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Keywords: "... with the right dedication/motivation."
Ophtho is overrated
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Yeah yeah we get it. You're brilliant. You could have gotten into medical school and become an ophthalmologist if you wanted to but you chose optometry instead. Blah blah blah...
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Yea look at SUNY Optometry's average matriculant cGPA (3.48), no joke bro. 
http://www.sunyopt.edu/admissions/od_demographics.shtml
I just checked the US medical school average cGPA and it's at (3.67) so slightly more. https://www.aamc.org/download/161690/data/table17-facts2010mcatgpa99-10-web.pdf.pdf
But whatever floats your boat - that's what I say.
http://www.sunyopt.edu/admissions/od_demographics.shtmlI just checked the US medical school average cGPA and it's at (3.67) so slightly more. https://www.aamc.org/download/161690/data/table17-facts2010mcatgpa99-10-web.pdf.pdf
But whatever floats your boat - that's what I say.
Yea look at SUNY Optometry's average matriculant cGPA (3.48), no joke bro.
I just checked the US medical school average cGPA and it's at (3.67) so slightly more. https://www.aamc.org/download/161690/data/table17-facts2010mcatgpa99-10-web.pdf.pdf
But whatever floats your boat - that's what I say.
Hey genius, if you want to make a comparison you need to compare ophthalmologists to optometrists. Not all medical students make it into ophthalmology.
Yea look at SUNY Optometry's average matriculant cGPA (3.48), no joke bro.
I just checked the US medical school average cGPA and it's at (3.67) so slightly more. https://www.aamc.org/download/161690/data/table17-facts2010mcatgpa99-10-web.pdf.pdf
But whatever floats your boat - that's what I say.
I don't get it. Why are so many optoms and optom students so insecure? Be proud of your accomplishments and your profession. No need to come into the ophthalmology forum touting the average gpa for optometry school, or telling the world you could have become an ophthalmologist if you wanted to.
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Yea look at SUNY Optometry's average matriculant cGPA (3.48), no joke bro.
I just checked the US medical school average cGPA and it's at (3.67) so slightly more. https://www.aamc.org/download/161690/data/table17-facts2010mcatgpa99-10-web.pdf.pdf
But whatever floats your boat - that's what I say.
It sounds like SUNY optom is a pretty competitive school. However, I don't think you realize how hard it is to get into an ophthalmology residency.
Lets look at some other stats from that site you linked. The average GPA of ALL MEDICAL SCHOOL APPLICANTS was 3.53. Of those applicants, less than 44% matriculated into medical school. And of those who matriculated, only approximately the top 1/3 will have a good shot at getting into an ophthalmology residency program.
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This thread has taken a ridiculous turn. There are several facts that I believe everyone can agree upon...
1) Getting into medical school is harder than getting into optometry school (I have a good friend who was accepted to 5 of 5 optometry schools applied to and 0 medical schools out of 30 applications – I know there are exceptions, but her experience says something to me.
2) The MCAT his more challenging than the OAT (my friend had a very respectable OAT score, but a poor MCAT score.
3) Medical school is more rigorous / time consuming than optometry school - especially if you want to be at the top your class.
4) Securing an ophthalmology position is no guarantee and one must be near the top of their class to do so.
5) Many optometry students / optometrists may be naturally smarter than ophthalmology residents / ophthalmologists. THIS MEANS NOTHNG - I am a believer that training experience actually makes a difference in competency no matter what the profession is. In other words, you could take an optometry student with an IQ of 160 and an MCAT of 36. By choosing to go to optometry school, he/she will not understand ocular disease / surgery at the same level as the ophthalmology resident with a 120 IQ and the MCAT of 30. I'm sorry, actually doing surgery, managing complex medical/surgical patients impacts how we look at the eye and systemic disease. My days would be so much simpler if I could practice in the arena of Dr. Ben Gaddie...
The beauty of our country is that anyone can go to medical school or optometry school if they would like.
1) Getting into medical school is harder than getting into optometry school (I have a good friend who was accepted to 5 of 5 optometry schools applied to and 0 medical schools out of 30 applications – I know there are exceptions, but her experience says something to me.
2) The MCAT his more challenging than the OAT (my friend had a very respectable OAT score, but a poor MCAT score.
3) Medical school is more rigorous / time consuming than optometry school - especially if you want to be at the top your class.
4) Securing an ophthalmology position is no guarantee and one must be near the top of their class to do so.
5) Many optometry students / optometrists may be naturally smarter than ophthalmology residents / ophthalmologists. THIS MEANS NOTHNG - I am a believer that training experience actually makes a difference in competency no matter what the profession is. In other words, you could take an optometry student with an IQ of 160 and an MCAT of 36. By choosing to go to optometry school, he/she will not understand ocular disease / surgery at the same level as the ophthalmology resident with a 120 IQ and the MCAT of 30. I'm sorry, actually doing surgery, managing complex medical/surgical patients impacts how we look at the eye and systemic disease. My days would be so much simpler if I could practice in the arena of Dr. Ben Gaddie...
The beauty of our country is that anyone can go to medical school or optometry school if they would like.
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Lol you guys are so defensive. I did not say I could become an OMD because I lack the dedication/motivation (again, keywords) at the moment. I am also not insecure, I was merely dispelling many OMD opinions about ODs that they are just like nurses (heard this directly from a retinologist). Also I am not a "genius" as I wouldn't even go to a professional school if I was and I would probably just be an entrepreneur. And like I said before, OMD training is much harder and more comprehensive so you definitely do not need to convince me of that.
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For someone that is claiming he's/she's not insecure you sure seem very intent on proving something.
Awesome, you're doing well on a practice test that really doesn't have much predictive factor of how well a clinician you'll be in the future. It takes more than just doing well on tests to be an OMD. Many of us don't have much beef with optometrists but now you're really just trying to stir the fecespile with us.
Oh yeah guess what? I made a 370 on a practice OAT while blindfolded, with one hand tied behind my back, and hung over. Probably means I can moonlight as an optometrist during residency right? Yeah I know it's the internet and I don't have proof, but........370!!!!!!!
You are implying that if you had the dedication/motivation then you could become an OMD. Very interesting statement to say the least.
I can't tell you how many times I heard that while growing up (I could do that if I actually tried/have the motivation/wanted to/etc). Turns out for most people, things are usually much harder than they think. There is much more than just dedication/motivation to becoming an OMD. So let's just not use that statement. It just.....how can I say it......doesn't sound that good.
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Can we please stop whipping out and comparing the sizes of our "cerebral junk." It's pretty pathetic. If you successfully pursue doctoral level training, you're plenty smart. Do I get on here degrading everyone who doesn't also have a PhD, just because I do? Nope. Different choices lead to different paths.
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Wait a minute.....your mere mentioning of the fact that you have a PhD is degrading to me, since I don't have one. What are you trying to prove?
I'm offended.
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This may be the dumbest thing I've read on SDN thus far. Congratulations. Additionally, you were right to assume that you don't understand the system.
Maybe you should limit your knowledge base to conspiracy theories about money grubbing Ophthalmologists oppressing the poor ODs and planning the eventual rise and take over of eye surgery.
Pathetic.
Maybe you should limit your knowledge base to conspiracy theories about money grubbing Ophthalmologists oppressing the poor ODs and planning the eventual rise and take over of eye surgery.
Pathetic.
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Thanks for the constructive criticism. Maybe if you would bring up a better idea to the table then I wouldn't label this as the dumbest response I've ever gotten on SDN. Congratulations. I wrote many disclaimers specifically to not get useless responses like this but I hope you are satisfied getting your internal anger out at a computer screen.
PS - I actually modeled it slightly on the European medical systems.
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No need to 'bring up a better idea.' Flip through a book on health service systems (particularly the U.S.) and then you'll probably start to get a grip on why this makes no sense, is completely unsustainable, develops an awkward class system, wouldn't work with insurance payments, wouldn't work with licensing boards, would probably cost more in the end (with regard to training, 'grandfathering,' and massive referrals), etc, etc, etc.
Additionally, the entire 'plan' seems to refer back to your general attitude of allowing those without medical education to step up and perform above their current level of training, practice medicine by passing a set of unregulated 'tests' that are established by the groups themselves, and simultaneously decrease the physician role in the healthcare system. Frankly, I see this as more of your point than anything else (with regard to fixing the system to avoid complications versus 'fixing' the system to simply give groups like ODs more rights/privileges while taking some sort of perceived authority away from physicians).
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DOs are equivalent to MDs.... unless you meant "OD"
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No I meant DO's. There is no need to have a separation of MD and DO. Both are equivalent as you said. It is just a bunch of higher-ups that wish to have positions of authority and govern their own separate Associations instead of coming together for the common good.
And JaggerPlate, I think you need to realize that most ODs, and myself, do not wish to do surgery. I only wish that when I practice I will not have the legislative headaches over every single new medication/procedure that comes out.
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While I don't agree that there needs to be a 'merger' of the professions (which, as you stated, are complete legal equivalents), but I agree 100% with your analysis of why they've stayed separate.
No one wants to micromanage. ODs are highly trained, competent professionals, but the bold statement is a very slippery slope in my opinion. You can interpret it as wanting to simply not have to fight for every little right that's already well within your range, but you could also view it as a free pass to essentially pick up any new technique - drug, surgical procedure, etc, related to the eye and run with it.
Frankly, both are extremes, but I see far more ethical issues with the second interpretation and I think that's what worries a lot of people. Again, I'm not accusing you of anything, and this could pertain to absolutely any health profession, physicians included, but I can personally see why issues like this make people nervous AND how pushing for increasing surgical rights in various states really isn't helping the cause of simply practicing within your full scope (especially because, as you said, most ODs agree that eye surgery isn't in their scope).
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Sadly, I have to agree with above. It's a very interesting field and I love what I do but compensation and job opportunities are lacking. I always thought that not being needed by hospitals is a good thing for an ophthalmologist. Well, if you are not needed they won't hire you, back your practice, etc. Sometimes I cringe when I hear that freind neurosurgeon has a $1500/night call stipend (even if he does not go in) or that his surgical PA makes $200K. Surely beats $100K starting salary in NY or SF if you can even find that in those areas...
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Well if you compare ophthalmology compensation to neurosurgery compensation, then yes our compensation sucks. But neurosurgery is not exactly representative of the rest of medicine.
That said, it's really the over saturation that is hurting ophthalmology. In colder/rural areas, the average income is much better. But there are just way too many ophthalmologists in every desirable location. Hopefully this issue will improve as the boomers continue to age.
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I am not sure about what needs to be done with compensation across medical specialties - it seems that there has been a lot of focus in recent years to attempt to lower reimbursements for all surgical specialties so that the discrepancy between primary care and procedure based specialties is not as great.
I wish treatments/procedures were reimbursed based on impact on a patient's life. In this situation all work of ophthalmology would trump any area of medicine in terms of cost effectiveness.
The $1,800 for a cataract surgery (facility fees and surgeon fees) is by far the biggest bargain in all of medicine when looking at cost and impact on quality of life– there is no debating this in my mind (before surgery –cannot qualify to drive. 20/20 vision on the day after surgery – not bad in terms of impact).
Our government / the insurance industry is very comfortable paying for Lipitor for life in some patients – no matter what the cost ($100/month, $1,200/year, $36,000/30 years). Is the $36,000 really worth it? If it is not Lipitor it is some other drug or 10 other drugs.
In my proposed model, specialties /ancillary testing that provide high cost end of life care would suffer. Sorry – the $200,000 spent on the resection of the stage 4 head and neck cancer, radiation, chemo may not be worth the 3 months of extra life expectancy –especially when quality of life is factored in (multiple surgeries, feeding tube, trach, infections from chemo).
However, the neurosurgeon who resects a enlarging pituitary adenoma that is compressing the chiasm should be reimbursed big time. The cardiologist who places a stent in the LAD of a 55 year old male having an acute MI would also be paid big time.
The problem is that currently ophthalmology suffers from the high cost of other medical disciplines because we are paid by "medical" insurance and medicare (Dentistry, for example, does not suffer from this). Americans refuse to die gracefully – tremendous amounts of money are spent in the last months of life. I am not saying heroic treatments and surgery should be denied to anyone - patients may simply have to pay for them if they want them.
As long as our society is committed to pull out all the stops for every patient, every time – even if quality of life is negatively impacted, reimbursement for all medical specialties MUST go down. Let's be honest – there is not enough money to do otherwise (even a 10 year old should understand that every medicare recipient cannot expect $500,000 of benefits during a lifetime when they paid in $60,000).
I wish treatments/procedures were reimbursed based on impact on a patient's life. In this situation all work of ophthalmology would trump any area of medicine in terms of cost effectiveness.
The $1,800 for a cataract surgery (facility fees and surgeon fees) is by far the biggest bargain in all of medicine when looking at cost and impact on quality of life– there is no debating this in my mind (before surgery –cannot qualify to drive. 20/20 vision on the day after surgery – not bad in terms of impact).
Our government / the insurance industry is very comfortable paying for Lipitor for life in some patients – no matter what the cost ($100/month, $1,200/year, $36,000/30 years). Is the $36,000 really worth it? If it is not Lipitor it is some other drug or 10 other drugs.
In my proposed model, specialties /ancillary testing that provide high cost end of life care would suffer. Sorry – the $200,000 spent on the resection of the stage 4 head and neck cancer, radiation, chemo may not be worth the 3 months of extra life expectancy –especially when quality of life is factored in (multiple surgeries, feeding tube, trach, infections from chemo).
However, the neurosurgeon who resects a enlarging pituitary adenoma that is compressing the chiasm should be reimbursed big time. The cardiologist who places a stent in the LAD of a 55 year old male having an acute MI would also be paid big time.
The problem is that currently ophthalmology suffers from the high cost of other medical disciplines because we are paid by "medical" insurance and medicare (Dentistry, for example, does not suffer from this). Americans refuse to die gracefully – tremendous amounts of money are spent in the last months of life. I am not saying heroic treatments and surgery should be denied to anyone - patients may simply have to pay for them if they want them.
As long as our society is committed to pull out all the stops for every patient, every time – even if quality of life is negatively impacted, reimbursement for all medical specialties MUST go down. Let's be honest – there is not enough money to do otherwise (even a 10 year old should understand that every medicare recipient cannot expect $500,000 of benefits during a lifetime when they paid in $60,000).
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True, neurosurgery is not a representative of the rest of the medicine. This friend of mine took a huge pay cut to stay in the more desirable area. He only took $700K offer; he was offered close to $2M to go rural. Another ENT friend fresh out of residency did an interview trail. Offers ranged from mid- three hundreds to five hundreds which also included loan repayment, signing bonus, relocation allowance, etc. I can go on and on with these examples. What's a common thread here? Hospitals NEED these surgeons. They do not need ophthalmologists. "Open globe? Ohhh, lets just put a shield over it and send it to the university...". The sad part is, we did this to ourselves.
Yes, rural is somewhat better. I live in CA. We have rural areas. I looked at rural areas when I was applying for jobs. Opportunities were just slightly better but not by much. But I guess you can argue any CA is still CA.
I wouldn't count on baby boomers to make a big difference anytime soon. All these oversaturated areas are full of not so busy practices that would love to get more patients. They will hire more techs, ODs, start seeing 50, 60, 70+ per day before a real "need" appears in the area. I don't know, but I don't see anything changing anytime soon other then reimbursements going down and overhead going up.
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I totally agree with pretty much everything you said. It seems to me that the older a person is and the closer to death that they get, the more they want to live those extra few weeks/months even. If you look at pre-civilization homo sapiens, the average life expectancy I believe was below 40. It is not natural for humans to live to 80, 90, 100. We are creating this artificially.
You struck at the core of this huge ethical/fiscal debate.
http://www.suite101.com/content/prehistoric-population-a72827
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Don't get me wrong - I have no problem with people making it to 90 or even 100. Last week I did cataract surgery on a 91 year old. He was much healthier than most of the 65 year olds I do cataract surgery on. He is 100% independent and is fit enought to probably walk a 5K tomorrow. My point is that our society should start focusing on quality of life when it provides state of the art treatments that cost lots of $.
During my intern year in internal medicine, virtually every patient came from a nursing home and returned to a nursing home. At times it felt like a revolving door - the closer to the end of life, the more times the door spins. The further a patient's family lives from the terminally ill parent, the more guilt they feel and the more they ask to do everything until the very end (sorry, running a code on a patient who has not been oriented to time or place for > 2years was very disturbing to me).
This is one of the reasons I love ophthalmology - 98% of the patients come into the office with their own power. 98% of my treatments increase quality of life (the exception in eye care is probably the treatment of glaucoma - medical and surgical).
Obama received a lot of flack for asking primary doctors to receive medicare reimbursement to discuss end of life issues with patients when they were actually competant to make intelligent decisions (the death panels). Such a practice makes sense - that way patients will not receive hopeless expensive care. It also allows a person to die with dignity.
It may be too late - medicare will go broke during my career unless something major changes (decreased reimbursements, rationing, increased taxes, increased premiums, increased age eligibility criteria). Even if doctors of all specialties were paid Nothing, the system would still go broke in its current form. State of the art care for all cost lots of money.
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Exactly, how does Obama think he can make this "universal" healthcare system in a country that has one of the biggest disparities in the wealth of its citizens in the world. I am guessing the rich will just have to go cash only. There will never be equal classes of people. Even in communism, all people were equal but some were more equal than others...
I mean we have ~45 million people below the poverty line in America right now. Who is going to pay for all their healthcare??? Some areas of the country look like third world countries not America: http://en.wikipedia.org/wiki/File:Camden_NJ_poverty.jpg
I mean we have ~45 million people below the poverty line in America right now. Who is going to pay for all their healthcare??? Some areas of the country look like third world countries not America: http://en.wikipedia.org/wiki/File:Camden_NJ_poverty.jpg
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I don't see any solution in seeing 50+ patients a day (I don't know what you can do at that volume, but I know what you can't do) because the staffing overhead balloons at that volume, both front and back office and so does the space requirement.
When you are losing money on every unit, it's hard to make it back on volume.
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People in poverty are covered by medicaid.
The biggest problem in our system is that the people who are most screwed by it aren't the so-called "welfare queens."
It's the working stiffs. The car mechanic, the plumber, the guy at the convenience store, the waitress serving you your club sandwich at the local diner.
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Especially plumbers. They can actually bill customers without government interference (unlike doctors), and often make almost as much as us.
Keep in mind that a lot of the uninsured "working stiffs" have iphones, digital cable, etc.
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Not bad at all:
"He notes that some master plumbers (about five to seven years experience) at the Cincinnati-based company make in excess of $100,000 a year. "A good plumber can pretty much write his ticket and make a good living with a good amount of experience," Abrams says. The outsourcing boom that has sucked information technology jobs overseas, coupled with a dearth of workers in plumbing a somewhat recession-resistant market makes for an industry ripe for growth."
"He notes that some master plumbers (about five to seven years experience) at the Cincinnati-based company make in excess of $100,000 a year. "A good plumber can pretty much write his ticket and make a good living with a good amount of experience," Abrams says. The outsourcing boom that has sucked information technology jobs overseas, coupled with a dearth of workers in plumbing a somewhat recession-resistant market makes for an industry ripe for growth."
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I was talking to an Established Retina Ophthalmologist about this Optometrist vs Ophthalmologist problem. He said that really this whole incidence in Kentucky is partially our own fault. We Ophthalmologists have a control problem. He said that there are MANY general ophthalmologists out there that want to refract themselves, do the minor problems, etc, and then also the surgical stuff, cataracts. He thinks that the bread and butter, corneal ulcers,conjunctivitis, abrasions, and ALL refractions should be handled by Optometrists. Yes, we should be proficient in that too, but our specialty should be concerned with the more technical and surgical aspects.
We are too much controlling!
We are too much controlling!
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By your logic, cardiologists should only do caths and read echos and shouldn't manage lipids because a general internist can handle that. Likewise, OBs should only do c-sections because family/IM can do pap smears, contraceptive management, and FPs can do vaginal deliveries. Heck, I could make the case that no other primary care specialty outside of family medicine should do any outpatient work because we can do that while their skills are needed elsewhere (hospitalists, ICUs, ORs).
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I know your retina friend never refracts, but refraction is a key part of the ophthalmic examination. It's not just for glasses. How else are you going to judge a visually significant corneal scar or cataract? I am sure many generalists would love to do surgery all day (myself included)- guess what, visually significant cataracts just don't fall into your laps. Most of the time, you have to develop a rapport and relationship with the patient. It may take years and years. You may have to see many patients because some may have a cataract and not need surgery (who would have thought?). Ask you friend if he would like all the generalists to be interpreting FAs and injecting Lucentis.
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Pay-wise, you don't seem to get as much buck for your bang compared to the other ROAD or even surgical specialties.
I've always wondered about this. Ophthos are surgeons but don't seem to get paid on that level. Why is this? I've had several physicians (of course ones that I know on a personal level) tell me to my face to avoid going into Ophtho in this day and age unless I wanted to be poor lol. Ophtho's one of the fields I had been considering for a while... but I have to admit the salary is one of the major "cons" on my list.
I've always wondered about this. Ophthos are surgeons but don't seem to get paid on that level. Why is this? I've had several physicians (of course ones that I know on a personal level) tell me to my face to avoid going into Ophtho in this day and age unless I wanted to be poor lol. Ophtho's one of the fields I had been considering for a while... but I have to admit the salary is one of the major "cons" on my list.
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CMS has a cost-control approach that amounts to knocking off the tall poppies. Ophthalmology, and particularly cataract surgery, was once such a flower. It remains the most commonly performed surgery, period. As such, CMS sees any cut in payment for ophthalmology service has having an tremendous amplification effect in reducing annual payouts. At one point, Medicare paid $2,500 and more per cataract (vice $670 or less, now), back in the 1980s when $500,000 still bought you an exceptional home, and the costs of running a practice were a lot lower than today. At this point, they have just about wrung out the profits from cataract surgery, unless they want everyone to be getting $1.50 PMMA implants made in some low labor cost country.
Why has retina been spared from this? It seems to be one of the highest paid medical subspecialties still
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It has not been spared.
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interesting. ive heard most retina surgeons make upwards of 500K...is this not true anymore?
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Redacted for emphasis.
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No part of ophthalmology has been spared. Retina actually took a huge hit recently with reductions in OCT and intravitreal injection reimbursements. It still has the highest revenue potential of the ophthalmology subspecialties; however, I would take the under on most making $500k per year. There are some who make much more, but they work ridiculously hard to do it. Since those folks are essentially maxed out on volume, their revenue has nowhere to go but down. Those of us who have room to grow can at least try and compensate for future cuts with increases in volume. For instance, they're working on additional cuts/restrictions on medical imaging, which may drop OCT reimbursements even further. Will make the ROI on SD-OCT hard to take. Fortunately, mine's already paid for!
