got the lowest OAT (220, its out of 400 in case you never bothered to research anything relating to optometry) score and gpa (2.00)for my class, in fact im barely passing optometry school! Too bad for you that with any luck I get to play eye surgeon in OKlahoma! You can play god and hate me. I cant play god but it makes me feel better that someone with superior training and intelligence has sunk to my IQ level to fight me on scope of practice laws!

I started thinking we can work together but you know what, why bother. It appears that its easier to work with the politicians to expand my scope then it is to get the MD to even acknowledge my existence! I now see why some optometrist are so out there in fighting the OMDs. Its because they hate us so much! So forget being moderate, im joining the dark side.

and since you think i want to do surgery anyways, you know what why not. Ill support my future collegues if they want to fight for surgery. Afterall anything to irk the mighty MDs!

in fact I'm going to take a step further. I support eliminating OMDs! Thats right! Just train ODs with surgical residency and be done with it. Some ODs have suggested eliminating ODs and sending us all to med school. I say why should we sacrifice anything? We wont be getting anything back.


and yes im ready to be banned/suspended, but i tell you its worth it! so in case this is my last post ever, i say fight them, we try to be nice but they dont care, so why bother? Its easier to convince your state legislature then it is to talk any sense into MDs. May Optometry Prevail, if for no other reason then to forever be a tiny thorn in the arrogant MDs' side.

peace out! (unless you are a MD, then there will be no peace until i get some surgical rights)

 

[eyestrain]

Well, that post certainly won't help anything.

 

[rpames]

I don't like to be a part of these discussions generally, but lets all just calm down.

Here are my thoughts.

I would be lying if I said I didn't want to do a chalazion removal, but that really is the extent. I have no desire to, except for the money reason, to do a cataract extraction. But instead of the OMDs and ODs fighting about scope, why don't the MDs open a 5 year residency to offer qualified ODs to become an MD while still earning an income. Similar in format to the OMFS program. I know this is not a new idea.

I feel many ODs push for the scope expansion b/c they want to be a surgeon, but don't want to quite their job and become a full student again for 4 years, taking classes they have already taken, and have no income.

This option would solve all the problems of, "They don't have the education" and "I took anatomy with you." By having an official program available to ODs to become surgeons, then we ODs would have little to fight for as far as scope expansion...I guess that would be a bad thing.

Here is my dream world-
OD scope: glasses, contacts, dx of disease, Rx rights including orals, injectables, superficial surgical rights (ie. chalazion, conj cyst, sebaceous cyst drainage). I ask for this b/c every MD I have worked with does not like wasting time with these procedures anyway. Give us 100 hours of CE on surgical technique and call it a day.

OD, FOLS = laser YAG, PI, SLT/ALT, Lasik
This would be a new fellowship available to OD (Fellow in Optometric Laser Surgery). This would entail a year of laser surgical training beyond OD school.

OD,MD = what every you want, your an MD. This is the 5 year residency. After the 5 years they could then do a fellowship, just like any OMD.

I see this is a problem b/c the states are pushing to get rid of different tiers of ODs and this would just add some back. The advantage is the difference in letters after the name. I believe this method would help all of us stop wasting money on stupid legislative bills.

I'm sure there are holes in this, so bring it on!

 

[cpw]

this thread serves no purpose what-so-ever so I'm shutting it down... it degenerated in one post to a OD/MD flame war

Kiss it goodbye folks

PS -- sorry I let things get so far. I've been home sick with bronchitis the past two days.