Oregon Ophthalmalogists vs. Optometrists

[Schroder79]

Advertisement - Members don't see this ad

Just released from OOPA: 1/30/2007 @ 3:40 pm

"If there ever was a time that you questioned what organized optometry is doing for you and why you should be a member of your professional association, read on.



The Oregon Academy of Ophthalmology chose to attack optometry openly Monday January 29, 2007. During testimony in opposition to the OOPA’s SB 35, Salem ophthalmologist Dr. James Tibolt stated that the Academy will introduce a bill in the Senate that will establish “greater safeguards for the Oregon public.” (See attached legislative draft)



The Academy’s bill is in direct response to the Oregon Optometric Physicians Associations Senate Bill 35 that proposes to remove the language in current statute that requires an OD to consult with an MD or DO prior to initiating treatment for Glaucoma. During testimony before the Senate Health & Human Services Committee, the Academy questioned optometry’s training and diagnostic judgment.



Members of the OOPA met with members of the Academy in June of 2006 to discuss OOPA’s bill and any concerns. The Academy did not express any concerns and have been invited to comment many times since. The bill from the Academy was unexpected and presented at the 11th hour just before the Senate hearing Monday. In a statement by the OOPA’s Executive Director Wayne Schumacher, “It is clear that this is an attempt by ophthalmology to confuse the issue and the members of the Senate Committee.”



The Committee Chair, Senator Bill Morrisette (D-Springfield), indicated that the Committee would discuss this issue at a later date when the Academy’s legislation is available. No action on your part is required at this point. We just wanted you to know your professional judgment is being questioned and your current scope is at risk."

I tried to add the attachment I saw but it was too big to put on this server. Basically it says in legal terms that OD's would not be permitted to treat glaucoma patients without MD or DO approval first.

After reading this it kind of hits home to me the fragile relationship between the two professions. It's frustrating to know that when DO's give prescriptions for glasses that are adequate at best they can continue in day to tday without any attack. Meanwhile any mistakes made by OD's in medications almost mean an automatic lawsuit and loss of rights.

I know there are some states that do in fact have these limitations in place, but Oregon hasn't really been one of them.

 

[Ben Chudner]

It's frustrating to know that when DO's give prescriptions for glasses that are adequate at best they can continue in day to tday without any attack. Meanwhile any mistakes made by OD's in medications almost mean an automatic lawsuit and loss of rights.

I would refrain from making comparisons like this as it only opens you up for attack. I think there is a big difference between the ability to sign a prescription for glasses and the ability to sign a prescription for topical medication that can have systemic side effects. Not to mention that an incorrect spectacle prescription is very unlikely to cause permanent vision loss, whereas incorrect management of glaucoma can. Of course, I agree with the main point of your post. This is an ocular condition that can be managed medically by OD's and should not require the consent of an MD or DO. If you want proof, just look at every state that does not have this restriction, which I would imagine is at least 45 states if not more. Now, I know that the MD's will counter with the massive number of patients that were referred later than they should have by OD's, but I can tell you from my residency experience as well as my previous employment that there are plenty of general OMD's that hold on too long before referring to a glaucoma specialist. The issue is not that OD's are bad, or make poor decisions compared to OMD's, it's that there are doctors in both professions that make poor decisions at times.

 

[PBEA]

Not to mention that that an incorrect spectacle prescription is very unlikely to cause permanent vision loss.

Unlikely perhaps, but definitely possible. Ive personally seen rx's prescribed for children that had amblyopia from untreated, or undertreated (read mistreated) astigmatism or other error. Often ending up on ritalin or concerta because of their "ADHD" etc. I have a number of these cases that will spend the bulk of their remaining life with permanent symptomatic visual loss. Contrast this with the larger glaucoma population most of whom will probably will never live to experience symptomatic visual loss (from glaucoma). This is just a side note to students really, as I agree with your comments.

 

[Schroder79]

It's frustrating to see the future scope of optometry being challenged like that, but I'm sure it will happen many more times in the future. One of my professors were really positive yesterday about the relationship that he has with DO's in the area. He also pointed out that OD's outnumber DO's by a pretty good margin, providing political leverage.
Like you all said previously, its amazing the MD's can hide behind their credentials with the AMA taking responsibility for their actions. It seems to me that AMA guidelines are more and more often becoming suggestions for patients while the internet seems to be a major source of information. I read an article recently called "The Health Profile of the Juvenile Delinquent:...." by Willard B Bleything OD MS. It was interesting to hear pediatricians and psychologists not following their own guidelines in exams. Given the patients were mostly complicated cases, but they could have done better.
Do you find compliance problems or patient trust diminishing with glaucoma treatment regimes? Do you find that the AOA is a good reflection of your optometry ideals? Most of the DO's I have met are supportive of OD's in practice. It's just the academic ones I have had problems with. I have heard of one in the area the school refuses to refer to due to stealing patients........
I intend to try to the comerodery in optometry though. Oh I argue sometimes but I think building the practice is more important than building myself.

 

[prettygreeneyes]

It's frustrating to see the future scope of optometry being challenged like that, but I'm sure it will happen many more times in the future. One of my professors were really positive yesterday about the relationship that he has with DO's in the area. He also pointed out that OD's outnumber DO's by a pretty good margin, providing political leverage.
Like you all said previously, its amazing the MD's can hide behind their credentials with the AMA taking responsibility for their actions. It seems to me that AMA guidelines are more and more often becoming suggestions for patients while the internet seems to be a major source of information. I read an article recently called "The Health Profile of the Juvenile Delinquent:...." by Willard B Bleything OD MS. It was interesting to hear pediatricians and psychologists not following their own guidelines in exams. Given the patients were mostly complicated cases, but they could have done better.
Do you find compliance problems or patient trust diminishing with glaucoma treatment regimes? Do you find that the AOA is a good reflection of your optometry ideals? Most of the DO's I have met are supportive of OD's in practice. It's just the academic ones I have had problems with. I have heard of one in the area the school refuses to refer to due to stealing patients........
I intend to try to the comerodery in optometry though. Oh I argue sometimes but I think building the practice is more important than building myself.

I'm confused. Aren't DO's and MD's on the same side? With OD's on the opposite, generally?

 

[Schroder79]

I'm confused. Aren't DO's and MD's on the same side? With OD's on the opposite, generally?

I think so. I was trying to point out that sometimes though they are DO's, they don't necessarily support their ruling government. Not all optometrists agree with the AOA guidlines, and not all DO's support the AMA's decisions or measures.

 

[VA Hopeful Dr]

I think so. I was trying to point out that sometimes though they are DO's, they don't necessarily support their ruling government. Not all optometrists agree with the AOA guidlines, and not all DO's support the AMA's decisions or measures.

DO's are not affiliated with the AMA, they have their own AOA (American Osteopathic Association). Also, the AMA is a political organization only, not a ruling body.

 

[Optiman]

I feel the primary goal of optometric national associations (AOA, ASCO, etc) right now should be to address the glut of OD's that are being pumped out of optometry schools. It is unbelievable that there is talk of new optometry schools opening.
What use does defending OD's rights and pressing for expanding scope of treatments do when there is a glut of OD's, inevitably decreasing fees, making it harder to pay back loans, much less start up a new practice/buy into an existing one.
I am not entering the proffession with aspirations of riches, however, if trends continue, what will the proffession look like in 10-20 years. According to ASCO stats, over 1400 students enrolled for the 2010 class in the United States. That is one years class. This is before schools expand enrollment and new schools open up.Eleven years experience (as an optician) in the field tells me that corporate opticals could care less about a quality exam as long as some new doctor will charge less and pump out the refractions; bringing down fees overall.
A representative from the AOA recently bubbled to our class that optometry is the fastest growing medical proffession. I dont know how true this is, but it probably is on a percentage basis.

While I realize that enforcing liimited enrollment brings up legal issues, however if dentists can do it, OD's can. What use is there in protecting the hard-earned rights of a proffession that could have a glut of doctors and all the consequences thereof. This should be a number one priority.😡

 

[Schroder79]

DO's are not affiliated with the AMA, they have their own AOA (American Osteopathic Association). Also, the AMA is a political organization only, not a ruling body.

I guess I took for granted the idea that DO would be understood as Doctor of Ophthalmology, but you're right it is osteopathy. The American Optometric Association isn't a ruling party either. The laws that govern our practice are set by state associations, not the AOA.

 

[Schroder79]

I feel the primary goal of optometric national associations (AOA, ASCO, etc) right now should be to address the glut of OD's that are being pumped out of optometry schools. It is unbelievable that there is talk of new optometry schools opening.
What use does defending OD's rights and pressing for expanding scope of treatments do when there is a glut of OD's, inevitably decreasing fees, making it harder to pay back loans, much less start up a new practice/buy into an existing one.
I am not entering the proffession with aspirations of riches, however, if trends continue, what will the proffession look like in 10-20 years. According to ASCO stats, over 1400 students enrolled for the 2010 class in the United States. That is one years class. This is before schools expand enrollment and new schools open up.Eleven years experience (as an optician) in the field tells me that corporate opticals could care less about a quality exam as long as some new doctor will charge less and pump out the refractions; bringing down fees overall.
A representative from the AOA recently bubbled to our class that optometry is the fastest growing medical proffession. I dont know how true this is, but it probably is on a percentage basis.

While I realize that enforcing liimited enrollment brings up legal issues, however if dentists can do it, OD's can. What use is there in protecting the hard-earned rights of a proffession that could have a glut of doctors and all the consequences thereof. This should be a number one priority.😡

How would you suggest to go about this? We live in a capitalistic society governed by supply and demand. If there are too many optometrists then it will be up to the public to decide how to resolve the issue. Do you think this may be a reason that insurance companies have so much power? I really hate the thought of dealing with them in the first place but I know it will happen. It seems everyone's biggest scare is money. I will have student loans to worry about soon too. It is a scary picture but then talking with all these Od's who have been out a while and are working 3 or 4 day weeks it isn't as scary to me.
It is unfortunate though that the AOA doesn't seem to see things eye to eye with us (no pun intended.) They did send out an email recently asking how I felt on events though. I hope to be more politically engaged in the future, and hopefully most of us will be. 🙂

 

[prettygreeneyes]

I guess I took for granted the idea that DO would be understood as Doctor of Ophthalmology, but you're right it is osteopathy. The American Optometric Association isn't a ruling party either. The laws that govern our practice are set by state associations, not the AOA.

That explains my confusion in the post above... DO hasn't ever stood for anything other than Doctor of Osteopathic Medicine, at least to my knowledge. People in a hurry might write OMD or Eye MD. (I think ophthalmologists prefer Eye MD?)

 

[The Eye Guy]

DO = Doctor of Osteopathic Medicine, we are governed by the American Osteopathic Association and some are members in the American Medical Association. To do Ophthalmology we need to go to medical school for 4 years and do Internship/Residency in either a DO or MD Ophthalmology residency program. The main difference is a DO learns Osteopathic Manipulation, although DO ophth don't use it as much as the primary care DOs. MDs can get certified in Osteopathic Manipulation nowadays, they have a program at certain places like Harvard, but its optional and not given on the Medical Licensing exams. The DO exams have manipulation on them.

Most DOs are more clinical based and don't work at big allopathic institutions, there are DOs at Allopathic Eye Hospitals though.

I'm a 4th year student going into Ophthalmology.

As for the MD eye association, it has been labeled that not to confuse people with Optometrists (OD)...its actually the MD/DO eye association (meaning Medical Doctor, not the degree) and the president of the academy has apologized to DOs for it being MD and not including DOs in the name, but whatever a degree is the same and you still get to work with patients. Overall, its how you are as a person that defines who you are, not your degree title.

Just trying to find information on optics, that's why i'm lurking on the OD forum.

 

[Schroder79]

DO = Doctor of Osteopathic Medicine, we are governed by the American Osteopathic Association and some are members in the American Medical Association. To do Ophthalmology we need to go to medical school for 4 years and do Internship/Residency in either a DO or MD Ophthalmology residency program. The main difference is a DO learns Osteopathic Manipulation, although DO ophth don't use it as much as the primary care DOs. MDs can get certified in Osteopathic Manipulation nowadays, they have a program at certain places like Harvard, but its optional and not given on the Medical Licensing exams. The DO exams have manipulation on them.

Most DOs are more clinical based and don't work at big allopathic institutions, there are DOs at Allopathic Eye Hospitals though.

I'm a 4th year student going into Ophthalmology.

As for the MD eye association, it has been labeled that not to confuse people with Optometrists (OD)...its actually the MD/DO eye association (meaning Medical Doctor, not the degree) and the president of the academy has apologized to DOs for it being MD and not including DOs in the name, but whatever a degree is the same and you still get to work with patients. Overall, its how you are as a person that defines who you are, not your degree title.

Just trying to find information on optics, that's why i'm lurking on the OD forum.

Though I would like to agree with this right off, I think it needs to be pointed out that being a part of a profession does dictate your limitations to a certain extent. We have an ethics course that I have really enjoyed (usually playing the advocate) and the instructor remarked a last week that by going into our professions we will start making decisions and choosing choices we never would have made before school or begining our professions. I hope that your degree won't alienate you from working with me in the future if we cross roads.