wanted to make a points generally rather than specifically.
First, I am NOT trying to attack optometry. I am not a "hater" of optometry as that one misguided pre-optometry student said. I do not support a Bill that would preclude you from using an earned title (i.e., "doctor"). If you have read any of my posts, you'd see that. In addition, I fully admit that I'm an MD with training in internal med and psychiatry only. I'm NOT an ophthalmologist. Other than treating basic allergic or infectious conjunctivitis, I have absolutely NO experience in treating ocular pathology. Also, I fully admit that I have never been to optometry school and don't know what receiving an OD degree requires.
Second, I have nothing against optometry. Optometrists are well-educated professionals who serve a very vital and important role in health care. MANY (I don't know how many, but MANY) children, adolescents, and adults require some form of corrective lenses. Without these lenses, many of us with poor eyesight couldn't perform our jobs or operate a motor vehicle. I have worn glasses since I was 12 and I'm 35 years-old now. A LONG TIME. Optometrists examine eyes, prescribe lenses, and now, provide a full range of visual health services. I never disputed that. Over the last year or so, many posters on the OD forum have taught me a great deal about how much your profession has evolved and what optometry school actually entails. Prior to this epiphany, I admit, I assumed you were glorified techs who had inflated degrees with little or no medical training.
The ODs I've seen, throughout my life, have worked mostly retail/commerical and did not seem very medical to me. I remember during med school, I needed new glasses, and saw my regular optometrist who was asking me about school. I was talking about a woman who had a CVA and some residual hemiparesis and the optometrist said "What's a CVA?" This guy, however, insisted on being called DOCTOR and never let his patients/clients forget that. Things like that stuck in my craw and helped form my opinion that optometrists were non-medical quasi-professionals who loved the title "doctor". Many MD/DO colleagues shared my sentiment.
This forum has helped change my views and I have learned that I was very wrong. That does not change the fact that I have some valid concerns about optometry, which I have shared here. Specifically, my concern is regarding the language of this proposed Bill, taking us back to the topic.
Many of you were concerned that this Bill might pass and would therefore somehow hinder your quest for expanded scopes of practice or would set the practice of optometry back. Many of you erroneously assumed that if the Bill passed, it would limit your use of the title "doctor", etc. I read the language of the Bill and posted comments that I do not believe it will ever pass because it is way too ambiguous and vague. There are terms that are not clearly defined and there are obvious politically-motivated groups fueling the Bill (e.g., the AMA and ADA).
Why does this Bill exist in the first place? Does the big-bad-old AMA wanna hurt optometrists? NO. This Bill is only partially focused on optometry. What it really is geared for is ANY health care professional who INTENTIONALLY, DELIBERATELY, or NEGLIGENTLY induces the public (a barely literate public that is already incredibly naieve and uninformed) into thinking that he/she is a physician or possess training equivalent to a physician.
Using the title "doctor" is only a small portion of what the Bill would limit. However, remember one thing, UNLESS your state has a specific law that limits the title "doctor" to specific uses, ANYONE who holds an earned doctorate, either academic or professional, is allowed to use that title in any capacity he/she chooses. In most states, practitioners must qualifiy and clarify what kind of doctors they are (e.g., "Doctor of Optometry" or "O.D." versus "eye doctor"). Here, in MI, optometrists must advertise with O.D or "Doctor of Optometry" or "optometrist". In ads and on signs, they cannot use "eye doctor", by law. In common language, they can use "eye doctor", but this Bill would make that practice illegal as that usage would induce the public into thinking that "eye doctor" = MD/DO. Why? The public is comprised, by and large, of mostly uneducated, lazy people who don't know the difference and assume every "doctor" is an MD.
You shouldn't be so hung up on the title anyway. You can still be "Bob" and do your job effectively even if the Bill were to preclude you from using "doctor", which it won't. It's amazing how petty some people are when confronted with losing some "prestige".
This Bill is primarily aimed at chiros and naturopaths who are egregious in their deceptive practices. I've seen ads for chiros who are wearing white coats and stethoscopes. WTF? A chiro? Chiros love their "doctor" title and often use it without appending "D.C." or "Doctor of Chiropractic". Many chiros use chiropractic physician other terms like "sports medicine", "physical med and rehab specialist", "team physician", etc. Many naturopaths use the term physician and over-emphasize the title "doctor".
Where do ODs fall into this? The terms "eye doctor" and "optometric physician" ARE misleading, ambiguous, or deceptive. You may not think so, but in reality, no matter how good your schooling is, an OD is not a physician under most state medical practice statutes. Unless you want the liability of a "physician", and therefore, the malpractice insurance of one, be thankful you're not and don't use that term. Don't go around saying "eye doctor". Be specific and honest -- what's wrong with optometrist? Most patients are stupid, but even the dumb ones understand an orthodontist means braces and an optometrist means glasses/eyes.
Also, don't go outside your realm of knowledge or your scope of practice. PBEA went out of his way to explain how I, as an internist/psychiatrist, am an idiot when it comes to ocular dx and tx. At least I went to medical school and understand systemic medicine, not just ocular med/path. Increased IOP might be indicative of glaucoma or something else. ODs are not trained to read MRIs and CTs. You guys don't know how to read MRAs. You don't really know much about evoked potentials. You know what you know and know it well but there is MUCH more to practicing medicine as a PCP than what you know.
You went to school for 4 years to be an optometrist. Some of you did, or will do, a ONE year post OD "residency" (which is not a 24/7 on-call, in a hospital, working ALL floors residency). Physicians went to med school for 4 years (and by the way, this only gives us a medical education; we don't learn how to be doctors in med school, we learn how to be doctors in residency by rotating in OB-GYN, neuro, psych, path, emergency med, etc.) and then went through a 3-7 year residency learning our craft. We see hundreds of patients and rotate through a myriad of specialties learning the subtleties and nuances of diagnosis, treatment, appropriate pharmacological tx, diagnostic testing, radiology, test interpretation, patient-counseling, etc.
In 4 years, you learn how to be primary care optometrists, not physicians. There is simply no way your training is adequate or comprehensive enough to qualify you as a physician. I'm sorry to tell you this, but it's true. How many of you have had to go out into a waiting room and tell some parents their teenage son's suicide attempt was successful this time around? How many of you have ever had to tell someone they were dying or somone they loved had died?
That does not mean an OD is inferior to an MD. Far from it. You're just different. There is nothing wrong that. However, if you're proud of who you are and what you do, why compare yourself to dentists and doctors? Why not just be happy that you're an OD and do your job the best you can? This Bill won't pass, so don't worry about it. However, if you're honest and specific with your language, it shouldn't apply to you.
Peace,
Zack