Assessing the Ophtho Claim that the MD > OD

[odieoh]

MD, OD, whatever you are, hopefully you get a little sick at this. Especially the part where the ER refused to let her back in.

http://www.healthnewsflorida.org/index.cfm/go/public.articleView/article/16297

Oh and this statement
Optometrists simply aren’t trained to understand the interactions of the drugs,” Fouraker said. “They are trained in the eye, not in the rest of the body.”

Hmm. I had to actually take Anatomy and Physiology as a prerequiste to optometry school and I have yet to see an optometry school where its not part of the curriculum. Interesting.

Not commenting on the debate in the article at all, but whats up with the before/after photo? Are they implying that the shingles caused her to stop doing her hair and wearing makeup?

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[Meibomian SxN]

I thought the statement was referring to drugs for systemic diseases and their interaction with the rest of the body, which if that is what it's referring to is somewhat true. I don't think optometry schools focus very much on drugs for systemic diseases (at least from what I have experienced). There is only a broad overview of drugs for the body, nothing really specific. Ophthalmic drugs on the other hand is obviously more detailed.

Maybe your school curriculum needs to be revamped then...

I just read a similar article about giving nurse practitioners more prescriptive authority:

http://www.msnbc.msn.com/id/36472308/ns/health-health_care/

That argument of "they are not medical doctors", "they are not trained" is getting old...

Personally I hope the nurses win!

 

[serenmoon]

That argument of "they are not medical doctors", "they are not trained" is getting old...

Personally I hope the nurses win!

Me too! Remember they will also be doing eye exams and if the public will go to them for other medical problems then they will definitely have no problem with going to them to get their eyes checked.

Nurses 'winning' won't help you. It opens the door for opticians to assume your role and so on and so forth. And don't tell me that opticians don't know how to examine eyes and can't do 90% of what you do because I've seen them do it!

 

[ibalz]

Me too! Remember they will also be doing eye exams and if the public will go to them for other medical problems then they will definitely have no problem with going to them to get their eyes checked.

Nurses 'winning' won't help you. It opens the door for opticians to assume your role and so on and so forth. And don't tell me that opticians don't know how to examine eyes and can't do 90% of what you do because I've seen them do it!

:troll::troll::troll::troll::troll:

Douche

...and as a "med student" more than 50% of his posts are on the optometry related boards....hmmm just seems funny.

 

[DOCTORSAIB]

MD, OD, whatever you are, hopefully you get a little sick at this. Especially the part where the ER refused to let her back in.

http://www.healthnewsflorida.org/index.cfm/go/public.articleView/article/16297

Oh and this statement
Optometrists simply aren’t trained to understand the interactions of the drugs,” Fouraker said. “They are trained in the eye, not in the rest of the body.”

Hmm. I had to actually take Anatomy and Physiology as a prerequiste to optometry school and I have yet to see an optometry school where its not part of the curriculum. Interesting.

I'm not quite sure undergrad or optometry level "anatomy and physiology" is enough for you to understand systemic disease or high level pharmacology. In medical school, anatomy is taught as a seperate class and is probably one of the most rigorous classes a physician takes in their training. Same goes for physiology. I'm talking 700+ page note packets type of rigorous. Very very intense. And this is only one trimester of the first year.

Second year you take courses in pathology, pathophysiology, pharm, etc, etc. That's where you learn the abnormals.

Then in 3rd/4th year and internship year, you take care of patients with systemic diseases. You see the effect of the drugs you learned in your pharm class. You see the diseases first hand. That's all part of becoming a doctor. And nothing can replace that combination of rigorous coursework and rigorous clinical experience.

So when you say "anatomy & physiology" I'm having a hard time believing your curriculum was very in-depth.

Again, a glowing example of not knowing what you don't know. It's becoming quite prevalent in healthcare these days.

 

[DOCTORSAIB]

And before somebody tries to turn this into another MD/DO vs OD fight, I'm commenting only on that specific post.

The article itself is up for debate.

 

[achirum]

And before somebody tries to turn this into another MD/DO vs OD fight, I'm commenting only on that specific post.

The article itself is up for debate.

Anatomy is a course in and of itself in Opt school. But I am not comparing it to Med School Anatomy as I know it is not as extensive.

 

[JMK2005]

To put on a spin on this conversation, I was recently thinking about maybe applying to Texas Tech Medical school's new 3yr MD program, and practice as a PCP & OD...

I could then perform minor laser procedures that I am trained to handle and also not worry about getting underpaid as an OD by the insurance companies...

Just a thought...

An MD by itself doesn't allow you to do anything. You'll need to do at least a 1 year internship to get your medical license. To practice ophthalmology, you'll still need the residency.

OD + MD + internship ≠ ophthalmologist.

 

[VA Hopeful Dr]

:troll::troll::troll::troll::troll:

Douche

...and as a "med student" more than 50% of his posts are on the optometry related boards....hmmm just seems funny.

Before I started posting in the Lounge, over half of my posts were in here.

The above post is slightly exaggerated, but its a decent parallel for what's going on with NPs and medicine. Why do ODs object to opticians refracting without supervision/an OD doing an exam at the same time? Because blurry vision, even if correctable with lenses, can often be a sign of more serious pathology. Giving opticians free reign will result in some amount of irreversible damage. Medicine worries about that with NPs as well. I'll even give you an example from my schooling.

A patient presented to with a 3 month history of clear nasal discharge. Over the next 9 months she was tried on decongestants, steroids, and antihistamines (oral and nasal for all 3) with no resolution. Patient gets a referral to ENT who figures out that she has pseudotumor cerebri. Now I'm not saying that every MD would catch that one, but, given the breadth of our education compared to that of NPs, I think we have a better chance at hearing those zebra hoofs than an NP would.

 

[VA Hopeful Dr]

Anatomy is a course in and of itself in Opt school. But I am not comparing it to Med School Anatomy as I know it is not as extensive.

Its best if we all just leave out undergrad classes when talking about our educations. Compared to any health professional school (MD/OD/PT) anatomy, undergrad anatomy is nothing.

 

[Optogal]

OD + MD + internship ≠ ophthalmologist.

You're right. That person would be a Optometrist/Ophthalmologist.

 

[KHE]

Before I started posting in the Lounge, over half of my posts were in here.

The above post is slightly exaggerated, but its a decent parallel for what's going on with NPs and medicine. Why do ODs object to opticians refracting without supervision/an OD doing an exam at the same time? Because blurry vision, even if correctable with lenses, can often be a sign of more serious pathology. Giving opticians free reign will result in some amount of irreversible damage. Medicine worries about that with NPs as well. I'll even give you an example from my schooling.

A patient presented to with a 3 month history of clear nasal discharge. Over the next 9 months she was tried on decongestants, steroids, and antihistamines (oral and nasal for all 3) with no resolution. Patient gets a referral to ENT who figures out that she has pseudotumor cerebri. Now I'm not saying that every MD would catch that one, but, given the breadth of our education compared to that of NPs, I think we have a better chance at hearing those zebra hoofs than an NP would.

I'm not so sure that type of anecdote is all that helpful. There are a few issues there....

Hypothetically, let's say that patient presented to the ENT on the first visit.

How likely is it that the ENT would have tried a battery of decongestants, steroids, and antihistamines?

The ENT coming up with a red herring like pseudo-tumor in that case is almost certainly aided by the fact that they KNOW that the NP tried all the common treatments for "clear nasal discharge" first.

And how often is "clear nasal discharge" the presenting symptom of pseudo tumor?

We've all had the experience of getting to be the hero where we figure out something that 4 other docs couldn't. I've had this happen to me a bunch of times, and yes, the other docs have been ophthalmologists. But I have the benefit of knowing what was tried and failed.

The flip side is also true. I've had those patients who did not resolve who upon presentation to another doctor figured out that they had some bizarre thing and again, THAT doctor had the benefit of knowing what I tried and failed but they fixed it and I get to be the goat.

 

[Optogal]

Good post.

 

[VA Hopeful Dr]

I'm not so sure that type of anecdote is all that helpful. There are a few issues there....

Hypothetically, let's say that patient presented to the ENT on the first visit.

How likely is it that the ENT would have tried a battery of decongestants, steroids, and antihistamines?

The ENT coming up with a red herring like pseudo-tumor in that case is almost certainly aided by the fact that they KNOW that the NP tried all the common treatments for "clear nasal discharge" first.

And how often is "clear nasal discharge" the presenting symptom of pseudo tumor?

We've all had the experience of getting to be the hero where we figure out something that 4 other docs couldn't. I've had this happen to me a bunch of times, and yes, the other docs have been ophthalmologists. But I have the benefit of knowing what was tried and failed.

The flip side is also true. I've had those patients who did not resolve who upon presentation to another doctor figured out that they had some bizarre thing and again, THAT doctor had the benefit of knowing what I tried and failed but they fixed it and I get to be the goat.

Fair points, and I think in this instance I perhaps didn't explain what my main points were. I'm basically questioning whether the NP degree is in-depth enough to even consider something like this on a differential even after the usual battery of tests failed. The original treatments are exactly what 99% of people would do in this exact same scenario, no argument there. So in short, my two points are thus: do NPs learn enough medicine for the less common diseases to even be in their minds, and do they get sufficient clinical experience to be able to apply said knowledge if they possess it.

Often times in these zebra cases, the diagnosis is often made by the person who has seen a similar case before. It need not be the most specialized person (though it often is), just someone with the experience.

We've all seen that one rare case that, even if we didn't make the end diagnosis, we won't forget. In this case, though it is exceptionally unlikely that I'll ever see a patient like this again; if I did, having seen the above patient would put this in my differential somewhere.

I guess long story short, I don't think that these nurses have enough knowledge or experience to do as much as they are trying to do.

 

[KHE]

I guess long story short, I don't think that these nurses have enough knowledge or experience to do as much as they are trying to do.

I don't know enough about nurse practitioner training to comment on whether they can, or should do whatever it is they do or are trying to do.

I would respectfully submit however that the biggest problem in cases like this is professional ego, not lack of knowledge or experience.

The problem in that case was that the nurse practitioner, in a case that made no sense, kept trying to do the same thing, for whatever reason.

It wasn't her (or his) lack of knowledge of "hey, this could be pseudotumer." It was there perseverance when they should have punted.

I would also respectfully submit that most MDs are far more guilty of that kind of perseverance than most mid level practitioners are.

 

[bobbio]

You're right. That person would be a Optometrist/Ophthalmologist.

Actually, I believe you need to do a ophthalmology residency to become an ophthalmologist.

 

[Optogal]

Actually, I believe you need to do a ophthalmology residency to become an ophthalmologist.

You're right. I was assuming the person was referring to an ophthalmology residency and had made a typo.

I believe the residency they were referring to was a Family Practice residency - so no, that person would not be an ophthalmologist.

 

[VA Hopeful Dr]

I don't know enough about nurse practitioner training to comment on whether they can, or should do whatever it is they do or are trying to do.

I would respectfully submit however that the biggest problem in cases like this is professional ego, not lack of knowledge or experience.

The problem in that case was that the nurse practitioner, in a case that made no sense, kept trying to do the same thing, for whatever reason.

It wasn't her (or his) lack of knowledge of "hey, this could be pseudotumer." It was there perseverance when they should have punted.

I would also respectfully submit that most MDs are far more guilty of that kind of perseverance than most mid level practitioners are.

Heh, I'd say professional ego is the cause of many of the problems in medicine. Its not only an MD problem, though we do seem to be the masters of that domain.

I don't have a huge knowledge set about NPs, so I go off what I'm told by people who employ them, who've been seen by them, and by what some of them say themselves. My concern is that we don't know how well they're trained, and I think with the number of online degrees this is a fair worry, and the subset of them that already think they can do the job of an MD as well (if not better) than we can.

I might argue about MDs being guilty of this kind of thing more often, at least on the level that I'll be working with. I don't know too many family doctors who sit on things for extended periods if nothing is getting any better. At the more specialized end of medicine, I could see this being an issue (going with the mindset of "I'm an expert in this area so I know exactly what's going on").

 

[IndianaOD]

Its best if we all just leave out undergrad classes when talking about our educations. Compared to any health professional school (MD/OD/PT) anatomy, undergrad anatomy is nothing.

In OD school we had two separate and dedicated anatomy courses. Gross anatomy which included cadaver dissection and neuroanatomy. It was intense and the PhD that taught it was notorious.

Thing is, honestly, I think learning all the minutia in the arms and legs etc was overkill.

I do think America needs to be careful of allowing non doctoral level professionals further and further along the trail of responsibility. Instead I think there could be more bridging opportunities. If an NP wants to practice like an MD they could take a bridging program to cover the areas that might be missing. Almost along the lines of I think ophthalmologists should be residency trained ODs. OD + trans year + residency = ophthalmologist. WAY more efficient.

 

[VA Hopeful Dr]

In OD school we had two separate and dedicated anatomy courses. Gross anatomy which included cadaver dissection and neuroanatomy. It was intense and the PhD that taught it was notorious.

Thing is, honestly, I think learning all the minutia in the arms and legs etc was overkill.

I do think America needs to be careful of allowing non doctoral level professionals further and further along the trail of responsibility. Instead I think there could be more bridging opportunities. If an NP wants to practice like an MD they could take a bridging program to cover the areas that might be missing. Almost along the lines of I think ophthalmologists should be residency trained ODs. OD + trans year + residency = ophthalmologist. WAY more efficient.

I'm aware of what y'all are taught and was making no comment about it.

How is the exact same number of training years more efficient?

 

[IndianaOD]

I'm aware of what y'all are taught and was making no comment about it.

How is the exact same number of training years more efficient?

Honestly you could make it less years (look at all the surgeons in other respected countries with bachelors degrees) but people in the US wouldn't go for it. Going to OD school first would make a much more knowledgeable and well rounded eye doctor/surgeon. Working with 1st year OMD residents in the past was an eye opener! With all due respect they know nothing about eye care. Its almost like they are starting from scratch and they have to cram in everything over 3 years of essentially an apprenticeship.

 

[VA Hopeful Dr]

Honestly you could make it less years (look at all the surgeons in other respected countries with bachelors degrees) but people in the US wouldn't go for it. Going to OD school first would make a much more knowledgeable and well rounded eye doctor/surgeon. Working with 1st year OMD residents in the past was an eye opener! With all due respect they know nothing about eye care. Its almost like they are starting from scratch and they have to cram in everything over 3 years of essentially an apprenticeship.

You've hit on a couple of points that occasion debate in the medical profession itself. I'll give you my thoughts.

I think going straight from high school to med school (even the 6 year programs) is not the best idea. I think getting a college degree adds a certain well-roundedness to future doctors (in this case, you/us/dentists/etc). I'd love to take this a step further and have additional non-science/math prerequisites. A semester or two of literature and western culture isn't a bad thing.

As it stands now, I think the MD curriculum has certain aspects that the OD curriculum lacks. We get quite a bit of OR exposure, the nuts and bolts of that takes a bit of getting used to. Likewise, we're exposed to the whole hospital system setup for 2 years. If OD school were changed to include that, I might feel differently.

Besides all of that, the system in place works pretty well from what I've seen. After finishing a residency, the ophtho folks are pretty good when it comes to medical/surgical care. I'm not sure it would be worth changing the whole system when it seems to be working fine.

 

[KHE]

I think going straight from high school to med school (even the 6 year programs) is not the best idea. I think getting a college degree adds a certain well-roundedness to future doctors (in this case, you/us/dentists/etc). I'd love to take this a step further and have additional non-science/math prerequisites. A semester or two of literature and western culture isn't a bad thing.

.

This is not on topic with the thread so I apologize for the minor hijacking but I gotta respectfully disagree with that.

I taught math and science to high schoolers for a few years and I've also taken college classes since I've been an OD.

I think we should have LESS non science-math prerequisites.

Part of the problem with high schools and colleges here in the USA, at least from my perspective is that for whatever reason, we've convinced ourselves that everyone needs to have the same basic education all the way through high school and college. I think that that is untrue much beyond the 9th grade.

When you hear things like students from India and Singapore and Sweden "beating" American students at math and science, the issue is that in those countries, they stream students at a much younger age. So a 10th grader in Sweden is and has been studying more advanced math from a younger age than a 10th grade American student.

Other countries accentuate, or even exploit their students talents. We do not. If someone has a talent for math and science, that's obvious at a fairly early grade. EXPLOIT IT! Stream them!

If someone wants to be a writer, or a ballet dancer, there's no reason that they need any math beyond that which is required to do your taxes, cook a recipe, balance your budget etc. etc. No ballet dancer needs to learn the quadratic equation or how many Newtons it takes to push a 50kg block up a 45 degree hill.

Conversely, a computer geek who loves math and science does not need to be forced into taking college level classes on critical poetry reviewing skills, or know about 1st positions and pas de deux and plie.

The greatest weakness of American education is that we do not accentuate or exploit the talents of our students.

*rant over* lol

 

[VA Hopeful Dr]

This is not on topic with the thread so I apologize for the minor hijacking but I gotta respectfully disagree with that.

I taught math and science to high schoolers for a few years and I've also taken college classes since I've been an OD.

I think we should have LESS non science-math prerequisites.

Part of the problem with high schools and colleges here in the USA, at least from my perspective is that for whatever reason, we've convinced ourselves that everyone needs to have the same basic education all the way through high school and college. I think that that is untrue much beyond the 9th grade.

When you hear things like students from India and Singapore and Sweden "beating" American students at math and science, the issue is that in those countries, they stream students at a much younger age. So a 10th grader in Sweden is and has been studying more advanced math from a younger age than a 10th grade American student.

Other countries accentuate, or even exploit their students talents. We do not. If someone has a talent for math and science, that's obvious at a fairly early grade. EXPLOIT IT! Stream them!

If someone wants to be a writer, or a ballet dancer, there's no reason that they need any math beyond that which is required to do your taxes, cook a recipe, balance your budget etc. etc. No ballet dancer needs to learn the quadratic equation or how many Newtons it takes to push a 50kg block up a 45 degree hill.

Conversely, a computer geek who loves math and science does not need to be forced into taking college level classes on critical poetry reviewing skills, or know about 1st positions and pas de deux and plie.

The greatest weakness of American education is that we do not accentuate or exploit the talents of our students.

*rant over* lol

Perhaps I had a unique experience, but all of my school prior to med school was pretty good at letting students play to their strengths. During high school there are plenty of advanced classes for things like math, science, history, and English as well as electives in certain areas designed for specific career paths. My best example would be the anatomy class that had the goal of giving students a slight head start for nursing school (or really any health care job that you start training right after high school).

College was very similar, even considering that we have one of the most complete core curriculum requirements still around. Some of my fraternity brothers were able to do as many as 4-5 elective courses in chemistry beyond what was required for a major just because they found value in knowing more about their field. Even amongst the core classes, you had some choice and could select areas that might be of use later. There's a good reason why there were 5 spanish professors and only one german one.

Now that being said, I could easily agree that much on the high school level could be taken out of the required courses. However, I still find merit in going for more well-rounded. Much of what you're described above is too specific for general education requirements, so perhaps courses that give a more general overview could be useful.

As an aside, I'm curious as to what sorts of advanced math some of the students in other countries are doing and try to compare it to our highest level students.

 

[IndianaOD]

You've hit on a couple of points that occasion debate in the medical profession itself. I'll give you my thoughts.

I think going straight from high school to med school (even the 6 year programs) is not the best idea. I think getting a college degree adds a certain well-roundedness to future doctors (in this case, you/us/dentists/etc). I'd love to take this a step further and have additional non-science/math prerequisites. A semester or two of literature and western culture isn't a bad thing.

As it stands now, I think the MD curriculum has certain aspects that the OD curriculum lacks. We get quite a bit of OR exposure, the nuts and bolts of that takes a bit of getting used to. Likewise, we're exposed to the whole hospital system setup for 2 years. If OD school were changed to include that, I might feel differently.

Besides all of that, the system in place works pretty well from what I've seen. After finishing a residency, the ophtho folks are pretty good when it comes to medical/surgical care. I'm not sure it would be worth changing the whole system when it seems to be working fine.

I think you are placing way too much emphasis on non eye related OR and hospital exposure. Almost all ODs now graduating have spent some time with OMDs doing cataract surgery. I bet an overwhelming majority of OMD procedures are done at ASCs and not hospitals.

 

[VA Hopeful Dr]

I think you are placing way too much emphasis on non eye related OR and hospital exposure. Almost all ODs now graduating have spent some time with OMDs doing cataract surgery. I bet an overwhelming majority of OMD procedures are done at ASCs and not hospitals.

I bet you're right on ASCs... except during residency training. The ophtho residency where I'm currently located does all non-laser, non-minor stuff in the hospital OR suite.

If there was a defined number of hours spent with MDs doing surgery along with a clear cut list of things you're expected to know by the time you're done, I'd be OK with that (its expected of us, after all).

As long as you have enough hospital exposure, it doesn't matter whether its eye or not eye related. I'll preface this next part by saying that if anything here is incorrect, please correct me.

It was my understanding, from looking over course requirements and speaking with ODs in my area, that y'all typically don't spend too much time in the hospital (residencies, of course, rectify that). This means no call, no admission/discharging, managing inpatients, and so forth. This is the sort of knowledge that first year ophtho residents are expected to have. If ODs have more experience in those areas than I'm aware of, then it might be a different story.

 

[IndianaOD]

I bet you're right on ASCs... except during residency training. The ophtho residency where I'm currently located does all non-laser, non-minor stuff in the hospital OR suite.

If there was a defined number of hours spent with MDs doing surgery along with a clear cut list of things you're expected to know by the time you're done, I'd be OK with that (its expected of us, after all).

As long as you have enough hospital exposure, it doesn't matter whether its eye or not eye related. I'll preface this next part by saying that if anything here is incorrect, please correct me.

It was my understanding, from looking over course requirements and speaking with ODs in my area, that y'all typically don't spend too much time in the hospital (residencies, of course, rectify that). This means no call, no admission/discharging, managing inpatients, and so forth. This is the sort of knowledge that first year ophtho residents are expected to have. If ODs have more experience in those areas than I'm aware of, then it might be a different story.

It depends on the OD and what rotations or residency they did. At the one VA rotation I was at their OD residents spent 1 month with neurology, 1 with general surgery, and 1 with something else in the hospital.

To be honest that is why I threw in the 1 year OD/OMD transitional year to get more hospital experience.

I don't really care if it stays the same way, but I think it would be nice to have an eye surgeon who understood both vision and all it entails AND the more standard organic stuff. If I went back to school it wouldn't be for ophthalmology. I bet most all truthful OMDs 10+ years out would quickly tell you they don't remember much of the non daily applicable stuff from medical school. That is just being a human. If all you do every day is limited the the eye the other stuff doesn't stick.

I have never seen or heard of a practicing OMD perform an H&P. In the VA the internist did it, here in Midwest America the family doc or internist does it. Very few of my patients undergoing any eye surgery rarely even have an H&P before hand.

 

[362.04]

Dear Indiana OD and VA Hopeful Dr,

I believe that hospital exposure is essential for predoctoral education and I think this is one of the things that all optometry schools should strive for. I don't believe that optometry is so specialized that it doesn't need hospital exposure or to learn or understand H&P's. I think that it betters optometry in playing a broader role in the health care system.

 

[optojake]

First of all to say that MD > OD or OD > MD is just plain stupid in all facets of the word. ODs (myself in a few months) are WONDERFUL at CLS/spec Rxs and treating diseases such as glaucoma, blepharitis, allergic conjunctivitis, etc. In fact, if I had any of these such diseases, I would undoubtedly go to an OD over an MD. However, an OD also has the responsibility to refer to an MD when something is out of his/her scope of practice depending upon the state, or when a surgical procedure needs to be performed. The two should work together seamlessly and get over everyone's egos! Patients need to understand that ODs can handle refractions and infections, diseases such as glaucoma, and other things. MDs do surgery. They WANT to do surgery. So ODs should refer to them for surgery. They are good at that.

And people need to quit saying MD school is harder than OD school. They are DIFFERENT, not necessarily harder than each other. ODs learn primarily about the eye (but I must say my 2 anatomy courses and physiology course was QUITE difficult). In the long run, each profession went to school 8 years (minus residencies since I am well aware than MDs must do an ophthalmological residency). You would be hard pressed to look at someone in the eye who went to school for 8 years and say "you aren't qualified to treat a disease".

 

[MKE2STL]

For anyone who has read my previous posts, the profession of optometry needs more mentored education. We need residencies. We need to push for hospital privledges. We need to get into the mainstream of health care. Sitting in a PP, seeing SCL patients, and managing an optical shop is not mainstream medicine. Sadly, it is mainstream optometry. And hence, the lack of mainstream credibility (or lack of awesome-ness) that the MD poster is eluding to.

Peace.

No country in the world allows optometrists to practice medicine. If you want to practice medicine, then go to medical school. If an optician wants to refract or examine eyes, then he or she should go to optometry school. People always seem to be looking for the short cut or the back door and it produces sub-par healthcare providers.

 

[Meibomian SxN]

....People always seem to be looking for the short cut or the back door and it produces sub-par healthcare providers.

And your proof that these healthcare providers are sub-par is?

 

[Shnurek]

Look up the history of stomatology and how it used to be an MD specialty but dentists took it over because they had a more efficient educational system.

 

[VA Hopeful Dr]

No country in the world allows optometrists to practice medicine. If you want to practice medicine, then go to medical school. If an optician wants to refract or examine eyes, then he or she should go to optometry school. People always seem to be looking for the short cut or the back door and it produces sub-par healthcare providers.

You bumped a 2 year old thread to make a ridiculous statement with no facts that is obviously meant to do nothing but start another flame war.

Go to hell.


Oh, and FYI, you're a medical student - you have neither perspective or sufficient knowledge of the subject to even attempt to make any claims.

 

[VA Hopeful Dr]

And your proof that these healthcare providers are sub-par is?

Look up the history of stomatology and how it used to be an MD specialty but dentists took it over because they had a more efficient educational system.

Please ignore the troll, even though I know its hard for both of you to NOT try and make a big deal out of nothing.

 

[Visionary]

No country in the world allows optometrists to practice medicine. If you want to practice medicine, then go to medical school. If an optician wants to refract or examine eyes, then he or she should go to optometry school. People always seem to be looking for the short cut or the back door and it produces sub-par healthcare providers.

Nice thread necro, bruh.

 

[balltc]

No country in the world allows optometrists to practice medicine. If you want to practice medicine, then go to medical school. If an optician wants to refract or examine eyes, then he or she should go to optometry school. People always seem to be looking for the short cut or the back door and it produces sub-par healthcare providers.

Your statements are arrogant, baseless, and your post was useless. Thank you for wasting my time.

 

[Dusn]

This topic of optoms vs ophthalmologists keeps coming up, when really, it seems to me that there are much bigger threats to our respective careers.

For optometrist, it sounds like the overproduction of optometrists and new optometry schools is the biggest threat that you have to deal with. I think a lot more of your energy should probably be spent stopping new, unneeded optom schools from opening rather than fighting for surgical privileges, which for all practical purposes would be useless to almost all of you.

If optometrist were to gain surgical privileges they would be completely oversaturating an already-saturated market. As it is, young ophthalmologists working anywhere within an hour of a major city have a hard time getting decent surgical numbers. Also, the only way to be good at surgery is to do lots of them. If optoms started doing surgery, we'd basically all be stuck in a completely oversaturated surgical market; you wouldn't have enough patients who needed the surgery's that you fought so hard to do, and we'd all be awful surgeons anyway because we'd be doing 2 cataracts a year.

For both ophthalmologist, and optometrist, and all health care professionals, the biggest threat is that medicare is not sustainable and the government and insurance companies control your income. From what I hear, reimbursements have steadily declined and will continue to do so. Basically you get paid what the government and insurance companies want to pay you, and their only incentive is to pay you less. Given that, what direction do you see your income heading? How low could they pay doctors before a large number of doctors quit their jobs? I personally don't find it very reassuring that my salary lies in the hands of insurance companies and a government that desperately wants and needs to cut costs. Given this, the fact that the small amount of political power we have is being wasted on this optom vs ophthalmology debate doesn't make any sense to me.

I'm only just finishing residency and haven't spent much time in the "real world," so feel free to correct me if some of my points are wrong. But optometry vs ophthalmology seems to be far from the biggest issue we face.

 

[blazenmadison]

Given this, the fact that the small amount of political power we have is being wasted on this optom vs ophthalmology debate doesn't make any sense to me.

I'm only just finishing residency and haven't spent much time in the "real world," so feel free to correct me if some of my points are wrong. But optometry vs ophthalmology seems to be far from the biggest issue we face.

I agree. I work in an ophthalmology clinic and medicare/medicaid is killing us. We are surviving only because of cash procedures like LASIK/premium IOLs.

Optometry has done well in the past because of the retail side, but now everyone wants a share of the pie and it's becoming harder compete with retail/online opticals/contact lens companies.

 

[east]

I also agree, bigger problems on all of our doorsteps.

 

[Jason K]

For both ophthalmologist, and optometrist, and all health care professionals, the biggest threat is that medicare is not sustainable and the government and insurance companies control your income. From what I hear, reimbursements have steadily declined and will continue to do so. Basically you get paid what the government and insurance companies want to pay you, and their only incentive is to pay you less. Given that, what direction do you see your income heading? How low could they pay doctors before a large number of doctors quit their jobs?

Unfortunately, the trends that are taking place will lead to exactly what the government is after; less private doctors of all kinds. Obama is after government control of healthcare and he's well on his way. All doctors should realize that, in the eyes of society, we're all in the 1%, no matter how much we don't make.

Fast forward 20 years and what you're going to see is a drastic decline in the number of solo doctor practices - many of them won't be able to make it. Optometry, on the low end of the billing scale when it comes to services rendered, will be some of the earliest casualties. It costs just as much to lease space for an OD office as it does for an MD office, but we can't generate nearly the same revenue in most cases. Group practices with several docs will probably push through, as will hospitals. That's what you're going to see in 20 years. That, and an infinite number of "doc-in-the-boxes."

 

[CL Doc]

Unfortunately, the trends that are taking place will lead to exactly what the government is after; less private doctors of all kinds. Obama is after government control of healthcare and he's well on his way. All doctors should realize that, in societies eyes, we're all in the 1%, no matter how much we don't make.

Fast forward 20 years and what you're going to see is a drastic decline in the number of solo doctor practices - many of them won't be able to make it. Optometry, on the low end of the billing scale when it comes to services rendered, will be some of the earliest casualties. It costs just as much to lease space for an OD office as it does for an MD office, but we can't generate nearly the same revenue in most cases. Group practices with several docs will probably push through, as will hospitals. That's what you're going to see in 20 years. That, and an infinite number of "doc-in-the-boxes."

Good summary of the problem.


Anyone not interested in "selling" glasses should forget solo practice. My concern for our future is there are too many students who think they will be well paid for their skills ( they won't). Most will end up working the assembly line we call commercial optometry.

With efficient group practice there will be even less need for additional ODs. But you and I know we as practicing ODs can't do anything about the supply of ODs.