Optometrists are a joke - not a threat

[mdkurt]

BTW, I co-authored a major article about Pseudotumor cerebri or IIH. I'd like to see Mr "future..etc." guy attempt to write even one paragraph. I would not even accept his paragraph for edition.

In all fairness, he was probably referring to ORBITAL pseudotumor, for which prednisone is indicated. That is, of course, assuming the diagnosis was correct and he wasn't trying to treat orbital lymphoma.

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[futuredoctorOD]

In all fairness, he was probably referring to ORBITAL pseudotumor, for which prednisone is indicated. That is, of course, assuming the diagnosis was correct and he wasn't trying to treat orbital lymphoma.

As usual you have good insight....YES it was ORBITAL pseudotumor and the patient did just fine. I am only a pre-opto but I am learning a signifigant amount with my shadowing along with the fact I took two semesters of Gross Anatomy (Professional school level) where I dissected---I did Head and Neck--that was a blast! I loved it! Anyways---My response to Deek is that he seems to be oblivious to an Optometrist's training. I printed this thread out and showed it to the doctor (OD) and even the (OMD) I am shadowing and they got a big laugh because they both know that OD's are trained in the treatment and referal protocols for pseudotumor cerbri as well as the ocular and systemic side effects of those treatments!!! And you wouldn't publish an article of mine?-----lol I am not even in Optometry school yet----wow----isn't that pretty obvious? Get back to me in 5 years when I am in residency---we can actually talk about that topic with seriousness....Anywho, Deek, Vanelo, and Brendang---good luck...Maybe we can all go grab a beer or something because I venture to say that your imflammatory opinions on here would not be duplicated in a face to face conversation with an OD. Opthalmology is a wonderful field, Optometry is a wonderful field. All three of you obviously have no clue as to scope and breadth of the training and that's pretty sad considering that I am not even in school (will be soon) and I am aware of this....

Opthalmology&Optometry

 

[EYESURG]

As usual you have good insight....YES it was ORBITAL pseudotumor and the patient did just fine. I am only a pre-opto but I am learning a signifigant amount with my shadowing along with the fact I took two semesters of Gross Anatomy (Professional school level) where I dissected---I did Head and Neck--that was a blast! I loved it! Anyways---My response to Deek is that he seems to be oblivious to an Optometrist's training. I printed this thread out and showed it to the doctor (OD) and even the (OMD) I am shadowing and they got a big laugh because they both know that OD's are trained in the treatment and referal protocols for pseudotumor cerbri as well as the ocular and systemic side effects of those treatments!!! And you wouldn't publish an article of mine?-----lol I am not even in Optometry school yet----wow----isn't that pretty obvious? Get back to me in 5 years when I am in residency---we can actually talk about that topic with seriousness....Anywho, Deek, Vanelo, and Brendang---good luck...Maybe we can all go grab a beer or something because I venture to say that your imflammatory opinions on here would not be duplicated in a face to face conversation with an OD. Opthalmology is a wonderful field, Optometry is a wonderful field. All three of you obviously have no clue as to scope and breadth of the training and that's pretty sad considering that I am not even in school (will be soon) and I am aware of this....

Opthalmology&Optometry

Whatever...you are the kind of person that have no regard to the field of Ophthalmology. You want shortcuts and your are not even in school. You are just pissed b/c somebody is standing-up for your BS. You have absolutely (apparently) no clue about the field of Ophthalmology! I think this "professional school" gross anatomy thing is a joke. Anatomy without clinical correlations is a joke!!!

 

[chalazion]

I say this in "good faith"--every doc on here OD or OMD/ ODO ---I have the utmost respect for your hard work and accomplishments---I aspire to be one of you in 5 years. That said, I feel that any degrading comments directed at Optometrists is completely uncalled for and ridiculous really. I for one have not seen one poster on here degrade an Opthalmologist--Opthalmology on the basis of what it is...I have seen people on here degrade optometry (Vanelo, Brendang, etc....)----the opinions from these folks hold no merit becuase of the unprofessional and degratory nature they exhibit regarding to optometric physicians. Both fields are respectable and very difficult to achieve--this is a fact....I propose that:

1. Creat a surgery residency for OD's like Dr. Doan suggested (maybe a couple tweaks here and there)---so there is an understanding between the two professions or we can look forward to enjoying years of legal "fun" as we did for the 25 yrs of prescription rights battles in 50 states---1972 to present---that was a joy wasn't it?

2. Expand the Optometric formulary to include oral meds in every state instead of just 41, and make it comprehensive to treat most eye diseases within the scope of a primary care eye doctor....Ohio is good example for a decent formulary but needs to expand each year and currently IS expanding. Face reality---optometrists are primary care eye doctors and if Opthalmology is respects this than STOP fighting with them over glaucoma medicines in New York, etc-----this is stupid and a waste of money.

3. Create more partnerships in hospitals between the two professions and WORK TOGETHER---as in optometric externships, residencies (there are VA hospital residencies cooperatives OD/OMD, and eye institutions, but not many if any private or state hospitals that I know of. (please correct me here if I am wrong.)

4. Be realistic.....Both professions are here and will be for a long time----be symbiotic not predatory or parasitic........

If optometrists wish to treat systemic disease and prescribe systemic medication, then they should be required to take and pass all 3 steps of the united states medical licensing exam just as MD's, DO's, and OMFS doctors must do.

I am just dumbfounded by this "shortcutting" the system attitude.
If OD's wish to do surgery, prescribe medicines, etc. shouldn't they undergo the same rigorous training and testing that other's must? Shouldn't they be held to the same standard? In my state, an MD cannot even prescribe medication after medical school until he completes an additional year of training. So 4 years for an OD to have prescribing rights, 5 years for an MD..wow.

Most of the OD's I have met are ok, I think it is this 10-15% who want to be overly-aggressive and extend themselves beyond what they were trained to do and what is appropriate it for them to do that is causing all this mess. The rest of the profession should be straightening out this small minority rather than getting laws passed such that an OD will be telling my grandmother that he is qualified to reconstruct her lid or repair her detachment..

 

[vanelo]

If optometrists wish to treat systemic disease and prescribe systemic medication, then they should be required to take and pass all 3 steps of the united states medical licensing exam just as MD's, DO's, and OMFS doctors must do.

I am just dumbfounded by this "shortcutting" the system attitude.
If OD's wish to do surgery, prescribe medicines, etc. shouldn't they undergo the same rigorous training and testing that other's must? Shouldn't they be held to the same standard? In my state, an MD cannot even prescribe medication after medical school until he completes an additional year of training. So 4 years for an OD to have prescribing rights, 5 years for an MD..wow.

How could they? If you looked at their applications, >90% of them wouldn't be admitted to med school.

That explains why they want the shortcut route, instead of the civilized, standardized one.

 

[futuredoctorOD]

Whatever...you are the kind of person that have no regard to the field of Ophthalmology. You want shortcuts and your are not even in school. You are just pissed b/c somebody is standing-up for your BS. You have absolutely (apparently) no clue about the field of Ophthalmology! I think this "professional school" gross anatomy thing is a joke. Anatomy without clinical correlations is a joke!!!

Do you make assumptions without having all the facts my friend? When I said "professional school anatomy" I meant the SAME as what my brother had who by the way was in his first year of Osteopathic Medical School at the time---we compared notes and were equally responsible for functional questions which covered 80% the tags. I should know because I took the classes-both neuroanatomy and gross. We had very few identification tags--the majority had funtional-clinical correlation. For instance--"If you had a lesion in this structure (which you had to know was the MLF)what would be the corresponding pathology?"---30 seconds for that question. I am going to be much more prepared in terms of neuroanatomy--especially cranial nerves and visual system related than an average optometry or medical student going into school. I am also taking opthalmic anatomy and phsysiology in the spring as a refresher before I matriculate. Oh ya and just so you know---my undergrad GPA science and overall where the equivalent of my brother's who is in his third year of DO school---I am choosing optometry because it is the best career for me. OD and DO students are not that far apart in terms of academic ability. My other brother who is a surgery resident (General Surgery) sat on the admissions committee at his MD school and broke it down this way.. The MD students "on the average" due to tremndous competition are better overall...This is without a doubt true. Take a step down (academically) after that and the "average" DO student is probably more academically sound than the average OD student. But the best 10% of any of the others DO, OD, DDS, DPM...could without a doubt be right there with the best of the MD applicants. It is supply and demand at its best..You are comparing apples with apples---all are bright and capable people, some are just more than others. Regardless, comparing programs is useless because an MD student would fail the NBEO's (Optometry Boards), Dental Boards, or Podiatry Boards, and correspondingly the OD student would fail the USMLE, Dental Boards, and Podiatry Boards...! lol These are totally different programs and without a commonality for comparison----comparisons are not valid. The MD schools without a doubt "on the average" get the most academically sound applicants-this cannot be debated. Does academic rigor translate to the best physicians? Too many variables and subjectivity to really test this. I am sure that my family practice doc who is an Osteopath did not have as much difficulty getting into his DO program but being the patient---do I care? I had horrible pain in my C6-T12 area and with NSAIDS and cervical manipulation---I am just fine. He is the only medical physician that can render this service to me (MD's do not do manipulative medicine) and is a fantastic doctor. The bottom line is, people on here like to say stupid, insulting and demeaning, things under a vail of anonymity which in the "real world" are far and between. I wish people on here were more professional about there opinions. And you are WRONG---I respect and admire Opthalmology and Optometry. I am going to be observing a LASIK procedure this week---I think that will be fun.

Bachelor of Science in Education 1997

 

[rubensan]

Regardless, comparing programs is useless because an MD student would fail the NBEO's (Optometry Boards), Dental Boards, or Podiatry Boards, and correspondingly the OD student would fail the USMLE, Dental Boards, and Podiatry Boards...! lol These are totally different programs and without a commonality for comparison----comparisons are not valid. The MD schools without a doubt "on the average" get the most academically sound applicants-this cannot be debated. Does academic rigor translate to the best physicians? Too many variables and subjectivity to really test this.

Unfortunately, I think you missed the point of many of the 105 posts on this thread. You're right, nobody expects a dentist to pass the USMLE. But if said dentists wants to take patients to the OR, he matches to an OMF residency, does an internship and passes all 3 steps of USMLE. Similarly, nobody expects an OD to pass the USMLE nor do I think that I (a 4th year medical student) could pass the NBEO. But if an OD wants to operate and prescribe the same scope of medications as an ophthalmologist with systemic side effects, this OD should go to medical school and pass the same requirements that an ophthalmologist does.

Are you saying that beyond these drugs they would need a medical internship or residency-------what do you mean?.

yes! and your past posts lead me to believe that you won't understand this. it goes back to something that most medical students and medical residents struggle with in their training:

side effects of certain systemic and even topical medications may be overt and one would need certain level of expertise and clinical suspicion to catch early signs of problems. ...no one can acquire such skills just by taking pharmacology classes.

JR is right! How do you know what you don't know? How can manage complications that you have never seen?

My wife is an OB/GYN resident and she along with others in her program feel that one of the deficiencies in her residency program is a lack of exposure to other fields. Indeed, OB/GYN is both a medical and surgical field and she wishes that she could have done some general surgery and internal medicine rotations as an intern to better understand the principles of management of hypertension so she can manage the meds of a pt with pre-eclampsia at a more sophisticated level. She also wishes she had more exposure to the management of bowel repair so that she is better equipped to deal with this complication when a bowel gets perfed during a TAH. My point? You need broad exposure to multiple medical fields and clinical scenarios to become an excellent clinician who treats health problems at both the medical and surgical level. That's why OMDs spend a year learning from the internal medicine docs and/or general surgeons so that we become versed in treating diseases and learn how to manage complications of our treatments, both medical and surgical. Will you get this if your training comes only from people in your own field (i.e., optometrists)? Remember, PRESCRIBING MEDS AND PERFORMING SURGERY ARE PRIVILEGES AND NOT RIGHTS JUST BECAUSE THE WORD "DOCTOR" IS IN YOUR DEGREE TITLE. MD OR OD!

And you are WRONG---I respect and admire Opthalmology....

we'll see, your actions in the years to come will speak much louder than your words on this forum.

Ruben

 

[rubensan]

p

 

[eyeful]

Do you make assumptions without having all the facts my friend? When I said "professional school anatomy" I meant the SAME as what my brother had who by the way was in his first year of Osteopathic Medical School at the time---we compared notes and were equally responsible for functional questions which covered 80% the tags. I should know because I took the classes-both neuroanatomy and gross. We had very few identification tags--the majority had funtional-clinical correlation. For instance--"If you had a lesion in this structure (which you had to know was the MLF)what would be the corresponding pathology?"---30 seconds for that question. I am going to be much more prepared in terms of neuroanatomy--especially cranial nerves and visual system related than an average optometry or medical student going into school. I am also taking opthalmic anatomy and phsysiology in the spring as a refresher before I matriculate. Oh ya and just so you know---my undergrad GPA science and overall where the equivalent of my brother's who is in his third year of DO school---I am choosing optometry because it is the best career for me. OD and DO students are not that far apart in terms of academic ability. My other brother who is a surgery resident (General Surgery) sat on the admissions committee at his MD school and broke it down this way.. The MD students "on the average" due to tremndous competition are better overall...This is without a doubt true. Take a step down (academically) after that and the "average" DO student is probably more academically sound than the average OD student. But the best 10% of any of the others DO, OD, DDS, DPM...could without a doubt be right there with the best of the MD applicants. It is supply and demand at its best..You are comparing apples with apples---all are bright and capable people, some are just more than others. Regardless, comparing programs is useless because an MD student would fail the NBEO's (Optometry Boards), Dental Boards, or Podiatry Boards, and correspondingly the OD student would fail the USMLE, Dental Boards, and Podiatry Boards...! lol These are totally different programs and without a commonality for comparison----comparisons are not valid. The MD schools without a doubt "on the average" get the most academically sound applicants-this cannot be debated. Does academic rigor translate to the best physicians? Too many variables and subjectivity to really test this. I am sure that my family practice doc who is an Osteopath did not have as much difficulty getting into his DO program but being the patient---do I care? I had horrible pain in my C6-T12 area and with NSAIDS and cervical manipulation---I am just fine. He is the only medical physician that can render this service to me (MD's do not do manipulative medicine) and is a fantastic doctor. The bottom line is, people on here like to say stupid, insulting and demeaning, things under a vail of anonymity which in the "real world" are far and between. I wish people on here were more professional about there opinions. And you are WRONG---I respect and admire Opthalmology and Optometry. I am going to be observing a LASIK procedure this week---I think that will be fun.

Bachelor of Science in Education 1997

Your arrogance and hubris is absolutely astounding. You seem to enjoy coming to this board spouting off what are to you esoteric medical facts which in actuality are really not that impressive. Do you enjoy talking like you are some expert in the medical field with your "professional level" classes and "clincal exposure" that any dime a dozen premed does? Yes, most matriculats to doctoral level health programs are intelligent, but to suggest that the top 10% of OD and DPM applicants are equivalent to the top 10% of md applicants is ludicrous. According to the AAMC, to be a top 15% or medical school matriculants you need a 3.90 GPA and 34.2 MCAT (not even top 10%). For top 15% of applicants it would be 3.84 and a 33.8 MCAT. Tell me if you think that your claim is still valid.

 

[futuredoctorOD]

Your arrogance and hubris is absolutely astounding. You seem to enjoy coming to this board spouting off what are to you esoteric medical facts which in actuality are really not that impressive. Do you enjoy talking like you are some expert in the medical field with your "professional level" classes and "clincal exposure" that any dime a dozen premed does? Yes, most matriculats to doctoral level health programs are intelligent, but to suggest that the top 10% of OD and DPM applicants are equivalent to the top 10% of md applicants is ludicrous. According to the AAMC, to be a top 15% or medical school matriculants you need a 3.90 GPA and 34.2 MCAT (not even top 10%). For top 15% of applicants it would be 3.84 and a 33.8 MCAT. Tell me if you think that your claim is still valid.

Seriously, I was just trying to give Deek an example of the kind of education I recieved--you should read his arrogant and demeaning comment earlier. Regardless--computers lie because in person if you met me you would know I am a very humble person yet extremely assertive. And actuality the most arrogant of responders on SDN are 3rd to 4rth year Medical students and some residents of CERTAIN PROGRAMS . I can cut and paste very demeaning responses from some of your cohorts and send them to your email but you don't have enough room and I don't have the time . I AM NO EXPERT and have done absolutely NOTHING yet (regarding becoming a doctor)---but I will. I will take you up on your challenge "According to the AAMC, to be a top 15% or medical school matriculants you need a 3.90 GPA and 34.2 MCAT (not even top 10%). For top 15% of applicants it would be 3.84 and a 33.8 MCAT. Tell me if you think that your claim is still valid.[/QUOTE]"------you can only use common points of reference though...MCATs, DAT's, OAT's, and VMAT's, etc. are different tests so I will throw that out. I will compare on the basis of commonality--overall GPA, science GPA, and the majors they earned their degrees in...I will make a couple of phone calls and get the statistics and get back to you. The fact is I don't consider an OD, DO, MD, DDS, DDS OMFS, DMD, DPM, or a DC...any better than each other---all serve important roles and coming from an entirely MD family (except for one of my brothers)---I know so very well that the MD profession is no different than any other respectable profession. See ya.

 

[futuredoctorOD]

Unfortunately, I think you missed the point of many of the 105 posts on this thread. You're right, nobody expects a dentist to pass the USMLE. But if said dentists wants to take patients to the OR, he matches to an OMF residency, does an internship and passes all 3 steps of USMLE. Similarly, nobody expects an OD to pass the USMLE nor do I think that I (a 4th year medical student) could pass the NBEO. But if an OD wants to operate and prescribe the same scope of medications as an ophthalmologist with systemic side effects, this OD should go to medical school and pass the same requirements that an ophthalmologist does.



yes! and your past posts lead me to believe that you won't understand this. it goes back to something that most medical students and medical residents struggle with in their training:



JR is right! How do you know what you don't know? How can manage complications that you have never seen?

My wife is an OB/GYN resident and she along with others in her program feel that one of the deficiencies in her residency program is a lack of exposure to other fields. Indeed, OB/GYN is both a medical and surgical field and she wishes that she could have done some general surgery and internal medicine rotations as an intern to better understand the principles of management of hypertension so she can manage the meds of a pt with pre-eclampsia at a more sophisticated level. She also wishes she had more exposure to the management of bowel repair so that she is better equipped to deal with this complication when a bowel gets perfed during a TAH. My point? You need broad exposure to multiple medical fields and clinical scenarios to become an excellent clinician who treats health problems at both the medical and surgical level. That's why OMDs spend a year learning from the internal medicine docs and/or general surgeons so that we become versed in treating diseases and learn how to manage complications of our treatments, both medical and surgical. Will you get this if your training comes only from people in your own field (i.e., optometrists)? Remember, PRESCRIBING MEDS AND PERFORMING SURGERY ARE PRIVILEGES AND NOT RIGHTS JUST BECAUSE THE WORD "DOCTOR" IS IN YOUR DEGREE TITLE. MD OR OD!



we'll see, your actions in the years to come will speak much louder than your words on this forum.

Ruben

I have a lot of respect for you and your posts. Can I ask you questions when I am in school? You seem to know what you know very well and I really respect your demeanor on here.. That said OD's already prescribe a number of topical and oral meds that have systemic effects safely and effectively....I gave an example earlier where the OD I shadow wrote oral prednisone for a patient with orbital pseudotumor...according to what he says they have a lot more training in terms of pharmocological applications in the clinical sense than most of the opthos on here realize. If you do a residency like he did----1 year in a tertiary setting such as VA Ocular Disease, Eye Institute--such as Bascom-Palmer, etc---that is an extra year dealing with medications. 5 years of training total is more than adequate (I am not including undergraduate--some respondants on here have!) to produce a fully competant primary care eye doctor not an eye surgeon.

 

[aphistis]

If optometrists wish to treat systemic disease and prescribe systemic medication, then they should be required to take and pass all 3 steps of the united states medical licensing exam just as MD's, DO's, and OMFS doctors must do.

You're right, nobody expects a dentist to pass the USMLE. But if said dentists wants to take patients to the OR, he matches to an OMF residency, does an internship and passes all 3 steps of USMLE.

Wrong and wrong. The majority of oral & maxillofacial surgeons do NOT possess an MD, and have never passed the USMLE. As I've said more than once, OMS is a self-sufficient specialty unique to dentistry--no MD required.

 

[JR]

Not categorically "wrong and wrong". Every single OMS I have ever met had to take USMLE I/II/III, had to complete MS3 and MS4 and do a surgical internship on top of that. I actually studied for Step III together with 2 OMSs at my hospital just a few months ago; these guys are finishing up their surgical internship. Having said that, there maybe programs out there that don't require all this to become an OMS. Maybe in Indiana .

Wrong and wrong. The majority of oral & maxillofacial surgeons do NOT possess an MD, and have never passed the USMLE. As I've said more than once, OMS is a self-sufficient specialty unique to dentistry--no MD required.

 

[demspawn]

I have a lot of respect for you and your posts. Can I ask you questions when I am in school? You seem to know what you know very well and I really respect your demeanor on here.. That said OD's already prescribe a number of topical and oral meds that have systemic effects safely and effectively....I gave an example earlier where the OD I shadow wrote oral prednisone for a patient with orbital pseudotumor...according to what he says they have a lot more training in terms of pharmocological applications in the clinical sense than most of the opthos on here realize. If you do a residency like he did----1 year in a tertiary setting such as VA Ocular Disease, Eye Institute--such as Bascom-Palmer, etc---that is an extra year dealing with medications. 5 years of training total is more than adequate (I am not including undergraduate--some respondants on here have!) to produce a fully competant primary care eye doctor not an eye surgeon.

I am guessing that with undergrad you mean pre-MD or pre-OD.

So here is the equation:
4 years OD training and 1 year internship is good enough to prescribe oral drugs you say.
Hmmm. Is it also equivalent to four years MD + 1 year Inernship (Med or Surg) + 3 more years of Ophtho residency?

Who will havemore experience and more knowledge concerning that oral drug?
Who would you trust to give it to you? Who would you take your child to?

 

[rubensan]

I have a lot of respect for you and your posts. Can I ask you questions when I am in school? You seem to know what you know very well and I really respect your demeanor on here.

.

THanks for the complement, but as a 4th year medical student, I acknowledege that I know very little and have so much more to learn as an intern and resident.

That said OD's already prescribe a number of topical and oral meds that have systemic effects safely and effectively....I gave an example earlier where the OD I shadow wrote oral prednisone for a patient with orbital pseudotumor...according to what he says they have a lot more training in terms of pharmocological applications in the clinical sense than most of the opthos on here realize..

So says the optometrist....I feel that it's really hard to have this argument with you because you are looking at this issue from the point of view that OD education is sufficient to prescirbe many medications with systemic side effects. We feel that you need more training. Nothing that I will say will change your mind. And all the evidence from the ODs about how adequate their training is won't convince any of us. Sure, differences of opinion make the world go around, but keep this in mind as you enter your own schooling....I really like how this person put it (and to be fair, you can substitue optometrist for ophthalmologist as well):

It is true that it takes more than a pharm class to understand the impact of meds on pt management. It doesn't matter if it was pharm in med school or optometry school, the truth is that it takes clinical experience. Different clinicians have different comfort levels in managing pts and I think it is based on both education and experience. I think most optometrists manage their pts within their comfort level and in the best interest of their pts. Any optometrist who specializes in treating pts with complicated medical histories has a responsibility to recognize any potential problems.

so futuredoctorOD, this will be my last post to you on this subject. You obviously have a lot of excitement about the field of optometry, so don't
waste it on this forum trying to justify why you think ODs should gain Rx rights. You're preaching to the wrong choir! Instead, go out there and learn how to be the best and most ethical optometrist that you can be. Patients need you just like they need us. And yes, you are more than welcome to ask me any questions when you are in school, I'll see if I can answer them.

Best Wishes,
Ruben

 

[rubensan]

The majority of oral & maxillofacial surgeons do NOT possess an MD, and have never passed the USMLE.

The ones I know, did my clinical clerkships and will graduate medical with in a few weeks did. However, I checked the AAOMS (the governing body of that field) website and found this:

Oral and maxillofacial surgeons are dentists specializing in surgery of the mouth, face and jaws. After four years of dental school, OMSs receive four to seven years of hospital-based surgical and medical training, preparing them to do a wide range of procedures including all types of surgery of both the bones and soft tissues of the face, mouth and neck.

So [bold/]I was wrong[/bold]. The definition is vague and there is no mention of receiving an MD at the end of it all. Perhaps it is up to the individual educational institution to confer the MD or not.

As I've said more than once, OMS is a self-sufficient specialty unique to dentistry--no MD required

I seem to remember a little spat here in California between OMS and ENT re: who gets to do elective cosmetic surgery of the head and neck. I am not about to go down that road, but maybe OMS is not as self-sufficient as you believe. Also, what about that Kansas dentist (along with 12 others) who got told by the courts to stop using the "MD" in his title after they learned that he received his degree from U of Antigua, but never took the appropriate steps to medical liscensure. Perhaps no MD is required, but it seems like these guys go to some pretty drastic extremes to be able to throw the term, "MD" around.

 

[aphistis]

Not categorically "wrong and wrong". Every single OMS I have ever met had to take USMLE I/II/III, had to complete MS3 and MS4 and do a surgical internship on top of that. I actually studied for Step III together with 2 OMSs at my hospital just a few months ago; these guys are finishing up their surgical internship. Having said that, there maybe programs out there that don't require all this to become an OMS. Maybe in Indiana .

Yes, JR, categorically wrong and wrong. A medical degree is absolutely unnecessary. I don't wish to be unnecessarily abrasive here, but you might consider opening yourself to the possibility that, as an ophthalmologist, your awareness of OMS might not be all-encompassing.

 

[aphistis]

So [bold]I was wrong[/bold].

Thank you, that's very gracious (no sarcasm).

I seem to remember a little spat here in California between OMS and ENT re: who gets to do elective cosmetic surgery of the head and neck. I am not about to go down that road, but maybe OMS is not as self-sufficient as you believe. Also, what about that Kansas dentist (along with 12 others) who got told by the courts to stop using the "MD" in his title after they learned that he received his degree from U of Antigua, but never took the appropriate steps to medical liscensure. Perhaps no MD is required, but it seems like these guys go to some pretty drastic extremes to be able to throw the term, "MD" around.

You're talking about one state, which is so saturated with doctors of every sort that everybody has to grab whatever slice of the pie they can find in order to get by. That leaves 49 where OMS are doing just fine for themselves.

As for your last point, you're generalizing the ethics of 12 people to the entire field. If you want to keep playing that game, just let me know so I can start sifting through OMDs to find the worst. Otherwise, we can just agree that anecdotal evidence is hopelessly flimsy.

 

[JR]

Agreed, no need to be abraisive, Bill. I was just simply pointing out that in my experience the OMSs I've worked with all had DDS,MD after their names. And you as well should keep yourself open to the possibility that ophthalmologists have interests and knowledge outside their field.

Yes, JR, categorically wrong and wrong. A medical degree is absolutely unnecessary. I don't wish to be unnecessarily abrasive here, but you might consider opening yourself to the possibility that, as an ophthalmologist, your awareness of OMS might not be all-encompassing.

 

[aphistis]

Agreed, no need to be abraisive, Bill. I was just simply pointing out that in my experience the OMSs I've worked with all had DDS,MD after their names. And you as well should keep yourself open to the possibility that ophthalmologists have interests and knowledge outside their field.

If you say so. I'd like to see your response to an oral surgeon in here claiming to know more about oculoplastics training than you and defending himself with the argument you're offering here. Considering that you've made several posts indicating a belief that even optometrists are incompletely informed about ophthalmology as a profession, I think expecting me to believe you wouldn't tear them apart for the mere suggestion is asking quite a lot. The argument is bidirectional, or it doesn't exist.

 

[futuredoctorOD]

If you say so. I'd like to see your response to an oral surgeon in here claiming to know more about oculoplastics training than you and defending himself with the argument you're offering here. Considering that you've made several posts indicating a belief that even optometrists are incompletely informed about ophthalmology as a profession, I think expecting me to believe you wouldn't tear them apart for the mere suggestion is asking quite a lot. The argument is bidirectional, or it doesn't exist.

As usual Bill, you hit it on the nose. The sense of entitlement in regard to the MD students and residents on here is limitless. You are IN Dental School and logically would know more about your field than an Opthalmology resident or Medical student---The funny thing is, the OMFS resident that I know says that the majority (vast majority) of his counterparts (OMFS's) do not have an MD next to thier name. As to this, "Considering that you've made several posts indicating a belief that even optometrists are incompletely informed about ophthalmology as a profession, I think expecting me to believe you wouldn't tear them apart for the mere suggestion is asking quite a lot. The argument is bidirectional, or it doesn't exist.[/QUOTE]" The moment one (someone pursuing another credential other than MD....and ok..DO) tries to have a frank discussion with "these people" from an angle that is alternative to the accepted MD doctrine, the enivitable conclusion is lambasting, degredation, and disrespect. You have good points.

 

[JR]

You are making a lot of assumptions about me, ha? I guess we just have to agree to disagree on this. Unless you find that oral surgen .

If you say so. I'd like to see your response to an oral surgeon in here claiming to know more about oculoplastics training than you and defending himself with the argument you're offering here. Considering that you've made several posts indicating a belief that even optometrists are incompletely informed about ophthalmology as a profession, I think expecting me to believe you wouldn't tear them apart for the mere suggestion is asking quite a lot. The argument is bidirectional, or it doesn't exist.

 

[aphistis]

You are making a lot of assumptions about me, ha? I guess we just have to agree to disagree on this. Unless you find that oral surgen .

I don't think that oral surgeon exists, which is half my platform.

Beyond that, I can always agree to disagree. Thanks for the civil discussion.

 

[rubensan]

Thank you, that's very gracious (no sarcasm).

No problem, I did not come to this forum pretending that I know everything and I hope that I can admit when I am wrong.

You're talking about one state, which is so saturated with doctors of every sort that everybody has to grab whatever slice of the pie they can find in order to get by. That leaves 49 where OMS are doing just fine for themselves.).

Okay, fair enough. Like I said, I do not pretend to be an expert re: OMS. The purpose of my post was to illustrate that attempts at OMS scope expansion as it relates to elective cosmetic surgery is occuring in California. Indeed, I am not naive enough to believe that California is emblematic of OMS in the other 49 states. Just like I don't believe that OK symbolizes the best interests of optometry accross the country. But i will say that people across the country carefully follow the results of such heated political issues. This forum should illustrate that point. But let's say this, you are in dental school, I will defer all future OMS/DDS issues to you. The point of all of this OMS stuff and what I think Andrew Doan, JR and I have been saying is that the 44 of 101 total OMS training programs that offer a dual DDS/MD degrees are worth looking at and may serve as models for optometry students who desire an expanded scope of practice.

What i think is really interesting is the following article:

Edwards RC, Foley WL. Expanding the specialty: a survey of oral and maxillofacial surgery residencies in the United States.J Oral Maxillofac Surg. 1993 May;51(5):559-63; discussion 563-4.

It states that most OMS residency directors oppose expandng the scope of OMS into elective cosmetic surgery. However, of the OMS residency directors of programs that offer a combined MD/OMS degree, a majority supported an increased scope of practice to include elective cosmetic surgeries. This is along the lines of what we are trying to say. And I think it is one of the solutions that many on this forum are proposing: to create some sort of MD/OD combined degree that supports the expansion of optometry.

As for your last point, you're generalizing the ethics of 12 people to the entire field. If you want to keep playing that game, just let me know so I can start sifting through OMDs to find the worst. Otherwise, we can just agree that anecdotal evidence is hopelessly flimsy.

this is what I said:

Also, what about that Kansas dentist (along with 12 others) who got told by the courts to stop using the "MD" in his title after they learned that he received his degree from U of Antigua, but never took the appropriate steps to medical liscensure. Perhaps no MD is required, but it seems like these guys go to some pretty drastic extremes to be able to throw the term, "MD" around.

when I used the term, "these guys" it implied those that used the term MD in their job title when it should not have been used, not OMS in general. aphistis, I don't want to "play any games" with you. This is not what this forum is supposed to be about. I agree, anectodotal evidence should not be used to describe entire fields and I hope that my previous posts on this forum attest to the fact that I try not to do that.

Warm Regards,
Ruben

 

[aphistis]

No problem, I did not come to this forum pretending that I know everything and I hope that I can admit when I am wrong.

Okay, fair enough. Like I said, I do not pretend to be an expert re: OMS. The purpose of my post was to illustrate that attempts at OMS scope expansion as it relates to elective cosmetic surgery is occuring in California. Indeed, I am not naive enough to believe that California is emblematic of OMS in the other 49 states. Just like I don't believe that OK symbolizes the best interests of optometry accross the country. But i will say that people across the country carefully follow the results of such heated political issues.

I'm 2/3 of the country away from California and completely unaffiliated with the AAOMS, so I can't comment authoritatively on that issue, but my thoughts on the matter run something like this: if the medical community wants to say cosmetic procedures belong to appropriately-trained personnel, that's cool with me. Give it all the the PRS guys and take them away from ENT & OMS both. We both know that'd never work, that the ENT community would raise holy hell about it, and rightly so, because many of them are properly trained in these cosmetic procedures.

I think OMS can submit the same defense for some (not all) of these procedures. With the name oral & maxillofacial surgery, I think you'd be very hard-pressed to mount a convincing argument against residency-trained OMS performing genioplasties & rhinoplasties, especially when you consider these people crack skulls in half performing orthognathic surgery as a matter of course.

This forum should illustrate that point. But let's say this, you are in dental school, I will defer all future OMS/DDS issues to you. The point of all of this OMS stuff and what I think Andrew Doan, JR and I have been saying is that the 44 of 101 total OMS training programs that offer a dual DDS/MD degrees are worth looking at and may serve as models for optometry students who desire an expanded scope of practice.

If you folks are OK with residency-trained optometrist surgeons, I certainly have no business getting riled up about it. My primary objection to OD surgery is that none of its advocates, at least here, have offered any significant justification for the field's existence. As I've mentioned elsewhere in this debate (maybe another thread), OMS accommodates a niche that none of the similar medical specialties fills. These proposed optometrist surgeons, on the other hand, would be completely redundant to ophthalmologists as far as I can tell.

What i think is really interesting is the following article:

Edwards RC, Foley WL. Expanding the specialty: a survey of oral and maxillofacial surgery residencies in the United States.J Oral Maxillofac Surg. 1993 May;51(5):559-63; discussion 563-4.

It states that most OMS residency directors oppose expandng the scope of OMS into elective cosmetic surgery. However, of the OMS residency directors of programs that offer a combined MD/OMS degree, a majority supported an increased scope of practice to include elective cosmetic surgeries. This is along the lines of what we are trying to say. And I think it is one of the solutions that many on this forum are proposing: to create some sort of MD/OD combined degree that supports the expansion of optometry.

Like I mentioned above, I think performing cosmetic procedures that exist in OMS' anatomic playground (noses, chins, lips, cheeks, etc.) is perfectly defensible, and I think performing any procedures that are outside that same area (breasts, butt, basically anything below the neck that isn't a necessary component of a legitimate OMS procedure [e.g., harvesting a rib to reconstruct a resected mandible {I like nesting parenthetical statements}])are equally indefensible.

this is what I said: when I used the term, "these guys" it implied those that used the term MD in their job title when it should not have been used, not OMS in general. aphistis, I don't want to "play any games" with you. This is not what this forum is supposed to be about. I agree, anectodotal evidence should not be used to describe entire fields and I hope that my previous posts on this forum attest to the fact that I try not to do that.

Warm Regards,
Ruben

Fair enough. There are sleazeballs in every profession, as I'm sure you can empathize. If these guys weren't carrying valid medical licenses, they shouldn't have been advertising the degree.

 

[smiegal]

I didn't want to add another post to this unfortunately-named thread, but this future "optometric physician" just keeps adding kindling.

"As usual Bill, you hit it on the nose."

Bill firmly disagrees with OD surgery (the focus of nearly all of your posts).

"The sense of entitlement in regard to the MD students and residents on here is limitless..."

What does that even mean in the context of your post?

Dr. Doan or JR, please kill this thread

 

[Andrew_Doan]

As long as things are civil, we'll keep the thread active for now.

 

[futuredoctorOD]

I didn't want to add another post to this unfortunately-named thread, but this future "optometric physician" just keeps adding kindling.

"As usual Bill, you hit it on the nose."

Bill firmly disagrees with OD surgery (the focus of nearly all of your posts).

"The sense of entitlement in regard to the MD students and residents on here is limitless..."

What does that even mean in the context of your post?

Dr. Doan or JR, please kill this thread

I respect Bill's opinion becuase he presents it in an intelligent and non-confrontational manner. Really the focus of my posts is not "Optometric Surgery" rather it is the concept of interprofessional respect and growth of my future profession. Surgery is just one of many issues on "optometry's plate" that needs to be dealt with an honestly it is of much lower importance than consistency in scope of practice in every state due to the tremndous variability (In illinois an OD cannot write oral meds whereas in Oklahoma they can do iridotomies!) I am for evolution and change if it is for improving fitness--just like natural selection the ultimate cause is to promote proliferation and propagation for the profession in the future. But in a proximate sense the profession needs to standardize the scope of practice in every state like having an acceptable level of oral meds in every state similar to Ohio or Oklahoma's formulary, create a legitamate surgical pathway that opthalmology and optometry both recognizes and concurrently develops to prevent years and millions of dollars of legal warfare, and broaden the scope of medical management to become even more effective at managing the maladies seen in the primary care role. I feel the motivation for many is self-preservation whether it be opthalmology protecting it's surgical turf from a percieved optometric threat or optometry having to fight opthalmology and medicine for decades to even have the scope it currently posesses (I can show a chronology of the bitter attempts by medicine to hurt optometry and prevent it's growth if one wishes ) The bottom line is that we are all doctors or in my case "going to be" and need to communicate without degredation and malice----can you hear me vanelo and brendang? lol We are going to have to deal with each other in practice and some of the acrimonious displays on here are disturbing.

 

[smiegal]

I respect Bill's opinion becuase he presents it in an intelligent and non-confrontational manner. Really the focus of my posts is not "Optometric Surgery" rather it is the concept of interprofessional respect and growth of my future profession. Surgery is just one of many issues on "optometry's plate" that needs to be dealt with an honestly it is of much lower importance than consistency in scope of practice in every state due to the tremndous variability (In illinois an OD cannot write oral meds whereas in Oklahoma they can do iridotomies!) I am for evolution and change if it is for improving fitness--just like natural selection the ultimate cause is to promote proliferation and propagation for the profession in the future. But in a proximate sense the profession needs to standardize the scope of practice in every state like having an acceptable level of oral meds in every state similar to Ohio or Oklahoma's formulary, create a legitamate surgical pathway that opthalmology and optometry both recognizes and concurrently develops to prevent years and millions of dollars of legal warfare, and broaden the scope of medical management to become even more effective at managing the maladies seen in the primary care role. I feel the motivation for many is self-preservation whether it be opthalmology protecting it's surgical turf from a percieved optometric threat or optometry having to fight opthalmology and medicine for decades to even have the scope it currently posesses (I can show a chronology of the bitter attempts by medicine to hurt optometry and prevent it's growth if one wishes ) The bottom line is that we are all doctors or in my case "going to be" and need to communicate without degredation and malice----can you hear me vanelo and brendang? lol We are going to have to deal with each other in practice and some of the acrimonious displays on here are disturbing.

1) Your #1 goal is to make changes based only on Optometry's own best interest. You won't change any minds (including that of Bill/Aphistis or any other intelligent disinterested Americans) without focusing on societal benefit as opposed to this self-serving alternative.

2) Prediction: Selling Optometric scope protection on the basis of professional Darwinism is not going to sway many intelligent people. Feel free to read up on the near-universal shunning of the concepts of social or professional Darwinisn in the intellectual community.

3) Do you honestly believe that you live up to your own stated goals of "interprofessional respect" (in your case inter-student respect), being "non-confrontational" and "communicat(ing) without degredation and malice?" I do agree that you have been on the receiving end of some crap, but you seem to have a short fuse and dish it quite well.

4) For background, could you, yourself, have gotten into medical school numerically?

5) Dude....OpHthalmology

6) You accuse Ophthalmology of acting for self-preservation, but YOU have the burden of proof (for the societal benefit of OD surgery) because YOU want to change an unbroken system. YOU have to realize that most intelligent & disinterested individuals (including Bill/Aphistis) won't side with you on OD surgery based on the dearth of good supporting arguments. "I want to and I think I can" simply doesn't cut it (pun intended). That's why your profession takes the legislative route. I think we can all agree that legislative victories can be won despite poor supporting evidence. And please don't lump together medication and PI privileges.

 

[Dr.SpongeBobDDS]

I have to side with the MDs on this one. We all chose our own professions here. If you are unhappy with that choice, you are free to change your mind and apply to med school. I chose my profession because I knew what it entailed and that was what I wanted to do. If you did not do the same due diligence... well that's your own fault.

I'll admit there are times when I too have been a little envious of the money and prestige that comes with certain medical specialities, but ultimately I love my chosen profession. If I ever decided that dentistry was just not cutting it for me (as optometry doesn't seem to be doing for some of you) I wouldn't hesitate to get out and go to med school.

 

[EYESURG]

I respect Bill's opinion becuase he presents it in an intelligent and non-confrontational manner. Really the focus of my posts is not "Optometric Surgery" rather it is the concept of interprofessional respect and growth of my future profession. Surgery is just one of many issues on "optometry's plate" that needs to be dealt with an honestly it is of much lower importance than consistency in scope of practice in every state due to the tremndous variability (In illinois an OD cannot write oral meds whereas in Oklahoma they can do iridotomies!) I am for evolution and change if it is for improving fitness--just like natural selection the ultimate cause is to promote proliferation and propagation for the profession in the future. But in a proximate sense the profession needs to standardize the scope of practice in every state like having an acceptable level of oral meds in every state similar to Ohio or Oklahoma's formulary, create a legitamate surgical pathway that opthalmology and optometry both recognizes and concurrently develops to prevent years and millions of dollars of legal warfare, and broaden the scope of medical management to become even more effective at managing the maladies seen in the primary care role. I feel the motivation for many is self-preservation whether it be opthalmology protecting it's surgical turf from a percieved optometric threat or optometry having to fight opthalmology and medicine for decades to even have the scope it currently posesses (I can show a chronology of the bitter attempts by medicine to hurt optometry and prevent it's growth if one wishes ) The bottom line is that we are all doctors or in my case "going to be" and need to communicate without degredation and malice----can you hear me vanelo and brendang? lol We are going to have to deal with each other in practice and some of the acrimonious displays on here are disturbing.

Dude, just apply to medical school . I am not sure you'll get accepted though. At least, you should give it a try. You are obviously applying to a profession that does not meet your criteria for happiness (based on all your baseless arguments to expand the scope of optometry). I think you should apply to medical school and then to Ophthalmology residency and if you wish to only do primary care then don't specialize. By the way, this way you give yourself the option of doing surgery. I think you should be honest with yourself and dump the optometry school application and go to medical school. I am being serious. BTW, you mentioned that you were going to see a LASIK procedure sometime last week or this week. Why are you shadowing an Ophthalmologist where in fact you should be shadowing an optometrist? Apparently, you enjoy watching eye surgery and spend more time on the eye physicians and surgery forum. Dude, I think you are making a mistake going to optometry. I know you are old relatively, but that shouldn't keep you from going the long route.

 

[futuredoctorOD]

Dude, just apply to medical school . I am not sure you'll get accepted though. At least, you should give it a try. You are obviously applying to a profession that does not meet your criteria for happiness (based on all your baseless arguments to expand the scope of optometry). I think you should apply to medical school and then to Ophthalmology residency and if you wish to only do primary care then don't specialize. By the way, this way you give yourself the option of doing surgery. I think you should be honest with yourself and dump the optometry school application and go to medical school. I am being serious. BTW, you mentioned that you were going to see a LASIK procedure sometime last week or this week. Why are you shadowing an Ophthalmologist where in fact you should be shadowing an optometrist? Apparently, you enjoy watching eye surgery and spend more time on the eye physicians and surgery forum. Dude, I think you are making a mistake going to optometry. I know you are old relatively, but that shouldn't keep you from going the long route.

I respect the advice but I picked Optometry because I am happy with what it is and feel that a primary care role is more than enough responsibility----I actually have shadowed 3 optometrists for one year (at different times) and currently still shadow two (one in an eye institute and one in a LASIK surgery center.) I am very excited about becoming an OD in the future and chose to observe a LASIK procedure to get a better understanding of pre/post operative care. I will promote growth of the profession but if it stayed the way it is I would be MORE than HAPPY. But thanks for the comments....