What is rationale for the term "optometric physician"?

[OphthalmicPilot]

Since optometrist don't go to medical school (in fact, many universities with optometry schools do not have medical schools), why do they claim to be physicians?

Is it because they do physical, i.e. bodily, work? If so, why aren't there dental physicians, nurse physicians, dietician physicians, psychologist physicians?

Is it because in this country, the degree is doctor of optometry, not bachelors of optometry? If so, why aren't there attorney physicians, geology physicians, history physicians, biochemistry physicians?

Any knowledge of the history of the use of the term. This post is NOT to say OD's are bad, stupid, unethical. I've met smart OD's and those who have special expertise or even just do a good job at refraction. This post is just a discussion about how their use of the term "physician" came about.

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[I Surgeon]

Since optometrist don't go to medical school (in fact, many universities with optometry schools do not have medical schools), why do they claim to be physicians?

Is it because they do physical, i.e. bodily, work? If so, why aren't there dental physicians, nurse physicians, dietician physicians, psychologist physicians?

Is it because in this country, the degree is doctor of optometry, not bachelors of optometry? If so, why aren't there attorney physicians, geology physicians, history physicians, biochemistry physicians?

Any knowledge of the history of the use of the term. This post is NOT to say OD's are bad, stupid, unethical. I've met smart OD's and those who have special expertise or even just do a good job at refraction. This post is just a discussion about how their use of the term "physician" came about.

I don't know anyone who calls them "physicians". Do you?

 

[DOCTORSAIB]

I'm noticing more and more these days that the word "physician" seems to be one of the most "hijacked" words in healthcare.

 

[Caffeinated]

I don't know anyone who calls them "physicians". Do you?

It's a term that came into vogue a few years ago. As far I can tell, most optometrists think the term is goofy and misleading.

Optometry is a state-regulated profession, which means that the individual state legislatures define the scope of care for optometrists in their states. In several states, the official state laws have been modified such that the term "optomemtrist" has been replaced with "optometric physician." So it looks like the term well be around for a while.

 

[VA Hopeful Dr]

Since optometrist don't go to medical school (in fact, many universities with optometry schools do not have medical schools), why do they claim to be physicians?

Any knowledge of the history of the use of the term. This post is NOT to say OD's are bad, stupid, unethical. I've met smart OD's and those who have special expertise or even just do a good job at refraction. This post is just a discussion about how their use of the term "physician" came about.

It originally came about as a way to get on insurance panels. Many insurance plans only allowed "physicians" to participate. So, you go from optometrist to optometric physician and then you can get in on that insurance.

Now, it obviously isn't JUST for that anymore (else why would ads and signs say it). For that, I think this best sums it up...

As far I can tell, most optometrists think the term is goofy and misleading.

95% of ODs are content to be optometrists. They know that what they do is valuable and will be worthwhile no matter what they call themselves. Every profession has a small percentage that does things that the rest don't entirely agree with.

 

[cpw]

It's a term that came into vogue a few years ago. As far I can tell, most optometrists think the term is goofy and misleading.

Optometry is a state-regulated profession, which means that the individual state legislatures define the scope of care for optometrists in their states. In several states, the official state laws have been modified such that the term "optomemtrist" has been replaced with "optometric physician." So it looks like the term well be around for a while.

my license says optometric physician in the state of Florida.

 

[orbitsurgMD]

my license says optometric physician in the state of Florida.

Not surprising, given the influence many optometric societies have had in state legislatures.

My guess is that it is seen as something doesn't hurt, confusion or not, and might possibly benefit optometry. (When have you ever heard of an ophthalmologist wanting to be called a surgical optometrist? Conversely, when have you ever heard an optometrist deny being an "optometric physician?). People associate physicians with lengthy training and superior expertise in medical fields.

 

[Rael]

What's next? Optician = optical physician?

Do you guys ever see those magazine/newspaper ads from optometrists who say "Dr. John Doe" with the O.D. left off...so people have no idea what kind of doctor they are? What's the deal? Seems like misrepresentation to me.
Chiropractors in advertisements are often guilty of this as well.

 

[JR]

I feel another ugly round of OMD vs. OD coming up. Let's try to keep it civil...

What's next? Optician = optical physician?

Do you guys ever see those magazine/newspaper ads from optometrists who say "Dr. John Doe" with the O.D. left off...so people have no idea what kind of doctor they are? What's the deal? Seems like misrepresentation to me.
Chiropractors in advertisements are often guilty of this as well.

 

[POJO]

Since optometrist don't go to medical school (in fact, many universities with optometry schools do not have medical schools), why do they claim to be physicians?.."

This term is strictly a third party reimbursement issue. Since Medicare has signified that optometrists could be clasified as physicians for the purpose of reimbursement, this has created a similar moves for other reimbursement schemes.

If optometrists were unhindered in medical panel membership or reimbursement due to definition, I really wouldn't care what I call myself or what I am called. I only care that I or my patients can get reimbursed at a level commensurate to the service provided.

Therefore, I don't believe optometrists care except for the above siutation.

 

[OphthalmicPilot]

This term is strictly a third party reimbursement issue. Since Medicare has signified that optometrists could be clasified as physicians for the purpose of reimbursement, this has created a similar moves for other reimbursement schemes.
QUOTE]

I feel another ugly round of OMD vs. OD coming up. Let's try to keep it civil...

It doesn't have to be ugly. I never said that OD's are no good, just asked about the term "optometric physician"

I think Pojo's assessment is wrong. I think there is some idea that they want to boast to patients and hope that patients will think they are "physicians", not just "optometric physicians". I think, if this is a motive, it is a sign of dishonesty.

I have to admit some dishonesty on my part. I am not a pilot even though I like to ride in a little private plane. However, I can claim to be a pilot much the same way as OD's claim to be physicians. After all, I pilot medical care. I hope OD's won't copy me and dishonestly claim to be "optometric pilots" or "optometric physician pilots".

If it were just a reimbursement issue, then the limited use of "optometric physician" would be ok much as MD don't usually call themselves allopathic MD's.

 

[VA Hopeful Dr]

It doesn't have to be ugly. I never said that OD's are no good, just asked about the term "optometric physician"

I think Pojo's assessment is wrong. I think there is some idea that they want to boast to patients and hope that patients will think they are "physicians", not just "optometric physicians". I think, if this is a motive, it is a sign of dishonesty.

I think Pojo's assessment (which mirrored what I said last week) is MOSTLY true. I'll say it again, MOSTLY true. The "optometric physician" began as an insurance thing. It has expanded since then, but it is hardly a uniform thing. Most ODs are content to call themselves "optometrists" and let their work stand on its own. But, like everything else, optometry does have some people who want to be called optometric physicians. These ODs are in the minority.

I have to admit some dishonesty on my part. I am not a pilot even though I like to ride in a little private plane. However, I can claim to be a pilot much the same way as OD's claim to be physicians. After all, I pilot medical care. I hope OD's won't copy me and dishonestly claim to be "optometric pilots" or "optometric physician pilots".

If it were just a reimbursement issue, then the limited use of "optometric physician" would be ok much as MD don't usually call themselves allopathic MD's.

The thing is, as I said, it STARTED as a reimbursement issue, and for most ODs that's still all that it is. There is just a small minority that prefers to use the term in their daily practice.

 

[toofache32]

I'm noticing more and more these days that the word "physician" seems to be one of the most "hijacked" words in healthcare.

It's similar to how ophthalmologists want to be called surgeons.

 

[I Surgeon]

It's similar to how ophthalmologists want to be called surgeons.

Ophthalmologists do surgery, optometrists do not do medicine.
It also similar how OMFS want to be associated with doctors, but somehow are always grouped with those "dentists", especially in the medical community.

 

[CSI Miami]

What's the rationale for the term "optometric physician"?

The simple answer: money, greed & dishonesty.
It's a slimy, used car salesman like tactic for optometrists to claim more money and prestige than they deserve based on their duration and intensity of training.

I respect optometrists who work hard and do a good job without risking patient safety by exceeding their limits. I have no respect for those who try to con the public with slimy tactics like some of those described above.

 

[smiegal]

It's similar to how ophthalmologists want to be called surgeons.

Please explain, toofache32. How is it similar?

Anyhoo, this issue has been discussed before. Not an appropriate title, but ODs were forced into it in some areas for reibursement purposes. It is not an accurate title out of the reimbursement context.

 

[Hines302]

The simple answer: money, greed & dishonesty.
It's a slimy, used car salesman like tactic for optometrists to claim more money and prestige than they deserve based on their duration and intensity of training.

I respect optometrists who work hard and do a good job without risking patient safety by exceeding their limits. I have no respect for those who try to con the public with slimy tactics like some of those described above.

Exactly what basis do you have for these serious claims?? Are you really comparing an optometrist to a used car sales man?? I hope I have interpreted that statement wrong.

To make the assumption that optometrists want to be dishonest to their patients and do not care if they inflict harm on them is an absolutely ridiculous statement with no factually evidence. Please lets try and be respectful.

 

[CSI Miami]

That's an emotional reply.
If you read my post, you will see that I did not say every optometrist was like that, just the ones who try to deceive patients into believing that they are physicians.
Any optometrist who wants to deceive patients, and do surgical or laser procedures that they are not trained or qualified to perform to no better than a sleazy salesman, who cares more about money, than patient care. I have no respect for that sort of behaviour.

 

[drgregory]

i think it is maybe a term used by private ODs in attempt to distinguish themselves from our own black sheep, corporate ODs. i do not use it. problem with eye care is that there are two fields competing for patients, both with too many liscensed providers. decrease the number of ODs and OMDs, have OMDs doing ALL SURGERIES AND TERTIARY CARE and ODs doing ALL PRIMARY EYE CARE and suddenly OMDs and ODs are best friends.

 

[drgregory]

problem with eye care is that there are two fields competing for patients, both with too many liscensed providers.

i realize i'm an idiot for responding to my own quote, but a large part of this overabundance problem is commercial ODs churning out 50 "exams", also known as refractions, per day, without regard to surgical recommendations or ocular disease. if appropriate time and care were provided by these ODs (which would include exponentially raising their fee for service) we would see more OMD referrals (because they would actually be looking at ocular health). there would also be droves of patients who would be in need of real eye care, to be found at private eye clinics. so, this would be one way we could even the keel without reducing the number of providers.
example - i see many patients who would greatly benefit from a surgical consult. take, for instance, the 55 year old -6.00 myope with a 20/30+ cataract in each eye. with today's lens calc technology, i'd be an idiot not to recommend early consideration of cataract surgery. that is one hell of a quality of life change. maybe this is easy for just me because i work with and am very good friends with a group of skilled surgeons. but after all, my patients think im a hero for the recommendation two weeks out of surgery at their post op when they are 20/20 OU without correction. (naturally their insurance kicking in on the surgery doesnt hurt things either). what i'm saying is, optometrists have bad eggs (alot of them). ophthalmologists have bad eggs. but if we all just get along, i can guarandamntee you that both parties will be economically better off, and most importantly patients will benefit.

 

[CSI Miami]

great post. You sound like exactly the kind of good, thoughtful and altruistic optometrist that I was referring to, that I have the world of respect for.
keep up the good work

 

[Caffeinated]

I believe that the term evolved from a combination of factors (in no particular order):

* The need for proper terminology to keep insurance panels from closing out optometrists
* The frustration with the fact that the general public does not know that optometrists have a doctoral level degree and can treat minor eye disease
* The desire for greater respect in the professional community
* The desire to set the profession above opticians (much of the lay public does not know the difference between an optician and an optometrist)

The problem with the term is that it is misleading in several ways. Just because an optometrist can manage some eye diseases does not make one an "optometric physican." Similarly, a dentist can clean teeth, treat gum disease, and whatever else dentists do. Should we call them "dental physicans"?

Having been an optometrist and and with only 12 weeks left in my 3rd year of medical school, I have a new appreciation for what it takes to make someone a "physician." It is not simply a term to describe a person that treats "diseases" but a person who is trained in treating the entire body and the entire person. (Before anyone tries to lecture me about the fact that ophthalmologist don't deliver babies, do hysterectomies, treat depression, or perform CABGs, please continue to read). Before one can become a specialist in any particular field of medicine, they must master the skill of treating the whole person - their body, their psychosocial context, etc. This is what makes one a physician. Yes, I realize that optometrists get extensive didactic training in physiology, pathology, systemic pharmacology, etc. I was there, and I took those classes too (and they were not easy). But there is a great leap one makes between didactic training and taking that knowledge to the clinic or the bedside. I know this because I am in the middle of that leap right now. It's a process that is rewarding, exhausting, and painful at times. It comes at a great personal sacrifice. Optometric education, while also challenging and rewarding, does not involve mastering the care of the whole person before one specializes. Optometric education is designed such that the hours spent learning physiology, pathology, and pharmacology can help the optometrist understand ocular disease in the context of systemic disease. But I would argue that this alone does not make one a "physician."

Now that I have offered this perspective, I sincerely hope that my optometric colleagues can begin to understand why ophthalmologists get so offended at the term "optometric physician." The process of becoming a physican (which occurs before one becomes an ophthalmologist) is a physically and emotionally demanding journey that takes years. The fact that a legislature can turn an optometrist into an optometric physican with a stroke of a pen is a bitter pill for most physicians.

 

[DOCTORSAIB]

I believe that the term evolved from a combination of factors (in no particular order):

* The need for proper terminology to keep insurance panels from closing out optometrists
* The frustration with the fact that the general public does not know that optometrists have a doctoral level degree and can treat minor eye disease
* The desire for greater respect in the professional community
* The desire to set the profession above opticians (much of the lay public does not know the difference between an optician and an optometrist)

The problem with the term is that it is misleading in several ways. Just because an optometrist can manage some eye diseases does not make one an "optometric physican." Similarly, a dentist can clean teeth, treat gum disease, and whatever else dentists do. Should we call them "dental physicans"?

Having been an optometrist and and with only 12 weeks left in my 3rd year of medical school, I have a new appreciation for what it takes to make someone a "physician." It is not simply a term to describe a person that treats "diseases" but a person who is trained in treating the entire body and the entire person. (Before anyone tries to lecture me about the fact that ophthalmologist don't deliver babies, do hysterectomies, treat depression, or perform CABGs, please continue to read). Before one can become a specialist in any particular field of medicine, they must master the skill of treating the whole person - their body, their psychosocial context, etc. This is what makes one a physician. Yes, I realize that optometrists get extensive didactic training in physiology, pathology, systemic pharmacology, etc. I was there, and I took those classes too (and they were not easy). But there is a great leap one makes between didactic training and taking that knowledge to the clinic or the bedside. I know this because I am in the middle of that leap right now. It's a process that is rewarding, exhausting, and painful at times. It comes at a great personal sacrifice. Optometric education, while also challenging and rewarding, does not involve mastering the care of the whole person before one specializes. Optometric education is designed such that the hours spent learning physiology, pathology, and pharmacology can help the optometrist understand ocular disease in the context of systemic disease. But I would argue that this alone does not make one a "physician."

Now that I have offered this perspective, I sincerely hope that my optometric colleagues can begin to understand why ophthalmologists get so offended at the term "optometric physician." The process of becoming a physican (which occurs before one becomes an ophthalmologist) is a physically and emotionally demanding journey that takes years. The fact that a legislature can turn an optometrist into an optometric physican with a stroke of a pen is a bitter pill for most physicians.

👍

 

[f_w]

Before anyone tries to lecture me about the fact that ophthalmologist don't deliver babies, do hysterectomies, treat depression, or perform CABGs,

But based on their training, they will be able to pick up on systemic diseases previously unrecognized or untreated.

Ophthalmologists are physician first, 'eye doctor' second (unfortunately some are cataract jockeys first, business man second) Every once in a while, there is a patient treated by their OD for various vision related problems for a while, who after an evaluation by an ophthalmologist where referred to the appropriate medical subspecialist for further workup (I remember a congenital heart disease, a critical LAD stenosis, 2-3 parkinsons, a smattering of MS and oodles of diabetics).

 

[cpw]

what i'm saying is, optometrists have bad eggs (alot of them). ophthalmologists have bad eggs. but if we all just get along, i can guarandamntee you that both parties will be economically better off, and most importantly patients will benefit.

👍 This is the smartest thing I've seen you say.... 😉

I'm shocked at how many times a day a hear "Oh, you're going to dilate me.. I've never had that done before !! What does it do ?? " . Especially when I know these patients have been seen by other local docs (MANY of them private practice) every year.

 

[cpw]

i think it is maybe a term used by private ODs in attempt to distinguish themselves from our own black sheep, corporate ODs. i do not use it. problem with eye care is that there are two fields competing for patients, both with too many liscensed providers. decrease the number of ODs and OMDs, have OMDs doing ALL SURGERIES AND TERTIARY CARE and ODs doing ALL PRIMARY EYE CARE and suddenly OMDs and ODs are best friends.

It's not a private doc vs commercial doc situation. I've been to a few bad private practice docs. I've been to some great commercial docs.It's just as you state lower down in your posting.... it's a good OD vs bad OD situation. There are good ODs and bad ODs just as there are bad MDs, good MDs and bad/good dentists.

 

[drgregory]

👍 This is the smartest thing I've seen you say.... 😉

I'm shocked at how many times a day a hear "Oh, you're going to dilate me.. I've never had that done before !! What does it do ?? " . Especially when I know these patients have been seen by other local docs (MANY of them private practice) every year.

i agree to this. i see many older ODs who dont know how to use a non-contact fundus lens, much less a BIO - and most of these are in private practice. these are the same ODs who wait until a -5.00D, spherical cornea cataract patient is 20/60 before sending for surgical consult. its these ANCIENT PRIVATE ODs and the hoardes of REFRACTION JOCKEY COMMERCIAL ODs who are giving us a bad image. i'd be confused as to what an OD is if i were a physician, and id be untrusting if i were an OMD. like i said, we just have too many bad eggs in optometry, including those who want to be major eye surgeons.
its up to the rest of us to build relationships with surgeons and physicians, in hopes that they havent run into these types of ODs in the past, giving them a leary disposition.

 

[VA Hopeful Dr]

these are the same ODs who wait until a -5.00D, spherical cornea cataract patient is 20/60 before sending for surgical consult.

Having worked with a private practice MD before.... it can be very tricky to get medicare to reimburse for surgery if the patient's vision can be corrected to better than 20/50.

 

[drgregory]

Having worked with a private practice MD before.... it can be very tricky to get medicare to reimburse for surgery if the patient's vision can be corrected to better than 20/50.

you got that right. we use a glare test - this usually takes care of any uncertainty.