I'm getting sick of the smack!

[Andrew_Doan]

I personally have no interest in doing surgery when I finish BUT I do believe there should be an Optometric Surgery Residency...

Hey, I have to admit you have a good sense of humor.....very important trait! I am just a smart-ass Italian guy who loves to argue and will lobby like bulldog when I am out practicing. I will pursue my dream and become a "limited scope" real physician of the eye (OD) and work in harmony with my surgical brothers "full scope" real physicians of the eye (OMD's).

You contradict yourself many times.

First you say you're not interested in surgery, but... there should be an "optometric surgery residency".

Second, you want to lobby like a "bulldog" because you want to be a "limited scope real physician of the eye (OD)".

If you don't want to do surgery, then why do you need to lobby when optometry already can medically manage 95% of the common diseases out there? Do you want to do more medically? Then why not forget optometry school and become an ophthalmologist. You don't have to do surgery as an ophthalmologist if you don't want.

Similar to your colleagues who are seeking surgical privileges, you want expanded scope of practice without the additional training. You want a backdoor route to your dreams of being the "limited scope real physician of the eye (OD)".

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[FutureEYEdoc09]

You contradict yourself many times.

First you say you're not interested in surgery, but... there should be an "optometric surgery residency".

Second, you want to lobby like a "bulldog" because you want to be a "limited scope real physician of the eye (OD)".

If you don't want to do surgery, then why do you need to lobby when optometry already can medically manage 95% of the common diseases out there? Do you want to do more medically? Then why not forget optometry school and become an ophthalmologist. You don't have to do surgery as an ophthalmologist if you don't want.

Similar to your colleagues who are seeking surgical privileges, you want expanded scope of practice without the additional training. You want a backdoor route to your dreams of being the "limited scope real physician of the eye (OD)".

What I have said in a previous statement (a few times mixing a little "tounge and cheek" to get a rise out of some of the more arrogant responders) is not contradictory.....One can support a cause yet not be directly involved with it.......For instance I support Chiropractic medicine (the legitamate Doctors of Chiropractic who are practicing musculoskeletal medicine) yet I will not be a Chiropractic Physician. I have more at stake in supporting surgery in Optometry because I shall become an Optometrist. I respect you immensely Dr. Doan but I feel you have some "tunnel vision"...case in point---you feel that optometry should not delve into surgery (at all) even if there is a legitamate track where it is safe and efficacious because you feel there needs to be a line of demarcation.....You are an educated scholar and Physician----remember Osteopathy and what that profession went thru and even now many MD's still call it "a backdoor route to medicine." Your attitude is exclusionary and defensive of your allopathic institution which you will defend until armagedon. This said, I look forward to discussing topics with you further to enhance my knowledge of Eye medicine.....I am a weathered 31 yr old man who champions the underdog. Optometric surgery will happen--it is enivitable........have a nice day

 

[Tony.]

Similar to your colleagues who are seeking surgical privileges, you want expanded scope of practice without the additional training. You want a backdoor route to your dreams of being the "limited scope real physician of the eye (OD)".

Dr. Doan,

I'm a first year optometry student and I'd be scared to perform surgery w/o additional training.....

eeeek, thats like taking my midterms without studying the matierial.....

 

[Andrew_Doan]

I respect you immensely Dr. Doan but I feel you have some "tunnel vision"...case in point---you feel that optometry should not delve into surgery (at all) even if there is a legitamate track where it is safe and efficacious because you feel there needs to be a line of demarcation.....

Here are some questions and concepts you need to consider:

1) As stated many times before, medical school provides a solid educational foundation for ophthalmic surgical training. At its current state, optometry education does not prepare you with the breadth of medical knowledge necessary for the management of medical AND surgical patients. We don't need another non-physician group to "change" their education to be like physicians. This does not benefit society, but only serves the optometrists who are pushing for expanded scope of practice.

2) Why do we need more surgeons when we already have enough ophthalmic surgeons? Again, scope expansion is self-serving rather then helping society. You may argue that optometric surgeons will work in underserved areas. However, if there is a separate surgical residency for optometrists, I doubt that the few graduates will work in rural Oklahoma. Why? Because rural and underserved areas cannot support a full-time ophthalmic surgeon. Your optometric surgeon colleagues will work in the same over-saturated markets as the ophthalmologists you call arrogant and self-serving.

3) None of your arguments explain why expanded scope of practice for optometry will benefit the healthcare community and society. Scope expansion will only help to produce a backdoor route for training of optometric surgeons.

 

[bustbones26]

I see the point of MD/DO trained physicians here. But may I just perhaps slightly defend the OD's by asking, why can midlevel providers like CRNP & PA's walk into the realm of MD/DO but not OD's? I am not saying that any of it is right, but I do have to ask.

The last time I went to an opthalmologist (sorry if I spelled it wrong), do you know who did my complete eye exam? The PA!! I never even saw the doctor, I swear to this! So if nurses and PA's can do it, why not OD's too?

AS far as surgery goes, are there restrictions for the OD's? ARe they actually alllowed to do everything an MD/DO does?

 

[Caffeinated]

I am actually not naive about residencies----my brother is in one. What I was trying to say in a previous post was....with a 5 yr medical-surgical residency for optometrists where the first 16 months of that fills in the "gap" of general medical training and the following 44 months would be equivalent to a general opthalmology residency would be sufficient for a General Optometric Surgeon. I am talking about 9 years including optometry school---a legitamate track to surgery----like DDS OMFS---they do not possess an MD neither does an ortho DPM...both of these have a 4 yr residency. I personally have no interest in doing surgery when I finish BUT I do believe there should be an Optometric Surgery Residency...there has to be growth in the profession and that would give the few OD's who want to pursue that a LEGITAMATE avenue for it......I respect your opinions but do not appreciate being called "clueless"---I know more than you might realize...... I just feel allopathy has manipulated the instutution of medicine to suit its own economic and political purposes. I support what you call "mid-level" practitioners...I call them Doctors just like MD's and DO's....just not medical doctors......Honestly, how much of your opposition to Optometric surgery (if done properly---with a 5 yr mediclal-opthalmic surgery residency) REALLY is patient safety versus just believing that since OD's did not go to medical school thus they have not "the right of passage" like you and your counterparts. With that type of thinking DPM's would do nothing but take care of Diabetic feet--no Podiatric Surgeon (orthos still don't really respect them), DDS's would just fill cavities and have no Oral Maxillo-Facial surgery residencies! Instead of Opthalmology opposing Optometric surgery completely (like they presently do) why not help legitamize it--because OMD's claim to be so concerned about patient safety--I have read sooooo many articles about this----by helping establish a legitamate track---5yr residency......Would you rather have OD's go to seminars for anterior chamber eye surgery instead? Optometry's lobbying machine is more stout than Opthalmology--much more...they have thier own autonomous state licensing boards.......they will eventually get some surgical rights in state practice scopes......Work together not against each other......


that said------medical residency is hell and very thorough...this I do know

Future,

Your comments about medical school being simply a "rite of passage" for eye surgeons is off base. The human body is not simply a visual system with a bunch of other stuff attached. That paradigm works for optometric education. But to suggest that you can take an optometrist, fill in a few "gaps" and they are suddenly equivalent to a medically educated eye surgeon is incorrect. All that "other stuff" IS important. You may not appreciate that yet. You may not even appreciate it by the time you graduate from optometry school. But the fact is that optometric education does not train what you need to know to be a good surgeon. Sure, you may learn the eye anatomy, and read some technical stuff about surgical procedures. You may even see some eye surgery videos. But surgery is not about operating on an eye--it's about operating on a person. That person has a heart, some lungs, a GI system, a liver, some kidneys, and the list goes on. Surgery does not simply disrupt the part you cut; it can perturb other parts of the entire system of the body. This is the educational paradigm that makes a good surgeon. Like I said before, if we were in a national crisis of eye surgeon shortages, then we could cut corners and fast-track some optometrists to become eye surgeons. Would it be optimal? No way. Until that happens, your 5 year optometric surgeon program will never happen. Why create a sub-optimal 5 year residency program (for a total of 9 years training) when an 8 year program to become an ophthalmologist already exists (med school + internship + residency)? This program turns out enough eye surgeons to meet the demand.

 

[mteeter]

Perhpaps we can create a residency for veterinary opthamologists to become human opthamologists. (http://www.acvo.com/) After all, they have true advanced training in medical management of a patient and surgery, so it shouldn't take them more than 6 months to a year to become qualified on humans!

 

[FutureEYEdoc09]

Future,

Your comments about medical school being simply a "rite of passage" for eye surgeons is off base. The human body is not simply a visual system with a bunch of other stuff attached. That paradigm works for optometric education. But to suggest that you can take an optometrist, fill in a few "gaps" and they are suddenly equivalent to a medically educated eye surgeon is incorrect. All that "other stuff" IS important. You may not appreciate that yet. You may not even appreciate it by the time you graduate from optometry school. But the fact is that optometric education does not train what you need to know to be a good surgeon. Sure, you may learn the eye anatomy, and read some technical stuff about surgical procedures. You may even see some eye surgery videos. But surgery is not about operating on an eye--it's about operating on a person. That person has a heart, some lungs, a GI system, a liver, some kidneys, and the list goes on. Surgery does not simply disrupt the part you cut; it can perturb other parts of the entire system of the body. This is the educational paradigm that makes a good surgeon. Like I said before, if we were in a national crisis of eye surgeon shortages, then we could cut corners and fast-track some optometrists to become eye surgeons. Would it be optimal? No way. Until that happens, your 5 year optometric surgeon program will never happen. Why create a sub-optimal 5 year residency program (for a total of 9 years training) when an 8 year program to become an ophthalmologist already exists (med school + internship + residency)? This program turns out enough eye surgeons to meet the demand.

You are misunderstanding me---I agree with you that surgery is not about operating on just the visual system rather the whole patient. Anyone can learn anatomy---The pretectile nucleus sends fibers bilaterally to the Edinger-Westphal nuclei which in turn send GVE Pre-ganglionics to the ciliary ganglion by way of Occulomotor nerve---these Pre-ganglionic GVE's synapse in the afformentioned ganglion to give rise to Post-ganglioic parasympathetic GVE's which in turn travel thru the short-ciliary nerve to innervate sphincter pupilae and the ciliary muscles.....blah blah blah.....I had this in undergraduate anatomy. Any monkey could memorize this crap----It takes a special person to be a doctor and even more special to be a surgeon-----I applaud surgeons......BUT I will say that when I mentioned 5 years-----I mean 2 of those years would be in every way equal to the 2 years of preceptorship by medical students. Combine this with 3 year surgery component and the 4 years of visual system training in Optometry school.....and you have a very qualified surgeon......OD's are primary care eye doctors already....this is not a joke......Refraction, prescribing systemic meds, rehabilitation, and so on----these are very important aspects of patient care that OD's do. I just feel that Opthos feel that thier way is the only way.........

 

[FutureEYEdoc09]

Perhpaps we can create a residency for veterinary opthamologists to become human opthamologists. (http://www.acvo.com/) After all, they have true advanced training in medical management of a patient and surgery, so it shouldn't take them more than 6 months to a year to become qualified on humans!

Bow wow wow yippie yo yippie yay!



(sorry I couldn't resist)

 

[Andrew_Doan]

BUT I will say that when I mentioned 5 years-----I mean 2 of those years would be in every way equal to the 2 years of preceptorship by medical students. Combine this with 3 year surgery component and the 4 years of visual system training in Optometry school.....and you have a very qualified surgeon......OD's are primary care eye doctors already....this is not a joke......Refraction, prescribing systemic meds, rehabilitation, and so on----these are very important aspects of patient care that OD's do. I just feel that Opthos feel that thier way is the only way.........

You're missing one major concept!

There's no need for more ocular surgeons. See my post above, but I'll repeat it:

Why do we need more surgeons when we already have enough ophthalmic surgeons? Again, scope expansion is self-serving rather then helping society. You may argue that optometric surgeons will work in underserved areas. However, if there is a separate surgical residency for optometrists, I doubt that the few graduates will work in rural Oklahoma. Why? Because rural and underserved areas cannot support a full-time ophthalmic surgeon. Your optometric surgeon colleagues will work in the same over-saturated markets as the ophthalmologists you call arrogant and self-serving.

Also, you need to really add 6 years: 2 years pre-clinical rotations like medical school, 1 year medical/surgical internship, and 3 years surgical/medical residency. You can't really treat the whole body without the experience of managing the whole body during the internship. Medical residencies are currently paid by tax dollars and is equivalent to ~$100,000 per resident per year. Where will the funding for optometry residencies come from? Are tax payers willing to train a new breed of optometric surgeons when there is absolutely no or little need for them?

You can't compare optometry to oral surgery. THERE IS A NEED FOR ORAL SURGEONS.

You mention capitalism... well market forces and demand drive economics. The demand for oral surgeons is there. Unfortunately for you, the demand for optometric surgeons and surgery is non-existent.

I recommend that you study hard to be a good optometrist and leave the surgery to the individuals who are trained.

 

[FutureEYEdoc09]

I see the point of MD/DO trained physicians here. But may I just perhaps slightly defend the OD's by asking, why can midlevel providers like CRNP & PA's walk into the realm of MD/DO but not OD's? I am not saying that any of it is right, but I do have to ask.

The last time I went to an opthalmologist (sorry if I spelled it wrong), do you know who did my complete eye exam? The PA!! I never even saw the doctor, I swear to this! So if nurses and PA's can do it, why not OD's too?

AS far as surgery goes, are there restrictions for the OD's? ARe they actually alllowed to do everything an MD/DO does?

The point is that-----OD's are doctors----autonomous----writing prescriptions of meds to treat common eye disease, doing diagnosis of eye conditions, refracting the patients, etcc....all of this without supervision-----no one debates this---they are primary care eye doctors NOT Medical physicians........Nurse pracs, and PA's have signifigant responsibilities but are under supervision (at least technically) of the attending. The key word here is attending who has the ultimate Responsibility-----this is why they allow PA's and Nurse Pracs to do "some" procedures because ultimately the responsibility lies with the MD/DO...I respect your point but your analagy is irrelavent because PA and nurses are in effect "part" of the Attending physician with much less responsibility and technically no complete autonomy. Ultimately everything you do as a PA is the ultimate responsibility of your attending---this is why you are allowed to do some "procedures." OD's are not surgeons. Autonomy, ultimate responsibility are the sole realm of the doctor.....MD, OD, DO, DPM, DDS, DC.....etc....

 

[mdkurt]

You are misunderstanding me---I agree with you that surgery is not about operating on just the visual system rather the whole patient. Anyone can learn anatomy---The pretectile nucleus sends fibers bilaterally to the Edinger-Westphal nuclei which in turn send GVE Pre-ganglionics to the ciliary ganglion by way of Occulomotor nerve---these Pre-ganglionic GVE's synapse in the afformentioned ganglion to give rise to Post-ganglioic parasympathetic GVE's which in turn travel thru the short-ciliary nerve to innervate sphincter pupilae and the ciliary muscles.....blah blah blah.....I had this in undergraduate anatomy.

Next time you're copying your Walsh and Hoyt, try to pay more attention to the spelling. Has anyone else realized that ONLY FutureEYEdoc is keeping this thread going? Many of his colleagues agree with us, we agree with us, and I don't think we're going to get through to this *****. Let's cut our losses and quit this thread.

 

[FutureEYEdoc09]

You're missing one major concept!

There's no need for more ocular surgeons. See my post above, but I'll repeat it:

Why do we need more surgeons when we already have enough ophthalmic surgeons? Again, scope expansion is self-serving rather then helping society. You may argue that optometric surgeons will work in underserved areas. However, if there is a separate surgical residency for optometrists, I doubt that the few graduates will work in rural Oklahoma. Why? Because rural and underserved areas cannot support a full-time ophthalmic surgeon. Your optometric surgeon colleagues will work in the same over-saturated markets as the ophthalmologists you call arrogant and self-serving.

Also, you need to really add 6 years: 2 years pre-clinical rotations like medical school, 1 year medical/surgical internship, and 3 years surgical/medical residency. You can't really treat the whole body without the experience of managing the whole body during the internship. Medical residencies are currently paid by tax dollars and is equivalent to ~$100,000 per resident per year. Where will the funding for optometry residencies come from? Are tax payers willing to train an inferior breed of optometric surgeons when there is absolutely no or little need for them?

You can't compare optometry to oral surgery. THERE IS A NEED FOR ORAL SURGEONS.

You mention capitalism... well market forces and demand drive economics. The demand for oral surgeons is there. Unfortunately for you, the demand for optometric surgeons and surgery is non-existent.

I recommend that you study hard to be a good optometrist and leave the surgeons to the individuals who are trained.

You make a good point Dr. Doan......So you feel that the main flaw in my argument is economical-----lack of a need in the market.............?

 

[FutureEYEdoc09]

Next time you're copying your Walsh and Hoyt, try to pay more attention to the spelling. Has anyone else realized that ONLY FutureEYEdoc is keeping this thread going? Many of his colleagues agree with us, we agree with us, and I don't think we're going to get through to this *****. Let's cut our losses and quit this thread.

Actually (Mr Kurt)----synonym for -----, I am not copying anything.......I learned that stuff in neuroanatomy a few years ago......not in Walsh and Hoyt----I have never even seen that before........I am closing this thread anyway----I am just finishing discussing this with someone credible---Dr. Doan......Because you my friend are a ------- -----I didn't call you any names.

 

[Andrew_Doan]

You make a good point Dr. Doan......So you feel that the main flaw in my argument is economical-----lack of a need in the market.............?

Yes, the main flaw in your argument is economal and demand.

Therefore, if you took the best optometrists, placed them in a 6 year post-graduate residency after completion of optometry school (i.e., 2 years of clinical rotations, 1 year internship, and 3 years of residency), then they can be awarded a MD with surgical privileges. Because of the logistics, cost, and lack of demand for optometric surgeons, I cannot see how this can be feasible. Thus, this is why your optometry colleagues in states like Oklahoma have employed legislation to pass laws to circumvent additional training to gain surgical scope expansion.

 

[FutureEYEdoc09]

Next time you're copying your Walsh and Hoyt, try to pay more attention to the spelling. Has anyone else realized that ONLY FutureEYEdoc is keeping this thread going? Many of his colleagues agree with us, we agree with us, and I don't think we're going to get through to this *****. Let's cut our losses and quit this thread.

Actually Mr. Kurt.......you should learn how to be more like Dr. Doan----he actually makes good points....You are the -------......

 

[FutureEYEdoc09]

Yes, the main flaw in your argument is economal and demand.

Therefore, if you took the best optometrists, placed them in a 6 year post-graduate residency after completion of optometry school (i.e., 2 years of clinical rotations, 1 year internship, and 3 years of residency), then they can be awarded a MD with surgical privileges. Because of the logistics, cost, and lack of demand for optometric surgeons, I cannot see how this can be feasible. Thus, this is why your optometry colleagues in states like Oklahoma have employed legislation to pass laws to circumvent additional training to gain surgical scope expansion.

Understood.............

 

[FutureEYEdoc09]

Yes, the main flaw in your argument is economal and demand.

Therefore, if you took the best optometrists, placed them in a 6 year post-graduate residency after completion of optometry school (i.e., 2 years of clinical rotations, 1 year internship, and 3 years of residency), then they can be awarded a MD with surgical privileges. Because of the logistics, cost, and lack of demand for optometric surgeons, I cannot see how this can be feasible. Thus, this is why your optometry colleagues in states like Oklahoma have employed legislation to pass laws to circumvent additional training to gain surgical scope expansion.

Thanks for your points.......Please tell Mr Kurt....not to call people on here "*****s" he attacked me first with that crudeness......

 

[FutureEYEdoc09]

Yes, the main flaw in your argument is economal and demand.

Therefore, if you took the best optometrists, placed them in a 6 year post-graduate residency after completion of optometry school (i.e., 2 years of clinical rotations, 1 year internship, and 3 years of residency), then they can be awarded a MD with surgical privileges. Because of the logistics, cost, and lack of demand for optometric surgeons, I cannot see how this can be feasible. Thus, this is why your optometry colleagues in states like Oklahoma have employed legislation to pass laws to circumvent additional training to gain surgical scope expansion.

Originally Posted by mdkurt
Next time you're copying your Walsh and Hoyt, try to pay more attention to the spelling. Has anyone else realized that ONLY FutureEYEdoc is keeping this thread going? Many of his colleagues agree with us, we agree with us, and I don't think we're going to get through to this *****. Let's cut our losses and quit this thread.


That was unnecessary on his part......

 

[FutureEYEdoc09]

Yes, the main flaw in your argument is economal and demand.

Therefore, if you took the best optometrists, placed them in a 6 year post-graduate residency after completion of optometry school (i.e., 2 years of clinical rotations, 1 year internship, and 3 years of residency), then they can be awarded a MD with surgical privileges. Because of the logistics, cost, and lack of demand for optometric surgeons, I cannot see how this can be feasible. Thus, this is why your optometry colleagues in states like Oklahoma have employed legislation to pass laws to circumvent additional training to gain surgical scope expansion.

I will take your advice on being a good OD........I will also be an advocate for the profession............Thanks for your input.......

 

[Mirror Form]

Perhpaps we can create a residency for veterinary opthamologists to become human opthamologists. (http://www.acvo.com/) After all, they have true advanced training in medical management of a patient and surgery, so it shouldn't take them more than 6 months to a year to become qualified on humans!

LOL! Although, since veterinary ophthalmologists make over 3x more money then human ophthalmologists, I tend to doubt too many would want to switch over.

 

[podarski]

I'm pretty much neutral in all of this as I don't plan on going into either field. First off I agree that as for me I would never let an optometrist perform surgery on my eyes, I much prefer the experience of an ophtamalogist. Number two is all sorry most of you md's seem a little arrogant and lacking in the self esteem department. There is more to life than prestige.