Job satisfaction

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ReMD

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Have any of you heard from private practice or academic Ophthalmologists that would advise against going into Ophthalmology nowaday or wish they specialized in a different medical field? Just wondering if all the legal, business, and reimbursement issues have taken a toll on job satisfaction in the "real" world. Maybe some of you have family members in the field or know a private practitioner well.

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Coming from a family of ophthalmologists, I can say that not one of them would want to do anything else with their lives... In fact, I don't know of one ophthalmologist who would. Everyone loves this discipline!!! In fact, it is so desirable that even those who aren't real doctors (I'm looking at the bottom-feeding OD's on this one) want to get into it...
 
brendang said:
Coming from a family of ophthalmologists, I can say that not one of them would want to do anything else with their lives... In fact, I don't know of one ophthalmologist who would. Everyone loves this discipline!!! In fact, it is so desirable that even those who aren't real doctors (I'm looking at the bottom-feeding OD's on this one) want to get into it...



Okay, okay we have to admit that this was a little harsh...they are still our collegues.
 
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brendang said:
Coming from a family of ophthalmologists, I can say that not one of them would want to do anything else with their lives... In fact, I don't know of one ophthalmologist who would. Everyone loves this discipline!!! In fact, it is so desirable that even those who aren't real doctors (I'm looking at the bottom-feeding OD's on this one) want to get into it...

I think that it's beyond hysterical that a guy who couldn't get into a medical school or residency program in his home country despite coming from a "family of ophthalmologists" and ends up at SABA and one of the lowest rated ophthalmology programs in the country would refer to any group of people as "bottom feeders."

Jenny
 
JennyW said:
I think that it's beyond hysterical that a guy who couldn't get into a medical school or residency program in his home country despite coming from a "family of ophthalmologists" and ends up at SABA and one of the lowest rated ophthalmology programs in the country would refer to any group of people as "bottom feeders."

Jenny

Jenny, he is still a medical doctor... what are you?? a freakin' OD? yuk
go prescribe some glasses or something
 
plasticbuddy said:
Jenny, he is still a medical doctor... what are you?? a freakin' OD? yuk go prescribe some glasses or something

Haha... if I'm not mistaken, JennyW is an OD, and from her past posts, a very knowledgeable one.

But regarding the original question, all of the ophthalmologist that I've interacted with have been very enthusiastic about the field. That was one of the reasons that I applied into the field. I'll tell you in a few years if my pespective has changed, but for now, I'm very enthusiastic about the field of ophthalmology.
 
So the question was what again??? Can't we all just get along?

Anyways, I have a family member in the field as well, and is exceptionally happy with his life. He's in private practice, works really hard (by his own choice), and loves his career. My advice is to spend time with real-world ophthalmologists in addition to your academic ophthalmologists, especially if that is where you eventually want to end up practicing. Try to get a feel for ophthalmology outside of academia, it can be very different!
 
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I have actually met a some that have regrets/issues with their choice. Both are younger ophthos and made comments like "it isn't what I thought it would be, I am working until 7 every night" or "If I could do it again I would have done a fellowship". The same docs said they love the work just not the other stuff that is changing the way the field is practiced.

They both commented about having to see patients to quickly because of lower compensation.

Just to note I am still leaning toward ophtho.
 
abcde said:
I have actually met a some that have regrets/issues with their choice. Both are younger ophthos and made comments like "it isn't what I thought it would be, I am working until 7 every night" or "If I could do it again I would have done a fellowship". The same docs said they love the work just not the other stuff that is changing the way the field is practiced.

They both commented about having to see patients to quickly because of lower compensation.

Just to note I am still leaning toward ophtho.


ABCDE, what's the "other stuff that is changing the way the field is practiced"
?? thanks snowinter
 
snowinter said:
ABCDE, what's the "other stuff that is changing the way the field is practiced"
?? thanks snowinter

i was wondering if anyone here was thinking about another surgical field (gen surg, plastics, ortho, uro, ent, etc) chose ophtho and regretted it.
 
I love medicine and do it because I enjoy surgery, patient care, and the challenge.

However, through out my training, I've learned that medicine no longer is the place to make a huge amount of money. If you hope to make millions- or even higher than several $100k/year, then medicine is not the place to be - for the average Joe physician (I've added this last statement b/c there are some who will capitalize and run their practice like a machine. These few individuals are truly exceptional. For instance, a former Iowa resident does 30-40 cataracts a week in Florida. You can do the math.).

But you'll argue, Andrew, there are specialties that make in excess $500K/year now. It's only a matter of time before the government and insurance companies take the high reimbursement rates away from the more lucrative fields, such as radiology, rad-onc, surgery, etc... There is only so much $$$ for medicine and the bank is broke. Trust me, no matter what field you pick, count on reducing your starting and average incomes by the time you're ready to practice.

The only people getting "rich" are the CEOs and executives of pharmaceutical companies, medical insurance companies, and other health care related companies. While these companies and their stock holders make money, congress and insurance companies continue to squeeze physicians more and more. Our response? Physicians have accepted the cuts and work harder. We see more patients. We accept less for our services. Less fees = more patients x more hours worked to make the same.

My advice: do it because you love it. If you love it, then the money is icing on the cake. If you hate it, then money becomes the shackle that binds you to the thing you hate.

For me, I've decided I love medicine. I don't expect to make money from doing surgery on patients and seeing clinical patients. This is why I've decided to practice in the military where I can deliver care to all, learn to live with my $120K/year starting salary, and not look for opportunities for me to do more surgeries & see more patients so that I can make more money via clinical medicine.
 
GrandMasterB said:
i was wondering if anyone here was thinking about another surgical field (gen surg, plastics, ortho, uro, ent, etc) chose ophtho and regretted it.

I was darn close to doing G-surg, but changed my mind when I saw my first cataract surgery. I wouldn't go back for anything.
 
I actually did rotate for 2 weeks earlier this year with an ophtho who tried very hard to talk me out of doing this specialty. He was involved for a long time in the fight at the state level to protect his profession, and was completely discouraged and burned out after all the losses to the OD's. Interestingly enough, he got divorced, and ended up marrying an optom 25 years his junior! Talk about surrender.

Let's face it, if you want $$ and lifestyle, right now, it's all about anesthesia, rads, and maybe a few other fields. The ironic thing is, that could all change by the time we get done with training. What convinced me to stick with ophtho was that 1) I like it more, and 2) rads and gas are facing exactly the same pressures we are in protecting their fields--from teleradiology in other countries and from nurse anesthetists. The gas boys are walking a particularly dangerous line, methinks. Have you noticed how many CRNA programs have changed to be Ph.D programs instead of master's? And when they're done, they're called, um...."doctor"? :p

Somebody's been taking lessons in obfuscation from.........I won't say it.
 
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I am not an ophto myself, but through my wife I have met many PP ophthos over the past couple of years. I have yet to meet one who is truly unhappy about his choice of specialty. They will ALL whine about how they have to work harder for their money, how the money-grubbing OD's make their life difficult and how things are just not the way they ought to be. But if you ask them whether they would rather do something else, they might joke that doing derm would have been a better choice, but none of the ones I have met so far would trade.

ALL specialties have the same issues to contend with in one way or another. Shifts in 'turf', intrusion of midlevels from one end (FP, peds, gas, optho), reductions in reimbursement and crashing case##s on the other end (e.g. CTS,GS).

If you want to make money: Leave medicine, get an MBA and open a homecare company or mailorder pharmacy. By the time you would finish residency, you will be up and running and well into the second mill that you scammed out of medicare.
 
As for the 'commercially successful' ophthalmologists, the ones doing 1000s of cases every year. I found this letter to the editor of AAO's EyeNet magazine a pretty good reflection of something I have observed in several cities so far (I hope the AAO and the mods here don't crucify me for the copyright infringement):

http://www.aao.org/news/eyenet


Phacomania: A New Phenomenon?

They always tell you how many cases they did in a day. It is a compulsion. You are supposed to be impressed. Six, seven or eight cases per hour. Each case perfect with no vitreous loss, 20/20+ vision, one day postop and a crystal clear cornea. They usually tie up two or three operating rooms and come in with a small army of support personnel to keep the flow going. They are truly gifted surgeons.

But what about the indications for cataract surgery? Does anyone ask the patient about their visual needs or how much trouble they are having? I’ll bet not. The indications for surgery must be loose. The technician gets the glare meter out and tells patients how poor their vision is and how bad the numbers are.

“But I seem to see pretty well and am not really having a problem, other than occasional difficulty seeing the golf ball.” The retiree is unable to see a golf ball at 100 yards and would benefit from cataract surgery. Why deny this geezer the only pleasure in life that he has left? “I must be seeing a whole lot worse than I thought—guess I better get these cataracts out.”

So this is what cataract surgery has come to. The surgeon will do the most cases possible and let the system absorb the cost. Occasionally, the patient shows up to the operating room and hadn’t seen the surgeon preoperatively. They are slowly killing the goose that lays the golden egg, ruining the system for those who do not practice that way.

The cataract surgery decision is—99.8 percent of the time—made by the patient. They decide how much trouble they are having in their life, not the technician or ophthalmologist.

A conscientious ophthalmologist will actively listen to the patient and help with the decision. You do not need 20/20 vision in each eye to “get through the gates.”

Phacomania is a form of slow insanity practiced by an ever-increasing number of ophthalmologists who don’t want to deny the world their surgical talents.

Judson P. Smith, MD
Fort Worth, Texas
 
this might be thoughts from a naive newcomer ...

but with the "baby boomer" population aging and diabetes as an ever-growing epidemic . . .. and since there is a cap on ophthamologist (only 420 new spots each year for us to match into ) how can business not be set? our population is growing -- but we aren't pumping out more eyes surgeons/doctors.

personally, lifestyle *is* important to me. eventually in my practice i hope to work 4-day weeks .. or some modified practice. its not so important to me to make big huge $$. then i wont look over at the ppl who are and be jealous. b/c i'll have that time off... to *live* and that will increase my job satisfaction.

we sure are getting negative on this forum. has it always been this way?
:love:
 
The US is pretty well stocked with ophthos at this point. If you are looking for a practice opportunity you have to look really hard to find a town that doesn't have a glut of ophthalmologists. They all do well, but the threshold to perform surgery is frequently 'adjusted' to make up for the shortage of surgical patients.

> personally, lifestyle *is* important to me. eventually in my practice i
> hope to work 4-day weeks .. or some modified practice. its not
> so important to me to make big huge $$.

There are plenty of ophthos out there that do exactly that. 4 days for the practice, 3 days in the lakefront condo. I find them the most pleasant people to hang out with.
But there are also plenty of hustlers. Running around 6days/week between 3 offices, doing some refractive here and some contracted clinic work there, allways on the lookout for a business opportunity, shareholder in some optical shop/OD office etc.
 
My experience has been that ophthalmologists are happy docs. I believe that these issues that you talk of (legal, business, etc) have taken their tolls on all fields of medicine...not just ophtho. In the end, I think it boils down to what you see yourself doing 10-20 years out of residency and making sure you choose a profession that will make you excited to get out of bed each morning and go to work. I know a lot of ophthalmologists in private and academic settings who love their work. I also know a couple who are completely miserable. I think this difference has to do with personality rather than the profession. Yes, lifestyle is important and everyone wants to make a good living, but like others on this thread have stated, you can be as busy as you want to be as an ophthalmologist and make $$$, But this will not necessarily make you happy.
 
this is a little silly (ie i know there is no great answer) but what personalities do you guys think fit well/ people end up being happy in ophtho?>
 
GrandMasterB said:
i was wondering if anyone here was thinking about another surgical field (gen surg, plastics, ortho, uro, ent, etc) chose ophtho and regretted it.


Actually, I started in general surgery. Had a categorical position and absolutely loved it. Critical care and trauma are very exciting. Unfortuantely, this was back when there were no hours regulations and I commonly worked 125 hours each week.

General surgery was great but I love my wife much more than any job, and she was miserable, so I applied to ophth. In medical school, I had promised her that if medicine ever negatively impacted our relationship I would change, so I kept my promise. Luckily I was accepted and it has been the best medical desicion I have ever made. At first I was bored out of my mind in ophth. Especially after spending the year before on every other or every third night ICU call, months at a time. As I learned more ophth I started to enjoy it more. Even today, I miss the excitement of general surgery but you sometimes have to make choices in life. I traded excitement for a much better lifestyle, and actually more money (I didn't decide for that reason, it is just how it has worked out). I decided life was too short and my wife was more important. If you have a choice, do ophth. It is fantastic.
 
brendang said:
Coming from a family of ophthalmologists, I can say that not one of them would want to do anything else with their lives... In fact, I don't know of one ophthalmologist who would. Everyone loves this discipline!!! In fact, it is so desirable that even those who aren't real doctors (I'm looking at the bottom-feeding OD's on this one) want to get into it...


ease up on the ODs. I cant approve of their methods but life is always a struggle and people will try any way to advance their cause. I dont approve, I cant change their minds, I dont want a relationship but human beings all deserve basic respect.

In regards to your practice happiness, more power to you but let me balance your perspective. The government will cut most physician reimbursement to medicare by 25% over the next 5 to 7 years. Large practices have 65 yo 75% overhead already. When the next round of cuts happens. the flushing sound will be unbelieveable. If i had a large family based ophthalmic practice I might be less stressed about the future but the future looks bleak indeed for all of medicine.

If i had a talent in computers, business skills, real estate, even commercial construction, I would look at the whole picture before i decided to "help people" Yes it is a beautiful field but the government and big business have made physicians including ophthalmologists their private punching bag.

Think about working hard AND smart

SamDo
 
I don't know much about this subject, so I thought I'd try to summarize the con's of ophthalmology: (it is a field i am considering)

1. Encroachment, specifically by OD's
2. Surplus, especially in large cities
3. Shrinking reimbursements
4. Malpractice crises

None of these problems seem like they will be going away soon? The surplus may be ameloriated by the diabetes epidemic, but management of diabetes is also advancing too.
Just wondering, if there are too many ophthalmologists, why aren't the residency slots reduced? Is it because the hospitals do not want to lose government funding?
 
carrigallen said:
I don't know much about this subject, so I thought I'd try to summarize the con's of ophthalmology: (it is a field i am considering)

1. Encroachment, specifically by OD's
2. Surplus, especially in large cities
3. Shrinking reimbursements
4. Malpractice crises


The "Cons" you mentioned here are not unique to just ophthalmology but affects ALL of medicine.

Even CT surgeons are finding a surplus in larger cities. BTW, ophthalmologists get paid more for a cataract surgery than many surgical procedures. In radiology, out sourcing to foreign countries is killing the field. Ortho is fighting with podiatrists. Psychiatry is fighting with psychologists. Family practice and internal medicine are fighting to keep nurse practioners back. I can go on and on.

Solution? Physicians need to make a stand together.
 
I am of the opinion that the number of Ophthalmology residency positions is held high due to the possibility that Optometry is incroaching on Ophthalmology's turf. Ophthalmologist's will be able to say that there is an abundant supply of eye physicians, and hence, there is no reason to broaden the scope of Optometrist's practice. I am still very curious of how many newly boarded Opthalmologists or PGY-4 residents are going about finding a job. Even in the rural Midwest, where I am willing to work, I could only 12 job openings online. Traditionally, this area is begging for more physicians. I am really not worried about the salaries, just the actual ability to find a job.
 
I discuss the issue of ophth. spots with colleagues in private practice. Our consensus is that academics are a bit more insulated from the rest of the world. What do they care about how many doctors they train? Many stay within the university catchment area and refer complex cases back to them. There is really no negative feedback to train these doctors. The RAND support indicated there was an oversupply even if doctors retire early and residencys cut back.
THE only way to level things back out is if optometrists are held back from medical/surgical privileges, medical students abandon the speciality like anesthesia in the early 90s, and they cut back on the number of spots.

It is a tremendously physically and mentally challenging field BUT your autonomy and productivity are being taken away from you.

Samdo
 
How much do family practise ophthalmologists earn?
 
Andrew_Doan said:
The "Cons" you mentioned here are not unique to just ophthalmology but affects ALL of medicine.

Even CT surgeons are finding a surplus in larger cities. BTW, ophthalmologists get paid more for a cataract surgery than many surgical procedures. In radiology, out sourcing to foreign countries is killing the field. Ortho is fighting with podiatrists. Psychiatry is fighting with psychologists. Family practice and internal medicine are fighting to keep nurse practioners back. I can go on and on.

Solution? Physicians need to make a stand together.

One of the problems, so far as my limited experience goes, is that each different specialty has its own pet battle that it is fighting. Making a vast generalization, but how many pathologists (just picked at random, no insult to the path guys) actually care that podiatrists want to move up and start doing some ankle work? I know that, in abstract, all of medicine does want to keep things as is; but, in truth, radiologists don't have all the much vested interest in whether ophthalmologists get $600 for a cataract or $300. The various specialties are just too diverse for medicine as a whole to be a united front all that often.

So, I have something that might be worth thinking about/discussing. As we've seen recently, when ophthalmology and optometry can actually agree on something (plano contact lens bill) it gets done. Since ODs and OMDs are pretty much the only "eye doctors", they are the only ones who bill for any type of exam/procedure that involves the eyes (with a few exceptions here and there, like pink eye). It seems to me that a united MD/OD front regarding Medicare/Medicaid reimbursement might get some response.

Since many of you placed decreased reimbursement as one of the major problems facing ophthalmology and since this affects ODs as well, I tend to think that this is an issue where everyone can put aside the surgical-scope fight for a bit and concentrate on something that will a) help both ophthalmology and optometry in the future and b) might encourage further cooperation between MDs and ODs.

Any thoughts?
 
VA Hopeful Dr said:
Since many of you placed decreased reimbursement as one of the major problems facing ophthalmology and since this affects ODs as well, I tend to think that this is an issue where everyone can put aside the surgical-scope fight for a bit and concentrate on something that will a) help both ophthalmology and optometry in the future and b) might encourage further cooperation between MDs and ODs.

Any thoughts?

I agree to the above. At the Mid-Year Forum, I presented out a controversial idea... (which wasn't warmly received)- making a OMFS-like track for optometrists who want to do surgery. Medical doctors retain control of who does surgery and optometrists can then enter medical school to complete 1 year of clinical rotations without completing years 1 and 2, then internship, and ophthalmology residency along with the MDs and DOs. ODs must past USMLE 1, 2, and 3. Then in the end, they are awarded the MD degree.

I think this is the best solution. We standardize what makes a surgeon, and then allow ODs to enter that track. Only ODs who complete this track can perform surgery.
 
As an OD student, I think Dr. Doan's plan is a good one. This would allow ODs to perform surgery if they decided that is what they want, without repeating so many classes.

As these battles get so heated, please, don't lose site that ODs are very well trained doctors.
 
Andrew_Doan said:
I agree to the above. At the Mid-Year Forum, I presented out a controversial idea... (which wasn't warmly received)- making a OMFS-like track for optometrists who want to do surgery. Medical doctors retain control of who does surgery and optometrists can then enter medical school to complete 1 year of clinical rotations without completing years 1 and 2, then internship, and ophthalmology residency along with the MDs and DOs. ODs must past USMLE 1, 2, and 3. Then in the end, they are awarded the MD degree.

I think this is the best solution. We standardize what makes a surgeon, and then allow ODs to enter that track. Only ODs who complete this track can perform surgery.

Dr. Doan,
I think this is a good idea also; however when optoms see just how hard medschool is and how much competition there is for ophtho they will realize that the avg medical student would likely do better than them on the stepI and clinical rotations. Also they would probably need 2 yrs of medical school just as OMFS does (here at columbia this is how it works ... i don't know at other schools). Do you think the optoms should compete head to head w/medstudents for residency spots. (this would be entertaining)

I think it is a great idea in terms of compromise b/c it allows for ODs to have a "shot" at proving themselves for surgery and also becoming skilled enough not to hurt patients. however i think more battles will ensue once optoms realize just how tough it is and that it isn't "easy money" the good thing will be that politically the optoms that toughed it out in ophtho will side w/us. just a few of the best optoms on our side would be a winning formula politically.

-ra
 
I approve of Dr. Doan's idea. I'm not really sure how many optometrists would do it, but it would be a good program for the few OD's that would. I am just glad to see that someone on this site is not completely bashing optometrists and the profession. I will be entering optometry school this upcoming fall and have no intention of ever doing any surgery. If I did, I would have gone to medical school. People choose to do optometry not because they can't handle medical school, but rather the professional demands would fit their lifestyle better (ie want a family, free-time, and not be on call, etc). Despite most of everyone's opinions, I DO NOT think that many optometrists want to take away from the profession of ophthalmology. I just think that it is really sad that both professions can't get along. What is up with people saying that they wish that opticians would replace us and that you should scare your patients into thinking that optometrists are basically crap. I do not think that this is right at all!! I will not stoop as low as to say that all ophthamology students and graduates are this way because then I would be generalizing. In return, I would expect that all of you very intelligent people would not be generalizing about optometrists as well. For those people who do think evil and hateful thoughts about optometrists, all I have to say is that I would hate to think of the way that you treat your secretaries and patients. I just think there needs to be more mutual respect between the 2 professions because we both need each other.
 
Andrew_Doan said:
I agree to the above. At the Mid-Year Forum, I presented out a controversial idea... (which wasn't warmly received)- making a OMFS-like track for optometrists who want to do surgery. Medical doctors retain control of who does surgery and optometrists can then enter medical school to complete 1 year of clinical rotations without completing years 1 and 2, then internship, and ophthalmology residency along with the MDs and DOs. ODs must past USMLE 1, 2, and 3. Then in the end, they are awarded the MD degree.

I think this is the best solution. We standardize what makes a surgeon, and then allow ODs to enter that track. Only ODs who complete this track can perform surgery.

I AGREE 100%!!!!!!! The irony of this (from a personal standpoint is that my brother and I discussed this--he is a surgeon, and your suggestion was EXACTLY what he said....lol Your idea is great because you are accepting and respecting the noble OD degree (by not resigning canidates for your plan to retake a lot of classes over again) and allowing for a legitimate pathway. If you got this rolling---in 5 years when I am an Eye Doctor I will support it 100%. Bravo Dr. Doan. :thumbup: It makes a lot more sense than legal battles on both sides and a sea full of discontent. Allow primary care OD's to do have a broad formulary--treat more medically, do primary care type procedures, and allow OD MD, OD DO, OMD, ODO's to do surgery.-------This is the best idea I have heard about this topic....... ;)
 
Dr. Doan, I feel that your suggestion would definitely NOT be in the best interest of Ophthalmology. OMFS residents do not directly impact any of the traditional MD specialties. Yeah, they may do a little plastics here and there but, for the most part, they stay in their niche of oral surgery. Giving Optometrists the ability to be trained in surgery would only further cloud the public's perception and limit opportunities for medical students seeking Ophtho residency. Even a bottom of the class medical student would be more suitable than an Optometrist to enter an Ophtho residency. If Optometrists know they want to do surgery then they should excel in college, apply to medical school, then get an Ophtho residency. If they come to that realization during Optometry school, then they should quit and apply to medical school. Many people change careers and if an optometrist wants to do surgery then they can change careers too. A year or two used to change careers is not that significant amount of time when determining a lifelong career.
Pre-Optometrist/Optometrists can prove their ability to do surgery by pursuing the traditional route rather than being given additional opportunities not granted to other non-physician fields. Should Podiatrist be given the opportunity to go through an Ortho residency. I guess then Psychologists, Nurse practitioners, Nurse anesthetists, Chiropractors, Audiologists, etc, should be allowed the opportunity to train in their perspective M.D. residencies.
I don't think so!!
 
Andrew_Doan said:
I agree to the above. At the Mid-Year Forum, I presented out a controversial idea... (which wasn't warmly received)- making a OMFS-like track for optometrists who want to do surgery. Medical doctors retain control of who does surgery and optometrists can then enter medical school to complete 1 year of clinical rotations without completing years 1 and 2, then internship, and ophthalmology residency along with the MDs and DOs. ODs must past USMLE 1, 2, and 3. Then in the end, they are awarded the MD degree.

I think this is the best solution. We standardize what makes a surgeon, and then allow ODs to enter that track. Only ODs who complete this track can perform surgery.


I think you'll find the majority of ODs will find this idea acceptable, but your problem with be convincing the ophthalmologists that this is a good idea. I'd be willing to wager that the majority of ophtalmologists would rather have ODs perforiming surgery under their supervision rather than alongside them.
 
ecoscuba said:
I think you'll find the majority of ODs will find this idea acceptable, but your problem with be convincing the ophthalmologists that this is a good idea. I'd be willing to wager that the majority of ophtalmologists would rather have ODs perforiming surgery under their supervision rather than alongside them.

it's a horrible idea... it would only lead to the even more blurring of boundaries between the "good" guys and the "bad" guys... patients are already being duped into a false sense of security by optometrists... imagine if they completed anything remotely related to medicine (and i know that the micro, biochem, whatever classes optoms take are a cakewalk compared to what med students are expected to learn)? they already call themselves eye doctors, which, in my opinion, is too much leeway already. if surgery is what they want, let them go to medical school (even a caribbean one, if desperate enough) and then pray they get into an ophtho residency... i don't see how andrew's plan could ever be approved... we should be finding ways to segregate ourselves further as the sole providers of surgery, not providing a side-route for them to sneak in through...
 
brendang said:
it's a horrible idea... it would only lead to the even more blurring of boundaries between the "good" guys and the "bad" guys... patients are already being duped into a false sense of security by optometrists... imagine if they completed anything remotely related to medicine (and i know that the micro, biochem, whatever classes optoms take are a cakewalk compared to what med students are expected to learn)? they already call themselves eye doctors, which, in my opinion, is too much leeway already. if surgery is what they want, let them go to medical school (even a caribbean one, if desperate enough) and then pray they get into an ophtho residency... i don't see how andrew's plan could ever be approved... we should be finding ways to segregate ourselves further as the sole providers of surgery, not providing a side-route for them to sneak in through...

Well I would hope that if this plan was approved, it would be done in a way that the optometrists would be entered into a program where they earned an MD (similar to the OMFS programs where the dental students then earn an MD). Therefore, they would be medical doctors like the rest of us. Trust me, after those OD's earned their MD's and went through internship and residency, they wouldn't be about to campaign for OD's w/o MD's (i.e. who hadn't done all of that) to also be able to do surgery.

The main problem is: where would those training slots come from? The OD's would have to get accepted like 3 years in advanced and we'd have to take potential slots away from traditional medical students. Are any opthalmology residency programs really going to do that?
 
I am a medical student, and I like Dr. Doan's idea. Optometrists do have special expertise in the eye (not unlike dentists and teeth), and so it is reasonable to offer some kind of postgraduate training for those who wish to pursue a surgical career, not unlike OMFS.

I think that OMFS+MD is competitive to enter, and that hopefully the same thing would be true for an optometrist-type program. A program like this would attract the brightest and most enthusiastic optometrists into surgery, instead of dispensing privelges willy-nilly by region. It would also be better for insurance purposes.

I fail to see how this is a way to "sneak past" the MD's. I think it would impose a rigorous standard for any optometrist to do surgery.
 
dentists are trained surgeons... moreover, there is no speciality like dentistry through medical school. in that sense, i consider dentists to perform at the same level of responsiblity as physicians and surgeons... just because optometrists are finding themselves bored, frustrated or simply dated, doesn't mean that they can jump into something that they want to do simply because they know something about the visual system...
 
brendang said:
dentists are trained surgeons... moreover, there is no speciality like dentistry through medical school. in that sense, i consider dentists to perform at the same level of responsiblity as physicians and surgeons... just because optometrists are finding themselves bored, frustrated or simply dated, doesn't mean that they can jump into something that they want to do simply because they know something about the visual system...

LOL...You have a very derogatory view about the field I am entering...It is almost comical...are you a cartoon? "Something about the visual system....." Yeah---4 years about it! specific training in every way as skilled as a general OMD in the common primary care scut--beyond that ---OMD territory. Dr. Doan's idea is brilliant because it would be just as rigorous as what an OMD has to go thru and you are doing the SAME residency and passing the same boards. YOU CANT HAVE IT YOUR WAY....Optometry will get these privilages thru the courts state by state unless the professions strike a compromise.... The only person who "dated" is you because you are living in 1970 when OD's where only "glasses" doctors...It is 35 years later......wake up and stop posting foolish comments degrading the profession that supplies your cohorts with most of their referrals! You are seemingly the most insecure person I have ever seen post on here and frequently act like a 10 yr old in your scathing and disrespectful comments---you are laughable, irrelavent, anomoly in your own profession---the OMD's I know have alot of respect for the OD's they work with and refer with. You are sooooo insecure.
 
ReMD said:
Dr. Doan, I feel that your suggestion would definitely NOT be in the best interest of Ophthalmology. OMFS residents do not directly impact any of the traditional MD specialties. Yeah, they may do a little plastics here and there but, for the most part, they stay in their niche of oral surgery. Giving Optometrists the ability to be trained in surgery would only further cloud the public's perception and limit opportunities for medical students seeking Ophtho residency. Even a bottom of the class medical student would be more suitable than an Optometrist to enter an Ophtho residency. If Optometrists know they want to do surgery then they should excel in college, apply to medical school, then get an Ophtho residency. If they come to that realization during Optometry school, then they should quit and apply to medical school. Many people change careers and if an optometrist wants to do surgery then they can change careers too. A year or two used to change careers is not that significant amount of time when determining a lifelong career.
Pre-Optometrist/Optometrists can prove their ability to do surgery by pursuing the traditional route rather than being given additional opportunities not granted to other non-physician fields. Should Podiatrist be given the opportunity to go through an Ortho residency. I guess then Psychologists, Nurse practitioners, Nurse anesthetists, Chiropractors, Audiologists, etc, should be allowed the opportunity to train in their perspective M.D. residencies.
I don't think so!!
Nurse practitioners, CRNA's, are not doctors----Dentists, Optometrists, Podiatrists, AuD's, and (although non-drug) Chiropractors are DOCTORS....And yes there is a 4 yr residency to do lower extremity surgery (beyond the bread and butter stuff) for Podiatry..(I know because I looked at this field before I decided on Optometry)...And yes---they should be given the rights if they qualify in an OMFS type program.....So I guess you think Dentistry is a non-physician field? hmmmmmm An OMFS is an oral surgeon---hmmmmm sounds like a physician to me.... :D This is a different medical world than the one in your mind---embrace it...
 
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futuredoctorOD said:
LOL...You have a very derogatory view about the field I am entering...It is almost comical...are you a cartoon? "Something about the visual system....." Yeah---4 years about it! specific training in every way as skilled as a general OMD in the common primary care scut--beyond that ---OMD territory. Dr. Doan's idea is brilliant because it would be just as rigorous as what an OMD has to go thru and you are doing the SAME residency and passing the same boards. YOU CANT HAVE IT YOUR WAY....Optometry will get these privilages thru the courts state by state unless the professions strike a compromise.... The only person who "dated" is you because you are living in 1970 when OD's where only "glasses" doctors...It is 35 years later......wake up and stop posting foolish comments degrading the profession that supplies your cohorts with most of their referrals! You are seemingly the most insecure person I have ever seen post on here and frequently act like a 10 yr old in your scathing and disrespectful comments---you are laughable, irrelavent, anomoly in your own profession---the OMD's I know have alot of respect for the OD's they work with and refer with. You are sooooo insecure.

This is the problem with optometrists... OD's are NOT equipped to diagnose and treat "common primary care scut" in the same manner as physicians and surgeons... Until you, and every other OD, can understand this, I will never be able to afford the field your deserved level of respect. (And we're not even talking about surgery at this point!) Refraction, contact lens fitting and low vision aids are the ONLY things I have ever heard an eye physician and surgeon refer to an OD... Sorry, but I haven't yet heard of an optometrist who is referred from an ophthalmolgist for a glaucoma/strabismus/RD/CME/whatever plan of management...Perhaps things in Canada here are much more skewed than in the US, but I highly doubt it...

And why should I be so insecure? I've been accepted into an ophtho residency... I've just graduated as an MD... I'm going to be an eye physician and surgeon in a few years (with FULL surgical rights!!!)... I know my place. Do you?
 
futuredoctorOD said:
Nurse practitioners, CRNA's, are not doctors----Dentists, Optometrists, Podiatrists, AuD's, and (although non-drug) Chiropractors are DOCTORS....And yes there is a 4 yr residency to do lower extremity surgery (beyond the bread and butter stuff) for Podiatry..(I know because I looked at this field before I decided on Optometry)...And yes---they should be given the rights if they qualify in an OMFS type program.....So I guess you think Dentistry is a non-physician field? hmmmmmm An OMFS is an oral surgeon---hmmmmm sounds like a physician to me.... :D This is a different medical world than the one in your mind---embrace it...

FYI, A nurse practitioner and CRNA have much more prescriptive rights and scope of practice than optometrists. They actually make decisions that can mean life or death for a patient (treating MIs, placing central lines, running codes, etc). You or a family member will likely be cared for by one of these professionals in the future. They may as well be called doctors b/c they definitely do more than you will in terms of scope of practice. And believe me , physician supervision is minimal to almost non-existent. Please don't try to make your field more than what it really is. Optometry is a limited scope profession that is comparable NPs and CRNAs. I respect them all, including optometry but these are the facts.
Also, FYI, a traditional medical student cannot apply for an OMFS residency spot unless they attend dental school. OMFS programs are allowed b/c dentists are the only ones allowed to fill them.
I say again. If you want to become an Ophthalmologist, then go to medical school. That way you won't have to worry about all these insecurities you have with you profession and you can have unlimited scope of practice.
 
Oh yeah, just to let you know that nurse practitioners can specialize in any field of medicine they chose, including Ophthalmology. If they chose to specialize in Ophthalmology than their scope of practice would even be more than an optometrist. They would be able to perform minor surgeries under physician supervision. As far as scope of practice, the only difference b/w them and an optometrist, in this setting, is that they have to work under M.D. supervision and cannot practice privately. Just thought you should know this considering your last comment that there is no comparison b/w optometrists (who are "doctors") and NPs.
 
carrigallen said:
I fail to see how this is a way to "sneak past" the MD's. I think it would impose a rigorous standard for any optometrist to do surgery.

I agree, my medical school offers an OMF track and I don't think anyone at USC would regard these students as sneaking past anything. Look, if you pass USMLE parts 1, 2CS, 2CK, and 3, live through an internship and match into and successfully complete an ophtho residency, you are an ophthalmologist with all the rights and privileges thereof regardless of whether you started as an allopath, osteopath, optometrist or foreign medical graduate.

Do we regard our FMG friends who frequently ask for advice on this forum as "sneaking past the system" just because they went to a foreign medical school but are willing to undertake all the above mentioned requirements to enter into an ACGME approved ophthalmology training program? I hope not!

Though I do not agree with everything that futuredoctorOD says, he does bring up an excellent point in that medicine of today is quite different from medicine of 30 years ago. As of right now and in the foreseeable future, optometrists are here to stay, and we will continue to need them. If they want to expand their scope of practice and gain surgical rights, we should look for ways to integrate them into our training programs like Dr. Doan suggests.

futuredoctorOD said:
Nurse practitioners, CRNA's, are not doctors----Dentists, Optometrists, Podiatrists, AuD's, and (although non-drug) Chiropractors are DOCTORS

FuturedoctorOD: you have made a few statements re: differences between CRNAs/CNPs vs. fields that have the word “doctor” in their title (OD, AuD, Dentists, Doctors of Oriental medicine, etc...) I agree 100% yes, it is a privilege not a right to call yourself a "doctor" just like it is a privilege not a right to call yourself an eye physician AND surgeon.

Ruben
 
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