drgregory said:
good point. most ODs arent to worried about that much medical-type power (note the word most - obviously there are exceptions). most just want to be the primary eye care person - red eyes, refractions, glaucoma, etc, and when major surgery is needed, send them to their OMD.
in reality, refracting opticians probably wouldnt change things (even though i doubt they would obtain these privilidges). right now our field is so full of sellouts who work commercial and lower the perception of our services that maybe getting them out and replaced with opticians might not hurt. and then when lawsuits start coming in and laws are changed back, ODs will have bargaining power to not work corporate. naturally, the cycle will then resume, whereby a sellout here and there decides to go commercial and the gradual comprimise of our services resumes. if opticians were allowed to refract, OD institutions would have to come around and decrease their class sizes. dentistry did this several years back, and look at how financially rewarding it is to be a dentist. ophthalmology residencies are cutting back on numbers. apparantly everyone but us in optometry know how to plan for the future.
Good points. One result of this change in scope for opticians might be that their educational programs would change like yours did. Originally, OD programs, from what I understand, included little, if any pharm, but now it seems that you guys receive a fair amount of pharm training while in school. So, using this example, maybe it's logical to infer to that opticians will increase their educational requirements similar to what ODs did.
As the opticians begin to refract CL, ODs might move more into the primary care realm and fill the void of fewer OMDs and poorly trained FMGs who wouldn't know conjunctivitis from iritis. So, while some ODs might think this change is not good, your options might just change. The world of health care is an ever changing one, so this might open more doors for you guys. If you continue to push for more changes in your professional curriculum, you might end up being more like DPMs and dentists.
I mean, if you think about it, a DPM is a full range physician/surgeon that is restricted to practice on the foot, below the ankle. In all states, DPMs have pretty liberal RxPs, hospital privis, and authorized to perform a wide range of surgeries on the foot/ankle. Dentists share similar restrictions to the oral cavity and non MD oral-maxillofacial surgeons (some are MD, some DDS, and some MD-DDS) are considered physicians/surgeons in all states with almost unlimited medical authority, including RxPs in all schedules, hospital admit d/c privis, etc.
Following that logic, if ODs adjusted their OD program to include more med and less refraction, you might eventually become the ONLY vision specialist (physician and surgeon). It's a thought. Many PsyD/PhD psychologists are trying to compel the APA to create drastic reforms in the education of clinical psychologists (who have RxP and hospital privis in some states) to convert from a standard research PhD (filled with non-clinical coursework such as stats, research methods, etc.) to a more clinical DCP or PsyD degree that includes the basic medical sciences, pharm, neuroanatomy, physical assessment, etc.
It's entirely possible that with time and continued reform, ODs would gain the status and financial independence that many DDSs and DPMs enjoy. If this occurs, you guys would eventually replace OMDs and become the only eye doctors, and in a similar fashion, the PsyDs would eventually replace the psychiatrists as the only full service mental health medical professional, although this is less likely. If you think about it, dentists and podiatrists both had their roots in allopathic med. Today, there are NO physicians who treat dental disease; it's all done by dentists. Some orthos treat orthopedic foot problems and some endocrinologists and internists treat diabetic foot problems, but by and large, most foot tx is performed by pods. If ODs undergo more medicalized professional training, and less refraction, they might wind up with a much broader scope of practice.
Of course, if this did happen, the AMA would resist, but would lose. Also, it would mean that optometry would change from being optometry to optometric medicine (similar to dental medicine and podiatric medicine). Many ODs might not like this change. It would enhance your status, but change the occupation. The days of Wal-mart/retail practice would be long gone, however.
Just some food for thought.
This is much more scary that opticians refracting... why is a 1st year opt student already pessimistic?? A trend like this spells disaster more than anything else. My views about the profession are very optomistic... but then again.. why shouldn't they be. Why would I want to committe my self to something that I dont fully believe in and support. I think your friend is already heading down the wrong path...
