Kentucky: The Latest Battleground for Optometric Scope Expansion

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Check out this guy in the video!

http://www.kyeyes.org/
Members don't see this ad.
 
The societies know. It has happened so fast most ophthalmologists probably do not know, however.

What is even more interesting is that the bill will would eliminate any future comments about scope of practice for optometry.

The bottom line is that money talks.
 
Frumps said:
Check out this guy in the video!

http://www.kyeyes.org/
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I love the awe struck stare the couple had on the couch lol!

Btw: If ophthalmology responds with a smear commercial, please post it!

Also, I find it interesting that this is happening in Rand Paul's (KY ophthalmologist senator) state.
 
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JaggerPlate said:
Shouldn't all this information be sent to the state medical board, AMA, Ophthal societies, etc??
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That's exactly what should be done!
The Courier-Journal is reporting
-that optomotrists have donated $400,000 to local legislators in the past two years (compared to ophthalmologists $500)
-that the Kentucky Medical Board opposes the bill
-and that the bill is "speeding through the House this week at a pace that threatens to break the sound barrier."
-Not to mention the fact that bill was intentionally introduced through the wrong committee to quicken its path. One physician in the legislator said, “I don't know ... but in my opinion the proper committee for this to have gone to — without question — would have been Health and Welfare which includes the House's two doctors and others who work in health care fields who have a wealth of medical knowledge.”

What can we do? This was an organized, premeditated endevour. Something needs to be done. This is certainly not an issue of access, or it would not have to be done behind closed doors. Someone with more experience....what can we do?
 
chalazion said:
Both the Senate & the House in Kentucky violated their procedures (see below) in their handling of SB 110.

Any vote on this bill needs to be delayed so that it can be considered by the appropriate committee:

House
http://www.lrc.ky.gov/record/11RS/HR1.htm
In this link click on HR1:

Senate
http://www.lrc.ky.gov/record/11RS/SR2.htm
In this link click on SR2:

In assigning this bill both in the senate and the house to the licensing and occupations committee rather than health and welfare committee, they have violated their own rules.

Rule 40. Jurisdiction of Standing Committees. The Committee on Committees shall refer each bill to the Committee with control over the subject matter. All bills and resolutions on the same subject matter shall be referred to the same committee. The general jurisdiction of the several standing committees shall be:

7. Health and Welfare: matters pertaining to human development, health, and welfare; delivery of health services; support of dependents; public assistance; child welfare; adoptions; children’s homes; disabled persons; family welfare; aid to the blind; commitment and care of children; mental health; substance abuse; health, medical and dental scholarships; local health units and officers; vital statistics; communicable diseases; hospitals, clinics, and long-term care facilities; health professions;physicians, osteopaths and podiatrists; chiropractors; dentists and dental specialists; nurses; pharmacists; embalmers and funeral directors; psychologists; optometrists,ophthalmic dispensers; physical therapists; senior citizens; eliminating age discrimination; non-public sector retirement; problems of aging; violent acts against the elderly.

10. Licensing and Occupations: matters pertaining to professional licensing not assigned specifically to another committee; racing; prize fighting and wrestling; places of entertainment; alcoholic beverage control; private corporations; cooperative corporations and marketing associations; religious, charitable and educational societies; nonprofit corporations; professional service corporations; cemeteries; barbers and cosmetologists; professional engineers and land surveyors; architects; real estate brokers and agents public accountants; detection of deception examiners; auctioneers; business schools; warehouses; partnerships; trade practices.
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This is currently being investigated. This or a veto by the governor are the most likely ways the bill will be defeated. As I mentioned earlier, the chair of the State Senate Health & Welfare Committee was purposely kept in the dark about this until it appeared on the Senate floor on 2/7. Very shady.
 
Meibomian SxN said:
You're right. All ophthalmologists are competent and never make mistakes. Never get stumped. Never over bill patients. Never sell pills & Rx pads. They are the gods that walk the earth.

And for that I'll be sending a check down to Kentucky in order to help their PAC pass their law :xf:. Maybe they can offer you an honorarium for teaching a certificate course on Blepharoplasty surgery...:idea:
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Let's not make this about who's smarter or less fallible or less greedy or.... Ophthalmologists are not gods. All doctors can and do make mistakes. Both camps have "good" and "bad" practitioners of their craft.

It's also not about ego. There's plenty of that on both sides, as well.

This is about having the appropriate training for the privileges being sought in the proposed bill. There are more than twice as many optometrists as ophthalmologists in the US. Some ophthalmology residencies struggle to achieve the minimum number of surgeries/procedures to maintain accreditation with an average of 3 residents per year. Where will the volume of pathology come from to provide adequate optometric training for said procedures? There just aren't enough patients, and as has been stated previously, you can't just practice on model or animal eyes.
 
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Visionary said:
Let's not make this about who's smarter or less fallible or less greedy or.... Ophthalmologists are not gods. All doctors can and do make mistakes. Both camps have "good" and "bad" practitioners of their craft.

It's also not about ego. There's plenty of that on both sides, as well.

This is about having the appropriate training for the privileges being sought in the proposed bill. There are more than twice as many optometrists as ophthalmologists in the US. Some ophthalmology residencies struggle to achieve the minimum number of surgeries/procedures to maintain accreditation with an average of 3 residents per year. Where will the volume of pathology come from to provide adequate optometric training for said procedures? There just aren't enough patients, and as has been stated previously, you can't just practice on model or animal eyes.
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How many is enough? As your fellow ophthalmologist Les Walls said in the Kentucky Optometric Assoc ad: "For over 35yrs he's trained ODs in the latest procedures...."

Also in the news story, the optometrist quoted "since 1998: 250,000 surgical procedures were performed in Oklahoma without A SINGLE incident report or complaint to the board...". Could ophthalmology tout numbers like that? And if they could, more praise to them!

Visionary said:
This is currently being investigated. This or a veto by the governor are the most likely ways the bill will be defeated. As I mentioned earlier, the chair of the State Senate Health & Welfare Committee was purposely kept in the dark about this until it appeared on the Senate floor on 2/7. Very shady.
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Reminds me of our current health care bill that was recently passed with lightening speed.

Instead of fighting such a stalemate battle :sleep:, ophthalmologists should just embrace the change and help out with the making sure the quality of care is maintained. :idea:
 
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Why is it a problem for ODs to be able to provide follow-up surgeries for the eye? WHY is it that such a huge problem to you guys? I think its a great idea! MD/DOs should NOT be the ones to control the medical rights of other medical professionals!
 
Meibomian SxN said:
making sure the quality of care is maintained. :idea:
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Therein lies the point (and I feel like I'm repeating myself). I've yet to see it described anywhere how optometrists will be trained to do the procedures proposed in this bill or how competency will be assessed. There is mention of the Optometry Board overseeing things, but where are the details? Will you have to complete a residency? Will it simply be a weekend course? Ophthalmology residencies have to answer to the same ACGME that all medical residencies do. The ACGME works with ophthalmology to determine accreditation criteria, but they are the ultimate overseers, when it comes to training. Perhaps the optometric community would like to do the same? If they can demonstrate equivalent training for these procedures, fine.
 
Visionary said:
Therein lies the point (and I feel like I'm repeating myself). I've yet to see it described anywhere how optometrists will be trained to do the procedures proposed in this bill or how competency will be assessed. There is mention of the Optometry Board overseeing things, but where are the details? Will you have to complete a residency? Will it simply be a weekend course? Ophthalmology residencies have to answer to the same ACGME that all medical residencies do. The ACGME works with ophthalmology to determine accreditation criteria, but they are the ultimate overseers, when it comes to training. Perhaps the optometric community would like to do the same? If they can demonstrate equivalent training for these procedures, fine.
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Optometrists are not evil, conniving doctors. They are professionals. And I would only assume a proper training process would be developed.
 
200UL said:
The societies know. It has happened so fast most ophthalmologists probably do not know, however.

What is even more interesting is that the bill will would eliminate any future comments about scope of practice for optometry.

The bottom line is that money talks.
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http://www.necn.com/02/18/11/House-...ockID=3&apID=a4f0a57261df41cf91e3a2b3d268161b

House approves more procedures for optometrists

FRANKFORT, Ky. (AP) — Optometrists could perform some uncomplicated medical procedures now reserved for ophthalmologists under a bill that has been approved by the state legislature.

The House voted 81-14 for final approval of the fast-tracked proposal on Friday after two weeks of contentious debate. It now goes to Gov. Steve Beshear, who hasn't yet said whether he will sign it into law.

The Kentucky Medical Association and the Kentucky Academy of Eye Physicians and Surgeons opposed the measure, saying optometrists aren't qualified to perform even simple eye surgeries.

The measure would allow optometrists to perform a variety of procedures but specifically excludes more complicated surgeries such as Lasik, which is used to correct poor vision.

___

The legislation is Senate Bill 110.
 
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Frumps said:
Check out this guy in the video!

http://www.kyeyes.org/
Click to expand...

What a blatant *****.

geronamo26 said:
Why is it a problem for ODs to be able to provide follow-up surgeries for the eye? WHY is it that such a huge problem to you guys? I think its a great idea! MD/DOs should NOT be the ones to control the medical rights of other medical professionals!
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You're right ... let's not let the surgeons regulate surgery. I mean, if another group feels they DESERVE it, why not throw caution to the wind.

Meibomian SxN said:
Optometrists are not evil, conniving doctors. They are professionals. And I would only assume a proper training process would be developed.
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You ASSUME??? Dude, COME ON. A group of health practitioners want to start performing eye surgery on the eyes of living, breathing patients and you're content to ASSUME they will get some sort of training to do so??? Wow. Again, I'm shocked.
 
Frumps said:
Check out this guy in the video!

http://www.kyeyes.org/
Click to expand...



"Les Walls, MD"

Thats funny....because he is Les Walls, MD. OD.
Why didn't they mention that?
This IS the Kentucky Optometry Association website, they can't be embarrassed of his credentials can they?

This is ironic and, frankly, repulsive, on so many levels.
 
In case anyone is still wondering if this whole process was premeditated and unnecessarily secretive....From the Courier Journal

"All but one of the 100 House members had received campaign contributions within the last two years from the Kentucky Optometric Association’s political action committee or its members.

The exception, Rep. David Watkins, D-Henderson, said while speaking against the bill Friday that he had previously received contributions from the Optometric PAC."
 
Wedgebuster said:
In case anyone is still wondering if this whole process was premeditated and unnecessarily secretive....From the Courier Journal

"All but one of the 100 House members had received campaign contributions within the last two years from the Kentucky Optometric Association’s political action committee or its members.

The exception, Rep. David Watkins, D-Henderson, said while speaking against the bill Friday that he had previously received contributions from the Optometric PAC."
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God, this seriously grosses me out all around.
 
As a pro-optometry individual, I would have to say "nay" to this bill.


If OD's want to be surgeons, they should just go through medical school. This is North America; we can't have just anyone doing surgery.
 
Interesting that Les Walls is not an ophthalmologist but is actually board certified in family medicine.

"For the other side, Dr. Les Walls, a physician and optometrist, said, "It's a shame the [medical] profession would use scare tactics to try to restrain the trade and practices of another profession."

Walls, a family practitioner, is associate dean of the University Oklahoma medical school and has served as dean and president at optometry schools.

Oklahoma is the only state in the union that allows optometrists to perform certain surgeries, including laser surgery."
 
"But Woody Van Meter, president of the Kentucky Academy of Eye Physicians and Surgeons, which represents ophthalmologists, complained that the contributions played a part in a process that deprived opponents of sufficient time to explain their concerns about the bill.

“The proceedings of this bill don’t pass the smell test for legitimate government,” Van Meter said.

He said his organization will ask Beshear to veto the bill but wasn’t optimistic that would happen.

“With so many other issues, he probably is unlikely to use up any political capital that he has on the first bill that comes to him,” Van Meter said.":eek:

I wonder if intravitreal injections are the next procedure for optometrist to target?:(
 
I am sure there are a lot of optometrist in Kentucky who will be signing up for these courses.

"Oklahoma state law ensures that optometrists will be well trained to perform laser procedures. When the Oklahoma bill was written, the optometric licensure board established very rigorous requirements for optometrists planning to perform laser surgery.

According to Keri Shields, coordinator of continuing education, Oklahoma College of Optometry, Northeastern State University, the school offers a 16-hour course on anterior segment surgery with Nd: YAG and argon lasers and a 19-hour PRK course.

Optometrists can earn certification to perform anterior segment laser procedures after completing that course, but additional requirements are necessary for PRK certification. Prerequisites for the PRK course include completing the anterior segment laser course, proof of therapeutic license, a Drug Enforcement Administration number and proof of malpractice insurance."
 
First of all, it’s all about $$$. The whole access to care argument is just a smoke screen. I wonder which ophthalmologist in KY is going to see the complicated s/p YAG caps patient done by some OD that now has an RD or IOL dislocation? Or the SLT or PI with the IOP spike unresponsive to MMT or oral meds? Per some of those KY OD’s: “we are trained to do those procedures and know how to manage the complications”. I guess you can do the pneumatic retinopexy for the RD since you know how to do injections. Or an anterior chamber paracentesis since you know how to remove a foreign body. I guarantee you that none of those state senators would ever allow an OD to touch them with a laser. Yet, they pass a bill in complete disregard for their constituents merely because they were legally bribed with campaign contributions. This is morally wrong and disgusting…
Geez, most OD’s barely know how and when to use steroids…
 
After thinking about this for a bit, I can see why. I actually feel if an optometrist performed a paracentesis that resulted in iris coming out of the eye that it would be grounds for assault in a legal sense.

Why? First of all they are not trained to do this in their training programs (and they never will be to the level of an MD). Only a person who has performed intraocular surgery can truly understand the nuances of iris behavior (and this can be unpredictable to us as well). Also, one must be ready to deal with immediate consequence of making wounds in eyes.

Iris coming out of the eye is a very predictable possible complication – if you are going to start making wounds in eyes, I believe you must be prepared for the immediate predictable consequences when a complication occurs (in this case repositioning iris or even placing a suture).

For the optometrists reading, while a 5 year old could mechanically make a paracentesis, there is a bit to think about. Even making a PI in the setting of angle closure is not as simple as it may first seem. When you compare paracentesis or LPI to stromal puncture or rust ring removal, you look ignorant.

(When I was training a patient came in who had a large thorn the penetrated the cornea near the limbus (it had to be 1.5 mm in length). The local optometrist attempted to tug it out at the slit lamp but was fortunately unsuccessful (the fact that it is an optometrist has no importance –it very well could have been an MD as well). There was a huge iris tranillumination defect and a rent in the anterior capsule (not sure what the eye doctor was thinking). I remember the patient was mystified when we explained we would have to go to the operating room for removal. We placed viscoelastic in the eye so the chamber did not shallow upon removal, but the wound took a couple of sutures to be water tight. The patient would have showed up with Iris plugging the wound or a flat chamber if this was removed in the field).
 
superretinadoc said:
Interesting that Les Walls is not an ophthalmologist but is actually board certified in family medicine.

"For the other side, Dr. Les Walls, a physician and optometrist, said, "It's a shame the [medical] profession would use scare tactics to try to restrain the trade and practices of another profession."

Walls, a family practitioner, is associate dean of the University Oklahoma medical school and has served as dean and president at optometry schools.

Oklahoma is the only state in the union that allows optometrists to perform certain surgeries, including laser surgery."
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So, this guy touted in the Kentucky ads as training optometrists in the latest procedures for 35 years isn't even ophthalmology trained?! Is this Bizarro World?
 
superretinadoc said:
"But Woody Van Meter, president of the Kentucky Academy of Eye Physicians and Surgeons, which represents ophthalmologists, complained that the contributions played a part in a process that deprived opponents of sufficient time to explain their concerns about the bill.

“The proceedings of this bill don’t pass the smell test for legitimate government,” Van Meter said.

He said his organization will ask Beshear to veto the bill but wasn’t optimistic that would happen.

“With so many other issues, he probably is unlikely to use up any political capital that he has on the first bill that comes to him,” Van Meter said.":eek:

I wonder if intravitreal injections are the next procedure for optometrist to target?:(
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Intravitreal injections are not the objective. Being allowed to do surgical procedures without having to show training of equivalent length and rigor to ophthalmology is the objective. This is the camel's nose under the tent. The endpoint is being able to define alternate terms of their choosing of training for any procedure without having to meet any objective demonstration that the professional preparation for doing so was equivalent to that required by the professionals presently allowed to do these operations. This will include the right to adjudicate their member's surgical practice not with the state board of medicine in many states but with the state board of optometry. Expect then the optometry boards to re-name themselves the Board of Optometry and Surgery, or some such title. Wait for the American College of Optometric Medicine and Surgery to inaugurate its first class of fellows shortly after. It will make for a nice cluster of professional initials.

The only group I can see giving any resistance to this would be malpractice carriers, who might balk at treating operating optometrists' underwriting the same as ophthalmologists. But risks can be monetized, so I am sure some price for coverage will be set.

YAG capsulotomies are not the appeal here; all-laser refractive surgery is, as is cosmetic periocular and facial plastic surgery, and really, any kind of plastic surgery, there really are no limits. Your optometrist could set up an outpatient cosmetic surgery practice doing facelifts, laser skin treatments, breast augmentations, liposuction, you can name it, really. You can expect optometrists to find their way onto the medical staff at your local hospital and their professional committees, vetting the privilege applications of every surgeon on the active staff.
 
Whats wrong with ODs doing minor surgeries? If they are able to get ample training through, say a two year residency, I do not see the harm. Podiatrists are not MDs, yet they are able to do surgeries, so why is it such a shock that Optometrists want to be able to provide the same to the public in need? I am not saying that ODs should be able to do Lasik, but minor post-operative surgeries if needed. The sky will not fall, nor will the world end if ODs are able to expand their scope to include this ability. Ive seen some immature arguments made online by OMDs against this bill that maked them look like stupid, whinny kids.
 
I too am disappointed. I too thought Les Walls was an ophthalmologist. I thought he stood to make millions off doing the actual training (I believe optometry is smart enough to realize they do need someone to actually show up to lecture on their new abilities).

I suppose Les Walls has made/will make millions off charm alone since he knows very little about eye surgery. I do really find him charming….in the same way I find George Bush charming.

In terms of people getting in the way – malpractice carriers will have no problem giving policies to anyone. Rates will be determined based on type of practice/style. I promise you that insurance carriers can figure out a price point where they are still sure to make $. It is rare to have a lawsuit over a botched ALT or YAG. If there was a problem, Les Walls could be called in to charm the patient – provide expert testimony on the training of optometry.

Optometry will run into trouble however if they show up to surgery centers (if they do not own them) or hospitals as any real surgeon would be a little concerned with the newly granted privileges (it will not make sense to the average MD how optometry can accomplish as much as ophthalmology ½ of the time from a training standpoint). Ophthalmology privileges are hard enough to get.

Equipment makers would love this. Many ophthalmologists do not own their own SLT, ALT….. equipment. They will never invest in these technologies because they do not need them for their practice style or do not believe in the efficacy (many glaucoma specialists I know are not huge fans of SLT. I personally have seen many patients harmed with ALT). The bill will provide another new market for all their products weather they work or not. Money talks.

I do agree this is about getting closer to refractive surgery. The bill puts lasik on a pedestal it does not deserve (like it is the most difficult / risky procedure ophthalmology does). This is done for good reason, because the lawmakers and public see it as the same way (lasik exclusion is mentioned in every news story or article on it). I am sorry but the implications of “laser lens extraction” worry me so much more than lasik. However, I would be shocked if any optometrists would tackle cataract surgery. If this law goes through, the next step in Kentucky would be the challenging lasik.

In summary by excluding lasik this time, they were able to push through an even more ridiculous / dangerous bill. Nice strategy.
 
geronamo26 said:
Whats wrong with ODs doing minor surgeries? If they are able to get ample training through, say a two year residency, I do not see the harm. Podiatrists are not MDs, yet they are able to do surgeries, so why is it such a shock that Optometrists want to be able to provide the same to the public in need? I am not saying that ODs should be able to do Lasik, but minor post-operative surgeries if needed. The sky will not fall, nor will the world end if ODs are able to expand their scope to include this ability. Ive seen some immature arguments made online by OMDs against this bill that maked them look like stupid, whinny kids.
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It is simple, Podiatry training is intensively surgical with live patients from professional school onward, as is Dentistry. Optometry is not. Dentistry has additional rigorous requirements for those dentists who want to specialize (in periodontics, for example): a one year general practice dental residency followed by two-year postgraduate clinical residency with a postdoctorate Master's degree and thesis.

If optometrists want to do surgical residencies of equivalent length and rigor to ophthalmologists, they would have a more compelling case for being qualified to perform surgery. The trouble is that they do not want to do that. What they want is to have friendly state legislators in states where they exercise influence by their campaign contributions declare them qualified with little or no training equivalent and no requirement that they ever develop a training process equivalent to the established standard already in place throughout the nation.

When there is already an established standard for qualification to do eye surgery--and there is, medical school followed by approved residency--using state laws to create a much shorter and much less rigorous pathway to surgery practice without any requirement at all to demonstrate equivalency reeks of opportunism and indifference to patient safety and welfare.

Optometry school is not as comprehensive, rigorous or at all inclusive of surgical training as is the combination of medical school, internship and ophthalmology residency. I call out anyone who says differently as a pretender and a fraud.

So I repeat my question to the proponents of optometric surgical practice expansion reading here: will you first (not later, or "eventually," but completely and beforehand) be willing to do what every eye surgeon practicing now must do to demonstrate adequate preparation to do eye surgery: internship and residency (four years) and if not, why not?
 
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Geronamo26

You are no different than the lawmakers / puplic... LASIK is a major part of my practice. From a technical standpoint, it is one of easier procedures ophthalmology does.

The bill says optometry will have the right to perform intraocular surgery, enucleations, strabismus surgery, and a host of other procedures that do not even exist in 2011. On top of that they have no training on real patients in 2011 on any type of surgery. The bill also gives them the right to perform any sort of anesthesia short of general. This is beyond the scope of most MDs.

In summary, optometry should have students take the USMLE, develop a 1 year internship (hang out in a hospital and understand what can happen to surgical patients) / 3 year surgical residency (actually train in eye surgery) if they would like these surgical rights. If they do this, I may not laugh at their bill.
 
Optometrists do not want to do lasik surgery....why don't any of you get that? Everyone, stop overreacting. Optometrists are not MDs, but they do deserve the right to expand their skills and abilities to best serve the public. The problem is that MDs seem to want keep all medical rights to themselves. More medical professionals are noticing this and are fighting back. MDs do not own the medical world. They should be working together with other medical professionals, not cutting their stems or clipping their wings.....
 
orbitsurgMD and I think alike - he just says it more clearly.

The dentistry and podiatry model is the way to go if you want to prove competancy. Some Optometrists do want lasik surgery - surface ablation was a major part of the OK bill - I am sure many of the the recently quoted "250,000" perfect eye surgeries were these (If only MDs could obtain such outstanding results).

Optometry does have the right to expand their skills, show us the equivalent training and knowledge and we will have a discussion. The model is there (podiatry/dentistry).

Don't pass a law and tell the public "we have been doing these procedures for years." This is a complete lie - again read the bill and examine what it is truly asking for.
 
geronamo26 said:
Optometrists do not want to do lasik surgery....why don't any of you get that? Everyone, stop overreacting. Optometrists are not MDs, but they do deserve the right to expand their skills and abilities to best serve the public. The problem is that MDs seem to want keep all medical rights to themselves. More medical professionals are noticing this and are fighting back. MDs do not own the medical world. They should be working together with other medical professionals, not cutting their stems or clipping their wings.....
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Optometry does not want to have to show equivalence in rigor and length of training to those presently performing the procedures that Optometry wants to expand to include.

And explain why Optometry "deserves" anything? Short of showing that as a profession they have required the same length and rigor of training as required of surgeons under the established standard for qualifying as eye surgeons, I don't think they deserve anything at all.

Your argument is that they "deserve" the right to expand their practice scope into surgery without having to show equivalent training, and for no better reason than they say so. (And who is the whiner there?)

And I do see this initiative for what it is, and it is much more than what you are saying it is.
 
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What a typical MD response, so defensive; full of anger with a hint of fear/denial......
I think if they are able to set of a sort of residency with adequate instruction and experience (which is the plan) then there shouldn't be a problem. I do agree that they should not be able to do almost any surgery they want, but I think post-operative minor surgeries/in-office minor surgeries should suffice. As a pre-optometry student, I do not have any interest in dong invasive surgeries such as cutting out eyeballs or administering anesthesia. If I wanted to do that, I would go to medical school. I would be willing to do a three-year surgery recidency if needed....just like Podiatists do...and i am sure there are Optometrists that if able, would go through whatever training to provide these services. Like i said before, ODs are not MDs and should NOT have unlimited scope, but they should be able to train in certain surgeries (not all) to BETTER SERVE THE UNDERSERVED PUBLIC ( and they DESERVE THE RIGHT TO HELP THEM!)
 
geronamo26 said:
What a typical MD response, so defensive; full of anger with a hint of fear/denial......
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Ad hominem and not true. Make a real argument, if you can.


geronamo26 said:
I think if they are able to set of a sort of residency with adequate instruction and experience (which is the plan) then there shouldn't be a problem. I do agree that they should not be able to do almost any surgery they want, but I think post-operative minor surgeries/in-office minor surgeries should suffice. As a pre-optometry student, I do not have any interest in dong invasive surgeries such as cutting out eyeballs or administering anesthesia. If I wanted to do that, I would go to medical school. I would be willing to do a three-year surgery recidency if needed....just like Podiatists do...and i am sure there are Optometrists that if able, would go through whatever training to provide these services. Like i said before, ODs are not MDs and should NOT have unlimited scope, but they should be able to train in certain surgeries (not all) to BETTER SERVE THE UNDERSERVED PUBLIC ( and they DESERVE THE RIGHT TO HELP THEM!)
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Optometrists do not deserve any more consideration than any other profession, nor do they "deserve" the right to perform anything without showing equivalent training in both length and quality to those already performing those procedures.

The pretense of exigency--"underserved"--is at once false and immoral. It is the justification that whomever one regards as "underserved" should be acceptably accommodated by those whose training adheres to a lower standard than would otherwise be acceptable to someone not so "underserved." The underserved do not deserve the undertrained any more than anyone else. Also, capitalizing your arguments does not make them any more persuasive; all it suggests is that you have exhausted your reasoning.
 
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KHE said:
I've said this dozens of times on here. No optometrist wants to do YAGs. (Well, I'm sure there's a couple renegades out there) Trust me, we understand that it's not viable. We don't see enough of them to justify a laser. The number of patients I sent out for a YAG last year was probably half a dozen. Modern surigal techniques don't even necessitate it that often anyways.

And no, optometrists don't want to do LASIK either.
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KHE said:
Optometrists are not interested in performing surgery. We want to be able to not have to grovel everytime there's a new beta blocker or topical anti-histamine on the market.
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I wish that above was true KHE, but it's complete BS. Optometry students these days are told they're going to be able to do lasers and lasik and "surgery" if they fight for expansion of scope.

Do you really think all this money that the optometry board is throwing to politicians in KY is just to avoid groveling for the next eye drop prescription. No, it's about getting that money back via doing lasers. Admit it.
 
I would hate to be your patient, or even an Optometrist working with you if I knew you thought this way. Your response does you no justice. Such puffery! ODs would be undertrained? Providing a lower standard of care? According to who? You? Who are you to say such things? You are entitled to your own opinion about the meaning of "underserved," is but you have no right to tell me what they do and do not deserve. If a patient needs medical help, they should be able to get it in a timely manner without having to drive hours to get quality help. So if someone needs a foreign body taken out of their eye, they should drive an hour to the nearest Optho instead of 10 mins to the nearest Opto for help because they can do it better because of the initials MD behind their names? NO. How is this different from providing MINOR surgical procedures? Do you need a medical degree to take foreign bodies out of the eye? NO. Do you need a medical degree to provide minor surgeries? No, but you need quality training and a certifying board (which would happen if this bill is passed). Medical school should NOT be the only way to get access to quality training for less-invasive procedures.
Money is not and should not be the reason for the passage of this bill. Those that keep claiming that ODs are doing it for the money have no right to say such things. It also makes it seem like thats REALLY what the opponants of the bill are concerned about. Their money.
 
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Mirror Form said:
I wish that above was true KHE, but it's complete BS. Optometry students these days are told they're going to be able to do lasers and lasik and "surgery" if they fight for expansion of scope.[/QUOTE

Some ODs may want to perform laser refractive surgery and some may not; but that should be THEIR decision. Their choice.

Mirror Form said:
Do you really think all this money that the optometry board is throwing to politicians in KY is just to avoid groveling for the next eye drop prescription. No, it's about getting that money back via doing lasers. Admit it.
Click to expand...

Yes, it is. It is called politics. Nothing gets done without money. The last elections proved that.
Click to expand...
 
To the attending and resident physicians in the room, I was hoping to get some input on how concerned I, as an M3 looking to pursue ophtho, should be about all of this talk. I’m nearly 100% set on ophtho, but with optometry looking to expand scope of practice in yet another state, I feel like I’m getting cold feet. I realize that that I would enjoy the field regardless of what optoms are doing in the future, but the idea of spending 8 to 10 years being an ophtho so that I can essentially have the same job as someone with half the educational experience doesn’t set well with me. Granted, if optoms develop some sort of residency training the discrepancy in educational sacrifice would cease to exist, but if these people want to do surgery they should have to go through the established channels like the rest of us. After I finished pharmacy school, I decided that it wasn’t my cup of tea, but rather than complain that I should somehow be entitled to prescribe the same meds that I was already dispensing, I counted my losses and went to medical school. Anyway, I’m getting tangential here, I just wanted to know if ophtho is a field that you would still recommend to a medical student (pretend I’m a close friend or family member, I prefer honesty here). Thanks so much for any responses.
 
geronamo26 said:
I would hate to be your patient, or even an Optometrist working with you if I knew you thought this way. Your response does you no justice. Such puffery! ODs would be undertrained? Providing a lower standard of care? According to who? You? Who are you to say such things? You are entitled to your own opinion about the meaning of "underserved," is but you have no right to tell me what they do and do not deserve. If a patient needs medical help, they should be able to get it in a timely manner without having to drive hours to get quality help. So if someone needs a foreign body taken out of their eye, they should drive an hour to the nearest Optho instead of 10 mins to the nearest Opto for help because they can do it better because of the initials MD behind their names? NO. How is this different from providing MINOR surgical procedures? Do you need a medical degree to take foreign bodies out of the eye? NO. Do you need a medical degree to provide minor surgeries? No, but you need quality training and a certifying board (which would happen if this bill is passed). Medical school should NOT be the only way to get access to quality training for less-invasive procedures.
Money is not and should not be the reason for the passage of this bill. Those that keep claiming that ODs are doing it for the money have no right to say such things. It also makes it seem like thats REALLY what the opponants of the bill are concerned about. Their money.
Click to expand...

I would love to work with orbitsurgMD and I know the optometrists I work with would as well.

Why do all the bill backers keep talking about "minor surgery." The bill allows for some of the most invasive eye surgeries in the field of ophthalmology. Basically if laser is placed in front of the procedure, optometry says they are trained to do it. This is not about foreign bodies.

Further, the access to care thing is a big joke. Most of the optometric surgeons in Oklahoma practice within 1 hour of Oklahoma City - I have seen a map of this. I suppose we should let chiropractors start performing neurosurgery because it is a little too much for a patient to drive 20 minutes for to have that intracranial hematoma evacuated.

Finally, the bill gives optometry the ability to perform laser cataract surgery. Do you really think the optometrist in the middle of nowhere will set up a $1,000,000 dollar piece of equipment (that is the cost of the lensx system). Maybe he/she will, but it is an interesting business model.
 
geronamo26 said:
I would hate to be your patient, or even an Optometrist working with you if I knew you thought this way.
Click to expand...

Is this your argument, or just juvenile outrage that someone might disagree with you and have clear reasons for doing so?

geronamo26 said:
Your response does you no justice. Such puffery! ODs would be undertrained? Providing a lower standard of care? According to who? You? Who are you to say such things?
Click to expand...

I am someone professionally better qualified than you are to know the requirements of my field, if that matters to you.

As for my response, it is more measured, logical and reasonable that what you have written. I think at least my post has done my thinking justice. I cannot say about anyone else, especially you and yours.



geronamo26 said:
You are entitled to your own opinion about the meaning of "underserved," is but you have no right to tell me what they do and do not deserve. If a patient needs medical help, they should be able to get it in a timely manner without having to drive hours to get quality help. So if someone needs a foreign body taken out of their eye, they should drive an hour to the nearest Optho instead of 10 mins to the nearest Opto for help because they can do it better because of the initials MD behind their names? NO. How is this different from providing MINOR surgical procedures? Do you need a medical degree to take foreign bodies out of the eye? NO. Do you need a medical degree to provide minor surgeries? No, but you need quality training and a certifying board (which would happen if this bill is passed). Medical school should NOT be the only way to get access to quality training for less-invasive procedures.
Money is not and should not be the reason for the passage of this bill. Those that keep claiming that ODs are doing it for the money have no right to say such things. It also makes it seem like thats REALLY what the opponants of the bill are concerned about. Their money.
Click to expand...



You are blowing smoke. Make an argument, if you have one.

And unless you can show how an optometrist without a training foundation in surgery is as qualified as a ophthalmologist with that training foundation, then I and anyone reading has every right to question the motive of optometrists. And greed is the main motive, in my opinion.

Everything in professional life is not relative to the interpretations or wishes of each individual or each profession. Medicine is held to standards, of education and of training. (I am not allowed to set myself up as a pain specialist and run a pain clinic any way I please.) Why do you think optometrists should be entitled to practice with less rigorous training (and give a logical reason, not "because we deserve to" or because "underserved" patients are deserving of our being available to them on terms we devise, free from established standards?) I sense you think optometrists seeking surgical privileges shouldn't have to be burdened with giving a cogent argument why Optometry is deserving of being held to a less rigorous standard of training. If so, I am curious why. When they don't have either the surgery training or the length of years of training behind their claims of qualification, I am curious exactly what it is about them that does qualify them. Perhaps you know, if so, please tell.

But don't just say, "because we do", or "because we want to." That won't cut.
 
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I don't have time to write a novel in response here since i have better things to do with my time than to argue around in circles with you. I have made my points and you have made yours...so lets just agree to disagree. The bill has gone far and fast with a lot of support. The ODs obviously have a solid amount of proof, reasoning, and documentation as the bill has gone as far as it has. Whether you want to support the bill or not is your choice.
 
geronamo26 said:
I don't have time to write a novel in response here since i have better things to do with my time than to argue around in circles with you. I have made my points and you have made yours...so lets just agree to disagree. The bill has gone far and fast with a lot of support. The ODs obviously have a solid amount of proof, reasoning, and documentation as the bill has gone as far as it has. Whether you want to support the bill or not is your choice.
Click to expand...

LMAO!!! Proof, reasoning, and documentation. Right, that's what drives the political process in this country, not the fact everyone supporting this bill has received campaign contributions from Optometry's lobbying group.
 
geronamo26 said:
I don't have time to write a novel in response here since i have better things to do with my time than to argue around in circles with you. I have made my points and you have made yours...so lets just agree to disagree. The bill has gone far and fast with a lot of support. The ODs obviously have a solid amount of proof, reasoning, and documentation as the bill has gone as far as it has. Whether you want to support the bill or not is your choice.
Click to expand...

Hahaha, yes - you've definitely 'made your points,' and been smoked at each and every level. I'm sure you 'don't have time,' to write a response. The response coming out of ODs and pre-ODs has seriously left me floored.

Yes, the bill has 'lots of support' - apparently paying off politicians, pushing the bill by attaching it to another, and bypassing health welfare committees shows throngs of support. The textbook definition of proof, reasoning, and documentation.

Speaking of which ... I'd like to see your proof, reasoning, and documentation that clearly supports expanded surgical rights. Prove to me that the new 'residency' system for ODs is thoughtfully planned out, and in place. Don't use the word assume in this explanation. Demonstrate to me the reasoning behind a DO/MD completing medical school and a 4 year surgical residency, but why an OD who has not done any of the above should be able to operate proficiently and without harming patients. Share the documentation that demonstrates an OD is more likely to set up a rural practice and 'serve the underserved' compared to an O-MD/DO. Let me see the documentation that explains the ODs only want to perform small 'surgical' procedures and that this bill DOESN'T have the potential to set up an untouchable OD board that gives them the rights to essentially any procedure (either real or futuristic) that they'd like to perform.

Because frankly, I see NONE of this in the bill that's being crammed down the state's throat via shady, Chicago-style politics.
 
geronamo26 said:
I don't have time to write a novel in response here since i have better things to do with my time than to argue around in circles with you. I have made my points and you have made yours...so lets just agree to disagree. The bill has gone far and fast with a lot of support. The ODs obviously have a solid amount of proof, reasoning, and documentation as the bill has gone as far as it has. Whether you want to support the bill or not is your choice.
Click to expand...

What was your valid reasoning again geronamo26. I think your argument amounted to "well because they should." :thumbdown:
 
geronamo26 said:
I don't have time to write a novel in response
Click to expand...

It wouldn't help you even if you did.


geronamo26 said:
here since i have better things to do with my time than to argue around in circles with you. I have made my points and you have made yours...so lets just agree to disagree. The bill has gone far and fast with a lot of support. The ODs obviously have a solid amount of proof, reasoning, and documentation as the bill has gone as far as it has. Whether you want to support the bill or not is your choice.
Click to expand...

You don't have a case, events in Kentucky notwithstanding. The bill in Kentucky has passed not because of merit or reason, such things are not required in politics, but because of influence paid for in campaign contributions. Don't assume that this bill is passed--if it is signed--on the merits of "proof, reasoning and documentation." It has none of that. I would think self-respecting optometrists in Kentucky would lament the passing of this legislation, especially in the way that it was passed. It really is nothing less than unseemly.
 
Frumps said:
What was your valid reasoning again geronamo26. I think your argument amounted to "well because they should." :thumbdown:
Click to expand...

No, no, no ... not "because they should," it's because they "deserve" it. Patient safety be damned!
 
geronamo26 said:
I don't have time to write a novel in response here since i have better things to do with my time than to argue around in circles with you. I have made my points and you have made yours...so lets just agree to disagree. The bill has gone far and fast with a lot of support. The ODs obviously have a solid amount of proof, reasoning, and documentation as the bill has gone as far as it has. Whether you want to support the bill or not is your choice.
Click to expand...


Can't practice law without a law degree and passing the bar. Can't fly a plane without a pilot's license. Performing eye surgery should be no different. Stop trying to find ways to circumvent the system.
 
speyeder said:
Can't practice law without a law degree and passing the bar. Can't fly a plane without a pilot's license. Performing eye surgery should be no different. Stop trying to find ways to circumvent the system.
Click to expand...

Medicine is the clear exception - you can practice family medicine without a residency or attending medical school ... just get your DNP. Hell, you can even put 'Dr' on your long white coat. You can be an anesthesiologist without ever stepping foot in a medical school - just ask a CRNA. You can deliver a child without any supervision and not even brush shoulders with a OB - ask a midwife. Now, you can operate on Grandma's eyes without a license that says physician and surgeon as well.

It's not about training, efficacy, safety, and results; it's about seeing an opportunistic void in the system, organizing a lobbying group, paying off the scumbag politicians, and practicing however you want because your group 'deserves it,' and any attempt to dissuade from this opinion is simply some DO/MD who's mad that he has to spend less time on the golf course discussing his bank account and more time keeping all these highly qualified, superior practitioners who are 'just trying to bring care to underserved populations' beaten down.
 
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