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Where is optometry headed??

Discussion in 'Optometry' started by sembaruthi, Dec 3, 2005.

  1. sembaruthi

    sembaruthi Junior Member
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    Hi everyone,
    I have a couple of interviews coming up and I know this questions comes up a lot.......where is optometry headed in the next 5 to 10 yrs.......any comments......insights .......would be grrrrrrreatly appreciated :)
     
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  3. HOLLYWOOD

    HOLLYWOOD Senior Member
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    safilo will be opening new opticals, davis vision has started opening new offices, i had a pt. tell me that they were getting there frames on line, there is no profit in contact lenses and medical insurance continues to lower payments. so tell them that optometry has a bright future that there wont be enough od's to work at all these new places. JUST LIE. for the record i told my brother not to go to optometry school,maybe he won't get in.
     
  4. sembaruthi

    sembaruthi Junior Member
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    wow you think there is a verry bad outlook for optometrists.......from what i've heard so far i thought the feild has a pretty good job outlook, cuz of the more aging population, plus for insurance companies are beginning to cover vision services also...are you a pre-opt student????? What do you think about optometrists gettin liscenced to do laser eye surgery....do you think it'll happen??
     
  5. HOLLYWOOD

    HOLLYWOOD Senior Member
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    i'm an od, i don't think ods should do lasik, if you want to do surgery go to med school. most of the vision plans stink. don't get me wrong you can make money but most of you will be working for someone. here is a great ques. what % of graduating ods are self employed my guess 25%.
     
  6. ariel winter

    ariel winter Senior Member
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    in my opinion, optometry is a growing profession. people are beginning to realize the importance of vision health, and as stated previously, the general population is aging. the more people care about their own eyes, the greater responsibility and opportunities for ODs. and while there are some negatives to the profession (this one's for you ucbsowarrior :D ), i think the positives definitely outweigh the pitfalls. optometry will continue to grow in both scope and importance (no matter how frustrating or wrong MDs think this is). i am not saying i am for ODs doing laser surgery or anything like that, but it seems to be an inevitibility with the shortage of docs in north america at the moment. this trend is only getting worse (believe me, i know... i have had many a discussion with my brother who is going to med school... for the record, he is completely supportive of ODs doing surgery... afterall, somebody has to do it if no docs are going to right?). i am not trying to start a flame war (although i probably already have), but this is just my opinion. take it however you want. :)
    good luck with your interviews! you will be great! :)

     
  7. KHE

    KHE Senior Member
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    In my opinion, optometry will end up very much like pharmacy with the overwhelming majority of ODs working retail hours in retail locations.

    Independantly owned optometric practices will become about as common as independantly owned pharmacies.

    The reasons for this are multifold but essentially it boils down to the fact that far too many ODs make far too much money from the retailing of spectacles and contact lenses. And unfortunately, large corporations can provide this service faster, cheaper, and with more variety and efficiency than independant private practices can.

    The tremendous oversupply of ODs is also going to add fuel to this fire. There just won't be enough "pie" to go around. In my area, it takes 6 weeks to get an appointment with just about every OMD yet you can get an appointment with any OD you want within two days, and many of them have very large ads in the yellow pages proudly proclaiming "WALK INS WELCOME."

    What does this say? It says that there is a huge demand for eyecare, but it is NOT being met by ODs. And there really isn't any reason to think that it will be met by ODs in the future.

    This problem is not going to get any better until optometric education extracates itself from retailing spectacles and integrates itself into the health care delivery system.

    Dentists have the same length of training as optometrists. Dentists are regarded as an integral part of the health care delivery team, yet optometrists continue to operate on the fringes. I notice there is a fellow on these forums who spouts the standard lines about physicians and non physician providers.

    That's not uncommon, and while ODs know the level of your training and your skill and it's obvious that this fellow is ignorant of it, you can't really blame him for thinking the way he does.

    How many ODs do medical students or medical residents encounter in their training? Zero. This is why optometry is not integrated into the health care delivery system and it's going to be a huge problem for the future of your profession.
     
  8. ProZackMI

    ProZackMI Psychiatrist/Attorney
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    I suppose you're referring to me. Personally, I have only encountered ODs on a personal level (now that I'm in my 30s, I need glasses). I have found them to be very professional and very knowledgeable about...refraction. I was surprised, almost shocked, when my optometrist told me she had TPA/DPA privis. I asked her about her pharmacology training in opt school (Ferris State University). She graduated in 1998, but based on what she told me, for her to have TPA/DPA privis, she was grossly undertrained in pharm. I did some investigating and did a research paper on changes in health care while in law school (for my health care law concentration). One of the topics was enhanced authority for ODs, NPs, PAs, PharmDs, AuDs, and even PTs.

    Right now, ODs have a very strong professional association that actively lobbies state legislatures for enhanced scope of practice authority. Audiologists do not have as strong a support structure, but they will in time. Pharmacy has a very strong prof. assn and lobby group just like the PTs, NPs, and PAs.

    You state that your education is the same length as that of a dentist. Well, if you're referring to a professional school (OD only), yes, but so is law school, chiropractic school, pharmacy school, vet school, podiatry school, medical school, osteo school, and even...naturopathic medical school. Since when does length of schooling equate to quality of schooling? Does 3-4 years of post undergraduate schooling automatically make one qualified for the practice of medicine?

    On the other hand, maybe the OD degree is another egregious example of degree inflation? Audiologists have been successful for years with an MA or MS degree. They see the ODs get "status" and prestige through the impressive OD degree, and with the degree, the increasing medicalization of the profession, so they lobby for the inflated degree Doctor of Audiology (AuD). So now they have to go to school for 3-4 years, post BA/BS, to study the same things they did for the 2 year MS, why? Is their knowledge and training better with an AuD? I've heard mixed reports, but the consensus is NO, it does not improve audiometric treatment or assessment, it only improves the status of audiologists so that they too are 'doctors'.

    Perhaps an OD should be converted back to an MA/MS and be a two year program? Do you really need four years to be an optometrist? Even if you argue yes, what you are trained in is vastly different than what physicians and dentists are trained in. I don't think an OD degree is on the same level as the MD, DDS, DVM, DPM, or even the PharmD in terms of basic sciences, pharmacology, and anatomy/physiology. A four-year graduate degree may actually be overkill. Many in the pharm forum believe the PharmD is overkill for retail pharmacists. I wonder if the OD is overkill for optometry in general.

    In most countries, an optometrist is a bachelor's-level professional technician and not a health care provider. I don't think that would be a bad thing for the US.
     
  9. Hines302

    Hines302 Senior Member
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    I think its really ironic that your a Psychiatrist. HAHAHA

    Prozack the bottom line is that Optometry, along with all the other Health Professions, NP, PA's etc.... are all growing in scope. Optometrist are recognized Health Care professionals that are very good at what they do. Almost everywhere in the US they are recognized as such and can treat certian eye conditions with oral and topical drugs, and can manage and co-manage many eye disease. Here is the kicker... are you ready for this.....

    There is absolutly nothing you can do about it. You are powerless to stop this.. regardless if its Optometrist or NP, or PA's. The Health Care industry is changing and there is nothing you can do about it. All professionals are very smart and well trained to do the tasks which they currently perform. You arguments are too late. So if sounding off in some Online Optometry board is really going to make you feel better... go for it. But Bottom line is that you have already lost! Optometrist are already well respected Health Care Professionals and this will only grow with time.
     
  10. gsinccom

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    ProZackMI is back :) take a look at this link our bitter friend.

    http://opt.pacificu.edu/test/pulldown5/index.html

    This is my first choice optometry curriculum and is similar to that at any OD USA school. I'd really suggest you please do a bit more research more before you say an OD degree is comparable to the recently made AuD degree in terms of curriculum intensity :) I've also compared curriculum at PharmD programs as well. From everything I've researched and heard in talking to ODs, MDs, DDSs, and PharmDs the OD degree intensity is nearly as an intense as the MD/DO degree (especially discounting the third year of MD/DO school) and is as intense as a DDS degree and is more intense than a PharmD degree.

    as far as other reasons why you may be bitter those have been, for the most part, successfuly refuted previously when you visited this forum.

    God Bless.
     
  11. Ben Chudner

    Ben Chudner Senior Member
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    How about actual statistics. This is from a talk I give to 3rd and 4th years about the future of optometry.

    From 2003 to 2004, the percentage of OD's working in a retail location more than doubled.

    This does not mean the actual number of OD's has doubled, and corporate OD's still make up a relatively small percentage of practicing OD's, however, it does show a disturbing trend.
    Ken, this is actually misleading. In the average OMD practice, just over 70% of the patients are brought back (after their first visit) at least once per year. That adds a lot of patients to the schedule. On top of that, most OMD's only have 4 clinic days with one surgery day, which decreases the amount of time per week they have to see those additional patient visits. OD's have the ability to do this as well, but they just do not know how to look for the opportunities.
     
  12. ProZackMI

    ProZackMI Psychiatrist/Attorney
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    You seem pretty knowledgeable for a kid who goes to Grand Valley State University. You'll do just fine at Ferris with your fine degree from the prestigious GVSU. By the way, in the future, it would behoove you to check your facts first. The AMA strongly objects to ODs increasing their scope of practice especially in areas such as surgical care and RxPs.
     
  13. KHE

    KHE Senior Member
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    I would be very interested in reading your paper. Would you be willing to post it on here? If not, feel free to PM me. It sounds very interesting. I would be interested to hear "the other perspective."

    But respectfully, I think you're making the same mistake that many other physicians make. You're indiciting an entire profession based on what was likely less than a 5 minute conversation with one OD.

    Throughout all your years in medical school and residency, how many ODs did you interact with? I would bet $5 that that number is ZERO. On the other hand, I would bet that you at least had SOME interaction with dentists and podiatrists. So unless you've actually sat through an OD curriculum, or sat for an OD licensing exam, I'm not so sure you have an adequate frame of reference from which to judge ODs training and/or skill levels. And you don't have to give us the story about how you "have many friends who are ODs" or how you "know someone who's brother in law is an OD and they're an idiot." We've all heard that one before.

    Only a fool would claim that ODs have as much training in pharmacology as physicians or pharmacists. Of course they don't. But that's not really the issue. The issue is does an OD have adequate training to prescribe the medications that they are licensed to prescribe and treat the conditions that they are licensed to treat. And for that, I would say that the answer is yes.

    If ODs were really running around killing their patients with oral Abx, or even if there was only ONE incident of it, I'm sure that that fact would be broadcast on the frontpage of the AAO website, and opthalmology times in 48 point type. I have yet to see that.
     
  14. KHE

    KHE Senior Member
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    If that percentage actually did double in only ONE year, then that is much worse than I thought. And there really is no reason to think that this trend will abate itself unless ODs divorce themselves from the retailing of specatcles and contact lenses as their major source of income. I'm not suggesting that it be eliminated in its entirety. Only that it needs to be drastically reduced.
     
  15. Hines302

    Hines302 Senior Member
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    Do not mock where I go to undergrad. GVSU is a great school. This years enetring Freshman class had a average GPA of 3.5 and an ACT of 25. These are better than most colleges in MI.

    For your information I have been accepted and will OSU... which is a very good program!

    Please stop your personal attacks.
     
  16. ProZackMI

    ProZackMI Psychiatrist/Attorney
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    Dr. KHE,

    I agree with your statements. You're right, I can only provide anectodal evidence to support my statements about optometry. In my IM residency, during my ophth rotation, one of the preceptors, an OMD, told us that optometrists were "glorified technicians who are good at prescribing lenses, but are morons in terms of dx and tx." Well, I'm paraphrasing, but it was along those lines. Every time a resident raised a question, the preceptor went on a lengthy diatribe about ODs and their "piss poor" training. I have no idea why he disliked optometrists so much, but many in my residency left feeling unsure about optometry. A similar preceptor during another rotation (maybe it was ortho?) said podiatrists were quacks. However, I had the opportunity to work with a few DPMs who treated a few of my diabetic patients for things like osteomyelitis and a BKA w/ prosthesis and I was very impressed at the quality of care my patients received. Very impressed indeed.

    Much of what I learned about optometry I found in research while in law school. I would be more than happy to share my paper with you either via e-mail or I can upload it somehow and then post a link. Of course, I would have to find the paper, which is located on a CD somewhere in my home office amongst my clutter! Essentially, my paper was on scope of practice issues and encroachment on medical practice by other practitioners.

    Some of the hot areas in health care now include:

    - ODs wanting increased/enhanced RxPs in all states as well as admitting privis for hospitals, increased reimbursement rates, and surgical training privis
    --> if successful, ODs will encroach upon ophthalmology and IM/FP

    - NPs and PAs want increased autonomy and full, unrestricted RxPs without MD/DO protocols

    - NPs wanting a clinical doctorate (NursD or ND or DNP) and use of the title "doctor" in treating patients

    - PharmDs wanting RxPs and to even see patients as primary care providers! Some PharmDs are now certified pharmacy practitioners and see patients at clinics, provide basic PEs, and even read labs and adjust and Rx meds. There are even a few PharmD/PA programs, such as UWash, where PharmD-PAs perform a wide range of clinical services!

    - PTs have upgraded to a DPT degree and will soon be seeking enhanced scope of practice authority to prescribe meds/treatment, perform PT services w/o MD/DO script, do PEs, etc. PT will encroach upon PM&R and Ortho.

    - AuDs are trying to parallel ODs and will soon seek enhanced authority and will try to encroach upon ENT/oto.

    - PhD/PsyD psychologists with a post doc MS degree in psychopharm are seeking unlimited, unrestricted RxPs and hospital privis. In several states, these psychologists have RxPs and hospital privis. LA, NM, and HI are examples. As a psychiatrist, this deeply concerns me.

    - CRNAs are lobbying for more authority and are trying to encroach upon anesthesiology.

    These issues are of great concern to physicians and the AMA. My research has shown that the AMA has kept too much advancement from taking place, but due to managed health care costs and expenses, this is no longer viable and professions like optometry are getting a strong foothold in the medical arena.

    You're also right in your assessment that ODs with limited TPA/DPA RxPs generally do little if any harm to their patients. However, this very well may be due to their limited RxPs. If ODs receive enhanced, or unlimited RxPs, then what?

    My whole argument is that optometry has its place in the health care professions, but that place should not include unfettered RxPs and surgery. I believe things will continue to change for both of our professions, but I don't think it's the best thing for patients and the general public.
     
  17. ProZackMI

    ProZackMI Psychiatrist/Attorney
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    I apologize, Hines, for attacking GVSU. It is a good school, you are right. However, what I really wanted to point out was that you're saying I know little about optometry, and while I'm not going to disagree with that statement, because there is reality to it, I will say that as an undergraduate kid, who is probably under 23, you don't know much about professional school. So, maybe you know about as much as I do about optometry, if not less.

    I am sorry for slamming your school. I think GVSU is a good school. I didn't Ohio State had an OD program.
     
  18. KHE

    KHE Senior Member
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    Dear Dr. Zack,

    Yes. Please email me or post a link to your paper when you get a chance. I would be very interested in reading it.

    However, your posting here pretty much proves my point.

    I'm not surprised to hear what the ophthalmology attending was telling medical students. That's pretty much standard operating procedure in ophthalmic residency programs. As you found out, and as I suspected it seems that it's standard operating procdure in orthopedic programs as well. I'd be willing to bet $5 that psychiatry attendings run down psychologists at every opportunity.

    However, if you had been given the opportunity to work with an OD (as you did with a podiatrist) maybe, just maybe, you would come to realize that ODs aren't quite the incompetent boobs that you thought. Just as you found out with your podiatrist.

    Also, in this post you seem to suggest that you have some concern with ODs having unfettered prescription and surgical priviledges. That is a very legitimate concern.

    Yet in other posts, your contention is that ODs shouldn't even be prescribing patanol:

    It would seem from those quotes that you feel that ODs should not have any prescribing priveledges at all, including topical. I'm not so sure that those statements are reconcilable with






     
  19. Ben Chudner

    Ben Chudner Senior Member
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    I completely agree. The actual numbers are:

    Employed OD's (2003) working for optical chains - 0.4%
    (2004) - 0.7%

    Self-employed OD's (2003) working for optical chains - 2.7%
    (2004) - 4.9%

    Self-employed OD's (2003) independent contractors - 1.6%
    (2004) - 4.3%

    I included indendent contractors because i would think a majority of them work in optical locations.
     
  20. HOLLYWOOD

    HOLLYWOOD Senior Member
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    when i went to od school i took classes with the med students same material same test same scale and i agree it was overkill, but dont belittle my education.
     
  21. J.opt

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    Does anyone know where information about “Optometry 20/20” can be found? This was a meeting the AOA had recently where they tried to predict the status of the profession in the year 2020.

    I heard that they predict that in the year 2020, 75% of new optometrists will work in a commercial setting. (That is, that almost everyone’s first job will be in a commercial setting).
     
  22. UABopt

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    At this point 4 years is almost too short for the OD program. Our schedules are jam packed from 8 in the morning until 5 at night sometimes even 7 at night (for electives) only to go home and study.

    As far as comparing our curriculum to dental school, as I have stated many times before at UAB we take nearly ALL of our basic science classes with dental students and are graded on the exact same curve, well besides the fact that the optometry school eliminated the ‘D’ letter grade while the dental school did not, but that is another story. This means we do take general pharmacology with the dental students. After general pharmacology we take ocular pharmacology at the optometry school. If this qualifies dentists to prescribe medications then certainly it would qualify us as well.

    The OD curriculum has been 4 years for 50+ years whereas pharmacy has only been made 4 years much more recently. I don't think there is any degree inflation going on here. If all an OD did was refract then 2 years would be more than enough, but there is more to learn than I ever imagined before I started school. Our classes certainly are not fluff that could be covered in 2 years. I have attached some random scripts from some of our courses to give an Idea of the depth of material covered.
     

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  23. Tom_Stickel

    Tom_Stickel Member
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    Ben,

    Where are your numbers from? 10% of ODs in commercial practice seems low. I'd like to take a look.

    Tom
     
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  25. VA Hopeful Dr

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    That's interesting. I could maybe, MAYBE see cutting down the basic science time somewhat if you're an MD/DO/DDS going for the OD. But how does a PhD in Electrical Engineering help at all? And can you really do all the same material in half the time?
     
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  27. KHE

    KHE Senior Member
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    It clearly states that the PhD must be in science or medicine. That hardly constitutes a PhD in "pretty much any field."
     
  28. ProZackMI

    ProZackMI Psychiatrist/Attorney
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    I agree, I think if I had worked with an OD during med school or residency, I might have a different view, but there are so few of you guys who work out of standard hospitals (non-VA) that such a working relationship is almost impossible unless there is some affiliation with a low vision OD, etc. I know at Wm. Beaumont Hospital where I did most of my IM res., there was a Dr. Wood who was on OD/MS who worked in the low vision clinic, but he was pretty much limited to refraction, not treatment, if memory serves. I had very little interaction with him, although I did have a patient who had macular degeneration and Dr. Wood saw him.

    You're correct, I do not think ODs should have any prescriptive privileges whatsoever. However, they do, so it's a moot point. Based on what I've read, ODs do not harm their patients. In fact, it seems that more MDs and DOs (especially IMG/FMG) do more damage by Rx'ing inappropriate meds or not bothering to do a thorough hx and overlooking possible interactions, etc. That does not mean I agree with ODs have any RxPs. PAs and NPs seem to be a good job with prescribing too, but I have a problem with them as well. Maybe I'm just old fashioned.

    By the way, you left optometry for what field? I believe I read somewhere that you're a teacher of some kind? Would you be willing to share your story? I'll look for my paper and post a link when I get a chance this weekend.

    Thanks,
    Zack
     
  29. Ben Chudner

    Ben Chudner Senior Member
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    I got them from the AOA, so you must take them with a grain of salt. Remember, figures lie and liars figure. The point was to show the increase not necessarily the absolute numbers. Also remember that corporate optometry has really just gotten big in the last ten years. If you were to look at the percentage of new grads that go into corporate practice, the numbers would be very much higher. So you have a large number of older private practice docs to offset the number of new docs going corporate. Unfortunately, as those docs retire I fear us private practice guys will eventually be outnumbered.
     
  30. KHE

    KHE Senior Member
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    Dear Dr. Zack,

    I do not think you are being old fashioned. I think that unfortunately, you have been denied the opportunity to work with ODs and as such, you are just regurgitating what your insturctors in medical school (like that ophthalmology attending) have drilled into you. It's really not your fault.

    There is not much point in me posting my story again. But if you, or anyone else really wants to hear it again, PM me and I'll share it.
     
  31. Ben Chudner

    Ben Chudner Senior Member
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    At least this is an honest answer. I can respect the fact that this is how you feel. It's all the unsubstantiated rhetoric of how OD's are doing harm that infuriates me. I remember in California when an MD stood up before the state legislature with a bottle of 10% phenylephrine and said "one drop from this bottle could kill you". I would love to talk to him now and ask how many people died from an OD dilating their eyes.

    Thanks for your honesty Zack.
     
  32. ProZackMI

    ProZackMI Psychiatrist/Attorney
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    No problem at all, Dr. Chudner. As I've said before, even though I come across as being anti-optometry, you ODs have done a great job, at least in MI, with TPA/DPA privileges. I have never read any case of an OD seriously injuring, or worse, killing a patient due to an inappropriate Rx. However, my fellow physicians, many of whom are in my own field (psychiatry), do their fair share of damage each year through inappropriate script writing. Go figure. Maybe I really am out of touch with the reality of optometry. I can't say I blame any OD for wanting to enhance the profession's scope of practice. I still think this may be dangerous in the long run, but so far, so good...in terms of RxP safety and all.

    What it boils down to is:

    - Most MDs and DOs feel they are at the top of the health care professional hierarchy. Most will deny this archaic viewpoint, but it is true.

    - Most MDs and DOs feel their training is overinclusive and vastly superior to the training of others is inferior, especially in terms of pharmacology and assessment.

    - Most MDs and DOs feel threatenend by the encroachment of other health care professions into areas that have traditionally been reserved for physicians (e.g., surgery, RxPs, hospital admit and D/C privis, diagnoses, medical source statements, etc.).

    - Managed health care has reduced the presitige and status of medical practice

    These factors make many of us, such as myself, skeptically scrutinize other professions and their advances. One of my best friends is a PharmD/MPH; he's on staff at my hospital. I frequently ask him questions about drug interactions, contraindications, titration levels, proper dosing, etc. I admit, he knows way more than I do about psychopharmacology.

    In reality, what I really need to do is either do more research, talk to more ODs, and just accept things the way they are...or shut my damned yap! :laugh:

    Like I said before, optometrists have never killed anyone, seriously hurt anyone, or even cheated anyone to the best of my knowledge. In fact, I was reading an article a few months ago that was discussing a study from a few years back. The article discussed the public's perceptions of the ethics of various professions. Pharmacy, dentistry, optometry, education, and I believe nursing all scored very high in terms of honesty, professionalism, and overall public outlook. The same could not be said about medicine, business, government, and law.
     

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