I think a lot of your comparisons are way off base actually.
Im going to have to reply your post here statement by statement. Too much to put into one paragraph.
First, on the optometrist/ophthalmologist comparison. Except that both can do refractions, there isn't much equivalency. I don't believe optometrists can even prescribe in many states - they can make a diagnose and refer, but that's about it.
Youre mistaken there. Optometrists can prescribe medications in most states (to varying degrees). Even if they cant, their education is certainly heading in that direction.
You really want these folks doing surgery on the eye? Where do they get that surgical background? They don't get it in OD school.
Where do ophthalmologists get their surgery background? Certainly not in medical school! I went to an allopathic program here in the U.S. and I got very little surgical experience -- save for a lot of observing in the OR, reading, and the occasional closure here and there.
Add a residency? Then you have still have a technician with a minimum of medical training.
Come on. How much general medical knowledge does an ophthalmologist have? Just what they can vaguely remember from medical school.
It cracks me up that my OD's office staff wants to take my blood pressure, like he's going to do anything about it. You're beating the drum that CRNA's are woefully unprepared to do anesthesia, but at most they're about a year shy of the training of the usual optometrist.
Bad comparison. A CRNA has reached the end of his/her formal training and with nothing more than that claims to be able to take the job of an anesthesiologist. Contrastingly, an OD seeking to perform surgery will (or should) have residency training in surgery above and beyond his doctoral degree.
And really - what does an ENT guy need to know about medicine, any more than what the ophthalmologist does?
Youre joking, right?
First, you can make that argument about any surgeon -- even general surgeons -- depending on how you define medicine. What ENTs know about medicine is what we remember from medical school and also what we use to manage our patients on the hospital floor. How often does an ophthalmologist admit a patient post-operatively? Virtually never. Not only that, as ENTs we deal with endocrine problems, sensory problems, infectious disease, allergy and immunology, neoplasms, airway, cosmetics, trauma, vascular, and even some GI. If that doesnt qualify as medical knowledge, I dont know what does. Also, the head and neck is an incredibly complex. There is more anatomy in the head and neck for an ENT to master than there is in the eye socket.
They operate on a few select structures (ears, nose, and sinuses, maybe a little neck work) and many of those end up sub-specializing to single organs (all ears, all sinuses, etc.) I'm not belittling the training of ENT docs
but really, isn't it just about as narrowly focused as opthalmology?
First-off, youre just plain wrong. I hate to say it, but for an anesthesiologist you know very little about what an ENT right out of residency is trained to do. We operate on a hell of a lot more than a few select structures. Granted, the bulk of our work is limited to ears, noses, and throats because thats where the money is, but we are trained to handle a great deal more.
Second, its not as though every ophthalmologist treats the eye from front to back! Within ophthalmology, you have dozens of specialists -- almost as many as there are in ENT, which deals with a decidedly larger and more diverse region of the body (i.e. the head and neck vs. the eye and related structures).
Podiatrists are another interesting story. For years, they've done fairly simple stuff - bunions, hammertoes, plantar fasciectomies, etc. Now, in the last few years, they've moved further. We have lots podiatrists doing ankle fractures and complex arthrodesis procedures - and some claim they're trained to do anything and everything distal to the hip, including the full gamut of knee surgery. All this with a four-year degree? Hmmmmm.
I will agree that podiatrists have no business operating above the ankle. It is an area of the body that is simply beyond the intended scope of their specialty.
However, the DPM fresh out of podiatry school doesnt perform ankle surgery, much less knee surgery. They have residencies where they acquire that kind of training.
It's only recently that we've even allowed them to do their own H&P's. Before that, they were required to get one done by an MD/DO because they assumption was they didn't know enough about medicine, despite their "legitimate four-year doctoral education.
We allow mid-levels to do H&Ps, dont we? If we trust them to do it, then Im sure a DPM could learn to do them too.
My point is - not all "doctorates" are the same. All may have their place, but they are hardly equivalent across the board. At one end you have the online DNP's which is a total crock. Then there's the other doctorate-level degree-creep types, like PharmD, DPT, DNP's that actually require at least some classroom time, and the like. Then the optometrists, dentists, podiatrists, etc. And the MD/DO. But even they're not the top of the heap, because most consider the PhD to be "the" doctorate.
Nobodys saying that all doctorates are the same. The point Im arguing is that the degree of OD gives an individual the necessary background to receive training in eye surgery.
Like I said, if you can take a friggin nurse and train him/her to provide anesthesia, you can certainly take an OD (whose training in the eye is extensive) and teach him/her to perform eye surgery.
