Hospital work as an Optometrist

[ac05]

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I have read that there are a few optometrists that hold jobs in hospitals, and I'm wondering is it really hard to find, or do most people prefer not to work in hospitals.

The reason that I am asking is because I would love do a residency in ocular disease or pre/post op, and one day work in a hospital at least part time. Is this unrealistic, I do realize that most people who work in hospitals are MDs, but I do not want to be an opthalmologist, I do want to be a primary eye doctor, but at the same time I want to be able to do more interesting cases, Am I being too greedy?

 

[drgregory]

I have read that there are a few optometrists that hold jobs in hospitals, and I'm wondering is it really hard to find, or do most people prefer not to work in hospitals.

The reason that I am asking is because I would love do a residency in ocular disease or pre/post op, and one day work in a hospital at least part time. Is this unrealistic, I do realize that most people who work in hospitals are MDs, but I do not want to be an opthalmologist, I do want to be a primary eye doctor, but at the same time I want to be able to do more interesting cases, Am I being too greedy?

Generally, this would be easiest to obtain through hospital privileges. But, your chances would be better with a small facility. The hospital will consider you only for your ability to generate revenue (like all other providers). ie, will you generate enough lab work to pay for yourself, or will you remove enough foreign bodies to pay for yourself, or will generate enough revenue if the hospital purchases a camera/visual field so you can do retina/neuro.

 

[vtrain]

Hospital positions are farily tough to come by and are mostly limited to VA settings. You would need to do a residency to have the opportunity to work in such a setting and possibly be willing to teach optometry/med students. It is entirely possible though.

 

[FamilyMD]

I have been on the credentialing committee for two different hospitals. Never, not once have we allowed an optometrist in the hospital. Unlike what someone else stated, it's not so much what revenue you can generate, it's more what liability will you expose the hospital to when the **** hits the fan. Not to be demeaning but if you are looking for interesting cases that would require a hospital OR, you honestly need to go the opthal route. Right now optometrist are just fighting to use lasers, much less a scalpel or anestesia. You got to realize something, in the OR the surgeon is the captain. When the pt is crashing YOU are in charge. What hospital is going to allow an optometrist this ability just so it can get its butt sued when there is trouble?

 

[vtrain]

FamilyMD - I think you are misinterpreting what the OP is trying to say. I don't think they want to do surgery and practice outside their scope of practice, rather they want to get exposure to a different aspect of optometry practice (to keep things interesting), which definitely exists in a VA setting. Often it is the optometrist that runs the primary eye clinic here. In this instance, optometrists have been proven to be no more a liability in this setting than MDs. In fact, it is often more cost effective to have a optometrist run the primary eye clinic, than hiring an ophthalmologist.

 

[FamilyMD]

FamilyMD - I think you are misinterpreting what the OP is trying to say. I don't think they want to do surgery and practice outside their scope of practice, rather they want to get exposure to a different aspect of optometry practice (to keep things interesting), which definitely exists in a VA setting. Often it is the optometrist that runs the primary eye clinic here. In this instance, optometrists have been proven to be no more a liability in this setting than MDs. In fact, it is often more cost effective to have a optometrist run the primary eye clinic, than hiring an ophthalmologist.

I see (pun intended ). Well how is working in a VA clinic any more exciting than a large chain clinic?

 

[vtrain]

Your pun doesn't really make much sense....I suggest you look up the definition of a pun 😉

Working in a VA setting is not necessarily more 'exciting' but it is a different spectrum of patients that you are dealing with, along with a different set of problems, as compared with patients that you would see at a chain. The doctors that I worked with at a VA often had a private clinic but would precept and see their patients at the VA 1-2 days a week. This provides some variety which I believe the OP is looking for.

 

[POJO]

I have been on the credentialing committee for two different hospitals. Never, not once have we allowed an optometrist in the hospital....

Has an optometrist ever applied before?
Pojo

 

[ac05]

FamilyMD - I think you are misinterpreting what the OP is trying to say. I don't think they want to do surgery and practice outside their scope of practice, rather they want to get exposure to a different aspect of optometry practice (to keep things interesting), which definitely exists in a VA setting. Often it is the optometrist that runs the primary eye clinic here. In this instance, optometrists have been proven to be no more a liability in this setting than MDs. In fact, it is often more cost effective to have a optometrist run the primary eye clinic, than hiring an ophthalmologist.

Yea, that's basically what I wanted to do. Ophthalmology is not something I want to do because of a bunch of factors. What I don't understand is why Optometrists seem to be treated as inferior doctors, the way some people are saying that they are a liablility and etc. If we take classes that are similiar to medical students and just focus more on the eye, aren't we suppose to know a great deal? I always thought that the real difference between an optometrist and ophthalmologist was the residency, that is where all the real knowledge and experiance is learned, correct me if I am wrong.

Even if I was wrong, do Optometrists lack common sense? As an fairly educated individual, don't we know what our limits are? We are not going to take control of something that we know we can't handle, so what is this whole thing with "Optometrists will be a liability" I am not even in optometry school yet and I have not been a liability since I was the age of 12, I have been working and taking care of my three siblings since then, so I really can not help feeling angry when people are belittling one another before they have even met them.

 

[FamilyMD]

Yea, that's basically what I wanted to do. Ophthalmology is not something I want to do because of a bunch of factors. What I don't understand is why Optometrists seem to be treated as inferior doctors, the way some people are saying that they are a liablility and etc. If we take classes that are similiar to medical students and just focus more on the eye, aren't we suppose to know a great deal? I always thought that the real difference between an optometrist and ophthalmologist was the residency, that is where all the real knowledge and experiance is learned, correct me if I am wrong.

Even if I was wrong, do Optometrists lack common sense? As an fairly educated individual, don't we know what our limits are? We are not going to take control of something that we know we can't handle, so what is this whole thing with "Optometrists will be a liability" I am not even in optometry school yet and I have not been a liability since I was the age of 12, I have been working and taking care of my three siblings since then, so I really can not help feeling angry when people are belittling one another before they have even met them.

Look, you're obvioiusly just starting thinking about your career. Sorry if what I stated "hurts your feelings" but nothing I have stated is false. It's funny how some people only hear what they want to hear and if some one states anything different, he's "mean". It also cracks me up when students state things like they are facts but if someone like me who is out in the real world practicing states something, it is questioned.
If it makes you feel better, it's not just optometry. Let's say I, as a family physician, decide I want to do appendectomies (take out the appendix), do you think any hospital will credential me for this? No way! So, it's not just picking on non-MD's, it's being realistic as far as liability when something does go wrong. And you are much misguided if you think optometry school (concentrates on primary eye care) is equivalent to medical school (whole body in depth).
In answer to the above poster, no optometrist has ever applied for privelages. I am so confused why an optometrist would need to admit or want to do surgery -> the only reasons to be credentialed at a hospital.

 

[ac05]

I'm sorry I think this whole problem is due to miscommunication, I dont' want to do surgery, period. I just would like to examine patients pre/post op, or something like that. When I said that the main difference between optometrist and ophthalmologist was residency, i wasn't talking about overall, i was just talking about the eye, we probably will learn the same amount of info about the eye. I respect you Family MD, you are a doctor, and probably very sucessful, so please listen to what i'm really asking.

 

[xmattODx]

I'm sorry I think this whole problem is due to miscommunication, I dont' want to do surgery, period. I just would like to examine patients pre/post op, or something like that. When I said that the main difference between optometrist and ophthalmologist was residency, i wasn't talking about overall, i was just talking about the eye, we probably will learn the same amount of info about the eye. I respect you Family MD, you are a doctor, and probably very sucessful, so please listen to what i'm really asking.

Why do you need to be in a hospital to do pre and post op? You are only going to pre and post op cataracts, refractive surgery, maybe a PI or something like that which can be done in your office. I think most ODs who want to work in a hospital want to treat the emergencies. i.e. be the ER eye guy. They would be the first line of defense and call down the ophthalmologist if needed.

I've never wanted to work in a hospital so I'm just speaking from things I've read and heard. Don't hold me to it! 🙂 Dr. Hom is really the best guy to talk to about this.

 

[ProZackMI]

FamilyMD - I think you are misinterpreting what the OP is trying to say. I don't think they want to do surgery and practice outside their scope of practice, rather they want to get exposure to a different aspect of optometry practice (to keep things interesting), which definitely exists in a VA setting. Often it is the optometrist that runs the primary eye clinic here. In this instance, optometrists have been proven to be no more a liability in this setting than MDs. In fact, it is often more cost effective to have a optometrist run the primary eye clinic, than hiring an ophthalmologist.

FamilyMD is absolutely correct. More importantly, what business would an OD have with hospital privis? At my hospital, only attending physicians and surgeons (MD, DO, DDS-OMFS, and DPM) are allowed privileges. An OD is neither a physician or a surgeon (at least in most states) and has no business in a hospital.

To the OP, if you want to be a doctor, go to medical school. If you want to be a primary care eye doctor, do an ophthalmology residency. Or, you could be an internist. Either way, that is how you'll get hospital privileges. I don't mean to be disrespectful, but honestly why would an OD need hospital privileges? If an OD is treating a pt who has a serious ocular problem, he/she will refer to an MD/DO. An OD would have no reason to admit a patient, d/c a patient, or recommend any hospital tx. It's not within their training or scope of practice. Serious medical problems of the eye should be treated by physicians only.

Any sane hospital would reject an OD's application for privileges. FamilyMD is absolutely correct; the liability issue is compelling.

At my hospital, we have a low vision clinic. There are two ODs on staff. They are considered hospital staff just like pharmacists, nurses, PTs, and other professionals. Many research hospitals employ ODs as staff also. In those roles, ODs do a great service by providing optometric service. Many also specialize in low vision treatment, but they are not on staff as physicians, and should not be.

In states where ODs have some enhanced authority, like OK, they might have privis and that would be okay, but in most jurisdictions, an OD has no business having hospital privileges.

 

[FamilyMD]

FamilyMD is absolutely correct. More importantly, what business would an OD have with hospital privis? At my hospital, only attending physicians and surgeons (MD, DO, DDS-OMFS, and DPM) are allowed privileges. An OD is neither a physician or a surgeon (at least in most states) and has no business in a hospital.

To the OP, if you want to be a doctor, go to medical school. If you want to be a primary care eye doctor, do an ophthalmology residency. Or, you could be an internist. Either way, that is how you'll get hospital privileges. I don't mean to be disrespectful, but honestly why would an OD need hospital privileges? If an OD is treating a pt who has a serious ocular problem, he/she will refer to an MD/DO. An OD would have no reason to admit a patient, d/c a patient, or recommend any hospital tx. It's not within their training or scope of practice. Serious medical problems of the eye should be treated by physicians only.

Any sane hospital would reject an OD's application for privileges. FamilyMD is absolutely correct; the liability issue is compelling.

At my hospital, we have a low vision clinic. There are two ODs on staff. They are considered hospital staff just like pharmacists, nurses, PTs, and other professionals. Many research hospitals employ ODs as staff also. In those roles, ODs do a great service by providing optometric service. Many also specialize in low vision treatment, but they are not on staff as physicians, and should not be.

In states where ODs have some enhanced authority, like OK, they might have privis and that would be okay, but in most jurisdictions, an OD has no business having hospital privileges.

👍

 

[ProZackMI]

FamilyMD - I think you are misinterpreting what the OP is trying to say. I don't think they want to do surgery and practice outside their scope of practice, rather they want to get exposure to a different aspect of optometry practice (to keep things interesting), which definitely exists in a VA setting. Often it is the optometrist that runs the primary eye clinic here. In this instance, optometrists have been proven to be no more a liability in this setting than MDs. In fact, it is often more cost effective to have a optometrist run the primary eye clinic, than hiring an ophthalmologist.

Keep in mind, there are three basic forms of hospital employment (or quasi-employment).

1. Attending physician privileges - the doctor (MD, DO, DDS/DMD-OMFS, or DPM) has staff privileges to use the OR, ER, visit patients, write orders, etc., but is not an employee of the hospital. He/she has a special contractual relationship with the hospital, but is not employed by the hospital. Liability flows back to the physician, but can be shared by the hospital if nurses and hospital employees are involved. These privileges are obtained through application to the hospital credentialing committee and are granted to licensed MDs, DOs, oral-max facial surgeons (dentists with additional training), and podiatrists. Rarely, PhD/PsyD psychologists are granted privis to attend to psychiatric patients only. Some NPs have privileges too. There is no pay involved. In fact, in come situations, but not all, the doc pays a fee to use the hospital and be on staff. Privis include admit and d/c authority, lab requests, patient orders (labs, x-rays, MRIs, PETs, etc.), etc.

2. Staff Employment - A professional or non-professional employee of the hospital. The hospital hires the employee and he/she is classified as a pharmacist, phlebotomist, tech, respiratory tech, x-ray tech, RN, LPN, optometrist, PT, etc. The hospital has full liability for an employee, unless the employee acts in a criminal manner (assault, battery, criminal sexual conduct, rape, drug offenses, etc.) or a grossly negligent manner. There are many hospitals who hire ODs as employees for vision clinics, vision research centers, pre-surgical screening centers, etc.

3. Contractual relationships - an OD can also be hired as a special consultant or advisor to a hospital board, committee, or center for a limited purpose.

So, if you're interested in working as an optometrist in a hospital setting, you may find work as an employee, but you'll likely never find work as an attending physician or optometrist with hospital privileges.

 

[FamilyMD]

Keep in mind, there are three basic forms of hospital employment (or quasi-employment).

1. Attending physician privileges - the doctor (MD, DO, DDS/DMD-OMFS, or DPM) has staff privileges to use the OR, ER, visit patients, write orders, etc., but is not an employee of the hospital. He/she has a special contractual relationship with the hospital, but is not employed by the hospital. Liability flows back to the physician, but can be shared by the hospital if nurses and hospital employees are involved. These privileges are obtained through application to the hospital credentialing committee and are granted to licensed MDs, DOs, oral-max facial surgeons (dentists with additional training), and podiatrists. Rarely, PhD/PsyD psychologists are granted privis to attend to psychiatric patients only. Some NPs have privileges too. There is no pay involved. In fact, in come situations, but not all, the doc pays a few to use the hospital and be on staff. Privis include admit and d/c authority, lab requests, patient orders (labs, x-rays, MRIs, PETs, etc.), etc.

2. Staff Employment - A professional or non-professional employee of the hospital. The hospital hires the employee and he/she is classified as a pharmacist, phlebotomist, tech, respiratory tech, x-ray tech, RN, LPN, optometrist, PT, etc. The hospital has full liability for an employee, unless the employee acts in a criminal manner (assault, battery, criminal sexual conduct, rape, drug offenses, etc.) or a grossly negligent manner. There are many hospitals who hire ODs as employees for vision clinics, vision research centers, pre-surgical screening centers, etc.

3. Contractual relationships - an OD can also be hired as a special consultant or advisor to a hospital board, committee, or center for a limited purpose.

So, if you're interested in working as an optometrist in a hospital setting, you may find work as an employee, but you'll likely never find work as an attending physician or optometrist with hospital privileges.

We have done #3 before, but why would not the hospital not consult an opthalmologist who is much more versed in hospital issues? We have done this before when looking at revamping our surgical suites and looking at ER eye equipment but it never even crossed our minds to ask an optometrist since they would not be the one using the OR or equip anyways. Just curious.

 

[POJO]

(...)In answer to the above poster, no optometrist has ever applied for privelages. I am so confused why an optometrist would need to admit or want to do surgery -> the only reasons to be credentialed at a hospital.

It is true that optometrists don't or cannot admit because they cannot do the complete H&P or do a discharge summary. But hospitals have admitted optometrists as either courtesy or associate staff with the ability to use the hospital facilities such as labs and imaging. Where ophthalmologic consultation is not immediate or near term, community optometrists everywhere have either received referrals from hospital physicians or ER staff or seen them in the ER or in the hospitals (ergo the "staff" privileges)

In addition, some hospitals admit the optometrists to rehabilitate post CVA or TBI (traumatic brain injured ) patients in conjunction with the OT or rehab departments.

FYI

 

[POJO]

We have done #3 before, but why would not the hospital not consult an opthalmologist who is much more versed in hospital issues? We have done this before when looking at revamping our surgical suites and looking at ER eye equipment but it never even crossed our minds to ask an optometrist since they would not be the one using the OR or equip anyways. Just curious.

1. There are optometrists who are versed in hospital issues. It is unfortunate that in your professional career you have not met them. I am an optometrist and have served successively on the P&T, medical records, JCAHO accreditation and CPOE committes.

2. Eye equipment need not be in a special surgical suite within the ER or in the hospital. Most ER eye work only requires a 9'x15' foot room, an Eclipse Examination table, handheld or table mounted slit lamp, Binocular indirect ophthalmoscope and a tonometer. Optometrists who have had ER and hospital experience can adequately work in the hospital just as ophthalmologists. In my own experience, the hospital has asked me to take first call during the day with the oncall being second call (however, I do the triage and call the on call ophthalmologist, rather than the ER docs). Regretfully, this has worked so well that some community hospital ER departments have been "dumping" or turfing the ER eye patients to our ER department because I'm much more available than the ophthalmologists.

 

[ProZackMI]

We have done #3 before, but why would not the hospital not consult an opthalmologist who is much more versed in hospital issues? We have done this before when looking at revamping our surgical suites and looking at ER eye equipment but it never even crossed our minds to ask an optometrist since they would not be the one using the OR or equip anyways. Just curious.

I would suspect that most hospitals in the US would hire MD, DO, JD, PharmD, or PhD type consultants only. There may be special circumstances where a board or committee might want the input of an optometrist for some reason (although I can't think of one), but chances are, that OD would have some additional training (an MS or MPH or PhD degree or specialized residency) or specialized area of knowledge.

I've worked at 3 hospitals in the past where temporary contractual employment was offered to clinical pharmacists (PharmD) who worked on drug information, computerized pharmacy projects, and specialized pharmacy related projects. I've known PhD economists, statisticians, public health, and biomedical engineering specialists to be hired for a special purpose or project. Many lawyers and law firms get hired as contractual employees for a limited purpose. I don't see many reasons why an OD would fit into a #3 category, but it's possible.

 

[ProZackMI]

1. There are optometrists who are versed in hospital issues. It is unfortunate that in your professional career you have not met them. I am an optometrist and have served successively on the P&T, medical records, JCAHO accreditation and CPOE committes.

2. Eye equipment need not be in a special surgical suite within the ER or in the hospital. Most ER eye work only requires a 9'x15' foot room, an Eclipse Examination table, handheld or table mounted slit lamp, Binocular indirect ophthalmoscope and a tonometer. Optometrists who have had ER and hospital experience can adequately work in the hospital just as ophthalmologists. In my own experience, the hospital has asked me to take first call during the day with the oncall being second call (however, I do the triage and call the on call ophthalmologist, rather than the ER docs). Regretfully, this has worked so well that some community hospital ER departments have been "dumping" or turfing the ER eye patients to our ER department because I'm much more available than the ophthalmologists.

I'm not sure what state you practice in, but your ER work is a law suit waiting to happen. As an attorney and physician, I would have a field day with you on the stand if a patient sustained any significant harm while being treated by you and under your care. "So, tell me, "doctor", what medical school did you attend?" YOU: "I'm an optometrist." ME: "What is the primary role of the optometrist." YOU: "We prescribe refractive/corrective lenses to improve a patient's vision. We can diagnose eye conditions, but have a very limited scope of practice and must refer complicated medical conditions to an MD. We cannot perform surgery and can only prescribe a limited array of diagnostic and therapeutic pharmaceutical agents." ME: "So, if someone comes in the ER with a foreign body imbedded in their eye, you cannot remove it under your current scope of practice law?" YOU: "That's correct." ME: "So what do you do in the ER if a pt comes in with a FB in his eye, a detached retina, severe proliferative diabetic retinopathy with vitreal bleeding, enucleation, or another severe ocular trauma?" YOU: "Um, I call a doctor!" ME: "So why not just have a nurse or PA help out in the ER? What good are you? Do you prescribe lenses while working in the ER? Hey, are their dentists alongside you diagnosing caries and dental avulsions sustained in MVAs? Any chiros making back adjustments in the ER?"


You have no business working in an ER. You should be reported to the Board of Medicine and the Board of Optometry. You are practicing outside the scope of your training and authority. You are putting people at risk. Unless you have PA or NP training, you are a menace to the population at large. An ER MD/DO or an OMD is optimal, but an OD? Jesus, just have an ER PA do triage. That would be better than some contact lens guy playing doctor. I'm telling you, any patient in that ER will end owning your license and the hospital if he/she leaves with any ocular problem after seeing you.

You are not only assuming the risk, but imparting that risk to that hospital, which apparently allows ODs to sit on their committees. Apparently, your hospital also doesn't employ any competent professionals in their Risk Management Dept. If I knew your name and state, I would report you myself.

 

[FamilyMD]

1. There are optometrists who are versed in hospital issues. It is unfortunate that in your professional career you have not met them. I am an optometrist and have served successively on the P&T, medical records, JCAHO accreditation and CPOE committes.

2. Eye equipment need not be in a special surgical suite within the ER or in the hospital. Most ER eye work only requires a 9'x15' foot room, an Eclipse Examination table, handheld or table mounted slit lamp, Binocular indirect ophthalmoscope and a tonometer. Optometrists who have had ER and hospital experience can adequately work in the hospital just as ophthalmologists. In my own experience, the hospital has asked me to take first call during the day with the oncall being second call (however, I do the triage and call the on call ophthalmologist, rather than the ER docs). Regretfully, this has worked so well that some community hospital ER departments have been "dumping" or turfing the ER eye patients to our ER department because I'm much more available than the ophthalmologists.

Why would you be on the P&T committee? What do you know about drugs when you can't prescribe them? Very strange hospital indeed...having an optometrist decide what meds the hospital will be using. LOL

 

[ProZackMI]

Why would you be on the P&T committee? What do you know about drugs when you can't prescribe them? Very strange hospital indeed...having an optometrist decide what meds the hospital will be using. LOL

I find his claims absurd and dubious, but distressing nevertheless. If he is telling the truth, then I really believe he needs to be reported for practicing medicine without a license. No rational hospital would hire an OD to work in the ER, UNLESS the OD was also a PA or NP. However, the OD/PA or OD/NP would be working as a PA or NP in the ER, not working as an OD.

Furthermore, no sane OD would expose himself to such liability by performing medical work in an ER. Honestly, I find his claim hard to swallow. All hospitals have boards composed of lawyers and risk managers. They would never let an optometrist sit on any medical committees or boards or allow one to practice in an ER. No way, no how.

At Beaumont, we had a dentist who also was a PA who worked in the ER. However, he worked as a PA and was paid as a PA, not a dentist. If a dental emergency presented itself, he could treat that problem better than any ER MD, but while in the ER, he was considered a PA only, not a dentist. An OD has neither the training or the authority to practice in a hospital (unless as a limited staff member) let alone a hospital ER!!!!! There are no OD residencies in emergency medicine. Who the hell does he think he's fooling? Stop puffing yourself up, POJO.

POJO, what's your name and where do you practice? What state are you licensed to practice?

 

[Ben Chudner]

First of all, everyone (especially Zack) just relax. I don't think the OP really meant he wanted hospital priviledges. It is obvious, to me at least, that he did not realize the actual meaning of the term. I would bet that he is looking to work in a hospital setting as a staff member, similar to a VA optometrist.

As for your typical ranting against optometry Zack, once again you are truely misguided. OD's in private practice see patients with intraocular FB's, detached retina's, severe proliferative diabetic retinopathy with vitreal bleeding, etc and make the appropriate referrals. There is no increased liability by having an OD do it in the ER. I can never understand why you continue to think that OD's will try to practice outside their scope. In an ER setting I would much rather have an OD making the diagnosis of macular-on retinal detachment vs macula-off. I doubt very seriously that a PA would be able to tell the difference. As long as the OD in the ER was practicing within their scope of practice, there would not be any difference (liability-wise) between him and a PA seeing the patient first, and in some cases there would probably be less exposure by having the OD.

 

[Ben Chudner]

Before the rantings begin, I want to clarify that I am not suggesting that an OD take the only call at the ER. Obviously, an MD has to be on second call. Basically, the OD takes the place of the PA, seeing the patient first and deciding if the MD needs to be called. I would think MD's would want OD's on first call. It seems like there is a ton of minor stuff that comes into the ER that the OD could handle without bothering the MD. When the retina specialist in my town takes county call, he sends me all the non-surgical patients from the weekend because he doesn't want to follow abrasions, ulcers, FB's, etc. This is one area in which I think the OD's and MD's can work together, but then we get guys like Zack that have a huge chip on their shoulder.

 

[ProZackMI]

Before the rantings begin, I want to clarify that I am not suggesting that an OD take the only call at the ER. Obviously, an MD has to be on second call. Basically, the OD takes the place of the PA, seeing the patient first and deciding if the MD needs to be called. I would think MD's would want OD's on first call. It seems like there is a ton of minor stuff that comes into the ER that the OD could handle without bothering the MD. When the retina specialist in my town takes county call, he sends me all the non-surgical patients from the weekend because he doesn't want to follow abrasions, ulcers, FB's, etc. This is one area in which I think the OD's and MD's can work together, but then we get guys like Zack that have a huge chip on their shoulder.

I may have a chip on my shoulder, contact lens man, but at least I don't have delusions of grandeur. You need an ample dose of reality. No OD should be working in any ER...PERIOD. I don't care about your one year contact lens residency (try doing 4+ in IM, ophthalmology, or psych). I don't care about ODs in the VA (which provides substandard tx anyway). No OD is qualified to perform medical procedures in a hospital. If you want to extract a FB in your office, fine...do it, but you have no business in the ER.

Call me what bitter and recalcitrant; call me a troll, but at least I'm grounded in reality. An OD has NO place in an ER, OR, or as an attending in any hospital.

 

[still_confused]

prozack and familymd are 100% right on this issue...everyone needs to do what they are trained to do...ODs are not trained in the ER setting nor is there any need if there are opths already.

i believe ben is right, the OP was not clear and hence started this in the wrong direction. OD's as staff is fine if they are given clear roles and know when they are out of thier scope. likewise i am sure ER doctors know thier scope and know when to refer me to the appropriate doctor when the needs arise.

do what we are trained to do...nothing more nothing less.

 

[ProZackMI]

prozack and familymd are 100% right on this issue...everyone needs to do what they are trained to do...ODs are not trained in the ER setting nor is there any need if there are opths already.

i believe ben is right, the OP was not clear and hence started this in the wrong direction. OD's as staff is fine if they are given clear roles and know when they are out of thier scope. likewise i am sure ER doctors know thier scope and know when to refer me to the appropriate doctor when the needs arise.

do what we are trained to do...nothing more nothing less.

That's what I said in several posts. ODs can find employment in hospitals, but like nurses and pharmacists and PTs, their role is limited to that of a staff member, not staff physician. ODs have a lot of experience and training in optometry, none in medicine. An OD has ABSOLUTELY NO PLACE working in an ER or OR. The only exception: if a state allows an OD to do invasive or laser surgery. In that case, working with MDs would ensure more patient safety. Obviously, Contact Lens Man never read my post about types of hospital employment. He seems to think his Bascom-Palmer/Wal-Mart Contact Lens Residency makes him equivalent to an MD. Things must be very lax where he is (California?), but in real states, we restrict the practice of medicine to physicians and surgeons...period...end of story.

Ask yourself: if you sustained an eye injury and were taken to the local ER, would you want Mr. Contact Lens Guy treating you? I'd rather have a PA or NP or MD internist treat me over any OD any day! Hell, I'd rather have a DVM treat me over an OD.

 

[iballer]

Before the rantings begin, I want to clarify that I am not suggesting that an OD take the only call at the ER. Obviously, an MD has to be on second call. Basically, the OD takes the place of the PA, seeing the patient first and deciding if the MD needs to be called. I would think MD's would want OD's on first call. It seems like there is a ton of minor stuff that comes into the ER that the OD could handle without bothering the MD. When the retina specialist in my town takes county call, he sends me all the non-surgical patients from the weekend because he doesn't want to follow abrasions, ulcers, FB's, etc. This is one area in which I think the OD's and MD's can work together, but then we get guys like Zack that have a huge chip on their shoulder.

I agree with Ben. There's no reason why an OMD need to treat abrasions, ulcers, EKC, iritis, FBs, etc. if an OD is around to take care of the patients. I worked in the military as a tech and the ER MD/DO often times are not comfortable using a slit lamp and diagnosing and treating patients with ocular problems. The ER docs often will page the Eye clinic on-call providers which are the ODs. They take care of all non-surgical patients and if the case is beyond their scope of practice they will then call the OMD.

 

[still_confused]

Ask yourself: if you sustained an eye injury and were taken to the local ER, would you want Mr. Contact Lens Guy treating you? I'd rather have a PA or NP or MD internist treat me over any OD any day! Hell, I'd rather have a DVM treat me over an OD.

if they have a DVM in the ER for an eye injury...ill suspect the DVM himself is in the ER for an injury (maybe bitten by rabid dogs). ill take the OD over a DVM for eye injury anyday (and unlike zack, i harbor no ill will towards DVM, they have kept my dogs healthy and happy for a long time)

you make good points but you ruin it with great lines like these that brightens everyone's day with a good laugh and its hard to take you seriously.

 

[iballer]

Ask yourself: if you sustained an eye injury and were taken to the local ER, would you want Mr. Contact Lens Guy treating you? I'd rather have a PA or NP or MD internist treat me over any OD any day! Hell, I'd rather have a DVM treat me over an OD.

It depends on the type of ER. I can only speak for a military ER. I will take an OD anytime over a PA, NP or an MD internist. You're obviously not totally aware of what ODs are capable of. I am assuming most OD schools have the same curriculum. If a military OD can treat such injuries where did they learned it?

There's so much politics involve in the laws and regulations that governs the scope of practice of ODs in the civilian world. The OMDs don't want the ODs to treat things that they are well capable of because that takes away the patient from them. There are a lot non-surgical treatments that ODs and OMDs can both treat but often goes to OMDs.

Commercialize optometry is the cause of the general population thinking that ODs are only good for refraction and fitting contact lens. It seems that Zack is included in this group since he only sees Ben as Mr. Contact Lens Guy. 😀

 

[POJO]

I find his claims absurd and dubious, but distressing nevertheless...

Even after state, federal and local medical society review, my actions and scope of practice at this hospital has withstood their review. I think your concept or idea of what an optometrist can do has been shaped or formed by your prior experience. I doubt, though, that you had a more recent experience.

 

[Ben Chudner]

That's what I said in several posts. ODs can find employment in hospitals, but like nurses and pharmacists and PTs, their role is limited to that of a staff member, not staff physician.

I believe I was agreeing with you.

ODs have a lot of experience and training in optometry, none in medicine.

Same rhetoric, different thread. I have always said that OD training is not the same as MD training. To say that OD's are only qualified to handle glasses and contact lenses however, is just plain ignorant.

An OD has ABSOLUTELY NO PLACE working in an ER or OR. The only exception: if a state allows an OD to do invasive or laser surgery. In that case, working with MDs would ensure more patient safety.

No one has said here that OD's should be allowed to work in the OR. In the ER, OD's can definitely play a role. I have seen enough ER attendings prescribe vicodin and sulfacetamide for corneal abrasions to know that an OD could increase the quality of care in the ER.

Obviously, Contact Lens Man never read my post about types of hospital employment. He seems to think his Bascom-Palmer/Wal-Mart Contact Lens Residency makes him equivalent to an MD. Things must be very lax where he is (California?), but in real states, we restrict the practice of medicine to physicians and surgeons...period...end of story.

Your argument is much more compelling with the attacks on my education. 🙄 First of all, my residency at Bascom Palmer was in ocular disease and I had the priviledge of working with some of the top ophthalmologists in the field. Secondly, I have no idea where you got Wal-Mart except that it must be your childish attempt to insult me. I have never said I am equivalent to an MD, but I am more qualified to treat ocular disease (especially in an emergency setting) than PA's and ER MD's that are not residency trained ophthalmologists. I work in Washington State.

Ask yourself: if you sustained an eye injury and were taken to the local ER, would you want Mr. Contact Lens Guy treating you? I'd rather have a PA or NP or MD internist treat me over any OD any day! Hell, I'd rather have a DVM treat me over an OD.

Classic Zack argument. One day you may have that injury and I hope I know the OD that gets to fix the problems caused by the PA, NP, or MD internist that did not know how to look through a slit lamp to acurately diagnose your condition. And if you insist on calling me names, I would prefer Dr. Contact Lens Guy. 😉

 

[cpw]

One day you may have that injury and I hope I know the OD that gets to fix the problems caused by the PA, NP, or MD internist that did not know how to look through a slit lamp to acurately diagnose your condition. And if you insist on calling me names, I would prefer Dr. Contact Lens Guy. 😉

Thanks for getting me to snarf coffee out of my nose, Ben.

 

[gerido]

You're very cocky for a psychiatrist. You have a superiority complex that is not warrented. You're a psychiatrist, you are not in any position to have a superiority complex. A f*cking psychiatrist.

gerido.

P.S. did I mentioned that you're just a psychiatrist?

I find his claims absurd and dubious, but distressing nevertheless. If he is telling the truth, then I really believe he needs to be reported for practicing medicine without a license. No rational hospital would hire an OD to work in the ER, UNLESS the OD was also a PA or NP. However, the OD/PA or OD/NP would be working as a PA or NP in the ER, not working as an OD.

Furthermore, no sane OD would expose himself to such liability by performing medical work in an ER. Honestly, I find his claim hard to swallow. All hospitals have boards composed of lawyers and risk managers. They would never let an optometrist sit on any medical committees or boards or allow one to practice in an ER. No way, no how.

At Beaumont, we had a dentist who also was a PA who worked in the ER. However, he worked as a PA and was paid as a PA, not a dentist. If a dental emergency presented itself, he could treat that problem better than any ER MD, but while in the ER, he was considered a PA only, not a dentist. An OD has neither the training or the authority to practice in a hospital (unless as a limited staff member) let alone a hospital ER!!!!! There are no OD residencies in emergency medicine. Who the hell does he think he's fooling? Stop puffing yourself up, POJO.

POJO, what's your name and where do you practice? What state are you licensed to practice?

 

[Ben Chudner]

You're very cocky for a psychiatrist. You have a superiority complex that is not warrented. You're a psychiatrist, you are not in any position to have a superiority complex. A f*cking psychiatrist.

gerido.

P.S. did I mentioned that you're just a psychiatrist?

This serves no purpose other than to continue the name calling. I may not agree with Zack, but he is obviously very passionate about this and we should respect that.

 

[ac05]

This serves no purpose other than to continue the name calling. I may not agree with Zack, but he is obviously very passionate about this and we should respect that.

I'm sorry for starting this thread, The only reason I was asking is because I'm starting optometry school this fall and I wanted to know to what extent can an optometrist work in a hospital, I didn't mention anything about hospital priviledges since I don't even know what that means.

On the brightside, I did learn a good amount of information of how hospitals work, and to what extent an optometrist is allowed to work, so thank you everyone.

 

[POJO]

I'm sorry for starting this thread, The only reason I was asking is because I'm starting optometry school this fall and I wanted to know to what extent can an optometrist work in a hospital, I didn't mention anything about hospital priviledges since I don't even know what that means.

On the brightside, I did learn a good amount of information of how hospitals work, and to what extent an optometrist is allowed to work, so thank you everyone.

ac05 - No problem. I contributed because I noted the thread followers may not have given you a well rounded view of the matter. There are hospital optometrists here and there and on the whole, it isn't a common situation. Most optometrists who are associated with hospitals usually do so in conjunction with a department of ophthalmology and either perform general "well eye" examinations for refraction, contact lens fitting or following early diabetic patients.

There is a definite minority who perform consulting services in departments of rehabilitation and work with occupational therapists improving the quality of lives of partially sighted or post stroke patients. And a still smaller minority perform to the fullest scope of their licenses in evaluating low to moderate complex acute eye problems that can be managed medically only.

I think by the time you graduate, you will notice more opportunities in many different venues. Your progress is only limited by your imagination.

 

[Hines302]

OD's who also earn PhD's are likely to have positions in Hospitals associated with Med Schools... being assistant professors of Ophthamology.... which many time includes a little bit of teaching, research, and clinical responsibilities (fitting contacts, and seeing patients for simple eye conditions)

 

[Ben Chudner]

I'm sorry for starting this thread...

We should apologize to you. You have unfortunately seen the ugly side of the profession where we are forced to argue with MD's that have no real knowledge of what OD's can do. I can assure you that there are plenty of MD's out there that have actually worked with OD's and understand the role we play in eyecare.

Good luck in your future.

 

[still_confused]

OD's who also earn PhD's are likely to have positions in Hospitals associated with Med Schools... being assistant professors of Ophthamology.... which many time includes a little bit of teaching, research, and clinical responsibilities (fitting contacts, and seeing patients for simple eye conditions)

im going to try to get a PhD also, anyone else trying that? given the animosity of MDs...i think ill just stick with clinics!

 

[gsinccom]

but he is obviously very passionate about this and we should respect that.

hmm...?...not so sure we need to respect someone that lives in a closed-minded and biased world and then spreads these opinions to the ignorant of the world....tolerate yes, but respect? 😕 I believe there is such a thing as misguided passion 😉
thanks to all for your comments...may we as ODs and future ODs continue to fight the battles 😎

 

[delfina]

My friend is working in a small hospital in Staten Island, New York and told that earn about 80,000.00/ year. Is it possible or it's just talking? 😉

 

[Ben Chudner]

hmm...?...not so sure we need to respect someone that lives in a closed-minded and biased world and then spreads these opinions to the ignorant of the world....tolerate yes, but respect? 😕 I believe there is such a thing as misguided passion 😉
thanks to all for your comments...may we as ODs and future ODs continue to fight the battles 😎

Yes, I guess you are right.

 

[Eyeguy2020]

I have read that there are a few optometrists that hold jobs in hospitals, and I'm wondering is it really hard to find, or do most people prefer not to work in hospitals.

The reason that I am asking is because I would love do a residency in ocular disease or pre/post op, and one day work in a hospital at least part time. Is this unrealistic, I do realize that most people who work in hospitals are MDs, but I do not want to be an opthalmologist, I do want to be a primary eye doctor, but at the same time I want to be able to do more interesting cases, Am I being too greedy?

Sorry I'm late to the discussion. Please ignore the folks who are showing their bias and ignorance concerning optometry in hospitals and as a profession. I assure you they do not possess the requisite knowledge to answer intelligently on the subject. Most MD's I know are much more informed.

Optometrists can and do work in hospital settings. I am on call for local ER's in my area. I treat trauma and decide a course of treatment and/or whether they need to be sent to an urgent care facility for emergency surgery. I am the liaison for these patients when getting them set up for surgery. Also, I am routinely called upon for minor conditions that the non-opthalmology physician are uncomfortable treating.

I am on staff with my local hospital. Physicians call me in to provide in-patient evaluation of treatment of eye conditions. I work very closely with local physicians and also provide them with both optical and medical care of their eyes. I refer surgeries, order lab tests, provide pre/post op care and support their attending physicians. I am a valuable asset to the facility even though I preform no surgeries of my own (as I have chosen not to do).

Obtaining employment directly within a hospital is rare. It is more likely (as is the case with other physicians), you operate out of your own office and work with/for the hospital (feeding them procedures and lab work).

Hope this helps.

 

[eye love lamp]

Sorry I'm late to the discussion. Please ignore the folks who are showing their bias and ignorance concerning optometry in hospitals and as a profession. I assure you they do not possess the requisite knowledge to answer intelligently on the subject. Most MD's I know are much more informed.

Optometrists can and do work in hospital settings. I am on call for local ER's in my area. I treat trauma and decide a course of treatment and/or whether they need to be sent to an urgent care facility for emergency surgery. I am the liaison for these patients when getting them set up for surgery. Also, I am routinely called upon for minor conditions that the non-opthalmology physician are uncomfortable treating.

I am on staff with my local hospital. Physicians call me in to provide in-patient evaluation of treatment of eye conditions. I work very closely with local physicians and also provide them with both optical and medical care of their eyes. I refer surgeries, order lab tests, provide pre/post op care and support their attending physicians. I am a valuable asset to the facility even though I preform no surgeries of my own (as I have chosen not to do).

Obtaining employment directly within a hospital is rare. It is more likely (as is the case with other physicians), you operate out of your own office and work with/for the hospital (feeding them procedures and lab work).

Hope this helps.

9 years have passed since this discussion. I wonder if OP got into his/her hospital setting and if it is as wonderful as they imagined.

 

[ac05]

Eye love lamp, to answer your question, many years later, yes I do work in a hospital setting. Funny thing is I completely forgot about the post and somehow ended up working in a hospital anyway. I work within the traumatic brain injury department as a developmental optometrist and I love it. I love working with the other rehab disciplines and really feel that we help improve the lives of our patients. Here is a link to my bio incase anyone is interested
Ps I am directly employed by the hospital
http://hcmc.org/providers/HCMC_P_059194

 

[eye love lamp]

Eye love lamp, to answer your question, many years later, yes I do work in a hospital setting. Funny thing is I completely forgot about the post and somehow ended up working in a hospital anyway. I work within the traumatic brain injury department as a developmental optometrist and I love it. I love working with the other rehab disciplines and really feel that we help improve the lives of our patients. Here is a link to my bio incase anyone is interested
Ps I am directly employed by the hospital
http://hcmc.org/providers/HCMC_P_059194

That's very interesting! Thanks for the update!

What kinds of things do you do with patients as a developmental optometrist? For someone who has lost vision (are we talking cortical blindness? VF defects? all of the above?) from TBI what services do you offer and what outcomes do you expect? Is it like a specialized field of low vision?

I've never had an exposure to this part of the eyeball world.

 

[ac05]

eye love lamp, I mainly diagnose sensorimotor /oculomotor deficits, i.e. convergence insufficiency, accommodative insufficiency, deficits of saccades in patients with mild to moderate TBI, in severe TBI and stroke I diagnose more hemianopsias, cranial nerve palsies, and also other things such as visual midline shift syndrome , visual neglect. In mild and moderate TBIs the outcomes are excellent, >90% of the patients are able to completely rehab their visual deficits, and it translates into improved reading and computer work ability (which is important for people who work in an office setting, engineers, professors) and also better balance, less headaches..etc. In the severe TBI and stroke, sometimes it's a matter of seeing how things improve with time and prescribing sector prisms to help them scan into their deficit field, prism to help resolve diplopia . Cortical blindness is really quite rare, and I think i have yet to see one. It is a specialized field, there are only a few residencies out there for acquired brain injury, I did one in SUNY.

oh and lots of tints for photosensitivity

 

[realityred]

My friend is working in a small hospital in Staten Island, New York and told that earn about 80,000.00/ year. Is it possible or it's just talking? 😉

Years ago my cousin OD worked at a small hospital in MA and his salary was about 80K working 8 to 5 , 12 to 8 and Sat 9 to 5. Paid for parking 100 per month. Worked in same dept. as Ophthalmology . 2% raise per year. The Ophthalmologist salary 520K annual. No evening and no Saturday schedule for the MD. On Surgery days 1 to 2 times a week the ophthalmologists start before 6 am and finish before noon. rest of the day off.

 

[ac05]

Years ago my cousin OD worked at a small hospital in MA and his salary was about 80K working 8 to 5 , 12 to 8 and Sat 9 to 5. Paid for parking 100 per month. Worked in same dept. as Ophthalmology . 2% raise per year. The Ophthalmologist salary 520K annual. No evening and no Saturday schedule for the MD. On Surgery days 1 to 2 times a week the ophthalmologists start before 6 am and finish before noon. rest of the day off.

I work 8-5 monday to friday, and make ALOT more than that....