Even our moderator wouldn't do it again...

[gettheleadout]

Would you encourage your kids to go into medicine? ~200k in loans all stacking up interest while in residency. 7-12 years of post-graduate schooling to get obamacare's stick shoved up their rectums and other practitioners spilling over on their scope of practice shorelines with loan amounts exceeding 300k when becoming an attending?

This is soooo biased.


Sent from my iPhone using SDN Mobile

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[thecgrblue]

So, I'm getting the impression that the only career one should be pursing these days is dentistry. Everything else....you're screwed.

Prostitution is still going strong...or so i hear.

 

[panamamike]

Mike,
I'm starting to wonder if you're Shurek since you make the same wild assumptions.

No, I'm not Shurek, just a guy that's looking for info. about the workings of the OD world. Specifically how Walmart leases work. Unfortunately, I haven't seen many responses to my query.

Nowhere did I suggest you are a "bumbling buffoon." What I did say is that you have no basis from which to come on here and tell ODs "how it really is." I seem to remember you saying something along the lines of "Oh, it's not really that bad...," did you not?

Jason, who in your opinion would have the right basis to compare OD to the world at large? Do you really feel no one outside of practicing OD's can give you perspective on the macro economic landscape of the U.S. workforce. I never claimed to know anything about being an OD, or how an OD should go about their work, I was simply trying to give some perspective.

You have no place in making such a statement.... Trying to speak about optometry, especially when you contradict what others are saying, makes you look a little foolish. But go ahead and get your feathers ruffled if you want, you're still way off base.

When you say trying to speak about optometry, what exactly are you referring to? I've only made general statements, I'm not making any claims that I have special insight to optometry, I was trying to say things are tough all over. I'm just in disbelief that someone would paint such a negative picture of optometry as if it has no redeeming qualities.

Mike

 

[panamamike]

except you probably have 0 debt while most of us will have 160-200k weighing down on us. I'm a single female that could relocate and live in crappy apartments to save money, but what are non-traditional, married with kids, Optometry students going to do? I mean they have a mortgage, wife, kids..etc. so they can't really move and have expensive responsibilities to take care of 0_0

Take a look here:

http://online.wsj.com/article/SB70001424052702304192704577406652556893064.html

Yes, medical professions have higher levels of debt, but this issue is not unique to OD.
IMHO, something needs to be done about the cost of education.

Mike

 

[Jason K]

Jason, who in your opinion would have the right basis to compare OD to the world at large?

That's simple => ODs who practice optometry or those who have studied the profession and understand it from the inside and out.

Do you really feel no one outside of practicing OD's can give you perspective on the macro economic landscape of the U.S. workforce.

I never said that no one could give perspective on the macroeconomic landscape of the US workforce. What I said was, no one outside of optometry should be commenting on the state of optometry. When you come on here and say things like, "It's not really that bad" - you're commenting on something which you know nothing about.

I'm just in disbelief that someone would paint such a negative picture of optometry as if it has no redeeming qualities.

I never said it had no redeeming qualities. The people in the profession are some of the most honest, caring, hard-working people I know in healthcare. I"m not bashing the profession, the people in it, or anything else about optometry. All I'm saying is that the profession is in big trouble. It has been for some time, and it's very good at hiding it's problems from people who would like to enter. We hide our dirty laundry better than any other profession I can think of. Some of it has to do with the fact that ODs often just don't want to be the one to crush someone's dreams. Some has to do with the fact that many practicing ODs today are very happy with how optometry turned out for them, and they may not realize or care that "their" optometry no longer exists in reality. Some might have to do with the fact that there are plenty of entities out there who profit from more people entering the profession, and some might even have to do with the fact that some might think "Hey, I got screwed and no one warned me so....."

I don't know what your reasons for being here are. If you're unhappy in IT and want an easy way to make 75K or so for the rest of your life, maybe optometry would be fine if you don't care that you'll be doing refracting tech work day in and day out, or that you'll never use most of what you pay to learn in optometry school. Just remember that you'll be paying those loans back every month for the next 20 years. It's a pretty big chunk of your pay if you're making 75 or 80K. Also remember that as we move forward, new grads are having an increasingly difficult time finding even the "junk" jobs that used to come easy. Is it due to the recession? I think most of it is not from the recession, but from problems that have been festering for years before the recession even began.

You might look at the Walmart OD and think "Hey, that's not a bad deal." Talk to some NEW grads who work at Walmart, not the guy making 150K at his 3 lease locations that you'll never have access to. Talk to the guy sitting in the box next to the lawnmowers, hoping and praying that a few large bargain shoppers will wheel in on their Rascals and ask for a $40 exam so he can go home with something that day. That's what many new grads are doing these days, although that's not the face of optometry that's being put forth by the AOA.

There will always be room for someone who wants to work in 4 or 5 PT positions as an independent contractor, taking home whatever exam fees trickle through the door since there are 5 Walmarts within a 1 sq mile area. That's where the profession is heading - an OD in every possible box on the planet...and there will be plenty of us to fill in the spaces.

 

[CL Doc]

Would you encourage your kids to go into medicine? ~200k in loans all stacking up interest while in residency. 7-12 years of post-graduate schooling to get obamacare's stick shoved up their rectums and other practitioners spilling over on their scope of practice shorelines with loan amounts exceeding 300k when becoming an attending?

Honestly, I would avoid all of the health professions. I know that's not what people want to hear but that's what I think.

 

[CL Doc]

Take a look here:

http://online.wsj.com/article/SB70001424052702304192704577406652556893064.html

Yes, medical professions have higher levels of debt, but this issue is not unique to OD.
IMHO, something needs to be done about the cost of education.

Mike

I think you're right.

 

[pseudoMCAT45]

I would like to thank panamamike/shnurek (yep, we all know you are the same person) for sharing his insecure thoughts on this topic, it's been very entertaining.

Jason K.... FINISH HIM!!!

 

[panamamike]

I would like to thank panamamike/shnurek (yep, we all know you are the same person) for sharing his insecure thoughts on this topic, it's been very entertaining.

Jason K.... FINISH HIM!!!

Wow, sorry to disappoint, I'm not Shnurek. Why would you say I'm insecure? I don't even have a dog in the fight. I was trying to put out a positive message, I guess it wasn't seen in that light. I'm just trying to say, make the best of your situation.

Mike

 

[Shnurek]

lol I'm not panamamike, relax guys.

By the way that one quote you quoted from Jason K:
"Originally Posted by Jason K
... If the problem were purely an oversupply issue, then I'd be more inclined to accept this line of thinking... The entire profession is diseased now and it all stems from the oversupply issue..."

Is actually not a contradiction on Jason K's part. Stemming from the oversupply problem does not mean that that is purely the only problem with the profession.

 

[panamamike]

When I saw this, I thought of you guys...


http://career-services.monster.com/...mc_n=yta_fpt_article_high_pay_low_stress_jobs

Mike

 

[Jason K]

When I saw this, I thought of you guys...


http://career-services.monster.com/...mc_n=yta_fpt_article_high_pay_low_stress_jobs

Mike

Mike, not to keep beating up on you, but you're citing an "article" which cites the BLS as its source. The BLS is widely known to be a pile of crap when it comes to the info it contains about optometry. I believe the 18% growth is probably accurate, but it's all going to be net growth in the commercial sector. It also fails to mention that there will be significant loss in the private practice sector which is really what will spell the end of optometry as we know it. Just some tiny details that no one bothers to mention because the folks at the BLS get their data from the AOA, which conveniently leaves that part out.

As I've said too many times to count, the info that is readily available to prospects is all rosy and sunny. It sounds great and looks great on paper. The reality of the profession, specifically for those entering now, is far different from what is seen on the surface. If you were to read the nonsense in the BLS, the "articles" out out by US News and other national periodicals stating that optometry is "one of the best jobs for the future," or the garbage put out by private OD programs and think that it's all valid, you wouldn't be the first to get duped.

 

[mclem222]

http://career-services.monster.com/...mc_n=yta_fpt_article_high_pay_low_stress_jobs

 

[Jason K]

When I saw this, I thought of you guys...


http://career-services.monster.com/...mc_n=yta_fpt_article_high_pay_low_stress_jobs

Mike

http://career-services.monster.com/...mc_n=yta_fpt_article_high_pay_low_stress_jobs

Doesn't anyone have any sense of critical thinking when it comes to looking at online "articles" anymore? This thing is an advertisement - nothing more. It's a way of generating traffic for monster and payscale. These things are slapped together by "journalists" who get paid about $10 to write an article like this. They get the assignment from writers' job boards if they're independent or their boss if they're employed, and they crank the thing out by doing a quick internet search, throwing together some job titles, and calling it a "Best jobs for _______ in 2012." I guess today, it's "low stress." I'd be willing to bet the author of this thing spent no more than 15 minutes from the time the word processing program was opened until it was sent off to editing. I'd also be willing to bet the author spoke with exactly zero professionals in the fields mentioned. These things are part of the very reason that people are being lured into some professions with terrible outlooks. They rely on information from people who have absolutely no clue what they're talking about, but the information they put out is what people want to hear so it's well received.

Seriously, if we're going to cite articles online that point one way or the other, let's not point to advertisements.

 

[panamamike]

Doesn't anyone have any sense of critical thinking when it comes to looking at online "articles" anymore? This thing is an advertisement - nothing more. It's a way of generating traffic for monster and payscale. These things are slapped together by "journalists" who get paid about $10 to write an article like this. They get the assignment from writers' job boards if they're independent or their boss if they're employed, and they crank the thing out by doing a quick internet search, throwing together some job titles, and calling it a "Best jobs for _______ in 2012." I guess today, it's "low stress." I'd be willing to bet the author of this thing spent no more than 15 minutes from the time the word processing program was opened until it was sent off to editing. I'd also be willing to bet the author spoke with exactly zero professionals in the fields mentioned. These things are part of the very reason that people are being lured into some professions with terrible outlooks. They rely on information from people who have absolutely no clue what they're talking about, but the information they put out is what people want to hear so it's well received.

Seriously, if we're going to cite articles online that point one way or the other, let's not point to advertisements.

Jason,

What do you plan to do to prepare for the OD apocalypse?

Mike

 

[Jason K]

Jason,

What do you plan to do to prepare for the OD apocalypse?

Mike

I started my exit from optometry in January of this year. I don't want to be depending on it for income when the ship finally sinks, which will happen in the coming years. I work as an OD alternating 1 and 2 days per week. The rest of the time I run my own business which has been in my family for years - quite happily, I might add. By the end of the summer, I hope to be free of optometry forever.

 

[panamamike]

I started my exit from optometry in January of this year. I don't want to be depending on it for income when the ship finally sinks, which will happen in the coming years. I work as an OD alternating 1 and 2 days per week. The rest of the time I run my own business which has been in my family for years - quite happily, I might add. By the end of the summer, I hope to be free of optometry forever.

Wow, you are serious about your stance. Good luck with the transition, it's always good to have a plan b.

Mike

 

[PharmaTope]

Take a look here:

http://online.wsj.com/article/SB70001424052702304192704577406652556893064.html

Yes, medical professions have higher levels of debt, but this issue is not unique to OD.
IMHO, something needs to be done about the cost of education.

Mike

the problem lies in that in this country you MUST go to a university to learn. in the past you could learn through apprentice work. this requirement to sit for board exams prevents people from avoiding debt.

i could sit at home, learn all the book material on my own, then learn the rest through apprenticeships and be able to do well. however, we are taught that you MUST have a school tell you that you are ready. it is this thought that is foolish and leads to the debt issues.

just walk away from the debt, leave the USA the loans will not follow you.

 

[panamamike]

the problem lies in that in this country you MUST go to a university to learn. in the past you could learn through apprentice work. this requirement to sit for board exams prevents people from avoiding debt.

i could sit at home, learn all the book material on my own, then learn the rest through apprenticeships and be able to do well. however, we are taught that you MUST have a school tell you that you are ready. it is this thought that is foolish and leads to the debt issues.

just walk away from the debt, leave the USA the loans will not follow you.

I agree with this idea in principle, if you can pass the test and have had the guidance of an existing doctor, why not?

AFAIK this isn't allowed because of the medical union AMA, wants to control the number of people in the profession to then control the earnings potential of those that become part of the system. I guess they found a second way to control growth by imposing significant cost to education.

It will be interesting to see how this plays out over the years. I think there should be a way to allow more people into the field to help address issues with the cost of health care as well as availability. However, that would certainly make certain people unhappy. It's a catch 22.

Mike

 

[BeesKnees22]

google Warby Parker...a lot of patients are getting their glasses there...feel good and cheap..

I'm wearing Warbys right now actually. They look cool and hip. I got them as an extra pair, but they are not the quality of ones that I've gotten from my optometrist. The left eye is slightly blurry from an angle and they creak when I open and close them. They were about 120.00 after I added some extras, so I don't know if I'd exactly call them cheap. I'd recommend the site overall, but I wouldn't wear these glasses as my main pair. They're also kind of tight and heavy; I get headaches after long wear. My 300.00 pair from the optometrist is great--prescription is perfect and they are of a very high quality. (I guess I could have sent the Warbys back, but I really didn't feel like waiting for their delivery again, and I was afraid that something might happen that would make them come back worse. They're certainly wearable.)

 

[Meibomian SxN]

I started my exit from optometry in January of this year. I don't want to be depending on it for income when the ship finally sinks, which will happen in the coming years. I work as an OD alternating 1 and 2 days per week. The rest of the time I run my own business which has been in my family for years - quite happily, I might add. By the end of the summer, I hope to be free of optometry forever.

Congrats!

I'm thinking of either getting a flying license and in the next 10yrs I'm planning on getting into small real estate ventures. That's as far as I got so far but I agree that an early exit plan DEFINITELY has to be in the equation.

 

[Shnurek]

Congrats!

I'm thinking of either getting a flying license and in the next 10yrs I'm planning on getting into small real estate ventures. That's as far as I got so far but I agree that an early exit plan DEFINITELY has to be in the equation.

I'm working on my hours as well. So far 2/40 for the private license Unfortunately, pilots are more saturated than ODs and if anything goes wrong with you medically, you may lose all flying privileges for the rest of your life.

http://thetruthabouttheprofession.weebly.com/professional-pilot-salaries.html

Its really hard to break into 6 figures as a pilot. Might take decades of flying experience.

But its a cool hobby

 

[Jason K]

I have to say, if you're not a military pilot who can much more easily link up with a major airline because of thousands of hours of time on jets, it's pretty ugly out there for pilots. My brother-in-law flies for a regional carrier and gets paid next to nothing. They're usually paid by the hour, but only while they're in the air, and even then it's pretty low. Guys who get pumped out of regional flight schools are analogous to ODs who get fired out of the new private schools.....just cannon fodder, feeding the beast.

 

[mclem222]

Just had some new grads to shadow for a potential job. I have to say, the private schools pump out some weak applicants. One grad told me that they had never fit an RGP and another had no idea what pachymetry was. The new line I am going with is "Adding every tom, dick and harry to your army doesn't make you have a better army, it just increases your body count during battle" A lot of grads are going into commercial. I would say the days of the private ODs are numbered. Probably give it 10-15 years. We will be all working for CVS, large chains, or OMDs.

 

[blazenmadison]

Just had some new grads to shadow for a potential job. I have to say, the private schools pump out some weak applicants. One grad told me that they had never fit an RGP and another had no idea what pachymetry was. The new line I am going with is "Adding every tom, dick and harry to your army doesn't make you have a better army, it just increases your body count during battle" A lot of grads are going into commercial. I would say the days of the private ODs are numbered. Probably give it 10-15 years. We will be all working for CVS, large chains, or OMDs.

Hard to believe that a new grad does not know what pachymetry is. I mean what is the point of going to OD school if he/she doesn't even know the basics. They shouldn't have passed the NBEO and be licensed. Seriously doubt your story.

 

[Jason K]

Hard to believe that a new grad does not know what pachymetry is. I mean what is the point of going to OD school if he/she doesn't even know the basics. They shouldn't have passed the NBEO and be licensed. Seriously doubt your story.

I don't see why it's so hard to believe. The quality of education at the new programs is awful, with 4-5 interns sometimes sharing a normal patient due to low patient volume. It's embarrassing that the ACOE doesn't step up and look at the accreditation standards.

I've encountered far worse from 4th year students when I was teaching - both from new programs and established ones. New ODs who have never fit a GP are nothing unusual these days. There's a number of programs that have faculty who have no idea how to do it, so they just fit softs. As for the pachymetry, it doesn't surprise me. I've dealt with 4th years who can't do a red/green balance, explain how it works, or even why you might choose to do it over a prism dissociation balance. I've also dealt with final rotation 4th years who literally don't know how to refract a patient - no clue what they're doing beyond following rules like a robot.

Attending: "Wow, according to your subjective refraction, your patient went from 0.75 cyl to 3.00 diopters in one year, and they came in today seeing 20/15 through their habitual spects. Something doesn't sound right, don't you think?

4th year intern: "Well, that's where she took me during JCC."

I used to have that exact conversation (with varying refractive error amounts) several times per rotation when I worked in an office that had interns from several programs coming through it. The schools are cranking out low-quality product because the raw materials they are working with are getting worse and worse. Yet another reason the profession is primed for a complete commercial takeover.

Everyone needs to understand that the new programs are not there to train ODs, they exist purely to make money from tuition - if a few people learn something along the way, great, but that's not their concern. Add in the fact that many of the "senior" faculty members at the new programs are only a few years out of school themselves, and you have a great recipe for the future collapse of the profession on several levels.

 

[Optomchick]

Just had some new grads to shadow for a potential job. I have to say, the private schools pump out some weak applicants. One grad told me that they had never fit an RGP and another had no idea what pachymetry was. The new line I am going with is "Adding every tom, dick and harry to your army doesn't make you have a better army, it just increases your body count during battle" A lot of grads are going into commercial. I would say the days of the private ODs are numbered. Probably give it 10-15 years. We will be all working for CVS, large chains, or OMDs.

how many grads do you get applying for one job? what state are you in? rural/city?

 

[Shnurek]

Just had some new grads to shadow for a potential job. I have to say, the private schools pump out some weak applicants. One grad told me that they had never fit an RGP and another had no idea what pachymetry was. The new line I am going with is "Adding every tom, dick and harry to your army doesn't make you have a better army, it just increases your body count during battle" A lot of grads are going into commercial. I would say the days of the private ODs are numbered. Probably give it 10-15 years. We will be all working for CVS, large chains, or OMDs.

Are you effing kidding me.

This is why I'm working as an ophthalmic technician on the side every chance I get. Currently, I am shadowing an ophthalmologist in the operating room and I am his "runner". Meaning in his private practice I follow him around everywhere unless he tells me to do something and then I put in drops/fluorescein strips as necessary, do tests such as pupils/CVF/EOM and also machine tests such as OCT/pachymetry/VF/FA's/fundus photography/auto refraction, do subjective refraction, take the patient history etc. I don't want to be one of those dumba** WesternU or IAUPR or MCPHS grads that might not know how to correct astigmatism properly or have never done some other procedure that is within our scope of practice. (no offense just there are hierarchies everywhere in life) I get to listen to his extensive consultations with the patients and some of the stuff is extremely interesting. I feel it is a privilege to not just be shadowing but to actually be paid to learn all of this stuff in such close quarters to an extremely intelligent eye surgeon. He is a comprehensive ophthalmologist but he does pretty much everything (except for the really difficult procedures and difficult cases), retina, glaucoma, cornea, cataracts, refractive sx, etc.

 

[mclem222]

That is great Shrunek but how many of your classmates are doing that? There has been such wide variation in the recent grads I have to screen much more before adding people to our group. I have made some big assumptions in the past and gotten burned...people treating ulcers with steroids, using topical steroids for optic neuritis, etc.. so now I assume everyone is an idiot and they have to prove themselves to me

 

[Shnurek]

That is great Shrunek but how many of your classmates are doing that? There has been such wide variation in the recent grads I have to screen much more before adding people to our group. I have made some big assumptions in the past and gotten burned...people treating ulcers with steroids, using topical steroids for optic neuritis, etc.. so now I assume everyone is an idiot and they have to prove themselves to me

Ya that seems to be the trend. That's why I'm all for board certification. To weed out some of the noobs. Do schools matter much more in your selection than most other prerequisites to get an interview at your practice? What about residencies?

 

[Jason K]

Ya that seems to be the trend. That's why I'm all for board certification. To weed out some of the noobs. Do schools matter much more in your selection than most other prerequisites to get an interview at your practice? What about residencies?

Oh god, I have a huge palm print on my forehead after reading this. The scam that is board certification has absolutely zero to do with ensuring competence; it exists purely as a money-maker for the ABO/AOA. It's retesting material that's already been learned in optometry school. There's absolutely nothing on the exam that an OD shouldn't already know as a new graduate. You're buying into the garbage that the AOA hopes you will so they can stay afloat in the presence of a mass exodus of members. Please do yourself and your future colleagues a favor and learn what board certification actually is. You've already been lured into the profession, don't let yourself be lured into yet another expensive mistake.

 

[mclem222]

Schools don't matter that much...I care more about the individual. Doing a residency is helpful in that I believe the person has more experience which is good. All in all, I need the person to show that they have good knowledge and experience and knows their limitations. I had a guy in the past who was treating a patient with acanthameba with antibiotic drops for three weeks..didn't realize what it was..didn't ask for help...didn't tell anyone...long story short, patient went blind..the guy got canned, my practice almost got sued...learned my lesson right there...In a practice which has an OMD and an experienced OD, if you have an ulcer that isnt getting better and its been a week, ask for help or a second opinion. Don't just let the patient go blind..At the time, he was really excited about getting the right to prescribe orals...I wouldn't let that guy prescribe artificial tears. The scary thing was he was right out of school and had the bravado and confidence of a person with 30 years experience. You know what he told me his mistake was when the whole case came up and everyone realized what he had done," I shouldve patched him, then it wouldve healed better". Are you serious? My partner at the time who served in Vietnam told me it reminded him of the 19 year olds who would rush into battle "guns blazing and overconfident" and within 5 minutes would end up in a bodybag. The young OD eventually went to work for the local commercial chain in town..Good luck and god bless. After the whole incident, I reviewed about 100 of his charts and was shocked at some of the things he did. That was a big lesson for me to assume nothing when it comes to recent grads.

To blazenmadison...I am sorry if what i said hurt your feelings but it is true..you will find colleagues who are completely clueless...Deal with it...The more people that are trained, the more watered down our peers become... I am sure you have classmates who you think "How the heck did they get through so far?" Well...some of them do..and go into practice...

 

[Shnurek]

That's really a sad story and I fear I may belong to the "guns blazing overconfident" group when I come out. That is why I want to do a residency and work with/for OMDs to get the most experience possible so this doesn't happen.

I agree about the whole watering down our education thing. I haven't really felt it at SUNY yet but I heard in NECO for example some students have to be in the auditorium to listen to the lecture via live video feed.

 

[eyeballfanatic]

what business does your family do jasonk? if we may ask?

 

[Jason K]

what business does your family do jasonk? if we may ask?

I'm not going to say exactly what kind of business it is, primarily because there's not many companies that do it and I'd be giving away a little more info than I'd like. It's a service-based company that was founded in the 1950s, although little of what was done when it was founded, is still done today.

 

[mclem222]

I would rather not say for anonymity purposes but I am 30 min outside a major US city in the northeast and I interview between 15-20 grads for an open slot. I usually have people on "probation" the first six months and monitor them carefully. I will just say this when it comes to scope of practice..just because you are allowed to do something doesnt mean you should do it if there is a greater chance compared to another provider you will cause harm. An OMD is "allowed" to do brain surgery but they don't because a neurosurgeon will do it better. I have seen a lot of new grads who don't know their limitations try to do stuff and harm people just because "it is in my scope of practice". I don't give a f*()) if something is in your scope of practice or what you think you can do...it only matters if you can do it. If someone else can do it better, then they should be doing it...This isn't selling glasses..it is taking care of people. The whole "I am going to do something because I am now allowed to by law" is business or shopkeeper mentality not doctor mentality.

 

[KHE]

I would rather not say for anonymity purposes but I am 30 min outside a major US city in the northeast and I interview between 15-20 grads for an open slot. I usually have people on "probation" the first six months and monitor them carefully. I will just say this when it comes to scope of practice..just because you are allowed to do something doesnt mean you should do it if there is a greater chance compared to another provider you will cause harm. An OMD is "allowed" to do brain surgery but they don't because a neurosurgeon will do it better. I have seen a lot of new grads who don't know their limitations try to do stuff and harm people just because "it is in my scope of practice". I don't give a f*()) if something is in your scope of practice or what you think you can do...it only matters if you can do it. If someone else can do it better, then they should be doing it...This isn't selling glasses..it is taking care of people. The whole "I am going to do something because I am now allowed to by law" is business or shopkeeper mentality not doctor mentality.

I don't understand this...

You're saying that new graduates are renegades and are hyperaggressive with their treatments but then you say that many don't know what pachymetry is. How is that possible? How many new graduates you have actually employed?

Then you say that you interview 20 people for a position and then you have them on probabtion for 6 months and "monitor them carefully."

But then you tell a story of an associate doctor who mishandles an acanthemoeba case so you fire him and then you review 100 of his charts and are shocked. So....how closely are you monitoring these people?

 

[mclem222]

Ahh all good questions...

I have employed about 7 new graduates in the last 10 years. So what happened is the associate doctors was one of the first new graduates I hired about 12 years ago. He was hyperaggressive in terms of trying to do things that were in scope of practice but recent victories at the time. What am I talking about? Trying to prescribe steroids in herpes cornea patients. Prescribing maxitrol for a new central ulcer? Also the example I sited earlier... After the experience with him and another new associate, I became much more cautious with new graduates and monitor people for 6 months. I interview 15-20 people and usually have the top 5 shadow me for a couple days and gauge what their knowledge is. So recently..I have a new graduate who I told them "I have a 24 year old man with pressure of 24, no family history, normal visual fields and pachymetry of 650 ou..what are your thoughts?" One kid told me literally "Well the pressure is high.What does pachymetry mean?". I replied "Corneal thickness" He said " I am not familiar with that test." A lot of new graduates have worked out fine and great but every year as I interview and hire more people I notice more and more graduates try to be hyperaggressive with patient management (do more and more things that most seasoned ODs would send out) without knowing some basic information. This is reflected in the a recent post where a student asked about ODs placing amniotic membrane grafts after seeing an OMD place one in the eye. That is what I mean by hyperaggressive. I watch people now because of the two new graduates I had 12 years ago. That's all I was saying... hope that helps..

 

[Shnurek]

In optometry like medicine there is no one way to treat a certain patient. There is an art to it as well. I'd say, from the facts and statistics I have read, ODs are in fact some of the most cautious practitioners as a whole: http://oaop.org/PDF_files/SurgicalDebatePoints.pdf Sure there are hyperaggresive new comers and of course it could all be to the nature of the job in that it mostly entails writing out prescriptions for glasses and contacts.

 

[mclem222]

There are major flaws in that article. Just because we have low malpractice doesn't mean that we aren't making mistakes etc..Malpractice claims are based on several things

1. The risk of the procedures and diseases (Neurosurgeons have higher malpractice than rehab doctors because they are doing more surgery, the surgery they do is way riskier than other surgeons etc..) We don't do surgery right now (yeah I know lasers are called surgery) but in reality its not a scalpel on the eyeball so our risk is lower. Also the procedures we do are way less risky.

2. Expectations of the patient (School nurses have a very low malpractice incidence also...why? because if Johnny is at school and has strep throat the school nurse misdiagnoses it and sends him home, the nurse is not held to the same standard as the pediatrician). A patient is much more likely to sue an OMD than an OD for the same mistake. They are held to a higher standard. We had a case in our county where two ODs and an OMD missed giant cell arteritis and the patient lost her vision. The only person who got sued was the OMD because they were the only ones who were held to the higher standard of not missing that diagnosis. The ODs lawyers got them out of it in the prelminary hearings by saying their clients should not be held liable for missing this diagnosis because they are just "glasses doctors" and the judge bought it.

To say our malpractice is $500 a year so it means we don't make mistakes, have hyperaggressive docs etc.. is silly. We just dont do the things that would allow us to get sued at the rate and level that an OMD does. An optom who is spending their days at Walmart spinning and grinning...what are they ever going to get sued for? A wrong glasses prescription?. Even if they miss something at the end of the day, the patient doesn't think "I went and saw a doctor who shouldn't have missed that melanoma". They think "Well I saw a Walmart glasses person..what do I expect" I have seen tons of missed diagnoses from Walmart, Sears Optical, Lenscrafters and at the end of the day is the good news is that the OD in that environment is held to a lower standard. Now an OD in private practice that may not be the case because the patient holds us to a higher standard. We are much more likely to be viewed as a doctor with the same level of expectations.
ODs also spend more time with patients than OMDs. As a result we bond more to our patients and thus when a mistake is made, they are less likely to sue. It doesn't mean we make less mistakes or are "more cautious".

Finally, the last point is that malpractice has to do with means. Poorer patients as a whole do not sue as much as patients with means once malpractice has occured. We have to look at the demographics of the patients that ODs on a whole see vs OMDs. We see more medicaid, no insurance patients than an OMD does thus part of our potential patients who may sue don't have to means to pursue something.

Just some thoughts from the paper that was submitted....That was a great example of how one can use data to say anything. There is no correlation between insurance rates for malpractice between professions and predicting what would happen to insurance rates if we got priveleges to do certain procedures etc.. This is like saying opticians don't have to pay any malpractice so they must be really cautious and know their limits so lets give them the opportunity to refract and give drops. ******ed logic and propaganda.

 

[KHE]

I'm not buying a lot of this.

There are major flaws in that article. Just because we have low malpractice doesn't mean that we aren't making mistakes etc..Malpractice claims are based on several things

1. The risk of the procedures and diseases (Neurosurgeons have higher malpractice than rehab doctors because they are doing more surgery, the surgery they do is way riskier than other surgeons etc..) We don't do surgery right now (yeah I know lasers are called surgery) but in reality its not a scalpel on the eyeball so our risk is lower. Also the procedures we do are way less risky.

It has nothing to do with how much surgery you do. It has to do with economic costs of messing up even a single surgery. A neurosurgeon who commits malpractice can kill or disable someone for life. An ophthalmologist who blinds a person in one eye has not created that much economic damage because....here's the dirty little secret of eye surgery.....YOU HAVE ANOTHER EYE. So unless you're a pilot for Delta Airlines or you were already blind in the other eye, the economic damages of a botched eye surgery tend to be low. You can still drive. Still go to work, etc. etc.

A patient is much more likely to sue an OMD than an OD for the same mistake. They are held to a higher standard. We had a case in our county where two ODs and an OMD missed giant cell arteritis and the patient lost her vision. The only person who got sued was the OMD because they were the only ones who were held to the higher standard of not missing that diagnosis. The ODs lawyers got them out of it in the prelminary hearings by saying their clients should not be held liable for missing this diagnosis because they are just "glasses doctors" and the judge bought it.

That is inconceivable to me on so many levels. I don't believe that story.

To say our malpractice is $500 a year so it means we don't make mistakes, have hyperaggressive docs etc.. is silly. We just dont do the things that would allow us to get sued at the rate and level that an OMD does. An optom who is spending their days at Walmart spinning and grinning...what are they ever going to get sued for? A wrong glasses prescription?. Even if they miss something at the end of the day, the patient doesn't think "I went and saw a doctor who shouldn't have missed that melanoma". They think "Well I saw a Walmart glasses person..what do I expect" I have seen tons of missed diagnoses from Walmart, Sears Optical, Lenscrafters and at the end of the day is the good news is that the OD in that environment is held to a lower standard.

There is some truth that the they are probably held to a lower standard by the general public. They are not held to a lower standard by the law.

If there really was that much difference in "standard holding", then you would have a different malpractice premium based on where you practice and that does not occur in our field.

Finally, the last point is that malpractice has to do with means. Poorer patients as a whole do not sue as much as patients with means once malpractice has occured. We have to look at the demographics of the patients that ODs on a whole see vs OMDs. We see more medicaid, no insurance patients than an OMD does thus part of our potential patients who may sue don't have to means to pursue something.

Every attorney who litigates personal injury or employment cases or such that I have ever spoken to has told me that medicaid patients and people without insurance are THE MOST likely to try to sue because they view it as a potential windfall.

 

[Shnurek]

There are major flaws in that article.

the nurse is not held to the same standard as the pediatrician). A patient is much more likely to sue an OMD than an OD for the same mistake. They are held to a higher standard.

Sorry, legally doctors of optometry are held to the same standards as any physician. The law trumps public perception. Nurses are not independent practitioners with their own independent practice license (except for NPs in limited cases) so you cannot compare nurses to optometrists. And when it comes to litigation, lawyers love to just sue everybody. Post some facts rather than speculation.

 

[speyeder]

Ahh all good questions...

I have employed about 7 new graduates in the last 10 years. So what happened is the associate doctors was one of the first new graduates I hired about 12 years ago. He was hyperaggressive in terms of trying to do things that were in scope of practice but recent victories at the time. What am I talking about? Trying to prescribe steroids in herpes cornea patients. Prescribing maxitrol for a new central ulcer? Also the example I sited earlier... After the experience with him and another new associate, I became much more cautious with new graduates and monitor people for 6 months. I interview 15-20 people and usually have the top 5 shadow me for a couple days and gauge what their knowledge is. So recently..I have a new graduate who I told them "I have a 24 year old man with pressure of 24, no family history, normal visual fields and pachymetry of 650 ou..what are your thoughts?" One kid told me literally "Well the pressure is high.What does pachymetry mean?". I replied "Corneal thickness" He said " I am not familiar with that test." A lot of new graduates have worked out fine and great but every year as I interview and hire more people I notice more and more graduates try to be hyperaggressive with patient management (do more and more things that most seasoned ODs would send out) without knowing some basic information. This is reflected in the a recent post where a student asked about ODs placing amniotic membrane grafts after seeing an OMD place one in the eye. That is what I mean by hyperaggressive. I watch people now because of the two new graduates I had 12 years ago. That's all I was saying... hope that helps..

Mclem222, I am an ophthalmologist and I agree with your sentiments about overly aggressive health care providers at all levels practicing beyond their comfort levels. In fact I don't know many comprehensive ophthalmologists who would place amniotic grafts on a patient. If a patient had corneal disease severe enough to warrant such treatment, most would opt to refer the patient to a cornea specialist, who has much more expertise in managing such patients. So to reiterate your point: Just because you can legally do something within your scope of practice doesn't mean you should. The well being of the patient always comes first and if that means referring the patient to someone who can manage their condition better, so be it.

 

[thanotoriousfob]

except you probably have 0 debt while most of us will have 160-200k weighing down on us. I'm a single female that could relocate and live in crappy apartments to save money, but what are non-traditional, married with kids, Optometry students going to do? I mean they have a mortgage, wife, kids..etc. so they can't really move and have expensive responsibilities to take care of 0_0

Are you even in optometry school yet? Why are you already complaining about it if you haven't started? The way you make it sound, it's as if you are already way too deep in and can't get out. A single white female w/o kids and could relocate.... sounds like you have options.

 

[mclem222]

I'm not buying a lot of this.



It has nothing to do with how much surgery you do. It has to do with economic costs of messing up even a single surgery. A neurosurgeon who commits malpractice can kill or disable someone for life. An ophthalmologist who blinds a person in one eye has not created that much economic damage because....here's the dirty little secret of eye surgery.....YOU HAVE ANOTHER EYE. So unless you're a pilot for Delta Airlines or you were already blind in the other eye, the economic damages of a botched eye surgery tend to be low. You can still drive. Still go to work, etc. etc.

That is true but if I was a surgeon who did surgery on people's eye I am engaging in much more high risk behavior. Are you telling me that refracting people all day at walmart or treating with drops is the same as putting a blade on someone's eye? My brother had a lawsuit for someone who after lasik ended up 20/20 and 20/25 and was -0.5 in the left eye. Would that have happened if I fit that person with glasses and it was off. Heck no..If you look at the top three things ODs get sued for they are missed diagnoses. For OMDs it is surgery complications first and then missed diagnoses.


That is inconceivable to me on so many levels. I don't believe that story.

Not my problem...



There is some truth that the they are probably held to a lower standard by the general public. They are not held to a lower standard by the law.

If there really was that much difference in "standard holding", then you would have a different malpractice premium based on where you practice and that does not occur in our field.

Because there are different standards that is why an OMD has higher malpractice even when they don't operate compared to an OD. My father found out when he stopped operating and tried to lower his premium. It went a down a whole lot but he definitely did not pay $600 a year. He asked why he doesn't pay the same as an optometrist who has malpractice. OMIC which is the ophthalmology insurance company explained it to him as a. Even nonoperating OMDs have more complicated "higher risk" patients than ODs b. When there are lawsuits they are held to much higher standards in court...they have more chance to get sued for the same missed diagnosis, more likely to get an unfavorable verdict because of a higher standard of care bar and when their is a lawsuit and they lose they pay more because they are percieved as having deeper pockets. This isn't me..this is what the letter to my dad from OMIC said.

The whole thing comes down to a violation of standard of care. If an OMD sees a patient and misses forme fruste keratoconus or tear duct obstruction secondary to cancer of the tear duct, it is considered a deviation from standard of care for them and thus a sueable offense. If an OD misses lets say something more esoteric like orbital varix etc. it may not be considered in our standard of care to catch that. My brother does independant medical examiner work and has testified on a lot of case (for and against doctors) and the standard of care is considered different for ODs and OMDs. period. This has nothing to do with whether medicare says we can bill as physicians or the Harkin amendment. This has to do with lawsuits which indirectly affect malpractice premiums. Juries are made of people and their decisions reflect bias in society. In the case of lawsuits it is in our favor compared to OMDs because we are not viewed necessarily in the same light. Actuaries for malpractice insurance companies calculate that into their data and rates.


Every attorney who litigates personal injury or employment cases or such that I have ever spoken to has told me that medicaid patients and people without insurance are THE MOST likely to try to sue because they view it as a potential windfall.

That is the opposite of what the data says

http://www.litigationteam.com/medical-malpractice-lawsuits-vs-income-status/


Listen I think being an OD is awesome and I love it but when there is propaganda I call it out period. The same for why we need more ODs and thus more schools and board certification. I call a spade a spade even if it goes against the optometry mindspeak. The implication is the article that was published was that we make less medical mistakes than OMDs and MDs and thus we are more cautious or better doctors.Seriously? Do you guys really think that? Do you think the number of lawsuits being higher in MDs compared to ODs is that ODs are better doctors and not that they deal with more serious disease, surgery etc? Come on people! I can't believe that you actually believe that.

 

[Optomchick]

Are you even in optometry school yet? Why are you already complaining about it if you haven't started? The way you make it sound, it's as if you are already way too deep in and can't get out. A single white female w/o kids and could relocate.... sounds like you have options.

I'm not sure what you mean by this, like instead of Optometry school? Or for finding a good job in Optometry?

 

[thanotoriousfob]

I'm not sure what you mean by this, like instead of Optometry school? Or for finding a good job in Optometry?

I guess both. You just make it sound like you are deep into optometry and can't switch careers.

 

[Optomchick]

I guess both. You just make it sound like you are deep into optometry and can't switch careers.

IDK i feel like i've sacrificed alot to get this far and would enjoy being an Optometrist. Maybe PAs have it made right now, but I don't think i have the stats to get in or would enjoy drawing blood from possible AIDS patients :/

 

[thanotoriousfob]

IDK i feel like i've sacrificed alot to get this far and would enjoy being an Optometrist. Maybe PAs have it made right now, but I don't think i have the stats to get in or would enjoy drawing blood from possible AIDS patients :/

You can always do post-baccalaureate work and raise those grades if there is something else out there that you may want to pursue. If you are having doubts about the profession now, I would highly recommend thinking about something else. I'm not trying to scare you like some of the other posters, I just think you need to give yourself a fair shake at what you want to truly do with your life and not have to settle.

 

[CL Doc]

For all you students who think the ODs on here misrepresent things, I just read the results of a survey that says only 54% of MDs would choose medicine again as a career.

The problems discussed here are universal to health care.