oklahoma optometrists to do surgery

[charcot]

Holy Sh#%! This is a freeking disaster. Is this true? Is optho in big trouble?
I heard that a couple of chiropractors in Arkansas are trying to get credentialled to do endoscopic back surgery, and thought it was a joke..

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[JennyW]

Holy Sh#%! This is a freeking disaster. Is this true? Is optho in big trouble?
I heard that a couple of chiropractors in Arkansas are trying to get credentialled to do endoscopic back surgery, and thought it was a joke..

OOooooo. Watch out! Soon the streets of Oklahoma will be littered with patients blinded by ODs who injected their chalazions with triamcinolone.

 

[Mirror Form]

Holy Sh#%! This is a freeking disaster. Is this true? Is optho in big trouble?
I heard that a couple of chiropractors in Arkansas are trying to get credentialled to do endoscopic back surgery, and thought it was a joke..

It would be an outrage is optometrists were allowed to do any major surgeries on the eye (eg cataracts). I don't think that has happened so far though, but optometrists are pushing for it and may be coming very close in Oklahoma.

 

[Andrew_Doan]

OOooooo. Watch out! Soon the streets of Oklahoma will be littered with patients blinded by ODs who injected their chalazions with triamcinolone.

This attitude is the strategy used by optometry to expand their scope of practice: ask for intraocular and scalpel sugery, but argue for something "minor".

The bottom line is that if you want to do surgery, then take the established route: medical school and ophthalmology residency.

 

[gizmoduck]

I'm an Oklahoma undergrad that had originally planned to go into optometry. I got a good taste of the degree of lobbying done by optometrists in this state and it was a bit creepy.

 

[Andrew_Doan]

I'm an Oklahoma undergrad that had originally planned to go into optometry. I got a good taste of the degree of lobbying done by optometrists in this state and it was a bit creepy.

From your experiences, what was "creepy"?

 

[gizmoduck]

Things like joining political lobbyists groups were mandatory. Even in pre-optometry club meetings they were handing out flyers demanding we sign such and such petition.

 

[!dr_nick!]

Bah, its oklahoma. We still bleed people, and rub crap all over them to stink the demons out. I mean, ive already performed a dozen surgeries as a premed.

 

[JennyW]

This attitude is the strategy used by optometry to expand their scope of practice: ask for intraocular and scalpel sugery, but argue for something "minor".

The bottom line is that if you want to do surgery, then take the established route: medical school and ophthalmology residency.

Perhaps we should do this in another thread, but let's ignore the rhetoric of oklahoma and have an honest discusion as to what constitutes "surgery."

No one will argue that vitrectomies, and cataract extractions aren't surgeries. But is injecting a chalazion surgery? How about removing a superficial foreign body? An embeded foreign body? Insertion of punctal plugs? Dilation and Irrigation? PIs? YAGs? Botox injections? Epilations?

Jenny

 

[Andrew_Doan]

Perhaps we should do this in another thread, but let's ignore the rhetoric of oklahoma and have an honest discusion as to what constitutes "surgery."

No one will argue that vitrectomies, and cataract extractions aren't surgeries. But is injecting a chalazion surgery? How about removing a superficial foreign body? An embeded foreign body? Insertion of punctal plugs? Dilation and Irrigation? PIs? YAGs? Botox injections? Epilations?

Jenny

Jenny,

Have you read the current VA bill? It includes most of the things you want to do.

Have you read the current OK bill? It includes much more than the procedures you listed above.

The fact is most optometrists want to continue doing many of the things you list but are silently approving what's happening in OK. Perhaps organized optometry wants to form a "back door" pathway into surgical ophthalmology? Indeed, this is what is happening.

 

[happy7]

I have been reading both postings here and in the Optometry forum, and am sadded by what I read. Why do ophthalmologists consider optometrists so far beneath them? I am so sickened by the stereotype that we are the people who "could not get into med school". I graduated in the top of my class both in high school and college, and was considering med school and optometry school. In the end, I chose optometry because it suited me and my life goals better. It wasn't because I didn't think I could do the work of medical school, or that I was lazy, which seems to be a common assumption. I am absolutely loving what I do, but really hate this posts that make it seem like we are second rate. We are getting a very good education, and learn a lot more than how to fit glasses. And not all of us are trying to steal patients and do surgery. If I wanted to do surgery, I would have gone to medical school. I am quite happy where I am.
Please do not continue to bash our profession and make generalized statements about the profession as a whole.

 

[JennyW]

Jenny,

Have you read the current VA bill? It includes most of the things you want to do.

Have you read the current OK bill? It includes much more than the procedures you listed above.

I have read them both. But that list of procedures was not meant to be something that I currently do, or even wish to do. I was trying to stimulate an honest discusion as to what constitutes "surgery."

Which of the aforementioned procedures do you think constitues "surgery"?

Jenny

 

[Mirror Form]

If I wanted to do surgery, I would have gone to medical school.

I'm glad you feel that way. However, there are a lot of optometrists who want to do surgery, and the rest of the optometrists seem to be supporting them (as Dr. Doan pointed out). Since optometrists are lobbying to invade into ophtho's turf, I don't see why you're surprised at ophtho's reaction. What would you say if opticians were going to great length's to lobby for bills to give them the same rights as optometrists???

 

[Andrew_Doan]

I have read them both. But that list of procedures was not meant to be something that I currently do, or even wish to do. I was trying to stimulate an honest discusion as to what constitutes "surgery."

Which of the aforementioned procedures do you think constitues "surgery"?

Jenny

No one will argue that vitrectomies, and cataract extractions aren't surgeries. But is injecting a chalazion surgery? How about removing a superficial foreign body? An embeded foreign body? Insertion of punctal plugs? Dilation and Irrigation? PIs? YAGs? Botox injections? Epilations?

Jenny

Of the things you mentioned:
YAGS = laser surgery
PPVx and Phacos = incisional surgery

The rest are not "surgery". Injectables are goverened by your board and state regulations in regards to pharmaceuticals.

Argue all you want about the petty things, but the fact is that you're ignoring what is happening in Oklahoma. Being silent is the same as supporting the cause, which will set precedence and slowly form a backdoor way into ophthalmic surgery. This is the goal of organized optometry.

 

[JennyW]

Of the things you mentioned:
YAGS = laser surgery
PPVx and Phacos = incisional surgery

The rest are not "surgery". Injectables are goverened by your board and state regulations in regards to pharmaceuticals.

Argue all you want about the petty things, but the fact is that you're ignoring what is happening in Oklahoma. Being silent is the same as supporting the cause, which will set precedence and slowly form a backdoor way into ophthalmic surgery. This is the goal of organized optometry.

The Oklahoma bill does not authorize anything that wasn't there before. The governor even released a statement when he signed the bill saying that it wouldn't. So you can relax Dr. Doan, optometrists will not be performing cataract extractions, enucleation or facial reconstruction any time soon.

Interestingly enough, this law came about because of a request to the attorney generals office by organized OPHTHALMOLOGY to clarify two issues:

? Can optometrists in Oklahoma perform any surgery (excluding retina surgery, LASIK, and cosmetic lid surgery) other than laser surgery, which is already permitted by statute?

? Can the Board of Examiners in Optometry authorize such non-laser surgical procedures?

The attorney generals answer to each question was NO.

No surprises there. But the attorney general?s opinion did create a problem. Certain procedures that most patients wouldn?t consider surgery (such as epilation, removal of foreign bodies, and punctal plug insertion) technically fall under the CPT codes for ?surgical procedures.? The attorney general?s statement would have precluded optometrists from billing for such procedures. (which wouldn't have surprised me if that was the goal of organized OPHTHALOMOLGY, since this tactic is something we dealt with here in New York.)

So the pharmacists bill which contained language regarding optometric scope of practice was ammended. To add any new procedures, the optometry board still has to go through the state's administrative process which includes formal public hearings, a vote by the legislature, and approval by the governor. The new law also specifically prohibits cosmetic lid procedures.

So again, Dr. Doan. The sky is not falling, and the people of Oklahoma are not going to be blinded to renegade ODs doing pars plana vitrectomies.

I have posted for you the tactics that I have experienced in my home state of New York where ophthalmology tried to restrict the removal of foreign bodies, or the use of Xalatan despite the fact that ODs had been doing these things quite competently for years.

Jenny

 

[Andrew_Doan]

? Can optometrists in Oklahoma perform any surgery (excluding retina surgery, LASIK, and cosmetic lid surgery) other than laser surgery, which is already permitted by statute?

I've learned that the wording of laws can be deceiving, and it's deceiving for a purpose. The OK law is trying to set precedence, not maintain the current level of optometric care.

Why doesn't the law proposed by optometry exclude cataract, glaucoma, muscle, and other incisional surgeries? Also, what gives the optometry board (a non-surgical specialty) the right to determine what surgical procedures its members can and cannot do? Finally, the new Oklahoma law is clear: only the board of optometry will determine the fate of surgical privileges without outside intervention from other boards. Your argument that legislation will prevent expansion of surgical privileges, but we all know that legislation fails to do what's best for patients. It's about the money and the votes.

Read this article: http://forums.studentdoctor.net/showthread.php?t=124132

Did you know that the Ok optometrists are negotiating the ability to perform a paracentesis wound? They argue it's necessary to do a paracentesis to co-manage cataract surgery. Don't be fooled, the final goal is to become an ophthalmic surgeon. You'll soon hear: "Hey, it's not surgery because we don't use stitches!".

Yes, I do agree that the sky isn't falling... yet. We have enough ophthalmic surgeons and an established route to train them. Society will NOT benefit from the establishment of a "backdoor" entry into ocular surgery.

 

[gizmoduck]

Just imagine the malpractice issues that'd be created. The majority of optometrists I know don't want to expand into surgery. However, I'd imagine the militant ones that are trying to do so are just going to shoot themselves in the foot. But hey, I'm the only one in this conversation that doesn't have a fancy title slapped on the side of his name yet so I could be wrong.

 

[MacGyver]

Also, what gives the optometry board (a non-surgical specialty) the right to determine what surgical procedures its members can and cannot do?

This is a VERY good point. Its the same way the NPs and CRNAs used to usurp authority to determine their own scopes of practice.

Each state board of nursing has SOLE authority over the scope of nursing practice. Thats no big deal.

What IS a big deal is the laws over the past 20 or so years in almost all states, brought forth by the nursing lobby, which gave SOLE AUTHORITY to the nursing board to define what "nursing" is in the first place.

For example, if the state board of nursing decides that a cardiac bypass is "nursing", then bingo nurses have the authority, delegated by the state nursing board, to run cardiac bypass surgeries. Now they wont take such a drastic step immediately, because they know there would be public outrage over it....instead they work at it gradually, years and decades at a time.

Now they are trying the same bull**** with Oklahoma. Its a smokescreen. Giving optometry boards sole authority to determine what their scope of practice would spell the end of opthalmology as we know it.