Is this fair to the older ODs?

[planex]

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(A) An optometrist licensed for basic practice of optometry as of July 1, 2005, may continue to practice under the conditions provided for in this section, and regulations promulgated under this chapter, as of July 1, 2005, until September 30, 2008. A basic certified optometrist may:

(1) employ any means, other than the use of drugs, for the measurement of the powers of vision or the adaptation of lenses for the aid of vision;

(2) in the sale of spectacles, eyeglasses, or lenses, use lenses in the testing of the eye therefor other than lenses actually sold;

(3) examine the human eye by the employment of any subjective or objective physical means, without the use of drugs, to ascertain the presence of defects or abnormal conditions for the purpose of relieving them by the use of lenses, prisms, or other physical or mechanical means;

(4) practice orthoptics or prescribe or fit contact lenses;

(B)(1) An optometrist licensed for diagnostic practice of optometry as of July 1, 2005, may continue to practice under the conditions provided for in this section, and regulations promulgated under this chapter, as of July 1, 2005, until September 30, 2008, if the optometrist has:

(a) complied with the educational requirements promulgated by the board; and

(b) passed a pharmaceutical agent examination which must be approved by the board.

(2) Notwithstanding any other provision of law, a diagnostically certified optometrist may purchase, possess, and administer pharmaceutical agents including pharmaceutical agents for topical application, other than controlled substances as defined in Section 44-53-110, for diagnostic purposes in the practice of optometry. For the purposes of this subsection, "pharmaceutical agent" means: anesthetics, mydriatics, cycloplegics, miotics, dyes, and over-the-counter drugs. Miotics may be used only pursuant to the following restrictions:

(a) miotics may not be used for treatment purposes;

(b) miotics may be used only for emergency purposes involving the buildup of pressure within the eyeball and immediately upon this emergency use, the optometrist shall refer the patient to an ophthalmologist and file with the South Carolina Board of Examiners in Optometry a written report of the incident in the manner prescribed by the board by regulation; and the South Carolina Board of Examiners in Optometry shall ensure that the quality and quantity of miotics possessed by a diagnostically certified optometrist is consistent with the use of miotics only for emergency purposes involving the buildup of pressure within the eyeball.

(C) After September 30, 2008, no person may practice as an optometrist in this State if the person has not met all requirements of this chapter in effect at that time and as may be amended in the future. A basic and diagnostically licensed optometrist who wishes to be recertified after September 30, 2008, shall conform to the licensing requirements for a therapeutically-certified optometrist as provided for in regulation.

 

[KHE]

(A) An optometrist licensed for basic practice of optometry as of July 1, 2005, may continue to practice under the conditions provided for in this section, and regulations promulgated under this chapter, as of July 1, 2005, until September 30, 2008. A basic certified optometrist may:

(1) employ any means, other than the use of drugs, for the measurement of the powers of vision or the adaptation of lenses for the aid of vision;

(2) in the sale of spectacles, eyeglasses, or lenses, use lenses in the testing of the eye therefor other than lenses actually sold;

(3) examine the human eye by the employment of any subjective or objective physical means, without the use of drugs, to ascertain the presence of defects or abnormal conditions for the purpose of relieving them by the use of lenses, prisms, or other physical or mechanical means;

(4) practice orthoptics or prescribe or fit contact lenses;

(B)(1) An optometrist licensed for diagnostic practice of optometry as of July 1, 2005, may continue to practice under the conditions provided for in this section, and regulations promulgated under this chapter, as of July 1, 2005, until September 30, 2008, if the optometrist has:

(a) complied with the educational requirements promulgated by the board; and

(b) passed a pharmaceutical agent examination which must be approved by the board.

(2) Notwithstanding any other provision of law, a diagnostically certified optometrist may purchase, possess, and administer pharmaceutical agents including pharmaceutical agents for topical application, other than controlled substances as defined in Section 44-53-110, for diagnostic purposes in the practice of optometry. For the purposes of this subsection, "pharmaceutical agent" means: anesthetics, mydriatics, cycloplegics, miotics, dyes, and over-the-counter drugs. Miotics may be used only pursuant to the following restrictions:

(a) miotics may not be used for treatment purposes;

(b) miotics may be used only for emergency purposes involving the buildup of pressure within the eyeball and immediately upon this emergency use, the optometrist shall refer the patient to an ophthalmologist and file with the South Carolina Board of Examiners in Optometry a written report of the incident in the manner prescribed by the board by regulation; and the South Carolina Board of Examiners in Optometry shall ensure that the quality and quantity of miotics possessed by a diagnostically certified optometrist is consistent with the use of miotics only for emergency purposes involving the buildup of pressure within the eyeball.

(C) After September 30, 2008, no person may practice as an optometrist in this State if the person has not met all requirements of this chapter in effect at that time and as may be amended in the future. A basic and diagnostically licensed optometrist who wishes to be recertified after September 30, 2008, shall conform to the licensing requirements for a therapeutically-certified optometrist as provided for in regulation.

I beleive it is fair. The public has come to expect a much higher level of care, and this is not something that occured in the past 18 months. This is been something coming down the pike since well before I started school which was in 1996. If you're not therapeutically certified in 2008, you really should not be practicing.

 

[SarahNC]

Don't you expect your other health care professionals to be up to date, why should opt be any different? You wouldn't want your 70 year old surgeon still working under the education he received 50 years ago without recertification, would you?

 

[Oculomotor]

One of the biggest problems the optometry profession is facing is having a consistent public perception of what OD's are capable of doing. Having a consistent standard of care is vital. A patient going to the 75 yr old general optometrist (although few in number) who will not or cannot treat anything and would just refer out is going to have a totally different experience with a "therapeutic optometrist". If you can't be proactive and keep up with new technologies, scope of practice, etc....then you probably shouldn't be practicing. The public deserves the best. The other day I had to explain to someone why I will not be doing cataract and laser surgery in the future. A couple of days before I got a "confused stare" when I told someone that in most states OD's can prescibe oral meds, in all states they can Rx ocular meds, allowing them to treat primary eye diseases. This misinformed person was a nursing student who's entire family was in some area of medicine! lol We need to have a consistent public perception and that will come with Public Health Education and a more uniform scope of practice nationwide.

 

[eyestrain]

Until we get out of big box stores and malls (and strip malls next to the nail salon and pizza place (just for you, KHE)) our perception isn't going to change much.

 

[KHE]

Until we get out of big box stores and malls (and strip malls next to the nail salon and pizza place (just for you, KHE)) our perception isn't going to change much.

Ummmmm....excuse me!

The correct expression is "in the strip mall IN BETWEEN the nail salon and the pizzeria" and I hold the copyright on that expression.

I also hold the copyright on the following expressions:

"in between the nail salon and the Payless Shoe Source"
"pinch a penny until Lincoln screamed for mercy"

among others.

I demand a $5 royalty for each use. Payments can be made via paypal to my SDN address.

 

[aphistis]

"Therapeutic optometrist"?

I didn't realize there were different tiers of optometry training and licensure. What are the differences?

 

[Richard_Hom]

"therapeutic" - certified to use therapeutic pharmacological and superficial mechanical procedures to treat certain ophthalmic pathology

non-therapeutic - can use diagnostics to detect medical eye problems but cannot use any to treat.

 

[Oculomotor]

Aphistis,

Statistically the VAST MAJORITY of O.D.s out there are TPA certified (Therapeutic Pharmaceutical Agents---Oral and Ocular Medications (all states have topical ocular drugs--47 states have oral authority), and varying degrees of injectible drug privilege depending on the state laws). Therapeutic = using drugs to treat ocular disease/pathology. My home state has over 2000 O.D. licenses with 1950 or so have TPA certification, and the rest are DPA (Diagnostic Pharmaceutical Agents only). Most O.D.s are now TPA certified.

 

[KHE]

Aphistis,

Statistically the VAST MAJORITY of O.D.s out there are TPA certified (Therapeutic Pharmaceutical Agents---Oral and Ocular Medications (all states have topical ocular drugs--47 states have oral authority), and varying degrees of injectible drug privilege depending on the state laws). Therapeutic = using drugs to treat ocular disease/pathology. My home state has over 2000 O.D. licenses with 1950 or so have TPA certification, and the rest are DPA (Diagnostic Pharmaceutical Agents only). Most O.D.s are now TPA certified.

Of those 1950, how many of them are actually using that certification in any meaningful way? Talk to any ocular drug rep from any of the major pharmaceutical companies and you'll find that 90% of OD prescriptions for medications are written by 10% of the ODs.

 

[Oculomotor]

KHE,

I have posted optometric practice surveys a number of times on here from Optometry and Vision Science Journal, the Journal of the American Optometric Association, and a couple others. Statistically when take as a whole 70% of O.D.'s practice is refractive while 30% is ocular health---a.k.a. prescribing mostly topical ocular medications in the categories of:

1) anti-allergy
2) anti-biotics
3) anti-glaucoma

This is what the DATA says. I have rotated through several practices in the last year and I witnessed this with my own eyes. Again opinions, like mine, the opinion of a drug rep, and of individual O.D.'s is not reliable. My friend back home has a disease based practice and works part time in an eye hospital. He told me he writes oral CAI's twice a week! (very very rare in a regular optometry practice!) Another I know who works at Walmart says he wrote 3 prescriptions for meds a month----very few. Again opinions are unreliable to develop a "big picture". You have to look at scientific data and I have 4 practice surveys done by peer reviewed journals that surveyed O.D.s from multiple practice settings that all indicate 70% refractive, 30% eye-health/ mostly topical meds (few orals here and there.) Please give me scientific data to back up what you said.....


KHE--Note: quite a few of those 1950 are getting DEA numbers (new law passed) and after speaking to the Executive Director of the State Optometry Board he said that treating eye disease (at the "primary ocular care level"---his words) is common place in the state.

 

[planex]

Don't you expect your other health care professionals to be up to date, why should opt be any different? You wouldn't want your 70 year old surgeon still working under the education he received 50 years ago without recertification, would you?

I agree that change is definitely needed and it should be required in each of the states' licensing boards of optometry and medicine as well.
The change I am referring to is education and competency for all professions need to be brought to higher levels of proficiency through time and required for licensure and especially renewals.
It should never be considered a degree earned and then done learning and proficient for all things within a profession which may be brought into the scope of legislated professions over time.

 

[KHE]

You have to look at scientific data and I have 4 practice surveys done by peer reviewed journals that surveyed O.D.s from multiple practice settings that all indicate 70% refractive, 30% eye-health/ mostly topical meds (few orals here and there.) Please give me scientific data to back up what you said.....

KHE--Note: quite a few of those 1950 are getting DEA numbers (new law passed) and after speaking to the Executive Director of the State Optometry Board he said that treating eye disease (at the "primary ocular care level"---his words) is common place in the state.

I have no scientific data to satisfy you because that data is marketing data that is propriertary to the drug companies, not born out of a scientific study.

Rather than rely of a survey of doctors who are self reporting their practice habits, making the results dubious at best you should consider asking the drug companies who make these anti glaucoma medications. Believe me when I say they know who's "selling" their product.

 

[Oculomotor]

Fair enough KHE.

One salient point that I will make is that it seems like you can practice optometry at any level you choose withing the scope of optometric training. I will take it as far as it can go in my future area of choice. Were the reps you dealt with from Alcon?

 

[KHE]

Fair enough KHE.

One salient point that I will make is that it seems like you can practice optometry at any level you choose withing the scope of optometric training. I will take it as far as it can go in my future area of choice. Were the reps you dealt with from Alcon?

Alcon, B&L, Allergan, and Pfizer. All said the same thing.

 

[Mucho Dinero]

fair indeed

 

[PeteRose]

These numbers that drug reps give don't give the entire picture. Here's why as explained to me. As previously noted, many optometrists don't have DEA numbers. If they are in a group practice or an ophthalmology practice, there may be only one DEA licensed Dr in the group. As you who practice know, pharmacies and insurance's computer systems are set up to only accept RX's with DEA numbers. Just easier filing I suppose. So if you are in a practice of 5 Drs and only have one DEA number for the group, the data will suggest that one Dr is writing all the scripts. Its getting harder and harder to write scripts without DEAs these days because you always get phone calls from pharmacies asking for the number. When you explain that you don't need one because you are a theraputic optometrist, they get lost fast. Its just easier to pay the fee and avoid the hassle. I suppose this sounds like a plug for everyone to get a DEA, otherwise ophthalmologists will be getting credit for many of our scripts and then will turn right back around and use the data against us when they want to paint a picture of us not doing our jobs.