Low pay for VA optometrists?

[HOLLYWOOD]

and in GA, OR, and WA they can't. soo?

read the other post

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[ProZackMI]

Here's the proof: I have looked at the curriculum of a typical MD program (since I live in Kansas, I picked KU Med). According to their curriculum, an MD student takes ONE semester of Pharmacology during the spring semester of the second year. An optometry student at SCO takes a total of three quarters of pharmacology: 2 quarters of general pharmacology, and 1 quarter of "Special topics in Ocular Pharmacology". Three quarters of pharmacology in OD school is "more pharmacology" than one semester at MD school. Perhaps you should look into facts before posting conjecture.



I have never asserted that an OD has the same training as a physician. I am merely trying to debunk the assertion that an OD is little more than an "over glorified tech." I have provided facts to support my assertion, and you have not!



Once again, I will refer to my comment asking you to move past your 1970's era understanding of what an OD is and is not qualified to do. At one time, your assertions were accurate, but that was at least a generation ago...

This is anectodal evidence at best. If it is true, that means physicians are also grossly undertrained in pharm in Kansas. At my med school, we had two semesters of pharm, plus in my residency, several courses in psychopharm and neuropharm. I went to MSU College of Human Medicine. Honestly, I find it hard to believe that any OD curriculum would be teaching more pharm than an allo or osteo med school. That is ridiculous.

Also, I was born in 1970, so I think it would be hard for me to have a 1970s era of understanding.

 

[ProZackMI]

Technically, in some states the MD degree lets you do any and all types of medicine/surgery you want. Does that mean its safe for an FP to be doing a gastric bypass? Just because the law says one thing, you can't always use that to prove anything about training.

I looked up and compared the curriculum at UAB school of optometry and compared it with my med school curriculum. I'll admit I was suprised to see that MD students only take 1 hour of pharm lecture more than the OD students do. Now, granted, their pharm classes were broken up into half general pharm and half pharm of the eye AND our clinic time is more inclusive than theirs; but, the eye is all they need worry about, and they get good clinic time in that. ODs aren't going to be giving out immunosuppresants, hormone analogs, or beta2 agonists. 95% of what ODs Rx is topical. The other 5% are things like antihistamines (zyrtec is some dangerous stuff), occasional narcotics (usually 3-5 day supply for corneal abrasions), or occasional anti-microbial agents (though I've rarely seen those used, topical works well enough). MDs know more pharm than ODs, but we also use more of it. ODs seem to be doing just fine with the training they receive.

Here's something I'm somewhat curious about: where are you getting all your information about how woefully undertrained ODs are to Rx any drugs? Just like the previous poster claimed that OD take more pharm (and was incorrect), how do you know enough about OD training to say conclusively that they have no business treating eye disease?

For what its worth, I always enjoy a polite, well-reasoned debate... here's to hoping this doesn't degenerate as such threads tend to.

To be completely honest, my main fear is that ODs are overstepping their bounds and scope of practice and are trying to encroach into medicine without additional training. I have examined some of the OD curricula (Ferris State, Chicago/Illinois Opt, Pacific, SUNY) and was surprised to see some of the coursework that I found, but was also unimpressed by the degree and quality of the coursework.

Am I basing my posts on hard fact? No, admittedly, I am not. I admit, ODs do not kill anyone by Rx meds. However, I believe that most competent and professional ODs don't Rx and don't tx diseases; they prescribe lenses and refract. It would appear to me, subjectively, that those ODs who engage in medical optometry are frustrated MD wannabes. I might be totally off and just another "arrogant and pretentious" MD, but I really do feel that ODs are not qualified to write scripts or treat diseases. Many physicians agree with me, many don't. I also feel that PAs and NPs shouldn't be writing scripts either, but that's a different rant and whole other issue.

Zack

 

[rkl_OD2be]

This is anectodal evidence at best. If it is true, that means physicians are also grossly undertrained in pharm in Kansas. At my med school, we had two semesters of pharm, plus in my residency, several courses in psychopharm and neuropharm. I went to MSU College of Human Medicine. Honestly, I find it hard to believe that any OD curriculum would be teaching more pharm than an allo or osteo med school. That is ridiculous.

Kansas University School of Medicine curriculum is the link I reference to substantiate the anecdotal evidence...

Also, I was born in 1970, so I think it would be hard for me to have a 1970s era of understanding.

I was born in 1969. (This is anecdotal evidence as well: I'm told that) As an infant, I reached up and scratched my father's eye so that he had a flap of skin in his eye (cornea?). He went to the family OD for treatment. At the time, all the OD could leagally do was fit an eye patch and encourage him to visit a medical doctor. Your assertions of what an OD is qualified to treat is consistent with this level of care, hence my references to the state of Optometry 30 years ago.

As others have said in this forum, if you had actually interacted professionally with OD's as part of your MD training, I think you would find that the level of training for an OD is consistent with what they're currently licensed to practice.

 

[Ben Chudner]

I might be totally off and just another "arrogant and pretentious" MD, but I really do feel that ODs are not qualified to write scripts or treat diseases.

This is a sweeping generalization, don't you think? Which scripts and diseases are you referring to? If you, like Jean-Luc want to draw the line, let's see where that line is. I believe most OD's (not the vocal ones that MD's are always quoting) are not looking for a scope that is much more than you would accept.

 

[jefguth]

Two things: 1. Look at total credit hours... MD programs tend to have 8 hours general pharm, SCO only has 7. We'll ignore the 2 hour special topic since MDs have residencies and it is generally thought that our clinical time is more intense than OD clinic.

Looking at the ICO curriculum I see 12 credit hours of pharm. Regardless of the details... somewhere along the way OD's must have picked up the necessary competency to manage their Rx's - afterall, OD's ARE currently practicing medicine (within limits) whether ProZak likes it or not.

 

[VA Hopeful Dr]

To be completely honest, my main fear is that ODs are overstepping their bounds and scope of practice and are trying to encroach into medicine without additional training. I have examined some of the OD curricula (Ferris State, Chicago/Illinois Opt, Pacific, SUNY) and was surprised to see some of the coursework that I found, but was also unimpressed by the degree and quality of the coursework.

Am I basing my posts on hard fact? No, admittedly, I am not. I admit, ODs do not kill anyone by Rx meds. However, I believe that most competent and professional ODs don't Rx and don't tx diseases; they prescribe lenses and refract. It would appear to me, subjectively, that those ODs who engage in medical optometry are frustrated MD wannabes. I might be totally off and just another "arrogant and pretentious" MD, but I really do feel that ODs are not qualified to write scripts or treat diseases. Many physicians agree with me, many don't. I also feel that PAs and NPs shouldn't be writing scripts either, but that's a different rant and whole other issue.

Zack

To my admittedly limited understanding, there are two real areas that MDs worry about ODs expanding into: surgery and unlimited RxPs.

Surgery first. Ok, I'll give you my take on it and you can make what you will of it. Do I think ODs should be doing any more surgery than they currently can (since, according to medicare coding, FBs and Punctal Plugs are "surgery")? Probably not. Simply put, the demand just isn't there. I worked with an ophtho guy who ran patients as fast as I could ever imagine and was the sole referral site for 10-12 ODs (my entire county of 140,000). This MD did MAYBE 12-14 laser surgeries in a given week. Were ODs to do this, that would be somewhere around 1-2 per month (judging from referrals). That just doesn't make sense. Do I think ODs COULD do anterior laser surgery safely? Probably. If you can play a video game, you can do a Yag. If ODs were not capable, the state of Oklahoma medical society would certainly be letting us know about it.

RxP. The trouble is, there isn't a unified scope of practice in this country. There are some states where ODs have to fight every time a new topical drug comes out. Seeing how much research is being done into glaucoma meds, this could be frustrating. As a psychiatrist, imagine how annoyed you'd be if every time a new anti-depressant came out, you had to fight the legislature for the right to use it. States like oklahoma and north carolina (broadest scope for ODs) aren't currently lobbying for anything that I've heard about. Its the states like NY that are behind the rest of the country. These are the major lobbying places you hear about.