Optometry strikes again!

[Indebt4Life]

There are a tons of bills this season for optometrist to practice beyond their scope. Are you doing anything to support your field?

-NEBRASKA OPTOMETRIC SCOPE OF PRACTICE EXPANSION LB 528, recently introduced on behalf of the Nebraska Optometric Association, would give the Board of Optometry sole authority to determine optometric scope of practice in the future, merely requiring approval by the state Board of Health

-Optometrists in Maryland want to be able to order every diagnostic or radiology test, and to prescribe all medications, even to children 2 and up, despite never going to medical school

-The Arkansas legislator is hearing arguments on the Optometrist Surgery Bill this week, which would allow Optometrists to do Globe and Eyelid surgery (among other things).

-The Wyoming optometry surgical privileges bill died in committee but they tried

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[Bronze Medal]

According to me, This is the right way to do something & take a stick action because Optometry is a health care profession which involves examining the eyes and applicable visual systems for defects or abnormalities as well as the medical diagnosis and management of eye disease.

I’m not sure what you are trying to say here.

 

[percyeye]

-Optometrists in Maryland want to be able to order every diagnostic or radiology test, and to prescribe all medications, even to children 2 and up, despite never going to medical school

Well this has been going on for most states for decades now. There are only a few left where this doesn't happen like Maryland or Massachusetts.

As for surgery bills I don't think Optometry as a whole has any interest in "surgery" in the way it is being portrayed. I think it is the state Optometric Associations just throwing bills out there to act like they are still doing something so that they can still keep collecting their dues.

I'd say calm down about it. Relations between Ophthalmology and Optometry have been getting better and it is proven it is beneficial for both to work together.

 

[MstaKing10]

-Optometrists in Maryland want to be able to order every diagnostic or radiology test, and to prescribe all medications, even to children 2 and up, despite never going to medical school

Well this has been going on for most states for decades now. There are only a few left where this doesn't happen like Maryland or Massachusetts.

As for surgery bills I don't think Optometry as a whole has any interest in "surgery" in the way it is being portrayed. I think it is the state Optometric Associations just throwing bills out there to act like they are still doing something so that they can still keep collecting their dues.

I'd say calm down about it. Relations between Ophthalmology and Optometry have been getting better and it is proven it is beneficial for both to work together.

Couldn’t disagree with you more. Optometric associations are indeed interested in procedures as a function of their members expressing said interest. That’s the way it works.

Agree that Mds and ODs should work together. Not sure these moves by optometric societies is moving things in the right direction.

For MDs interested in countering these bills I would urge you to donate to your state and national ophthalmology societies (ie AAO)

 

[percyeye]

Couldn’t disagree with you more. Optometric associations are indeed interested in procedures as a function of their members expressing said interest. That’s the way it works.

Agree that Mds and ODs should work together. Not sure these moves by optometric societies is moving things in the right direction.

For MDs interested in countering these bills I would urge you to donate to your state and national ophthalmology societies (ie AAO)

My statement was a little sarcastic. But yes they are interested in procedures. Not starting another scope war here but lets not pretend any time ever in the history of these medical fields that when Optometry reached out for further scope Ophthalmology has ran out screaming that people will be killed and blinded. So far scope has never been pushed back because of patient harm so we all know its just turf/ money protection which I totally get and really don't take offense to it at all. Optometry is fighting its own turf battles legislatively so I get it. But when I see a young medical student/Ophthalmologist scream Optometrists are trying to prescribe medication! I about spit my coffee out.

 

[Indebt4Life]

According to me, This is the right way to do something & take a stick action because Optometry is a health care profession which involves examining the eyes and applicable visual systems for defects or abnormalities as well as the medical diagnosis and management of eye disease.

For certain things I think seeing an optometrist is fine. But optometrist need to stay in their lane and realize what is beyond their scope. As a patient recently, I was seen by an optometrist who walked in the room and call himself Doctor. He completely misdiagnosed me and had the balls to tell me that he has never made this diagnosis before but he was sure of it. I went to see a real Doctor that same afternoon and got a real medical plan that included a differential diagnosis, reviewing labs, ordering labs and imagining. I called that office and demanded that they do not bill my insurance and refund my copay which they did. The practice manager told me that this optometrist had NO business seeing a young person with acute vision issues.

 

[VA Hopeful Dr]

For certain things I think seeing an optometrist is fine. But optometrist need to stay in their lane and realize what is beyond their scope. As a patient recently, I was seen by an optometrist who walked in the room and call himself Doctor. He completely misdiagnosed me and had the balls to tell me that he has never made this diagnosis before but he was sure of it. I went to see a real Doctor that same afternoon and got a real medical plan that included a differential diagnosis, reviewing labs, ordering labs and imagining. I called that office and demanded that they do not bill my insurance and refund my copay which they did. The practice manager told me that this optometrist had NO business seeing a young person with acute vision issues.

Anecdotes are not helpful. For every story like this, we can easily find an optometrist who sent a patient with X to an ophthalmologist who blew it off, said optometrist sent the patient to a different ophthalmologist who got it right. Heck, I get new patients all the time who when I get records from their previous FP can only conclude that said FP is an idiot.

 

[percyeye]

For certain things I think seeing an optometrist is fine. But optometrist need to stay in their lane and realize what is beyond their scope. As a patient recently, I was seen by an optometrist who walked in the room and call himself Doctor. He completely misdiagnosed me and had the balls to tell me that he has never made this diagnosis before but he was sure of it. I went to see a real Doctor that same afternoon and got a real medical plan that included a differential diagnosis, reviewing labs, ordering labs and imagining. I called that office and demanded that they do not bill my insurance and refund my copay which they did. The practice manager told me that this optometrist had NO business seeing a young person with acute vision issues.

Everyone can stand down. Obviously the OP is a troll who doesn't know what they are talking about.

Again I have a great relationship with Ophthalmology and never had any problems. Let us all move on now with our jobs we enjoy.

 

[MstaKing10]

Yeah a lot of these comments aren’t useful. But really at the crux of the issue is optoms trying to bypass the already established route to gaining procedure rights...med school and residency! Instead of lobbying and legislating, why not go through the established process? I don’t think I’ll get a coherent and meaningful explanation here but it’s food for thought

 

[percyeye]

Yeah a lot of these comments aren’t useful. But really at the crux of the issue is optoms trying to bypass the already established route to gaining procedure rights...med school and residency! Instead of lobbying and legislating, why not go through the established process? I don’t think I’ll get a coherent and meaningful explanation here but it’s food for thought

Fresh NPs and PAs right out of school can go work under a Derm or Plastics person and after a week of training are injecting faces all day. But someone like me who knows ocular anatomy better than them are the dangers here? If a NP can learn to do injections under an Ophthalmologist why can't I?

This is all just a legislation and money battle nothing more, nothing less until you have some proof that when expanded scope happened we have some large numbers of patients being injured.

 

[HaveAnOsteoblast]

As a patient recently, I was seen by an optometrist who walked in the room and call himself Doctor.

All optometrists call themselves doctors... cuz they are doctors. just not physicians

 

[MstaKing10]

Fresh NPs and PAs right out of school can go work under a Derm or Plastics person and after a week of training are injecting faces all day. But someone like me who knows ocular anatomy better than them are the dangers here? If a NP can learn to do injections under an Ophthalmologist why can't I?

This is all just a legislation and money battle nothing more, nothing less until you have some proof that when expanded scope happened we have some large numbers of patients being injured.

The comparison to NPs and PAs is apples and oranges. Really not pertinent. And the legislation up for votes is not for optoms to work under the supervision of an ophthalmologist but rather to work indipendantly. So really not the same thing, at all.

I’m sure patient safety data will be available at some point, obviously numbers are too low to perform any legitimate data analysis at this point.

Again, if you want to perform surgeries and procedures, by all means do so...go to med school

 

[percyeye]

The comparison to NPs and PAs is apples and oranges. Really not pertinent. And the legislation up for votes is not for optoms to work under the supervision of an ophthalmologist but rather to work indipendantly. So really not the same thing, at all.

I’m sure patient safety data will be available at some point, obviously numbers are too low to perform any legitimate data analysis at this point.

Again, if you want to perform surgeries and procedures, by all means do so...go to med school

How is it not pertinent? Or are you saying that it is not about safety or something else? Because if a NP or PA can inject someone in the face I don't see what the argument is against an OD? And NPs can work independently. I'm not really interested in doing injections I'm just saying if you can train a PA to do it I'm sure we'd be just fine.

And they have been doing surgery and lasers in Oklahoma, Kentucky, Louisiana for 20 years. So that should be a good amount of data.

I don't need to go to Med school to do lasers. I'll just move to Oklahoma.

Again if you can name some big lawsuits or times they have rolled by scope of practice because so much harm was done I'll think you have some merit.

 

[increscence]

Oh gosh, here we go again...

It's not just about doing the procedure. Let's be honest, actually doing an intravitreal injection isn't that hard. The reason it makes sense to leave these procedures to ophthalmologists, with longer training that is focused more intensively on complex pathology, procedural experience, and clinical decision-making is that that training is required to know when to do those procedures, when not to do those procedures, and how to manage complications. Optometrists would require much more extensive training because of the perioperative evaluation and care that these procedures need.

So, please recognize the limits of your training. I can do PRP and focal laser and Avastins, and I can do a trab, and I can do lateral tarsal strips, and I can even do an optic nerve sheath fenestration. I was trained to do all of these things during residency. But I know my limits. I know that I can't evaluate the candidates for these surgeries as well as my fellowship-trained colleagues can. I know that I can't do the surgeries as well as they can. I know I can't manage the post-ops as well, and I certainly can't clean up the complications.

Please, to the minority of optometrists who want to broaden scope to include any kinds of in-office procedures, recognize your limitations. You do great work and your training enables you to do a lot of things that I, as an ophthalmologist, cannot do. By the same token, my training enables me to do things that you cannot do. Have the humility and integrity to recognize what you services you can and cannot safely provide to patients.

 

[LightBox]

It's funny how Optometry uses "lack of access to eye care" as one of their talking points in trying to legislate additional scope of practice. But at the same time, they call online glasses prescriptions "dangerous" and "unethical." Gimme a break. It's all about the money. Let's face it: if Wal-Mart, Costco, and Warber-Parker weren't destroying independent OD practices' optical sales, ODs wouldn't care so much to move into the territory of the Ophthos. But the Optometry leadership has seen the writing on the wall. They know that in 10-20 years, the general population will be getting their glasses and CL prescriptions measured and filled online via Amazon kiosks. And then, there will be no niche for the general OD to carve out. It's like an animal population. If you cut off their food supply (e.g. optical sales), they are going to migrate into other populations' food source.

And for some god forsaken reason, new Optometry schools keep opening up and pump out the grads with no place to go. Please write your Optometry leadership and tell them to stop opening new schools!

Lastly, don't be naive to think that Optometry wants to "only" do styes and YAG caps. Their ultimate goal is doing refractive surgery... not doing PKPs and infero-nasal tubes. They want the $$ without the complications or responsibility. And they don't want to answer to any medical boards.

 

[increscence]

Please don't be hostile, and don't distort the picture to make your point. It works against you.

Also, please take care not to paint all optometrists with the same brush. The optom lobby does not necessarily reflect the wishes of all optometrists out there.

Optometrists do a lot more than just glasses checks. They can evaluate whether the glasses are working well and can adjust the glasses according to the patient's needs. They can fit contacts, including specialty contact lenses. They can provide basic eye care/eye screenings.

I stand firmly in opposition to scope expansion efforts by the optometry lobby - I think that their licenses in most states are too broad as it is - but it does not help anything to belittle and demean optometrists or to trivialize their role in eye care. It only makes ophthalmologists look petty and defensive.