Which states practice full scope?

[JennyJet]

---

Members do not see this ad.

So now that I'm a 2nd year (YAY!) i'm starting to hone in on where I would like to practice. During a casual conversation with a 4th year, I asked "So are you going to stay here in CA to practice?" He said, "No way" because he said you can't practice full scope in CA. Hmm ... I was a bit confused since the optometrist I work for seems to practice full scope to me, but maybe I really don't know what full scope entails. Can someone school me on this one?

Oh, right now I'm considering southern CA (mom lives there) and northern OH (friends like family live there). I'm torn between the two, but being close to my immediate and extended family is very important to me. Any comments on the two locations or an alternate location.

Jenny
UCBSO, Class of 2009

 

[Richard_Hom]

So now that I'm a 2nd year (YAY!) i'm starting to hone in on where I would like to practice. During a casual conversation with a 4th year, I asked "So are you going to stay here in CA to practice?" He said, "No way" because he said you can't practice full scope in CA. Hmm ... I was a bit confused since the optometrist I work for seems to practice full scope to me, but maybe I really don't know what full scope entails. Can someone school me on this one?

Oh, right now I'm considering southern CA (mom lives there) and northern OH (friends like family live there). I'm torn between the two, but being close to my immediate and extended family is very important to me. Any comments on the two locations or an alternate location.

Jenny
UCBSO, Class of 2009

Dear Jenny,

I practice in CA. What do you want to do that you think is not "full scope" of practice in CA? Just go to my web site to see some of what I do. See also this thread on SDN http://forums.studentdoctor.net/showthread.php?t=301075

If you have any questions, you can private message me at your convenience.

Richard Hom OD FAAO
San Mate CA

 

[Ben Chudner]

So now that I'm a 2nd year (YAY!) i'm starting to hone in on where I would like to practice. During a casual conversation with a 4th year, I asked "So are you going to stay here in CA to practice?" He said, "No way" because he said you can't practice full scope in CA. Hmm ... I was a bit confused since the optometrist I work for seems to practice full scope to me, but maybe I really don't know what full scope entails. Can someone school me on this one?

Oh, right now I'm considering southern CA (mom lives there) and northern OH (friends like family live there). I'm torn between the two, but being close to my immediate and extended family is very important to me. Any comments on the two locations or an alternate location.

Jenny
UCBSO, Class of 2009

It is not that California OD's can't practice full-scope optometry. The real issue, in the past, has been that the scope of practice in Caliifornia was not as advanced as other states. To my knowledge that is no longer the case. Cali may not be as advanced as Oklahoma, but the OD's have come a long way. A more appropriate question would be to ask what the prescribing rights in Cali are.

 

[KHE]

You guys knew I wasn't going to let this one go by without commenting.

JennyJet, please pay close attention to the next few statements because they may just well be the most important words you read regarding your career in optometry:

SCOPE OF PRACTICE IN A STATE DOES NOT MATTER! WHAT MATTERS MUCH MUCH MORE SO IS THE ABILITY TO BE ADMITTED ONTO MEDICAL INSURANCE PLANS IN THAT STATE. YOU CAN PRACTICE IN A STATE THAT HAS THE WIDEST SCOPE OF OPTOMETRIC PRACTICE IN THE UNIVERSE AND IT WILL NOT MAKE ONE SINGLE SOLITARY LICK OF DIFFERENCE BECAUSE YOU WILL NOT GET PAID TO PERFORM THOSE PROCEDURES IF YOU CAN'T BILL THE PATIENT'S INSURANCE.

CONVERSELY, YOU CAN PRACTICE IN A STATE THAT HAS A RELATIVELY LIMITED SCOPE OF PRACTICE, BUT YOU WILL AT LEAST BE ABLE TO PERFORM THOSE PROCEDURES IF YOU CAN BE ADMITTED ONTO MEDICAL PLANS.

WHAT YOU NEED TO LOOK AT, IS NOT SCOPE OF PRACTICE....BUT THE ABILITY TO BE ADMITTED ONTO MEDICAL INSURANCE PLANS. IF YOU CAN GET BOTH, THAT'S FANTASTIC, BUT THE MOST IMPORTANT IS ACCESS TO MEDICAL PLANS, NOT SCOPE OF PRACTICE.

*phew*

So now that I'm a 2nd year (YAY!) i'm starting to hone in on where I would like to practice. During a casual conversation with a 4th year, I asked "So are you going to stay here in CA to practice?" He said, "No way" because he said you can't practice full scope in CA. Hmm ... I was a bit confused since the optometrist I work for seems to practice full scope to me, but maybe I really don't know what full scope entails. Can someone school me on this one?

Oh, right now I'm considering southern CA (mom lives there) and northern OH (friends like family live there). I'm torn between the two, but being close to my immediate and extended family is very important to me. Any comments on the two locations or an alternate location.

Jenny
UCBSO, Class of 2009

 

[WoodyJI]

Well, with that good advice being given, perhaps someone could tell us how one goes about discovering if they will or will not be able to be admitted onto medical plans in their state when they graduate?

 

[Richard_Hom]

Well, with that good advice being given, perhaps someone could tell us how one goes about discovering if they will or will not be able to be admitted onto medical plans in their state when they graduate?

Dear woodyji,

I think the prevalence of ocular disease is sometimes forgotten. An ophthalmologic practice and one that had traditionally done well is one with patients in their 70's and 80's. Only optometrists seem to have only patients in their teens - 50's.

Becasue of the prononced predilection for the populaton over 65, Medicare is the first plan that you need to be included on. In this special group, however, even HMOs have made inroads into this population group which infruriates even mainstream ophthalmologists sometime.

And general garden variety Medicare do reimburse optometrists for primary care. If you want to treat ocular disease, then may I suggest that you get focused on geriatric health care.

 

[KHE]

Well, with that good advice being given, perhaps someone could tell us how one goes about discovering if they will or will not be able to be admitted onto medical plans in their state when they graduate?

What you have to do is research what the top 5-6 MEDICAL plans are in the area that you want to practice in. Then you have to phone up the provider relations department of those plans and ask if they are credentialing NEW optometrists. Don't make the assumption that if there are other ODs on the panel that you will be able to be admitted onto that panel as well.

You can get on medicare in theory because medicare at the federal level does not discriminate against ODs. HOwever, in many parts of the country, medicare is administered by an HMO. If you can't get on that HMO, bye bye medicare patients for you. Even if you can get on medicare, many patients have a medigap policy which is administered by an HMO to cover the 20% that medicare does not. If you cant get on the medigap plan, your medicare patients will have to pay out of pocket to you the 20% that medicare does not cover. Rest assured that the number of patients who will pay you out of pocket for services that they can have covered elsewhere is vanishingly small.

So again, find out what the top 5-6 medical plans are and find out directly from them if they are credentialing new ODs.

 

[JennyJet]

Thanks for the input everyone. The insurance perspective was something I had forgotten about. There's a lot I need to research, but right now, I need to make sure I survive my 2nd year. I've heard it's the hardest at UCBSO.


Jenny
UCBSO, Class of 2009