I like optometry. I don't like unemployment. Someone find me an alternative.

[310]

If the law or US Supreme Court allows optical shops to hire optometrists in their stores, do you think there will be more job opportunities for ODs?

That is a state issue, and the answer is yes, that produces more jobs in states that allow it. Most of those jobs are nothing to write home about, though.

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[ophthope]

Yeah OK bro not everyone with the highest IQ's joins the M.D.s. Maybe some people realize that neuroplasticity is greater at a younger age and specializing in the eye younger is better? By the time Ophthalmology residents start learning a vast amount about the eye they are at a minimum age 26 for the average student. The pre-frontal cortex has already finished developing, the peak of abstract reasoning has passed.

Most medical post-graduates that start out an Ophthalmology residency have almost no clue what they are doing because the learning curve is so great and there is little to none exposure to eye care before residency except if they specifically do an ophthalmology rotation which is uncommonly available to medical students.

Seriously, neuroplasticity is greater at a younger age so OD training > OMD training? What a horrible argument.

Also I spent plenty of time even prior to my third year in medical school in eye care. In third year I of course got to spend even more time with Ophthalmology in the OR and in the clinics. And for four months of fourth year all I did was Ophthalmology. Not to mention the other rotations that added to knowledge I need to treat eye disease. You think my Rheumatology experiences have no impact on my practice of Ophthalmology? My Endocrinology, Infectious Disease, and extensive Surgery experiences have no utility? You're being completely absurd. But no worries, per your argument you've got greater neuroplasticity so maybe we can fix you yet.

Is our learning curve steep during PGY-2 year? Absolutely. Are we insanely well prepared to tackle eye-specific disease processes and begin surgery after medical school and internship? Absolutely. We have an insanely broad and deep base upon which we are working. You obviously have no idea what an MD education entails and how it applies to Ophthalmology.

This statement is as unfounded as it is pointless. If to you, "surpassed" means seeing more complicated pathology, well then hats off to you, but lest you consider yourself to be at the top of your perceived food chain, remember that cornea and retinal specialists have "surpassed" you. Fortunately, none of that matters. If your end goal was to call out a previous post about OD's being more proficient eye care providers than OMD's, you have succeeded, because the poster did not have a basis for that statement aside from neuroplasticity, which is a terrible argument in my opinion. Similarly, you have no basis (no relevent one) to support your opposite claim. To say that either one is a "more proficient" eye care provider is to propose an argument based on irrelevance and a false hierarchy. The two cannot be lined up that easily, because despite the overlap, they are two distinct professions, that in practice, should work together to provide the best care possible for the patient.

In my experiences with Optometric education, which admittedly are minimal, I have to say that OMD education absolutely entails orders of magnitude more experience with serious and varied eye pathology. I don't even really think that's a serious argument to be had. I agree that "surpass" or "more proficient" are not useful words and phrases to use in this discussion. As you precisely pointed out our two professions are distinct. Where I am training we highly value our Optometrist colleagues. They are wonderful eye docs. There need be no animosity.

Once all the scope of practice nonsense is settled down perhaps we can stop spending so much freaking money lining the pockets of lobbyists to make sure that some State legislature agrees or does not agree to let Optometrists repair lid lacs or do blepharoplasty or an AC paracentesis. If you want to do those, can we not all agree that you should just become on Ophthalmologist? In no way should that statement mean that Optometrists are less valuable, the difference is in training and education, not value. And perhaps if all that money was instead spent on lobbying Optometric organizations to stop opening so many new schools and flooding the market with Optometrists and watering down your degrees, well maybe we wouldn't have so many gloom and doom comments in this thread. I can only imagine how much a difference it would have made in the Optometry profession's outlook if that Oklahoma and Kentucky lobbing money was spent on restricting or maybe even closing a few of the lower-performing OD schools instead of allowing the opening of more. Instead, a crapload of money and effort was spent on lobbying for scope expansion and some OD practice in Oklahoma bought an OMD and now does a bunch of LASIK. Big win. Way to go. That battle was won over arguing that patients needed better 'access to care' and Optometrists could provide that with expanded scope privileges. Those patients desperately needed 'access' to surgical care for their elective surgery I suppose. I hope it was worth it to sit idly by why some school executive is ruining the value of your degrees and letting a few of your colleagues get rich while your world burns. Sorry for the rant there, but I personally know an Optometrist doing great work who is feeling the brunt of their degrees' declining value and some of this hits close to home. I can only imagine how ticked off some of you are about this.

Ultimately more than anything your last sentence is what we need to focus on: we should work together to provide the best care possible for the patient. I'm glad the AAO and AOA are at least talking to each other now. It's a step in the right direction.

 

[opto2be]

The payment gap from Medicare between optometrists and ophthalmologists is ridiculously high. A news release stated that there are 17,067 ophthalmologists nationwide, earning an average Medicare payment of $327,239. Meanwhile, there are 25,500 optometrists, earning an average Medicare payment of $26,667. Given the importance of Medicare, how are optometrists even surviving with their comparatively paltry payment?

 

[ophthope]

The payment gap from Medicare between optometrists and ophthalmologists is ridiculously high. A news release stated that there are 17,067 ophthalmologists nationwide, earning an average Medicare payment of $327,239. Meanwhile, there are 25,500 optometrists, earning an average Medicare payment of $26,667. Given the importance of Medicare, how are optometrists even surviving with their comparatively paltry payment?

That number does not correlate to "earning" like you may think it does. Look at the recent Medicare payment data dump. A lot of those 'Medicare payment' dollars go straight through our clinics and are passed on to others. For instance we get paid ~$2,105 for a Lucentis injection. That shows up as a $2,105 Medicare payment to us. What that doesn't show is that the Lucentis costs $2,000 and we have to store it refrigerated and if it goes bad before we use it, that's a $2,000 loss to the clinic. We are paid $105 for the exam that day, imaging, materials for the injection, and doing the actual procedure. Not to mention for taking all of that risk. So a lot of those payments are going to Genentech, a pharmaceutical company. It's not really going to us.

 

[310]

The problem with schools opening is something that 99% of optometrist are more concerned about than doing LASIK, which isn't gonna happen on any real scale anytime soon.

A big part of the problem is that optometrists don't decide if the schools open. The schools can exist independently of the optometry community's opinions if they meet certain requirements. But yes, lobbying to stop the schools would be nice.

 

[EyeCaptain]

In my experiences with Optometric education, which admittedly are minimal, I have to say that OMD education absolutely entails orders of magnitude more experience with serious and varied eye pathology. I don't even really think that's a serious argument to be had.

Which is why no one is making this argument. You created it yourself, for the purpose of destroying it. No one thinks Ophthalmologists don't need extensive experience with serious and varied pathology. An equally poor argument is making a definitive claim based on comparison immediately following an admission of limited experience. Especially when that claim involves the phrase "orders of magnitude."

I agree that "surpass" or "more proficient" are useful words and phrases to use in this discussion. As you precisely pointed out our two professions are distinct. Where I am training we highly value our Optometrist colleagues. They are wonderful eye docs. There need be no animosity.

I'm not really sure who you think you are agreeing with here. Your first sentence doesn't support the second, so I'll assume a typo, in which case I agree.

Once all the scope of practice nonsense is settled down perhaps we can stop spending so much freaking money lining the pockets of lobbyists to make sure that some State legislature agrees or does not agree to let Optometrists repair lid lacs or do blepharoplasty or an AC paracentesis. If you want to do those, can we not all agree that you should just become on Ophthalmologist? In no way should that statement mean that Optometrists are less valuable, the difference is in training and education, not value. And perhaps if all that money was instead spent on lobbying Optometric organizations to stop opening so many new schools and flooding the market with Optometrists and watering down your degrees, well maybe we wouldn't have so many gloom and doom comments in this thread. I can only imagine how much a difference it would have made in the Optometry profession's outlook if that Oklahoma and Kentucky lobbing money was spent on restricting or maybe even closing a few of the lower-performing OD schools instead of allowing the opening of more. Instead, a crapload of money and effort was spent on lobbying for scope expansion and some OD practice in Oklahoma bought an OMD and now does a bunch of LASIK. Big win. Way to go. That battle was won over arguing that patients needed better 'access to care' and Optometrists could provide that with expanded scope privileges. Those patients desperately needed 'access' to surgical care for their elective surgery I suppose. I hope it was worth it to sit idly by why some school executive is ruining the value of your degrees and letting a few of your colleagues get rich while your world burns. Sorry for the rant there, but I personally know an Optometrist doing great work who is feeling the brunt of their degrees' declining value and some of this hits close to home. I can only imagine how ticked off some of you are about this.

Ultimately more than anything your last sentence is what we need to focus on: we should work together to provide the best care possible for the patient. I'm glad the AAO and AOA are at least talking to each other now. It's a step in the right direction.

You are without a doubt preaching to the choir here. I have not met a single OD who wishes they could perform surgery, only disgruntled third year Optometry students who make ridiculous claims about something something neuroplasticity something, sparking meaningless confrontations like these.

My original argument stands. Here on SDN it is common to take passionate stances based on very limited knowledge and experience, such as OD vs. OMD education. Arguments as to which is better/who is more proficient at eyecare/arm wrestling, are pointless. By doing this, we are either stroking our own egos, or arguing that because the two professions are similar, one of them is unnecessary.

I am not accusing you of either one of those things. I am only making a general statement, hoping for more productive exchanges so that we can actually provide useful information.

 

[opto2be]

That number does not correlate to "earning" like you may think it does. Look at the recent Medicare payment data dump. A lot of those 'Medicare payment' dollars go straight through our clinics and are passed on to others. For instance we get paid ~$2,105 for a Lucentis injection. That shows up as a $2,105 Medicare payment to us. What that doesn't show is that the Lucentis costs $2,000 and we have to store it refrigerated and if it goes bad before we use it, that's a $2,000 loss to the clinic. We are paid $105 for the exam that day, imaging, materials for the injection, and doing the actual procedure. Not to mention for taking all of that risk. So a lot of those payments are going to Genentech, a pharmaceutical company. It's not really going to us.

The payment number for optometrists probably isn't the true earning then either. The true earning must be even less. Considering a significant portion of patients are the elderly population, it is disturbing that the average optometrist earns less than $26,667 from Medicare.

 

[ophthope]

Which is why no one is making this argument. You created it yourself, for the purpose of destroying it. No one thinks Ophthalmologists don't need extensive experience with serious and varied pathology. An equally poor argument is making a definitive claim based on comparison immediately following an admission of limited experience. Especially when that claim involves the phrase "orders of magnitude."

I didn't think you were making that argument, but it did appear that RadixLuminogen was making such an argument which is why I commented as I did. I wasn't creating the argument to destroy it; I meant it to stand in contrast to RadixLuminogen's claims that neuroplasticity and earlier focus on eye specialty care made ODs "possibly more proficient in eye care" in his words. My experience is limited and as you point out, my subjective experience doesn't offer much and we must consider real data in these discussions. That data does appear to be sparse, but perusing optometry school websites I see numbers like 1000-2000 patients seen during the entirety of training. That is absolutely on the scale of at least ten times fewer patient encounters than I will have in training. I'll have had more than 2000 patient encounters this internship year alone. Far more than that if you count the number that I have rounded on more superficially as a team. And I'll be seeing far more than that yearly as a PGY2-4. I've been spending 60-90 hours per week either studying medicine or performing direct patient care for the last 5 years except for about 9 months in there during M4 year and between M1 and M2 years, and will continue to invest my time at that level for the following 3-5 years. Once again this is subjective, but comparatively this is far more than the OD students that I know. I'm not trying to be hyperbolic here when I say 'order of magnitude', just realistic when confronted with comments like RadixLuminogen's. It is a gargantuan amount of effort and sacrifice to become a well trained Ophthalmologist or any sort of MD/DO, and just as noone should attempt to diminish or lambast the training which Optometrists undergo - Ophthalmology deserves the same respect and I feel no shame in arguing for that. Again EyeCaptain I do not think you are disrespectful toward any sort of medical practitioners in any way, this is a general argument.

Once again I feel the need to clarify that I am in no way intending to bash the training of Optometrists by saying this, I'm not saying that Optometry school doesn't expose one to enough patients to be an Optometrist, I am only trying to defend my own profession's training. I hope that one day our professions reach a point when we can talk about training differences without having to add qualifiers like this though.

I'm not really sure who you think you are agreeing with here. Your first sentence doesn't support the second, so I'll assume a typo, in which case I agree.

It was a typo. The word "not" was missing. I've corrected it in the original post now.

You are without a doubt preaching to the choir here. I have not met a single OD who wishes they could perform surgery, only disgruntled third year Optometry students who make ridiculous claims about something something neuroplasticity something, sparking meaningless confrontations like these.

Quite honestly I don't find these discussions meaningless. I like to discuss these confrontational-in-nature things here because lets be honest - there's no way I'm going to discuss them with the Optometrists I work with as a resident. Even among the private practices where I've been in which ODs and OMDs work together scope of practice issues were talked about behind closed doors. Where else are we going to talk about this stuff? Right now it's just on various State Capitol hills while wearing pins, flying banners, screaming at each other and spending hundreds of thousands of dollars for the privilege. My wife holds a privileged position as she is friends with a handful of Optometrists' spouses in her home State, and they seem free to be more candid with one another. Perhaps our best bet would to be let our spouses figure it out as they somehow are able to have amicable conversations in public settings.

I haven't met any actual ODs either who are vocal about performing surgery, but I have met some OD students who are definitely vocal about it. While I often see the argument that most ODs in practice feel as you do and while I do not know any ODs myself who have any desire to perform surgery, I'm not sure that is actually the case. Once again both of our experiences are entirely subjective and limited although I'm sure as an OD you know far more ODs than myself. However I get the feeling that there must be a fairly legitimate number who do think ODs should be doing surgery or at least small number with deep pockets who think so because the scope of practice battles that OD lobbying has won are most definitely about surgery. Although perhaps some of the problem is defining 'surgery' as well. I get the feeling that some people would say that anything performed with any sort of laser doesn't qualify as surgery, and some people who want to refer to tweezer epilation as a surgical procedure.

Along this line of discussion I would be curious to see what ODs and OD students on this forum think is the role of Ophthalmology in eye care, as well as what they think that ultimately what the final scope of practice goal should be for Optometry. I don't think I've ever seen a discussion about that. Confrontational or not I'd be interested in seeing the comments...

 

[EyeCaptain]

You were right to defend your profession against RadixLuminogen's comments, I only assumed that because you were responding to a quote of mine that you believed I had made that argument. He obviously was spitting smoke. Qualifiers like that are only necessary when you deal with experts on neuroplasticity.

I can't speak for the ~30,000 OD's in the US, but I honestly believe there are very few who would agree with lobbying for surgical privileges. Among Optometry students it would definitely be more popular because they are typically in favor of anything that expands the OD's scope of practice. I agree that controversial topics are welcome. The "who's better" argument is the one I believe to be pointless.

I would much rather send my wife to capitol hill than go myself, so I also agree with you there. She is very civil in social settings. Plus I don't want to go to capitol hill.

 

[PBEA]

If the law or US Supreme Court allows optical shops to hire optometrists in their stores, do you think there will be more job opportunities for ODs?

that is already allowed, and while it may have created "more job opportunities" (or artifical demand, IMO) those kinds of settings are typically not desirable. You will either compromise your ethics or become really good at rationalizing your behaviour.

 

[SMK_12]

"Because it's clean" and you enjoy "drawing pretty irises" are just about the dumbest reasons in the world to become an optometrist.

Being an optometrist (any clinician) requires a good background in science and scientific method. You also need to have good critical thinking skills and a genuine sense of scientific curiosity to be a good clinician. You seem to have none of that.

I don't think this is the career for you.

The person is asking advice about what it's like to be an optometrist, not your opinion or their reason for considering the profession. I've been considering optometry as a profession, but am reconsidering after reading these forum threads. Not so much because of the advice all of you give about how awful the career is, but more because so many of the optometrists replying on these forums sound like a bunch of whiny, snarky, judgemental jerks. I would think people skills would be important to succeed or enjoy a career which involves dealing with the public...you seem to have none of these.

 

[Weirdy]

The person is asking advice about what it's like to be an optometrist, not your opinion or their reason for considering the profession. I've been considering optometry as a profession, but am reconsidering after reading these forum threads. Not so much because of the advice all of you give about how awful the career is, but more because so many of the optometrists replying on these forums sound like a bunch of whiny, snarky, judgemental jerks. I would think people skills would be important to succeed or enjoy a career which involves dealing with the public...you seem to have none of these.

This was 3 years ago.

 

[SMK_12]

It may have been posted 3 years ago, but it is still one of the first links that shows up when someone Google searches for advice on becoming an optometrist. It is also still amongst the many rude and unprofessional responses on this forum that are available for the world to see as a representation for the type of people in the optometry profession. I have been researching several health care professions that I have been considering and have not seen such a large number of negative, unhelpful and ignorant replies as I have with optometry. I don’t understand what this is about, but if optometrists are accurately represented by the calibre of people shown here, potentially having these types of people as my future colleagues would certainly be a deterrent from entering this profession.

 

[Weirdy]

It may have been posted 3 years ago, but it is still one of the first links that shows up when someone Google searches for advice on becoming an optometrist. It is also still amongst the many rude and unprofessional responses on this forum that are available for the world to see as a representation for the type of people in the optometry profession. I have been researching several health care professions that I have been considering and have not seen such a large number of negative, unhelpful and ignorant replies as I have with optometry. I don’t understand what this is about, but if optometrists are accurately represented by the calibre of people shown here, potentially having these types of people as my future colleagues would certainly be a deterrent from entering this profession.

I can tell by the way you speak you are mentally still young.

Especially if you are basing the whole profession on something you've seen on SDN.

Grow up. Do your own research. Shadow vigorously.

If you have time to dig up 3 year old SDN posts and speak eloquently about a non-factor, you should have time to score well on your OAT and shadow the different modalities available for optometry.

 

[SMK_12]

This was 3 years ago.

It may have been posted 3 years ago, but it is still one of the first links that shows up when someone Google searches for advice on becoming an optometrist. It is also still amongst the many rude and unprofessional responses on this forum that are available for the world to see as a representation for the type of people in the optometry profession. I have been researching several health care professions that I have been considering and have not seen such a large number of negative, unhelpful and ignorant replies as I have with optometry. I don’t understand what this is about, but if optometrists are accurately represented by the calibre of people shown here, potentially having these types of people as my future colleagues would certainly be a deterrent from entering this profession.

 

[SMK_12]

I can tell by the way you speak you are mentally still young.

Especially if you are basing the whole profession on something you've seen on SDN.

Grow up. Do your own research. Shadow vigorously.

If you have time to dig up 3 year old SDN posts and speak eloquently about a non-factor, you should have time to score well on your OAT and shadow the different modalities available for optometry.

You are giving me advice to "grow up" after a response like the one you have given. Clearly I am not basing my final decision on some forums. I am in the preliminary stages of choosing a career and am taking the typical steps of doing a basic search for pros and cons to some different options. The point I was "eloquently" trying to make is that the type of replies given on this forum are obscenely rude and immature. Any who seems to point this out is met with yet another rude and immature response. It makes me angry just reading them and I'm surprised that people who have gone through a 4 year doctorate degree would come out with such a level of social immaturity. I'm sure the 15 minute search I have just done to look up "job satisfaction for optometry" will not impact any test I am to ever take. I appreciate your advice and now here is some I have for you: have some manners, show some respect and conduct yourself in more a more professional manner. Hiding behind the anonymity of a computer is no reason to act ignorant.

 

[Weirdy]

You are giving me advice to "grow up" after a response like the one you have given. Clearly I am not basing my final decision on some forums. I am in the preliminary stages of choosing a career and am taking the typical steps of doing a basic search for pros and cons to some different options. The point I was "eloquently" trying to make is that the type of replies given on this forum are obscenely rude and immature. Any who seems to point this out is met with yet another rude and immature response. It makes me angry just reading them and I'm surprised that people who have gone through a 4 year doctorate degree would come out with such a level of social immaturity. I'm sure the 15 minute search I have just done to look up "job satisfaction for optometry" will not impact any test I am to ever take. I appreciate your advice and now here is some I have for you: have some manners, show some respect and conduct yourself in more a more professional manner. Hiding behind the anonymity of a computer is no reason to act ignorant.

The moral high ground is fine- for someone who has not gone through the schooling and experienced the real work-life for themselves.

I use my anonymity to be brutally honest with you. No one will tell you what you don't want to hear in real life.

Another word of advice, SDN is an internet forum, nothing more. Whether the posters hold doctorate degrees or a high school GED, you should read more and post less, question their responses and experiences, cipher between what is real and what is fake.

Your shortcomings lie in the fact that you are too rigid with your image of what a doctor should be, say, and act like. Professionalism taken to the nth degree even on an internet forum is unrealistic.

Good luck with your journey. Learn to grow a thicker skin so your conviction for what you want does not get shaken so easily. You will have a harder time when you encounter patients or colleagues in real life who act even worse than what you've seen on an internet forum.

 

[SMK_12]

The moral high ground is fine- for someone who has not gone through the schooling and experienced the real work-life for themselves.

I use my anonymity to be brutally honest with you. No one will tell you what you don't want to hear in real life.

Another word of advice, SDN is an internet forum, nothing more. Whether the posters hold doctorate degrees or a high school GED, you should read more and post less, question their responses and experiences, cipher between what is real and what is fake.

Your shortcomings lie in the fact that you are too rigid with your image of what a doctor should be, say, and act like. Professionalism taken to the nth degree even on an internet forum is unrealistic.

Good luck with your journey. Learn to grow a thicker skin so your conviction for what you want does not get shaken so easily. You will have a harder time when you encounter patients or colleagues in real life who act even worse than what you've seen on an internet forum.

I think somewhere along the line this conversation has completely gone on a different topic from what I had written. I’ve been doing searches of job satisfaction within various health professions to get some basic ideas of how people in fields view their jobs. There are an unusual number of rude, negative and unhelpful responses and posts from optometrists. It stands out as I have not seen anything like it from anything else I’ve read from other health professionals. Others I have known doing similar searches (a very common thing to do for those considering future plans) have commented on how rude and negative towards their profession the optometrists and optometry students seem as well. The message I commented appeared to me as an inappropriate response directed at someone politely asking advice on working as optometry and I chose to comment on my opinion of the nature of these responses. Some how you have twisted this around to attack me in various ways on assumptions you’ve made without basis. None of your “brutal honesty” has been of much use to me because it’s simply based on unfounded judgements you’ve been contriving. I’m not asking for any advice from you, I’m simply stating a rule of common decency and a distain for the immature, rude and bullying remarks. Other than the odd comments you made towards me about being supposedly immature in trying to base my career choice on a forum, the remarks on here have not been directed at me. I’ve not posted on here other than this weird back and forth discussion that’s been going on between the two of us, and so thick skin really has nothing to do with it.