Potential Opthamologist With Questions...

[suction]

Hello all,
I am a third year medical student who is considering opth as a potential specialty. I was wondering what you guys feel is the best type of relationship for MD's and OD's... I have heard so many different things, mostly from my classmates, who dont really know much about optometry.

More specifically, how do you feel...

Should MD's do any primary care? How much?
Would you like to practice in a combined MD/OD setting?
Why did you choose OD vs MD?
What can I do as an future MD to form the best symbiotic relationship with
OD doctors....

Thanks for any opinions, and/or advice...



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[VA Hopeful Dr]

Should MD's do any primary care? How much?

That is entirely up to you. However, the license to practice surgery is what really sets you apart from ODs. Also (and this is just speculation on my part), but after spending 8 years learning how to do everything for the eye, do you really want to spend your days refracting and looking at perfectly healthy individuals? Many of the MDs over in the ophthalmology forum often express a desire to only see patients that actually need their care for a problem.
That said, I don't think you're going to really upset any ODs by doing alot of primary care. It is always preferred if you try and do more surgery and very complex problem patients, but that's not a big issue.

What can I do as an future MD to form the best symbiotic relationship with OD doctors

Simple answer: don't steal patients. If you get a referral for a specific problem (cataracts, pco, chalazion), fix it and then send the patient back to the referring OD. That's really all it takes. Now, it helps if you're on friendly terms with all of your referring optometrists. The best answer is to play nice, then everyone wins.

 

[ODhopeful]

That is entirely up to you. However, the license to practice surgery is what really sets you apart from ODs. Also (and this is just speculation on my part), but after spending 8 years learning how to do everything for the eye, do you really want to spend your days refracting and looking at perfectly healthy individuals? Many of the MDs over in the ophthalmology forum often express a desire to only see patients that actually need their care for a problem.
That said, I don't think you're going to really upset any ODs by doing alot of primary care. It is always preferred if you try and do more surgery and very complex problem patients, but that's not a big issue.



Simple answer: don't steal patients. If you get a referral for a specific problem (cataracts, pco, chalazion), fix it and then send the patient back to the referring OD. That's really all it takes. Now, it helps if you're on friendly terms with all of your referring optometrists. The best answer is to play nice, then everyone wins.

I second everything said. I feel that if ophthalmologists spent twice as much schooling as ODs to perform surgery, they should use that skill to its maximum potential. I know of some OMDs that allow technicians to perform refraction on patients and then just merely sign off on the prescription. Let me ask, is that good and fair for the patient? The patient goes into an OMD office thinking they will be getting the best eye care possible, but when a tech performs the examination that is no longer the case, in fact, the patient is getting very minimal care. I believe from what I see and hear that alot of OMDs do not wish to perform primary eye exams, why not just send the patients to an OD who would perform the primary exam instead of letting some off the street technicians with minimal training do the refraction. With all that said I feel that if OMDs allow ODs to provide all the primary care to patients, the ODs will be so busy taking care of all the patients, there will be less time for them to want to expand their scope of practice into ophthalmology, therefore less bickering between the two.

 

[Andrew_Doan]

I believe from what I see and hear that alot of OMDs do not wish to perform primary eye exams, why not just send the patients to an OD who would perform the primary exam instead of letting some off the street technicians with minimal training do the refraction.

A well trained technician can refract well... very well. When working with new technicians, I check their work before giving out glasses. If they are right on, then they gain more trust. Good techs know when to ask for help so if there is a problematic refraction, they flag the OMD. 9 out of 10 times they don't need help. When they need it, I refract.

There's nothing wrong with well-trained technicians doing refractions.

 

[Richard_Hom]

(...)but when a tech performs the examination that is no longer the case, in fact, the patient is getting very minimal care. I believe from what(...).

Dear ODhopeful,

I must concur with Dr. Doan.

I believe that you may not be aware of the refractivecompetency of most opthalmic technicians or technologists. They are generally excellent. In many circumstances, the refraction isn't necessarily going to result in a pair of glasses but a measure of what the "best vision" is. I've worked in large (17-ophthalmologist) medical eye offices and I have seen their good work. I have rarely needed to "change" their findings on recheck.

I do believe, though, that optometric and ophthalmologic prescriptions (not just the refraction) may not necessarily be equivalent as their paradigms differ slightly.

Although I may agree on the spirit of your observation, I don't believe that you can conclude about technician qualities unless you have personal experience to the contrary.


Richard

 

[cpw]

I work with four COA's every Friday and they're all excellent. It's just like doctors there are good and bad ones. This particular doctor has done well in his hiring and firing.