NM surgical scope bill

[John_Doe]

March 21, 2007

“Nationally significant expansion bill pending in New Mexico”
-- Arthur Epstein, OD, Optometric Physician, March 19, 2007

Optometrists continue their push for surgical authority in New Mexico and have now advanced their surgery bill through both the state House and the Senate. Their aggressive efforts continue in other states too, revealing more evidence of a national strategy in progress. Right now, Texas legislators are considering a bill that mirrors the New Mexico legislation.

We need your immediate support of the Surgical Scope Fund to counter these attacks! Without a concerted Eye M.D. effort, your state could be next.

Texas O.D.s have introduced a bill expanding optometric scope of practice to include the following surgeries:

Eyelid surgery, including removal of lid cancers
Administration of any drug by injection, including Avastin, Lucentis or Macugen injections for AMD
Repair of perforations with tissue glue, and more!

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Members don't see this ad.

 

[VA Hopeful Dr]

March 21, 2007

“Nationally significant expansion bill pending in New Mexico”
-- Arthur Epstein, OD, Optometric Physician, March 19, 2007

Optometrists continue their push for surgical authority in New Mexico and have now advanced their surgery bill through both the state House and the Senate. Their aggressive efforts continue in other states too, revealing more evidence of a national strategy in progress. Right now, Texas legislators are considering a bill that mirrors the New Mexico legislation.

We need your immediate support of the Surgical Scope Fund to counter these attacks! Without a concerted Eye M.D. effort, your state could be next.

Texas O.D.s have introduced a bill expanding optometric scope of practice to include the following surgeries:

Eyelid surgery, including removal of lid cancers
Administration of any drug by injection, including Avastin, Lucentis or Macugen injections for AMD
Repair of perforations with tissue glue, and more!

I hadn't heard about the Texas bill.... do you have a link/copy of the proposed bill?

 

[John_Doe]

No, but this is interesting: http://www.abqtrib.com/news/2007/mar/15/commentary-dont-hand-optometrists-scalpel/

another article http://www.freenewmexican.com/news/58716.html

 

[GuP]

Good article. We need a way to get info like that out to a whole lot more people. I wish New York Times or some other major paper would publish something similar so that the public can understand what the hell is going on and its dangers.

 

[PDT4CNV]

March 21, 2007

"Nationally significant expansion bill pending in New Mexico"
-- Arthur Epstein, OD, Optometric Physician, March 19, 2007

Optometrists continue their push for surgical authority in New Mexico and have now advanced their surgery bill through both the state House and the Senate. Their aggressive efforts continue in other states too, revealing more evidence of a national strategy in progress. Right now, Texas legislators are considering a bill that mirrors the New Mexico legislation.

We need your immediate support of the Surgical Scope Fund to counter these attacks! Without a concerted Eye M.D. effort, your state could be next.

Texas O.D.s have introduced a bill expanding optometric scope of practice to include the following surgeries:

Eyelid surgery, including removal of lid cancers
Administration of any drug by injection, including Avastin, Lucentis or Macugen injections for AMD
Repair of perforations with tissue glue, and more!

Top 10 undergrad university, magna cum laude and junior AOA at top med school, internship, residency, and I have to worry about a bunch of hacks pretending to be physicians (MDs!). I don't even know what an "optometric physician" is...Seriously?

I am just disgusted with the optometrists these days. Patients are at serious risk here. I donated to the academy's surgical scope fund today. I highly recommend all of you do the same before this kind of BS happens in your state too.

 

[VA Hopeful Dr]

No, but this is interesting: http://www.abqtrib.com/news/2007/mar/15/commentary-dont-hand-optometrists-scalpel/

another article http://www.freenewmexican.com/news/58716.html

The 2nd article reinforced what I'd already heard. I was actually quite impressed at what you ophtho guys pulled off there. They push for scope expansion, you change medicare billing so they lose all 60000 series codes. I wonder if NM is a special case, or if that's a useful strategy for future use. Sure it got overturned, but the ODs in NM had to redirect from new stuff to getting back what they already had.

 

[VA Hopeful Dr]

Top 10 undergrad university, magna cum laude and junior AOA at top med school, internship, residency, and I have to worry about a bunch of hacks pretending to be physicians (MDs!). I don't even know what an "optometric physician" is...Seriously?

I am just disgusted with the optometrists these days. Patients are at serious risk here. I donated to the academy's surgical scope fund today. I highly recommend all of you do the same before this kind of BS happens in your state too.

That's something that has always amazed me about medicine, especially compared to optometry. I got a look a few years back at OD contributions to their PAC from my state. Over half of the ones who contributed gave $1000 or more. Average MD contribution in the same state - around $300. Something isn't right here.

 

[PDT4CNV]

That's something that has always amazed me about medicine, especially compared to optometry. I got a look a few years back at OD contributions to their PAC from my state. Over half of the ones who contributed gave $1000 or more. Average MD contribution in the same state - around $300. Something isn't right here.

You are right there. The average ophthalmologist contribution is $20/year. Being few in number with donating like that, what can you expect. It is pathetic.

 

[Eyesore]

I hadn't heard about the Texas bill.... do you have a link/copy of the proposed bill?

Texas OD Surgery Bill Introduced in Senate
The Academy and the Texas Ophthalmological Association are working to defeat S.B. 1265 – legislation that allows optometrists to perform surgical procedures by redefining the word "surgery.” Optometrists are prohibited from performing surgery in the state. Surgeries that would no longer be legally defined as "surgery" are: draining of abscesses and cysts, removing lid lesions and "small bumps," injecting of drugs in and around the eye, closing of wounds by glue, removing of epithelium, and punctal occlusion by cautery. The legislation also gives optometrists access to a nearly unlimited formulary, including oral and injectable drugs, and removes all physician input from the treatment of glaucoma.

 

[salmonella]

To differentiate these procedure oriented optometrists from ophthalmologists, we should start using terms such as interventional optometry, procedural optometry, optometric interventionalist. That way the lay public would not get confused about optometrists doing surgery.

 

[GuP]

To differentiate these procedure oriented optometrists from ophthalmologists, we should start using terms such as interventional optometry, procedural optometry, optometric interventionalist. That way the lay public would not get confused about optometrists doing surgery.

I hope you are being sarcastic with these ridiculous names. While it is true that most ODs do not wish to partake in surgical procedures, it is the militant ODs that diligantly continue to push for surgical rights. If we grant these ODs special names, then I am sure it will boost their egos more and make them sleep w/o the Lunesta. Moreover, these terms usually refer to positions where one has further training than the others in his/her field, i.e. cardiologist vs an interventional cardiologist, etc, etc. and just b/c an OD feels he is competent enough to perform a surgical procedure doesn't really make him qualified.

 

[salmonella]

I hope you are being sarcastic with these ridiculous names. While it is true that most ODs do not wish to partake in surgical procedures, it is the militant ODs that diligantly continue to push for surgical rights. If we grant these ODs special names, then I am sure it will boost their egos more and make them sleep w/o the Lunesta. Moreover, these terms usually refer to positions where one has further training than the others in his/her field, i.e. cardiologist vs an interventional cardiologist, etc, etc. and just b/c an OD feels he is competent enough to perform a surgical procedure doesn't really make him qualified.

As the poster Eyesore mentioned earlier, certain procedures are not considered "surgery" anymore: "draining of abscesses and cysts, removing lid lesions and "small bumps," injecting of drugs in and around the eye, closing of wounds by glue, removing of epithelium, and punctal occlusion by cautery." It is therefore more appropriate to call these interventional procedures. Many ophthalmologists have always thought these procedures are boring, non-lucrative, and not real surgery. Having opto do these will free up time for ophtho to do more hardcore surgeries.

Optometrists are pushing for rights to perform simple procedures/interventional, not surgical rights. I have couple friends at prestigious opto schools who are absolutely ecstatic about this new field of "interventional optometry." They hope to push for a formal certification program.

 

[Pinkertinkle]

Interventional Optometrists, what a joke.

 

[PDT4CNV]

As the poster Eyesore mentioned earlier, certain procedures are not considered "surgery" anymore: "draining of abscesses and cysts, removing lid lesions and "small bumps," injecting of drugs in and around the eye, closing of wounds by glue, removing of epithelium, and punctal occlusion by cautery." It is therefore more appropriate to call these interventional procedures. Many ophthalmologists have always thought these procedures are boring, non-lucrative, and not real surgery. Having opto do these will free up time for ophtho to do more hardcore surgeries.

Optometrists are pushing for rights to perform simple procedures/interventional, not surgical rights. I have couple friends at prestigious opto schools who are absolutely ecstatic about this new field of "interventional optometry." They hope to push for a formal certification program.

That is ridiculous. Draining an abscess or removing a cyst or skin cancer from the eyelid or face certainly IS surgery. And certain procedures, while not "surgeries" in of themselves, are still procedures with associated risks, or have potentially severe or irreversible consequences associated with them and should not be done by anyone other than a competent physician.

Knowing HOW to do a procedure is just as important as knowing WHEN it is appropriate to the procedure and WHAT the appropriate procedure to do is. This is the art of medicine.

And Salmonella, you should not presume to know what most ophthalmologists think about procedures or what they consider exciting or boring.

Furthermore, it is just plain idiotic to suggest that a treatment or procedure for a disease should be performed by a mid-level practitioner because the physician does not find that treatment exciting or lucrative.

Obviously, because a procedure is not a "surgery" does not mean it falls within the scope of practice of auxillary health care providers.

If YOU ever need a...upper or lower GI endoscopy, cardiac catheterization, placement of central venous or pulmonary artery catheters, placement of chest tube, placement of suprapubic catheter, lumbar puncture, pericardiocentesis, abdominal paracentesis, placement of a sengstaken-blakemore tube, needle cricothyroidotomy, arthrocentesis and periarticular/intraarticular injections, "pain blocks",closed joint reduction, needle biopsy of thyroid, breast, lymph node, liver, kiddney, pancreas, laryngoscopy with biopsy, trans-rectal prostate biopsy, tympanocentesis, culdocentesis, I/D Bartholin abscess, I/D upper extremity abscess, I/D oral/periodontal abscess, drainage of sub-ungual heamtoma, I/D pilonidal cyst, bone marrow biopsy, or transesophageal echo...., I think we will just call the optometrist or pharmacist or nurse to come and do this non-surgical procedure for you. I'm sure that the neurologists are tired of doing LP's by now anyway, this will free up more time for them...For myself and my family, the appropriate physician will do nicely.

The ophthalmic and eyelid procedures you mentioned fall into the above list of procedures that should only be performed by a competent physician. Not an optometrist, optician, nurse, pharmacist, SA, PA, psychologist, chiropracter, physical therapist, beautician, massage therapist, or any other mid-level provider.

 

[JR]

As usual, right on the money

 

[salmonella]

If YOU ever need a...upper or lower GI endoscopy, cardiac catheterization, placement of central venous or pulmonary artery catheters, placement of chest tube, placement of suprapubic catheter, lumbar puncture, pericardiocentesis, abdominal paracentesis, placement of a sengstaken-blakemore tube, needle cricothyroidotomy, arthrocentesis and periarticular/intraarticular injections, "pain blocks",closed joint reduction, needle biopsy of thyroid, breast, lymph node, liver, kiddney, pancreas, laryngoscopy with biopsy, trans-rectal prostate biopsy, tympanocentesis, culdocentesis, I/D Bartholin abscess, I/D upper extremity abscess, I/D oral/periodontal abscess, drainage of sub-ungual heamtoma, I/D pilonidal cyst, bone marrow biopsy, or transesophageal echo...., I think we will just call the optometrist or pharmacist or nurse to come and do this non-surgical procedure for you. I'm sure that the neurologists are tired of doing LP's by now anyway, this will free up more time for them...For myself and my family, the appropriate physician will do nicely.

The ophthalmic and eyelid procedures you mentioned fall into the above list of procedures that should only be performed by a competent physician. Not an optometrist, optician, nurse, pharmacist, SA, PA, psychologist, chiropracter, physical therapist, beautician, massage therapist, or any other mid-level provider.

I don't quite understand your argument: why would you call the optometrist or pharmacist to do cardiac cath or GI endoscopy procedures? Pharmacists and optometrists don't have training in heart or GI, so they can't do even the "non surgical" procedures in those organs. But optometrists and ophthalmologists both have specialized training in the eye, so with some additional training (most likely a 1 year residency/certification program in interventional optometry after graduating from optometry school), even optom can become competent in the simplest procedures.

Cardiologists do cath (instead of cardiac surgeons) and gastroenterologist do endoscopy (instead of general surgeons), because these are interventional procedures that don't require full fledged surgeons. Sure these interventions carry with them risks, etc, but even non surgical docs (such as cardiologists) can handle cases ok. In the near future optometrist (instead of ophthalmic surgeons) will perform "interventional procedures."

 

[VA Hopeful Dr]

I don't quite understand your argument: why would you call the optometrist or pharmacist to do cardiac cath or GI endoscopy procedures? Pharmacists and optometrists don't have training in heart or GI, so they can't do even the "non surgical" procedures in those organs. But optometrists and ophthalmologists both have specialized training in the eye, so with some additional training (most likely a 1 year residency/certification program in interventional optometry after graduating from optometry school), even optom can become competent in the simplest procedures.

Cardiologists do cath (instead of cardiac surgeons) and gastroenterologist do endoscopy (instead of general surgeons), because these are interventional procedures that don't require full fledged surgeons. Sure these interventions carry with them risks, etc, but even non surgical docs (such as cardiologists) can handle cases ok. In the near future optometrist (instead of ophthalmic surgeons) will perform "interventional procedures."

Two problems with this. 1) There isn't really much of a need for more practitioners to be fooling around in the eyes. Most surgeons don't have that long of a waiting list. 2) Current optometric education is not sufficient for y'all to have surgical rights. I don't opthalmology will ever change about granting ODs surgery, but you definitely won't get it until the education is up to snuff.

 

[I Surgeon]

I don't quite understand your argument: why would you call the optometrist or pharmacist to do cardiac cath or GI endoscopy procedures? Pharmacists and optometrists don't have training in heart or GI, so they can't do even the "non surgical" procedures in those organs. But optometrists and ophthalmologists both have specialized training in the eye, so with some additional training (most likely a 1 year residency/certification program in interventional optometry after graduating from optometry school), even optom can become competent in the simplest procedures.

Cardiologists do cath (instead of cardiac surgeons) and gastroenterologist do endoscopy (instead of general surgeons), because these are interventional procedures that don't require full fledged surgeons. Sure these interventions carry with them risks, etc, but even non surgical docs (such as cardiologists) can handle cases ok. In the near future optometrist (instead of ophthalmic surgeons) will perform "interventional procedures."

cardiologists and gastroenterologists are MDs. read salmonella's past posts. He clearly does not know what he is talking about with any speciality. Some of his thoughts are quite amusing though I must admit. Avoid the troll.

 

[DiveMD]

The AAO needs to spearhead an aggressive public education campaign and explain the difference between ophthalmology and optometry; which is evidently not very clear. A few ads in the mainstream media can make a significant difference. Laws like this one in New Mexico will never pass in other states if the AAO efficiently targets public misconception.

 

[jefguth]

I smell a first year med school troll.... 'interventional optometry,' WTF is that? Salmonella clearly doesn't seem to know a thing about either profession IMHO.

 

[salmonella]

I smell a first year med school troll.... 'interventional optometry,' WTF is that? Salmonella clearly doesn't seem to know a thing about either profession IMHO.

When "interventional cardiology" just came out in the 70s and 80s, the cardiac surgeons were responding just like you: "WTF is that"?

Of course those stubborn and narrowminded surgeons weren't visionaries and did not see where the field was going. Now they are out of work and suffered the consequences.

The lesson to be learned here is, whether you like it or not, every medical science field advances, even optometry. Instead of being antagonistic to them, you guys should work together, become partners to achieve a common goal. Only this will ensure both specialties' prosperity in the years to come.

Our next generation will see interventional optometry just like the way we see interv cards, interv neuro, interv rads today.

 

[DiveMD]

Neurologists, cardiologists and radiologists are ALL physicians; optometrists are NOT. You are comparing apples with oranges.

 

[salmonella]

Neurologists, cardiologists and radiologists are ALL physicians; optometrists are NOT. You are comparing apples with oranges.

That's a good point, but the situation here is different. We've got two types of clinical eye specialists with doctoral degrees (MD and OD), whereas there is only one type of clinical doctoral degree (MD) you can get to be a heart specialist. The degrees Doctor of Cardiology or Doctor of Neurology don't exist.

 

[Mirror Form]

That's a good point, but the situation here is different. We've got two types of clinical eye specialists with doctoral degrees (MD and OD), whereas there is only one type of clinical doctoral degree (MD) you can get to be a heart specialist. The degrees Doctor of Cardiology or Doctor of Neurology don't exist.

That's a strange association you're making b/w MD and OD. They're both "doctoral" degrees. Wonderful, but that doesn't make OD's any more qualified to be doing surgery than a pharmacist or nurse practicioner. Or wait, don't phd's have advanced degrees too? Why can't they do surgery???

 

[toughlife]

Medicine as a whole is under attack and not only opthalmology. Look at anesthesia and the CRNA problem, ER docs and PA/NPs wanting to be docs, etc.

The issue is that physicians are too individualistic, refuse to work together and are politically apathetic. You better start emailing your political action committee and see that those threats do not become reality. Otherwise, next thing you know you'll be working side by side with an OD at the mall.

Remember that all midlevels and nonphysicians are trying to achieve through legislation what they couldn't achieve through education. Sadly, we have idiots running our government and the lay public is uneducated about these issues.

In the anesthesia forum we are tossing around ideas about residents and concerned attendings starting a mass media campaign to educate the public about these quacks trying to play physicians and surgeons.

 

[VA Hopeful Dr]

Medicine as a whole is under attack and not only opthalmology. Look at anesthesia and the CRNA problem, ER docs and PA/NPs wanting to be docs, etc.

The issue is that physicians are too individualistic, refuse to work together and are politically apathetic. You better start emailing your political action committee and see that those threats do not become reality. Otherwise, next thing you know you'll be working side by side with an OD at the mall.

Remember that all midlevels and nonphysicians are trying to achieve through legislation what they couldn't achieve through education. Sadly, we have idiots running our government and the lay public is uneducated about these issues.

In the anesthesia forum we are tossing around ideas about residents and concerned attendings starting a mass media campaign to educate the public about these quacks trying to play physicians and surgeons.

First off, quacks? That's a bit harsh.

Second, this could be an example of an education that, while not equal to an MD, is sufficient for some things.

 

[PBEA]

Medicine as a whole is under attack and not only opthalmology. Look at anesthesia and the CRNA problem, ER docs and PA/NPs wanting to be docs, etc.

Remember that all midlevels and nonphysicians are trying to achieve through legislation what they couldn't achieve through education.

I do find some perverse humour when I see comments like this. Maybe its because I see unbridled passion getting in the way of actual fact. I naturally assume you are an MD who has little to no ophthalmic background or understanding of the eye. While some MDs do know their way around an eyeball (they are called ophthalmologists), you do not. So please spare us all your keen insight on the "big picture". Oh and if you decide to take up the habit of treating any eye condition, please be sure and consult an ophthalmologist (or an OD), because it is MALPRACTICE if you do not.

In the anesthesia forum we are tossing around ideas about residents and concerned attendings starting a mass media campaign to educate the public about these quacks trying to play physicians and surgeons.

Wow, if you do that, I would have to reccomend that ODs start a campaign against PCPs, pediatricians, nurses, pas, EMTs (even iridologists, astroocularists, and chiro-tibetan-holism eyeists!!!). We would specifically call into question the skills and training that any of the above receive in the intricate examination and treatment of the eye. Please dont even get me going on this subject, because you are doomed if you do.

 

[toughlife]

duplicate

 

[toughlife]

Wow, if you do that, I would have to reccomend that ODs start a campaign against PCPs, pediatricians, nurses, pas, EMTs (even iridologists, astroocularists, and chiro-tibetan-holism eyeists!!!). We would specifically call into question the skills and training that any of the above receive in the intricate examination and treatment of the eye. Please dont even get me going on this subject, because you are doomed if you do.

I hope your kidding with your remarks. I should remind you that as an OD you are not the expert in the eye and should defer to the better trained opthalmologist to guide you in the treatment.

I never see patients with eye condition nor do I treat them. I readily call an opthalmology resident for a consult if needed be. I doubt I would ever consult an optometrist for anything. Why settle for a Toyota Corolla when I can get the Lexus.

 

[Donkeyman]

Toughlife....I completely agree. I think we need to tackle the midlevel issue collectively as MDs.

I still cannot believe that a CRNA makes more than most family docs I know (how is this possible?). Even the ortho PAs make more. The problem is that it is going to continue to worsen and many smart people will say "why go to medical school?" Let's see...two years to become a CRNA or eight years to become an anesthesiologist.

 

[qwopty99]

I should remind you that as an OD you are not the expert in the eye and should defer to the better trained opthalmologist (sic) to guide you in the treatment.

how do u define "expert in the eye"?


a corneal molecular biologist studying the effect of sonic hedgehog on the repair of damaged corneal epithelium does not have expertise in the eye?


before u answer, think about this. the ophthalmologist ultimately implements the treatment, but who invented the treatment?



there are experts in this world (in the eye, in the body, whatever) outside of MDs.




(btw - learn to spell the word ophthalmologist)

 

[VA Hopeful Dr]

Toughlife....I completely agree. I think we need to tackle the midlevel issue collectively as MDs.

I still cannot believe that a CRNA makes more than most family docs I know (how is this possible?). Even the ortho PAs make more. The problem is that it is going to continue to worsen and many smart people will say "why go to medical school?" Let's see...two years to become a CRNA or eight years to become an anesthesiologist.

Same reason dentists do - they spend their whole day doing procedures which reimburse far better than exams. I shadowed a FP that did lots of endoscopy and he did quite well for himself compared to the national FP average, even in little ole' backwoods SC.

 

[VA Hopeful Dr]

how do u define "expert in the eye"?


a corneal molecular biologist studying the effect of sonic hedgehog on the repair of damaged corneal epithelium does not have expertise in the eye?


before u answer, think about this. the ophthalmologist ultimately implements the treatment, but who invented the treatment?



there are experts in this world (in the eye, in the body, whatever) other than just MDs.




(btw - learn to spell the word ophthalmologist)

Wow, if you do that, I would have to reccomend that ODs start a campaign against PCPs, pediatricians, nurses, pas, EMTs (even iridologists, astroocularists, and chiro-tibetan-holism eyeists!!!). We would specifically call into question the skills and training that any of the above receive in the intricate examination and treatment of the eye. Please dont even get me going on this subject, because you are doomed if you do.

Ok seriously now, you guys have got to stop. Sarcasm doesn't get you anywhere and will just make these residents (or attendings) dislike optometry more. You certainly don't need that.

And PBEA, in most states physicians have unlimited license under state law.... very little they do is actually malpractice in the strictest legal sense. I'm sure a scumbag lawyer could prove otherwise infront of a jury, but they could probably get the best of us anyway.

 

[qwopty99]

Ok seriously now, you guys have got to stop. Sarcasm doesn't get you anywhere and will just make these residents (or attendings) dislike optometry more. You certainly don't need that.

And PBEA, in most states physicians have unlimited license under state law.... very little they do is actually malpractice in the strictest legal sense. I'm sure a scumbag lawyer could prove otherwise infront of a jury, but they could probably get the best of us anyway.

w t f r u talking about? what do the above comments have to do with what i wrote?

 

[DiveMD]

Let's keep the tone in a professional level before we loose another thread.

 

[toughlife]

how do u define "expert in the eye"?


a corneal molecular biologist studying the effect of sonic hedgehog on the repair of damaged corneal epithelium does not have expertise in the eye?


before u answer, think about this. the ophthalmologist ultimately implements the treatment, but who invented the treatment?



there are experts in this world (in the eye, in the body, whatever) outside of MDs.



(btw - learn to spell the word ophthalmologist)

His expertise is limited to the research realm. He is not able to take a patient to the OR and perform eye surgery if his life depended on it.

Would you let that researcher put your kid on the table and reattach his retina?

Many physicians perform research and develop treatments on a regular basis. Don't try to change the focus of the issue. It being that only an ophthalmologist should be performing eye surgery since it is part of the training. Optometrists do not operate on the eye.

Limit yourself to running the Pearle Vision store and write scripts for new eyeglasses like mine does.
That is what you went to school for.

 

[toughlife]

Part of the deception campaign that non-physicians use to deceive the public is by using titles that the public associates with MD/DO like chiropractic physician, optometric physician, etc.

Now nurses are starting DNP (doctoral of nursing practice) programs that will allow NPs, CRNAs, etc to call themselves doctors. The AMA introduced a bill in congress to counter this new deception.
http://www.govtrack.us/congress/bill.xpd?bill=h109-5688
http://www.magnetmail.net/images/clients/AOA_/attach/BillText.pdf

This is all a big campaign from non-physicians to compete directly with MD/DOs without the proper training all, while putting patient's at risk.



As you can imagine the optometrists saw it as a threat.

http://www.aoa.org/x5856.xml

The podiatrists did:
http://www.acfas.org/hr5688.htm

The "doctors of naturopathy" didn't like it:
http://www.camlawblog.com/health-tr...hcare-truth-and-transparency-act-of-2006.html


The nurses didn't like it:
http://www.camlawblog.com/health-tr...hcare-truth-and-transparency-act-of-2006.html


This is what I mean. Everyone wants to be you without proper training and education.

 

[VA Hopeful Dr]

Part of the deception campaign that non-physicians use to deceive the public is by using titles that the public associates with MD/DO like chiropractic physician, optometric physician, etc.

Now nurses are starting DNP (doctoral of nursing practice) programs that will allow NPs, CRNAs, etc to call themselves doctors. The AMA introduced a bill in congress to counter this new deception.
http://www.govtrack.us/congress/bill.xpd?bill=h109-5688
http://www.magnetmail.net/images/clients/AOA_/attach/BillText.pdf

This is all a big campaign from non-physicians to compete directly with MD/DOs without the proper training all, while putting patient's at risk.



As you can imagine the optometrists saw it as a threat.

http://www.aoa.org/x5856.xml

The podiatrists did:
http://www.acfas.org/hr5688.htm

The "doctors of naturopathy" didn't like it:
http://www.camlawblog.com/health-tr...hcare-truth-and-transparency-act-of-2006.html


The nurses didn't like it:
http://www.camlawblog.com/health-tr...hcare-truth-and-transparency-act-of-2006.html


This is what I mean. Everyone wants to be you without proper training and education.

As I said earlier, just because they don't have the MD doesn't mean they aren't trained well enough to do what they do.

 

[PBEA]

And PBEA, in most states physicians have unlimited license under state law.... very little they do is actually malpractice in the strictest legal sense. I'm sure a scumbag lawyer could prove otherwise infront of a jury, but they could probably get the best of us anyway.

I am aware that MDs have an unrestricted license to perform any procedure they deem within their sphere of expertise. And, that is exactly my point. The fact that any MD, with little to no ophthalmic background (like toughlife), can treat the eye at all is absurd. Yet an OD whose education and training is entirely devoted to the eye can't?!? And to top it off I get to hear comments like toughlife's about how the "mid-level" OD is not able to do this thing or that. Wow, they must start the brainwashing on day one of medical school. If I share these comments to anyone with half a brain, they quickly see the ignorance and bias. Again in summary, people trained to examine and treat the eye (OD) should be prevented from doing just that. And people who receive little to no training in ophthalmic care (MD, except OMD) have carte blanche to treat whatever the hell they want. And yes the law basically restricts the trained OD from tx the eye and allows the undertrained MD (except OMD) to again treat whatever the hell they want. Holy ludicrous Batman!!!! I know Robin, it may not be "considered" malpractice, but it sure is malpractice.

 

[PBEA]

This is what I mean. Everyone wants to be you without proper training and education.

I know what you mean I have on numerous occasion seen a pt who had been previously "treated" by their PCP, etc. The nerve of these MDs thinking that they could adequately assess the eye. It makes my blood boil! Enough is enough. Ive been considering advancing another bit of legislation. Its called the EYE CARE PROVIDER BILL HR5689. It states that only those who are actually educated and trained in the examination and treatment of the eye (OD/OMD) should be allowed to administer tx of any kind to the eye. In this way the public will not be mislead by MDs, PAs, NPs etc who are being deceptive in their hiding the fact that they are not qualified to tx the eye. These "midlevel eye providers" will have to preface there exams with a statement that explains how they received very little training with regard to the eye and as such could very well inadvertently blind them, or worse! I think the lay public would understand this bill clearly.

Done yet toughguy? or do you want some more? cause there is more, we can dance all day and all night

 

[Pinkertinkle]

Pretty sure medical school includes diagnosis and treatment of eye conditions.

 

[VA Hopeful Dr]

Pretty sure medical school includes diagnosis and treatment of eye conditions.

I think what he's getting at is that some of your primary care folks, like FP, aren't as well trained in the eyes as ODs are.

 

[Caffeinated]

I know what you mean I have on numerous occasion seen a pt who had been previously "treated" by their PCP, etc. The nerve of these MDs thinking that they could adequately assess the eye. It makes my blood boil! Enough is enough. Ive been considering advancing another bit of legislation. Its called the EYE CARE PROVIDER BILL HR5689. It states that only those who are actually educated and trained in the examination and treatment of the eye (OD/OMD) should be allowed to administer tx of any kind to the eye. In this way the public will not be mislead by MDs, PAs, NPs etc who are being deceptive in their hiding the fact that they are not qualified to tx the eye. These "midlevel eye providers" will have to preface there exams with a statement that explains how they received very little training with regard to the eye and as such could very well inadvertently blind them, or worse! I think the lay public would understand this bill clearly.

Done yet toughguy? or do you want some more? cause there is more, we can dance all day and all night

Sarcasm and bravado courtesy of PBEA. While I appreciate that you feel very passionate about these debates, you might consider that any rational or logical argument (the "signal") that you might have gets overshadowed by your sarcasm and schoolyard-style bravado (the "noise").

I recognize that your argument is sarcasm, but be careful what you wish for, young man/young woman. The more you invite legislators (read: "lawywers") into the process of regulating and micromanaging the delivery of healthcare, the more problems we will all have. The biggest losers will be our patients. When we start inviting legislators (read: "lobbyists' clients") to assume the authority to determine who is best qualified to deliver specific types of care, these decisions will be based more upon who has the most powerful and well-funded PAC and less upon important things like qualifications, education, training, patient safety, and oversight by peers.

It is easy to take shots at physicians when you have not been through medical school. At the same time, it is easy to make slurs about ODs if you have not gone through optometry school. I have the fortunate perspective to say that I have been through both, and I can say without reservation that they are not equivalent. They are both respectable degrees, and both require time, dedication, and a certain amount of personal sacrifice. Med school has been more intellectually challenging in both breadth and depth. It has also been more emotionally challenging, and more taxing on my loved ones. I say this not for sympathy, because in these challenges I find fulfillment and a greater ability and confidence to enter the next phase of my training. My 4 years of medical school is almost complete. I am half way to becoming an ophthalmologist. These observations and comparisons are in no way meant to be a slur on the educational or profession of optometry, and I denounce anyone who tries to use them as such. I am just sharing my view from the trenches.

From where I sit, and knowing what I know about optometry and ophthalmology, I have to wonder why we (both optometrists and physicians) continue to invite legislators to police our professions and fight our battles? Although it may achieve short-term successes, it invites disaster later. I sincerely believe that most optometrists have an intrinsic knowledge of what is appropriate for their scope of practice, and what is outside their scope. I also believe that optometry could realistically come to a concensus scope of practice definition that most ophthalmologists would find reasonable. But for whatever reason, the extremists tend to gravitate toward the leadership, and opthalmology finds it very easy to distrust the profession of optometry when these extremists are allowed to speak for the profession. At the same time, the ophthalmologist who tries to relegate optometry to simply refracting is squandering a valuable resource. There is a role for both professions, and these roles need to be defined based upon education, qualifications, and patient safety. This is the duty that we as optometrists and physicians owe to our patients, and we should not turf this responsibility to the legislators.

Caff

 

[Caffeinated]

I know what you mean I have on numerous occasion seen a pt who had been previously "treated" by their PCP, etc. The nerve of these MDs thinking that they could adequately assess the eye. It makes my blood boil! Enough is enough. Ive been considering advancing another bit of legislation. Its called the EYE CARE PROVIDER BILL HR5689. It states that only those who are actually educated and trained in the examination and treatment of the eye (OD/OMD) should be allowed to administer tx of any kind to the eye. In this way the public will not be mislead by MDs, PAs, NPs etc who are being deceptive in their hiding the fact that they are not qualified to tx the eye. These "midlevel eye providers" will have to preface there exams with a statement that explains how they received very little training with regard to the eye and as such could very well inadvertently blind them, or worse! I think the lay public would understand this bill clearly.

Done yet toughguy? or do you want some more? cause there is more, we can dance all day and all night

Sarcasm and bravado courtesy of PBEA. While I appreciate that you feel very passionate about these debates, you might consider that any rational or logical argument (the "signal") that you might have gets overshadowed by your sarcasm and schoolyard-style bravado (the "noise").

I recognize that your argument is sarcasm, but be careful what you wish for, young man/young woman. The more you invite legislators (read: "lawywers") into the process of regulating and micromanaging the delivery of healthcare, the more problems we will all have. The biggest losers will be our patients. When we start inviting legislators (read: "lobbyists' clients") to assume the authority to determine who is best qualified to deliver specific types of care, these decisions will be based more upon who has the most powerful and well-funded PAC and less upon important things like qualifications, education, training, patient safety, and oversight by peers.

It is easy to take shots at physicians when you have not been through medical school. At the same time, it is easy to make slurs about ODs if you have not gone through optometry school. I have the fortunate perspective to say that I have been through both, and I can say without reservation that they are not equivalent. They are both respectable degrees, and both require time, dedication, and a certain amount of personal sacrifice. Med school has been more intellectually challenging in both breadth and depth. It has also been more emotionally challenging, and more taxing on my loved ones. I say this not for sympathy, because in these challenges I find fulfillment and a greater ability and confidence to enter the next phase of my training. My 4 years of medical school is almost complete. I am half way to becoming an ophthalmologist. These observations and comparisons are in no way meant to be a slur on the education or profession of optometry, and I denounce anyone who tries to use them as such. I am just sharing my view from the trenches.

From where I sit, and knowing what I know about optometry and ophthalmology, I have to wonder why we (both optometrists and physicians) continue to invite legislators to police our professions and fight our battles? Although it may achieve short-term successes, it invites disaster later. I sincerely believe that most optometrists have an intrinsic knowledge of what is appropriate for their scope of practice, and what is outside their scope. I also believe that optometry could realistically come to a concensus scope of practice definition that most ophthalmologists would find reasonable. But for whatever reason, the extremists tend to gravitate toward the leadership, and ophthalmology finds it very easy to distrust the profession of optometry when these extremists are allowed to speak for the profession. At the same time, the ophthalmologist who tries to relegate optometry to simply refracting is squandering a valuable resource. There is a role for both professions, and these roles need to be defined based upon education, qualifications, and patient safety. This is the duty that we as optometrists and physicians owe to our patients, and we should not turf this responsibility to the legislators.

Caff

 

[DiveMD]

Want to be an engineer, go to engineering school.
Want to be an architect, go to architecture school.
Want to be a lawyer, go to law school.
WANT TO BE A PHYSICIAN, GO TO MEDICAL SCHOOL!!!

We don't see electricians, physicists or chemists trying to be engineers.
We don't see interior designers acting like architects.
We don't see paralegals trying to be lawyers.
Then why should we tolerate NON-PHYSICIANS who want to act like physicians?

 

[Donkeyman]

The bill put forward to define "Dr" I think is a good idea. I have seen so many commercials lately that are promoting some herbal supplement/diet regimin/etc. and there is some guy in a white coat stating I'm Dr so-and-so. What the hell does this mean anymore?? Is this guy a MD/DO or chiropracter, optometrist, naturopath, physical therapist, psychologist, etc. Or in the near future, nurse, CRNA, PA, etc. In fact I'm watching TV right now and I just saw an ad for glucosamine, that stated 'Dr. recommended."

When I see this, I would like to know what their level of education is. The problem is that the public is becoming confused. What is wrong with saying I'm a nurse, chiropractor, optometrist, CRNA, and so on. I am going into ophthalmology and whenever anyone asks who I am, I will say "Hello, I'm Jon Smith the ophthalmologist." Even I feel if I say that I'm a doctor, this is a little misleading (even though I've trained as one and have completed an internship in Family med). I would rather be specific...I have no need to mislead anyone as to my qualifications.

Also, to PBEA...doctors (MD/DOs) usually refer patients with any eye problems. They try not to treat anything we were not trained for (and yes we get training on tx and eval of the eye). If something goes wrong we are held liable for malpractice, therefore we are very cautious. Also, most patients do not come to the FP doc when there primary complaint is with the eye...they usually go to the OD/OMD.

One more thing PBEA, don't bring up MDs or other providers tx the eye...there is no other group of providers pushing for surgical tx of the eye except for ODs (and they do not recieve the level of surgical experience that MD/DOs get). If you do...please enlighten the rest of us about how many surgical cases you have scrubbed/assisted with.

Thanks for letting me vent, but we have to work on this with the AMA (do I have any support out there on this?)

 

[qwopty99]

I should remind you that as an OD you are not the expert in the eye and should defer to the better trained opthalmologist (sic) to guide you in the treatment.

how do u define "expert in the eye"?

 

[qwopty99]

Limit yourself to running the Pearle Vision store and write scripts for new eyeglasses like mine does.

and removing foreign bodies, and using lasers, and using scalpels...

 

[Caffeinated]

We don’t see electricians, physicists or chemists trying to be engineers.
We don’t see interior designers acting like architects.
We don’t see paralegals trying to be lawyers.
Then why should we tolerate NON-PHYSICIANS who want to act like physicians?

Actually, I think a lot of these examples do occur but to a lesser degree. I have worked with physicists who have some crossover into engineering-type duties. I have heard of paralegals and realtors that skate very close to that line that defines the practice of law (usually as it relates to contracts -- I haven't heard of anyone in these fields arguing that they should be able to retain clients to represent in them in court).

 

[exmike]

and removing foreign bodies, and using lasers, and using scalpels...

which begs the question, why didnt you just go to medical school then ophthalmology, rather than pushing for surgical rights?

In the hundreds of threads on this stupid topic, i've yet to hear a convincing argument for going to opto school then trying to pursue surgical rights through legislation vs the already established route of ophthalmology.