None of what you wrote matters at all. If someone wants to hire an optometrist to operate on his eyes, he should have the right to do that even if you disagree with the decision.
What if the patient, by his or her own right of free choice, prefers a MD/DO ophthalmologist trained in eye surgeries but ends up seeing an OD who he/she knows as 'Dr' and informs him/her that he's also a surgeon trained to perform the operation.
Have you ever discussed the pre-clinical training of practitioners with the average health care consumer? They are shockingly misinformed.
If you take someone in a white coat, allow them to walk into a room, introduce themselves as Dr ___, and then state that they perform said surgical procedure, 99% of individuals are going to believe that person is an 'MD' and trained surgeon. Not an optometrist.
This completely negates the ability to 'chose.'
There is no reason why your judgment should override anyone else's. If you think optometrists are unfit to perform surgery, DON'T GO TO ONE. Simple. But somehow I doubt that this has nearly as much to do with protecting patients as it does with educational snobbery on the part of MDs.
See above post about 'not going to one.' If your 85 year old grandmother has glaucoma, she's going to figure out which 'eye doctor' takes medicare, go see him, and if he/she offers to perform some necessary surgery stemming from the initial appointment, she isn't going to whip out her iphone, pull up his CV, and realize she doesn't want to see him for surgery. She's going to book the surgery and have essentially very little idea as to his background because she's been told he's also an eye surgeon.
How again is this patient choice??
Additionally, this has nothing to do with 'MD snobbery,' whatever the hell that means. This has to do with a group seeing an opportunity to both fill an insecurity void and PROFIT from the ability to perform a procedure. In the end, it's all about the money.
You're begging the question. I'm arguing that the government should not pass judgment on who is fit to practice medicine, and that anyone should be allowed to practice regardless of his type or level training.
While I agree that governmental regulation should be minimal, I cannot possibly fathom how regulation in general (from boards overseen and regulated by clinicians) should be minimal. Again, you're trying to box the U.S. health service system into a type of consumer, free market that it just doesn't belong in.
If you want to say that it's wrong, trust-esque, non-democratic to say that only one type of car manufacture can sell cars in a certain U.S. state, then that's fine and true. If some guy wants to open a Toyota dealership 100 yards from a Honda dealership and give consumers the right to chose - then that is fine.
However, if you want to say that it's okay to apply these same principles to medicine, where the adverse outcome of buying a 'lemon' from a slick salesman who didn't have the right stuff to back up his claims is death, disfigurement, enormous legal recourse, etc, then I don't think many would agree.
The bottom line is that these individuals simply aren't trained to perform this type of procedure, and in the most recent case where it was passed (Kentucky), there has been very little reassurance as to how this additional training will occur, how it will fulfill stated goals, how it will be regulated, how it will be posed to patients, etc.
and that anyone should be allowed to practice regardless of his type or level training.
By this logic, my mechanic should be able to open up an orthopedics practice (as long as he can find malpractice and volume, it's legitimate in the eyes of a 'free market,' right?). Why don't barbers continue practicing surgery? Why don't chiropractors start performing neurosurgery?
Even if you try to counter with some type of 'the public should be allowed to chose, and no one will' type of argument, is this line of reasoning (or lack thereof) worth it if only one single person dies because of this laissez faire health care system?
Ironically enough, I'm all for a lot of freedom in the market, less government involvement, etc, but because the currency here is human beings, there HAS to be a basic set of requirements before entering this 'market' to begin with. I see absolutely no reason why this shouldn't be attending medical school, completely a residency, and practicing effectively and safely within that field.
The requirements established by the government are arbitrary, and it is dangerous for one body to have a legal monopoly on medical knowledge. Consumers should be allowed to decide for themselves whom they want to consult. Laws should not be established on the assumption that people are too stupid to find a competent physician on their own, nor should they be established to protect people from the consequences of hiring quacks if they are foolish enough to do so.
Again, you're completing skirting the issue of how opaque understanding the qualifications of a health care practitioner can become when everyone on the planet wants to play physician.
Let me set up a hypothetical situation for you here:
Your mother finds some type of questionable blemish on her nose and is worried it may be basal cell carcinoma. She's around 50, not overtly computer savvy, but tech-educated to know that googling practitioners in her area is the easiest way to find the dermatology expert she's looking for.
She googles 'dermatlogy, X city, Y state' and finds the following description on a website:
Dr. Jan Doe, residency trained dermatology expert
She reads on and finds that Jan Doe is board certified, and completed a dermatology residency at the University of South Florida. Additionally, Dr. Doe is a skin cancer expert and will be happy to analyze, make a diagnosis, and treat.
So, by your own comments, the average health care consumer in this situation should be able to analyze this situation and see that Dr. Doe is :
1. A doctor (presumed physician, why wouldn't she be)
2. Board certified in dermatology
3. Residency trained in treating skin cancer
She makes an appointment, and all is good. Right???
Here's the reality of the situation - Dr. Doe is a DNP who went through the 8 month 'nursing dermatology residency' at the University of South Florida. Legally, there is absolutely nothing inaccurate about what was written in Dr. Doe's description, but the reality of the situation is that your Mom is now seeing a nurse who took a 8 month course in dermatology taught by other nurses, when she thinks she's seeing a residency trained, board certified, MD/DO dermatologist.
If you tell me that this is a clear, easy decision, you're either lying or you're greatly overestimating how confusing this can be for the average health care consumer.
Rather than asking how much training optometrists currently receive in surgery, it would be more relevant to ask whether optometrists are capable of acquiring the needed skills if they are given a chance. If surgical training were introduced into the optometry curriculum, or if continuing education in surgery became available, would optometrists be able to achieve competence? Is there any reason why surgery has to be the sole province of MDs?
1. No, it's not inappropriate to ask what type of base optometrists have in surgical training before they ascend into some sort of unregulated, ill-defined post OD school 'surgical training.' The qualifications of a newly minted MD/DO entering an Ophthalmology residency (and the skills and knowledge base thereafter) are well understood; can the same be said for these surgical ODs?
2. If they want to integrate surgical training INTO the curriculum that is on par with an Ophthalmology residency - ie fit 4 years of surgical training into an OD curriculum, and prove they are on par, then this would be a completely different argument.
However, I still personally believe that a surgically trained DO/MD should perform eye surgery, and the general public feels the same way. It's the same way I'd like a JD and not a paralegal to handle future malpractice cases; the way I'd want a DDS/DMD and not a dental tech to perform my root canals etc, etc, etc.
