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keeping it going

Discussion in 'Optometry' started by puffy1, Apr 22, 2001.

  1. puffy1

    puffy1 Senior Member
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    I wanted to help keep this forum going...even though I'm not going to optometry school.

    Anyway, a few years ago I started counting how many of my classmates and how many other people I knew from Tulane were going into optometry school. I think I counted 10 people (all Asian) who are either already in opt school or are interviewing this year. These people graduated between the years of 1997 to 1999. That's a huge number I think, especially from a school like Tulane that sends a high number of students into medical school.

    About 7 of those people were women. And while some always wanted to go into optometry, most chose optometry because they figured that medical school wasn't a viable option for them.

    I believe optometry, at least among Asians, is becoming a more and more attractive alternative, even more attractive than, say, dentistry (which is more lucrative than optometry at this point). I make this point because there is a dental school in my city, yet all of those people went hundreds of miles away to go to optometry, and none considered dental school seriously. They all seem to be very happy with optometry, as it is less stressful than medicine and allows them more personal freedom (these are the same reasons that dentists give for their career decisions).
     
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  3. mpp

    mpp SDN Moderator
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    I think there are several reasons that optometry is more popular than dentistry these days. Optometry can be less stressful because your are doing more diagnosis/treatment stuff instead of actual physical manipulation on patients as in dentistry. I also think that dentistry requires a higher level of manual dexterity than optometry and some poeple may feel they don't have the skill required. Lastly, and I think most importantly, is the infamous "mouth factor". To many people, eyes are more interesting than mouths. Both dentistry and optometry have the potential to be rewarding and lucrative given the right circumstances. I've considered them both but have chosen the M.D. path over either of them.
     
  4. puffy1

    puffy1 Senior Member
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    Same here...I actually went to dental school for a semester before deciding to go with medicine. But you're right, optometry is a pretty good career all things considered. Some people believe that laser surgery will remove the need for optometrists, which is just plain wrong. First of all, many people have trouble with their vision after having LASIK done on their eyes, and a good percentage still need help (i.e. eyeglasses). Second, the prospect of having one's corneas sliced isn't too favorable for a lot of folks.
     
  5. mpp

    mpp SDN Moderator
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    The myth that ocular surgery is going to wipe out the need for optometrists is believed by many. However, the huge demand for this type of corrective surgery has actually widened the optometrists scope of practice because of the pre- and post-operative care needed.

    However, there is some strange stuff going on in Florida right now regarding co-managing patients undergoing ocular surgery. Essentially a new state bill (it might have been passed into law by now) would only allow licensed physicans (that is M.D.'s or D.O.'s) to perform pre- and post-operative care on eye surgery patients. It is causing a big uproar in Florida optometry as a lot of this type of care is performed by optometrists. If other states begin to follow suit (the AMA is a proponent of this legislation) optometrists may see their scope of practice shrink. This legislation seems ridiculous to me since it is as if the legislators are deciding on what type of care a patient requires and not the patient's own physician. The Florida state legislature should trust practicing ophthalmologists in choosing competent optometrists to work with to provide the necessary care for their patients.

    The text of the bill can be found at
    http://www.leg.state.fl.us/data/session/2001/Senate/bills/billtext/pdf/s0924e1.pdf

    [This message has been edited by mpp (edited April 24, 2001).]
     
  6. kundun

    kundun Senior Member
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    I think it is a great bill and hope it to be passed in more and more states
     
  7. puffy1

    puffy1 Senior Member
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    If this is the case, then those thinking optometry in the future may want to reconsider and go on to med school...although it won't be as easy as I make it out to be.

     
  8. mpp

    mpp SDN Moderator
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    kundun,

    What do you see as the advantages to this bill?
     
  9. kundun

    kundun Senior Member
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    well, it puts ultimate authority in managing surgical patients in the hands of the surgeon...where I think it should be...my father had no problem managing his own surgical patients...he never established any professional relations with optometrists...in case you haven't noticed ophthalmologist aren't just surgeons...they are also highly skilled and competant in the medical management of eye disease as well...I hate to think that the New York Eye and Ear Infirmary at Columbia, where my father trained, produces clinicians unable to manage the surgical eye patient
     
  10. puffy1

    puffy1 Senior Member
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    OK, I'll pose this question: Should optometrists be allowed to perform LASIK procedures? I think the school in Oklahoma trains their students to perform LASIK (or is that optometrists are allowed to perform LASIK in OK...I'm not sure). I could be wrong, but anyway, should they?

    Personally, I say no because the procedure has too many side effects, and the optometrist may be ill-equipped to handle them all.
     
  11. mpp

    mpp SDN Moderator
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    kundun,

    Current law does not disallow ophthalmologists from managing patients. Of course opthalmologists have the skills to treat eye disease. But optometrists also have some of those skills and if a patient's ophthalmologist feels the patient can be treated competently by an optometrist they should be allowed to refer them. Co-managment of patients is a necesary part of health care.

    The proposed law would decrease the powers of the ophthalmologist by preventing them from referring their patients to an optometrist pre- and post-surgery. With this legislation all three sides lose: opthalmologist by limiting their powers of patient co-management, the optometrist by narrowing their scope of practice even though they are trained in those procedures, and, most importantly, the patient in reducing the availability of affordable and competent health care. Any opinions?

    [This message has been edited by mpp (edited April 25, 2001).]
     
  12. mpp

    mpp SDN Moderator
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    puffy1,

    I think in Oklahoma certified optometrists can perform photorefractive keratectomy (PRK) only -- I'm not totally sure on this though. I have also heard (rumors only) that optometrists perform PRK in Wisconsin and Texas, but again I don't know the whole story.

    My opinion is that optometrists should not be allowed to perform surgery, i.e. physically altering body tissue. I do not have a problem with optometrists adminstering medications for treatment of eye diseases so long as the state licensing exams ensure competency in this area. I strongly disagree with any laws that prohibit ophthalmologists and optometrists from co-managing surgery or patients with ocular disease. Patients' needs come first and often affordability is included in the needs. Optometrists provide a necessary service at a lower cost when compared with ophthalmologists.
     
  13. kundun

    kundun Senior Member
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    no [email protected]#%ing way should an optometrist be allowed to perform surgical procedures...isn't that what the OPHTHALMOLOGIST is trained to do after four years of a SURGICAL residency...where countless surgical procedures have been performed to hone the skills of the surgeon...so my answer to that question is NO, NO, NO!!!!!!!! I wouldn't trust anyone else cutting my eyes except an ophthalmologist...and I think the general public would unanimously also agree
     
  14. cpw

    cpw It's a boy !!!
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    I totally disagree with the last post. I think given the correct training an optometrist could very easily learn to perform LASIK. They've spent four years in school honing techniques and it's not like the national and state boards of optometry are going to let untrained optometrists shoot lasers at people's eyes. (come on now) Granted, not every optometrist will be qualified or could afford to buy the equipment to perform the procedures (the main reason some will stay away). I also think surgery would scare some off. (myself included) I just think public opinion of the optometrists true capabilies is way too low. I've seen the doctors I've worked with treat occular disease, co-manage lasik patients, CA is just starting to allow treatment of glaucoma (even though we're all trained in school to do this), and the standard care for patients with glasses and contacts. refraction is a TINY portion of their knowledge and should not be all the OD is allowed to perform.
    *steps off her soapbox*
     
  15. mpp

    mpp SDN Moderator
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    Hey kundun,

    I'm still curious what you see as the advantages to the Florida bill? I'm not trying to pick a fight or nothing I just can't understand what the advantage of this bill might be nor why the AMA would support it. Enlighten me.
     
  16. kundun

    kundun Senior Member
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    I personally have a very indifferent attitude regarding optometry...saying I view it as a bastard profession with an HMO stepmother may be a slight exaggeration...but not off by very far...but that's just my opinion

    [This message has been edited by kundun (edited April 26, 2001).]
     
  17. mpp

    mpp SDN Moderator
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    kundun,

    Your opinion regarding optometry is noted and even though I disagree with it, I won't argue it. However, the bill I am referring never mentions the words "optometry" or "optometrist". As far as I can tell the bill only limits the power of the ophthalmologist albeit by disallowing the ophthalmologist to choose to co-manage patients with anyone other than another opthalmologist. Does support of the bill mean you are in favor of forcing opthalmologist to perform out-patient care that can be provided by other health care professionals?

    To me, this bill is almost the equivalent of making physicians be the only persons allowed to dispense medication (I don't mean prescribe, but dispense), i.e. nurses and pharmacists are not competent to do this. It seems the ever-so-power-hungry AMA is promoting legislation that appears to empower physicans but really removes delegatory responsibilities forcing over-qualified opthalmologists to perform straight-forward ocular procedures at the patient's (or HMO's or insurance companies, or government, etc.) expense. I cannot see how this legislation is in anyone's interest...neither the physican, the optometrist, nor the public. Current law does not prohibit opthalomologists from performing this type of care if they (and their patient) desire. Under current law the ophthalmolgist and patient can also agree to have an optometrist perform the post-surgical care. The new legislation would prohibit that. Limiting choice is not a good plan in this situation.

    By the way, Florida residents can sign an electronic petition against this bill at http://www.petitiononline.com/mod_perl/signed.cgi?HB553&51
     
  18. Mikado

    Mikado Senior Member
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    Why is this post so wide?
     
  19. Mikado

    Mikado Senior Member
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    It was when I made the post, I swear. Instead of stoping at the end of the screen the lines were just going on and on. I think there are still a few bugs on this server.
     
  20. DrDMD05

    DrDMD05 Senior Member
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    Mikado at your posting rate you should catch up to KC and turtleboard in a manner of days. Reading your recent post, I think that's your only objective.

    DMD
     
  21. puffy1

    puffy1 Senior Member
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  22. cpw

    cpw It's a boy !!!
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    The Florida billl mentioned in the above posts was shot down. (just so you know) Optometrists will not lose their rights to co-manage surgical patients. (and rightly so)
    :)
     
  23. gower

    gower 1K Member
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    This discussion has echos of the 1960s and 1970s when allopathic medicine mounted an attack (including legal attempts to have states deny licensure to DOs) on osteopathic medical schools and osteopathic medicine. It failed and the two coexist today, peacefully if not always on amicable terms. Osteopaths and allopaths often participate in the same residency programs; the Armed Forces accept MDs and DOs on equal terms for their medical branches. The same sort of cold war exists between allopathic/osteopathic medicine and chiropractic and naturopathic medicine. Each has its adherents and patients are free to make their own choices. There is no shortage of patients for MDs. If optometrists are succesfully trained in some procedures that have hitherto been the exclusive province of ophthalmologists, the world will not collapse nor will the need for medically trained opthalmologists disappear. Even faith-based healers and witch doctors have their adherents and effect cures. I am a firm believer in going to an MD for my medical treatment but I go to a podiatrist for my foot problems (which have been minor) an optmetrist for my non-medical vision problems, to a dentist for my teeth and oral cavity. I view dentistry, optometry and podiatry as specialities within medicine, but specialties which have not (yet?) been absorbed into the MD/DO world. Save your energy for maintaining health and fighting illness, not for fighting each other.
     

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