Kentucky: The Latest Battleground for Optometric Scope Expansion

[Wedgebuster]

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!)

Really? A Pre-optometry student? Really? You are not even in optometry school yet? and you are arguing with an oculoplastic surgeon about how to provide eye care to the public? Really? Ha. Is this a joke? really, this HAS to be a joke, you must be an MD inciting anger in us.

This is funny, and demonstrates a very important point about this whole situation. The scariest human being is the one who doesn't know what he doesn't know. I am about to get my MD. I guess now I 'deserve' to be able to do breast augs, treat epilepsy, give chemo, and put in VP shunts. Interestingly, I now know enough to know that without A LOT of extra training, I could not properly serve my patients.

This is why I, like every doc I have ever met, send my kids to a pediatrician not an NP, send my wife to an OB not a midwife, and get my braces from a orthodontist not a general dentist.

I only know of one profession trying to expand their 'scope of practice' without trying to expand their 'scope of training'. There is no substitute for training.

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[JaggerPlate]

The scariest human being is the one who doesn't know what he doesn't know.

Quoted for truth ...

 

[Visionary]

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.

Another point regarding this issue. The reason for having committees that deal with particular types of legislation is that those individuals have more experience with it, having dealt with it on regular basis, and can scrutinize it more thoroughly and modify it appropriately before it is presented to the full senate/house. That's the required process at every level of government--fact.

By purposely avoiding the correct committee, they avoided the degree of scrutiny this bill deserved. Shady.

 

[DiveMD]

To dangerously lower the standards of care under the guise of “helping those living in underserved areas” is ludicrous. What is next for this wannabe MD’s? ENT procedures? I guess the nose is close to enough to the eyes? And I’m sure there is a need for ENT’s in rural areas of KY. Why don’t we just grant medical privileges to the town’s butcher so everyone can have access to orthopedic procedures? This discussion is unethical and beyond my comprehension.

I wonder if any of the optoms in this forum would ever send one of their family members to an “optometric physician” (what a joke!) for a surgical procedure.

 

[Frumps]

To dangerously lower the standards of care under the guise of “helping those living in underserved areas” is ludicrous. What is next for this wannabe MD’s? ENT procedures? I guess the nose is close to enough to the eyes? And I’m sure there is a need for ENT’s in rural areas of KY. Why don’t we just grant medical privileges to the town’s butcher so everyone can have access to orthopedic procedures? This discussion is unethical and beyond my comprehension.

I wonder if any of the optoms in this forum would ever send one of their family members to an “optometric physician” (what a joke!) for a surgical procedure.

I for one actually like the idea. I think chiropractors should be able to perform back surgery as well. They currently bill themselves as experts in the nonsurgical treatment of the spine, but since they attend 4 years of postgraduate education (like optometrists), they should be able to handle it. Besides, there are definitely not enough orthopods or neurosurgeons in the rural areas.

 

[200UL]

I actually feel my local car mechanic may be able to assist in knee replacements/hip replacements and he has many friends in rural areas. Having assisted on about 25 joint replacements while I was in medical school, I know he definitely has the strength and is accustomed to some of the styles of instruments used.

He only lacks experience with patients, but he is a member of the ASE. They have a big lobbying group and they can figure out the actual training on humans down the road. The citizens in rural america are counting on this...

 

[qcy07]

I have occasionally looked at these forums over the last 3 or 4 years and it seems that there are relatively few people posting, with some making arguments and points that seem somewhat out of touch with what I see as the reality that exists between Ophthalmology and Optometry. This is my first post, and I decided to jump in because some of the arguments on both sides of this and many other issues involving the two professions just don't jive well with my experiences. I have been a practicing Optometrist for five years in a state far from Kentucky. I work in a rural area where the nearest Ophthalmologist (and for that matter Optometrist) is an hour and a half drive from my location. I realize this is somewhat unique, but it has given me a perspective I don't think I would have in a more saturated eye care market. I work directly with general ophthalmology as well as every sub-specialty in eye care, from retina, to cornea, oculoplastics, neuro-ophthal, etc. I visit with all of them. I sit down and break bread with them. I get along great with all of them. I respect them greatly. I have learned so much from all of them. I can't be sure that behind my back there would not be some small overtones in the OMD community in my area regarding Optometry and its political wing and agenda. Overall we all work well together for the good of the patients we take care of. I know my limits of training, and do not hesitate to refer or consult on something that is out of my comfort level even though it may be within my legal scope. I am happy with my scope currently. Everyone within a 50 mile radius to me is sent to my office with an ocular problem. I get daily referrals from all 9 primary care physicians in my area, and night calls weekly from all 5 ED physicians. They have all grown to trust me over the years because they understand that I understand my limits and because of my relationship to Ophthalmology they can be confident that they can pass the patient off to me and the patient will receive appropriate care. Some of these bills just go too far, but some Ophthalmologists in this forum make statements regarding our training as if they had audited all of my classes during my four years of post graduate work.

Here's a few things I just wanted to say as well:

1. The term "Optometric Physician"= stupid... I am an optometrist
2. Ophthalmology does not have a monopoly on all eye care knowledge.
3. Many times it is about the money on both sides
4. We should not be doing most surgical procedures until our training justifies them. I know this will make some of my fellow Optometrists unhappy but it is a fact.
5. If I have to read one more article about how Ophthalmologists receive 20+ years of training counting junior high school, and Optometrists basically printed their diplomas at kinkos, I will vomit.
6. Please to all optometry students, do not post unless you know what the hell you are talking about and can spell.
7. I wish this forum and the Optometry forum was more productive instead of spiraling down to inane attacks with sometimes very poor information.
8. Can we get some new blood to post here and have a productive healthy discussion.

sorry for the long post

 

[Visionary]

I have occasionally looked at these forums over the last 3 or 4 years and it seems that there are relatively few people posting, with some making arguments and points that seem somewhat out of touch with what I see as the reality that exists between Ophthalmology and Optometry. This is my first post, and I decided to jump in because some of the arguments on both sides of this and many other issues involving the two professions just don't jive well with my experiences. I have been a practicing Optometrist for five years in a state far from Kentucky. I work in a rural area where the nearest Ophthalmologist (and for that matter Optometrist) is an hour and a half drive from my location. I realize this is somewhat unique, but it has given me a perspective I don't think I would have in a more saturated eye care market. I work directly with general ophthalmology as well as every sub-specialty in eye care, from retina, to cornea, oculoplastics, neuro-ophthal, etc. I visit with all of them. I sit down and break bread with them. I get along great with all of them. I respect them greatly. I have learned so much from all of them. I can't be sure that behind my back there would not be some small overtones in the OMD community in my area regarding Optometry and its political wing and agenda. Overall we all work well together for the good of the patients we take care of. I know my limits of training, and do not hesitate to refer or consult on something that is out of my comfort level even though it may be within my legal scope. I am happy with my scope currently. Everyone within a 50 mile radius to me is sent to my office with an ocular problem. I get daily referrals from all 9 primary care physicians in my area, and night calls weekly from all 5 ED physicians. They have all grown to trust me over the years because they understand that I understand my limits and because of my relationship to Ophthalmology they can be confident that they can pass the patient off to me and the patient will receive appropriate care. Some of these bills just go too far, but some Ophthalmologists in this forum make statements regarding our training as if they had audited all of my classes during my four years of post graduate work.

Here's a few things I just wanted to say as well:

1. The term "Optometric Physician"= stupid... I am an optometrist
2. Ophthalmology does not have a monopoly on all eye care knowledge.
3. Many times it is about the money on both sides
4. We should not be doing most surgical procedures until our training justifies them. I know this will make some of my fellow Optometrists unhappy but it is a fact.
5. If I have to read one more article about how Ophthalmologists receive 20+ years of training counting junior high school, and Optometrists basically printed their diplomas at kinkos, I will vomit.
6. Please to all optometry students, do not post unless you know what the hell you are talking about and can spell.
7. I wish this forum and the Optometry forum was more productive instead of spiraling down to inane attacks with sometimes very poor information.
8. Can we get some new blood to post here and have a productive healthy discussion.

sorry for the long post

Good post.

 

[MR1]

Serious question here then

Is this bill about getting some basic things like FB removal and expanding Rx rights?

I don't care if OD's take out corneal FB (they SHOULD be trained for this) or write most all meds.

Now, retinal lasers, intravitreal injections (or whatever you call them, ie inoculations), sub-tenon injections, lid lesion removal, AC taps. OD's should not do these period. Any OD's on here if you disagree with me on this, have a rational conversation about it. Tell me why you think you should and how you were trained for it, ie number of actual patients "practiced on" and if you could handle the complications.

YAG caps - torn here actually if OD's should be able to do these, I understand they are safe and simple but it still worries me. Are any OD's doing these in school on actual patients?

SLT\ALT\YAG PI's - can cause K decomp if hit the cornea (easier than you think with PI's). Can have pressure spikes, what if they need AC tap? How many are OD's doing in school? Give me a reason why OD's should be doing these. Is there really an underserved need here.

Lastly, how is it safe for patients to expand scope without having expanding training first.

 

[geronamo26]

I'm sure if the bill is passed, OD schools will have to change their curriculums to include training in sed procedures, perhaps even have test tries to a limited few ODs to see how well they do. Scope expansions are always going to happen in all medical professions to keep up with new advances in medicine. Its common sense.

 

[EyeGuy15]

What is the most frustrating about this whole discussion is that the ophtho people here seem to just want to complain about the optoms questionable "ethics" and being "shady" in regards to how they presented the bill.

I may not agree with Meibomian SxN, but I will applaud his tenacity in the manner. While the ophtho people are complaining, the optoms are making real moves.

Unfortunately, from my experiences with ophthalmologists (residents/attendings), I have seen basically two types of people:

The older ophthalmologists for the most part are not too concerned about the new bill because most of them have built their strong practices and have reaped a great deal of financial benefits in their time. In addition, any real changes to the financial environment will most likely take years to really take their effect from the time the bill is officially passed etc. By that time, the old school will be retired or be VERY comfortable financially so that their lifestyle wont truly be affected.

The younger ophthalmologist (residents/attendings/med students pursuing the field) that I have encountered are similar to what I am seeing on this forum. Complain, complain, complain and just sit back and claim the ethical high ground. Yes the optoms donated money to the right people and put out commercials that may be considered unethical and spreading "propaganda", but this is all legal and happens in politics EVERY SINGLE DAY. It is the reality of the USA. I may not agree with what the optoms who want to expand scope are saying, but you can not stop them from saying it and they were VERY SMART for going through the political channels. If ophthalmologists want to fight back they should fight "fire with fire". Instead all I read is a bunch of posts from people in ophtho basically crying and whining and trying to use smart ***** remarks.

Honestly, me and visionary have had our disagreements, but as one of the few attendings who post on this site, I sure hope you are spending as much time on SDN as you are in conferences and meetings to address the future of ophthalmology. If the field of ophthalmology has a fighting chance at keeping the respect it deserves, it has to come from the younger generation of ophthalmologists, because most of the older generation won't waste their time and energy(and I don't blame them).

Unfortunately, and I will probably be destroyed for this, most of the young ophthalmologists I meet, although incredibly bright in the field of medicine, are so incredibly lost when it comes to dealing with the finances and politics of medicine. We may have some of the highest board scores for a medical field, but that means nothing in the real world outside of medicine. Props to the optoms for understanding the way America really works and using the system to reach their goals. I am not happy about it, but as a fourth year med student years away from finishing my residency, all I can do is hope the young ophthalmologists who do push some weight have some sort of clue on how to address these new matters affecting all physicians.

 

[Visionary]

What is the most frustrating about this whole discussion is that the ophtho people here seem to just want to complain about the optoms questionable "ethics" and being "shady" in regards to how they presented the bill.

I may not agree with Meibomian SxN, but I will applaud his tenacity in the manner. While the ophtho people are complaining, the optoms are making real moves.

Unfortunately, from my experiences with ophthalmologists (residents/attendings), I have seen basically two types of people:

The older ophthalmologists for the most part are not too concerned about the new bill because most of them have built their strong practices and have reaped a great deal of financial benefits in their time. In addition, any real changes to the financial environment will most likely take years to really take their effect from the time the bill is officially passed etc. By that time, the old school will be retired or be VERY comfortable financially so that their lifestyle wont truly be affected.

The younger ophthalmologist (residents/attendings/med students pursuing the field) that I have encountered are similar to what I am seeing on this forum. Complain, complain, complain and just sit back and claim the ethical high ground. Yes the optoms donated money to the right people and put out commercials that may be considered unethical and spreading "propaganda", but this is all legal and happens in politics EVERY SINGLE DAY. It is the reality of the USA. I may not agree with what the optoms who want to expand scope are saying, but you can not stop them from saying it and they were VERY SMART for going through the political channels. If ophthalmologists want to fight back they should fight "fire with fire". Instead all I read is a bunch of posts from people in ophtho basically crying and whining and trying to use smart ***** remarks.

Honestly, me and visionary have had our disagreements, but as one of the few attendings who post on this site, I sure hope you are spending as much time on SDN as you are in conferences and meetings to address the future of ophthalmology. If the field of ophthalmology has a fighting chance at keeping the respect it deserves, it has to come from the younger generation of ophthalmologists, because most of the older generation won't waste their time and energy(and I don't blame them).

Unfortunately, and I will probably be destroyed for this, most of the young ophthalmologists I meet, although incredibly bright in the field of medicine, are so incredibly lost when it comes to dealing with the finances and politics of medicine. We may have some of the highest board scores for a medical field, but that means nothing in the real world outside of medicine. Props to the optoms for understanding the way America really works and using the system to reach their goals. I am not happy about it, but as a fourth year med student years away from finishing my residency, all I can do is hope the young ophthalmologists who do push some weight have some sort of clue on how to address these new matters affecting all physicians.

I actually agree with much of what you've stated (including the last couple of paragraphs). To your point, ophthalmologists, perhaps because of the two categories you described, as a whole do not give much money to their PACs. Organized optometry absolutely hammers us, in that regard. My understanding, and my optometrist colleagues can correct me, is that optometric PAC contributions are almost like a tithe. In other words, everyone contributes on a regular basis. For ophthalmologists, it's like getting blood from turnips.

As to some of my prior comments, to which you appear to be eluding, the "shady" aspects of how this bill was presented and evaluated can surely be considered politics as usual. That doesn't mean we can't be critical of it. That's also part of politics.

 

[JaggerPlate]

I'm sure if the bill is passed, OD schools will have to change their curriculums to include training in sed procedures, perhaps even have test tries to a limited few ODs to see how well they do. Scope expansions are always going to happen in all medical professions to keep up with new advances in medicine. Its common sense.

I literally can't count the number of times I've heard people 'assuming,' 'guessing,' and 'sure' of increased training with regarding to these increased scope expansion.

No offense, but your anecdotes, opinions, and assumptions mean absolutely nothing and offers no guarantee that proper training will occur.

 

[KHE]

I actually agree with much of what you've stated (including the last couple of paragraphs). To your point, ophthalmologists, perhaps because of the two categories you described, as a whole do not give much money to their PACs. Organized optometry absolutely hammers us, in that regard. My understanding, and my optometrist colleagues can correct me, is that optometric PAC contributions are almost like a tithe. In other words, everyone contributes on a regular basis. For ophthalmologists, it's like getting blood from turnips.

I would say that in general, there are those ODs that contribute and contribute well and there are those where it is like getting blood from a turnip.

I guess the balance is a bit better in optometry than in ophthalmology.

 

[JaggerPlate]

From the American Osteopathic Association (2/22):

AOA President Karen J. Nichols, DO, wrote to the Speaker of the Kentucky House of Representatives on 2/16/11 to express the AOA’s opposition to SB 110, a bill that would authorize optometrists to perform surgery and administer injectable drugs. It is the AOA’s position that the optometric education track does not provide practitioners with the medical knowledge or the clinical experience required to perform the surgical procedures authorized in the bill, and we urged lawmakers to vote against it. To further our cause, AOA Trustee Boyd R. Buser, DO, along with several fellow medical leaders from Kentucky, met with “Bluegrass State” Governor Steve Beshear on 2/21/11 to urge him to veto this expansion of optometrists’ scope of practice. Dr. Buser reports that Governor Beshear was very interested and attentive in the information presented by the physicians. The AOA will also follow up with this meeting by sending a formal letter to Gov. Beshear.​

 

[Meibomian SxN]

From the American Osteopathic Association (2/22):

AOA President Karen J. Nichols, DO, wrote to the Speaker of the Kentucky House of Representatives on 2/16/11 to express the AOA’s opposition to SB 110, a bill that would authorize optometrists to perform surgery and administer injectable drugs. It is the AOA’s position that the optometric education track does not provide practitioners with the medical knowledge or the clinical experience required to perform the surgical procedures authorized in the bill, and we urged lawmakers to vote against it. To further our cause, AOA Trustee Boyd R. Buser, DO, along with several fellow medical leaders from Kentucky, met with “Bluegrass State” Governor Steve Beshear on 2/21/11 to urge him to veto this expansion of optometrists’ scope of practice. Dr. Buser reports that Governor Beshear was very interested and attentive in the information presented by the physicians. The AOA will also follow up with this meeting by sending a formal letter to Gov. Beshear.​

If you're so worried about patient safety, why not petition the FDA? Seems they do more harm than all optometrists combined...

No worries, I'm sure the governor got some of that $450K. I don't see him reneging on that...

 

[Visionary]

If you're so worried about patient safety, why not petition the FDA? Seems they do more harm than all optometrists combined...

No worries, I'm sure the governor got some of that $450K. I don't see him reneging on that...

Actually, he's the only one in the state government who received more from ophthalmology. :-D

Still, don't foresee a veto.

 

[DiveMD]

No worries, I'm sure the governor got some of that $450K. I don't see him reneging on that...

Sounds like you are happy and proud of the way your profession is literally purchasing a medical degree in KY. But why can’t you attend medical school if your interest for surgery is so strong? Judging by the amount and frecuency of your posts, you definitively have plenty of time on your hands. It’s time to take the MCAT if you want to be a physician and a real surgeon.

 

[Frumps]

http://www.youtube.com/watch?v=fA6tW8bFpmE&feature=player_embedded

And to think these people are responsible for your healthcare. He has no idea what he is talking about...

LASIX.

 

[JaggerPlate]

http://www.youtube.com/watch?v=fA6tW8bFpmE&feature=player_embedded

And to think these people are responsible for your healthcare. He has no idea what he is talking about...

LASIX.

Jesus Christ ... not only did he mispronounce cataract, I'm 90% sure there was some guy sleeping behind him (who no doubt received compensation from the OD PAC group and voted yes on the bill).

The worst part of this entire situation is that it isn't just the ODs who play this gross political game ... it's everyone in American who wants something and has the financial means to fill the pockets of these politicians. UGH.

 

[Meibomian SxN]

http://www.youtube.com/watch?v=fA6tW8bFpmE&feature=player_embedded

And to think these people are responsible for your healthcare. He has no idea what he is talking about...

LASIX.

LMAO!

1:05 - Man sits down with 2 DRINKS!

2:33 - Another handshake deal is done!

3/4ths of the inattentive people wear glasses, I wonder who Rx'd them?

 

[JaggerPlate]

3/4ths of the inattentive people wear glasses, I wonder who Rx'd them?

Lens Crafters? The kiosk at Wal * Mart? Who knows ...

The real question is who they will see when they need eye surgery - an OD or the board certified Ophthalmologist?

 

[janenwil]

long time lurker but felt the need to chime in. all this going back and forth really seems to me just wasted energy. in the end, you just don't know what you don't know, and all the rants are not going to convince anyone of anything.

i've always been one of those pwoplw that didn't believe it would really happen this way. the bottom line is, the general public (including politicians and some medical students) don't know the difference between an ophthalmologist and an optometrist. to them, they both wear white coats and are eye doctors. probably, most people assume optometrists are medical doctors.

i think the only real viable solution (aside from contributing to the politicians - $400,000 from the Kentucky optometrists with full time lobbyists vs $500 from the Kentucky ophthalmologists is just... well, makes me lose faith in our system) is to educate the public and our patients. An anesthesia colleague has been doing this with this website: www.doctorbyyourside.org. does anyone know how the AAO might be able to do something similar?

in the end, i believe most optometrists and ophthalmologists truly care about their patients and that patients benefit most when we all work together. i also believe that most optometrists are not interested in doing surgery, and i also recognize that they are, at times, not given the respect they deserve with respect to their training. i've always wondered why we couldn't work out a way for optometrists to pursue an ophthalmology residency and put this issue to rest. however, how things went down in kentucky made me realize that maybe the leaders of optometry are not interested, and that there is a long-term agenda that has been planned. i've heard that an optometry school in texas is building a surgery center (why would they do this? the usual answers of billing, do what we were trained for, etc etc etc are just not consistent). we as physicians need to take a more active role and find better ways of working together. educating the public and our patients is a good place to start.

 

[Visionary]

Actually, he's the only one in the state government who received more from ophthalmology. :-D

Still, don't foresee a veto.

As expected, signed into law today. There is a possibility of severely limiting it, however. More to come....

 

[Meibomian SxN]

As expected, signed into law today. There is a possibility of severely limiting it, however. More to come....

Let it go, the bill is signed and now optometrists in Kentucy can practice to the maximum of their education and training.

 

[Visionary]

Let it go, the bill is signed and now optometrists in Kentucy can practice to the maximum of their education and training.

I think you meant to say "beyond."

 

[Mirror Form]

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

Okay, so who should be allowed to practice medicine then? Should be zero regulations? Should anybody who wants to be able to open a business and market themselves as any type of physician?

Yes, it is. It is called politics. Nothing gets done without money. The last elections proved that.

That's a nice way of describing corruption. But yes that is our political system, and physicians as a whole are pathetic when it comes to politics and business.

 

[200UL]

Meibomian SxN - Where are you at in your career? After reading your posts, I wonder if 1) you are simply trying to get under the skin of some posters (and therefore do not believe a thing you post) or 2) you are simply ignorant and have no concept on what is involved in learning things like providing actual medical care to patients.

Do not state that optometry has already started training in these things - doing so requires actual patients - obviously a bizarre concept for some.

I am sick of reading the thought - "should optoms have the ability to perform YAG capsulotomies?" The bill has granted so much beyond this.

The optometrists I work with simply role their eyes about this law - don't get me wrong - most of them are looking to increase scope, but they are practical and realize that a law that asks for "laser lens extraction" is a bit beyond their skill set.

Until optometry shows equivalent training programs, the legislator approved/trained "surgeons" will simply be seen as frauds in my opinion by the educated observers. Enjoy trying to implement equivalent training programs.... Your profession will never do it because it appears to have no desire to do so...

 

[Mirror Form]

The younger ophthalmologist (residents/attendings/med students pursuing the field) that I have encountered are similar to what I am seeing on this forum. Complain, complain, complain and just sit back and claim the ethical high ground.

A big part of that problem is the ivory tower liberal idealism that most medical students are brainwashed with from day 1 of med school. The only politics I was taught in medical school was that we should all go out and support a single payer government healthcare system

The idea of contributing money to politicians in order to actually help physicians is almost considered taboo within the walls of most med schools.

 

[JaggerPlate]

Let it go, the bill is signed and now optometrists in Kentucy can practice to the maximum of their education and training.

Although I don't expect this bill to be altered (whatsoever) ... this isn't the way the game is played. You guys used shady politics to jam it through, and now the party who opposes it gets to use shady politics to try and break it down and make it a shell of what it was.

Do keep us updated though Visionary

Meibomian SxN - Where are you at in your career

I don't want to bash Meibomian here whatsoever ( I apologize in advance if it comes off that way), but I read a thread recently where he claimed that he was essentially disappointed with a career in Optometry and what Optometrists were and were not allowed to do. In fact, I believe he even stated that he felt "lied to" by those who influenced his decision to enter the field and those educating him in school.

Additionally, in the same thread, Meibomian mentioned that he WOULD go back and get the MD, but he found the time and financial commitment too much, and would simply make the best out of Optometry for the time being.

Frankly, this kind of correlates with one of my biggest issues with the newly enacted law - filling some sort of insecurity void and taking what's traditionally performed by the DO/MDs because 'they are real doctors too and deserve just as much.' As everyone has said the entire time, it's patients ... not Ophthalmologists ... who really suffer from all this ego stroking and chest thumping.

http://forums.studentdoctor.net/showthread.php?p=10596249#post10596249

However, it's now Thursday, the law was passed Wednesday, and we were PROMISED a description of the increased training in the OD model. Anybody have official word on this yet? It seems like there was plenty of time along the way to craft this plan and release it right after the bill passed.

 

[Meibomian SxN]

Okay, so who should be allowed to practice medicine then? Should be zero regulations? Should anybody who wants to be able to open a business and market themselves as any type of physician?

So you are saying an optometrist is "any type of physician?" Typical MD "arrogant grip" response...

That's a nice way of describing corruption. But yes that is our political system, and physicians as a whole are pathetic when it comes to politics and business.

Exactly, so stop being so naive about the issue. Play the game or take your ball home from the court and continue to whine.

Meibomian SxN - Where are you at in your career? After reading your posts, I wonder if 1) you are simply trying to get under the skin of some posters (and therefore do not believe a thing you post) or 2) you are simply ignorant and have no concept on what is involved in learning things like providing actual medical care to patients.........The optometrists I work with simply role their eyes about this law - don't get me wrong - most of them are looking to increase scope, but they are practical and realize that a law that asks for "laser lens extraction" is a bit beyond their skill set.

You sound like the terror alert system: "Its red, its orange, be suspicious, etc"; redundant, monotonous and moot. Be a doctor and stop whining please.

Are you a politician? Are you on a PAC committee? Sometimes the law has to be written as such in order to get passed, not to gain permission to hurt the patients for money; as you are alluding to.

If you care so much about the patients, how about protesting the use of cigarettes or high fructose corn syrup. Make yourself useful.

 

[Meibomian SxN]

....I don't want to bash Meibomian here whatsoever ( I apologize in advance if it comes off that way), but I read a thread recently where he claimed that he was essentially disappointed with a career in Optometry and what Optometrists were and were not allowed to do. In fact, I believe he even stated that he felt "lied to" by those who influenced his decision to enter the field and those educating him in school.

That is true. We were taught much more than we get to practice, and so I feel as though the optometry school educators are doing a disservice. Also income ranges are skewed.

Additionally, in the same thread, Meibomian mentioned that he WOULD go back and get the MD, but he found the time and financial commitment too much, and would simply make the best out of Optometry for the time being.....

Frankly, this kind of correlates with one of my biggest issues with the newly enacted law - filling some sort of insecurity void and taking what's traditionally performed by the DO/MDs because 'they are real doctors too and deserve just as much.' As everyone has said the entire time, it's patients ... not Ophthalmologists ... who really suffer from all this ego stroking and chest thumping.

Nothing to do with insecurity. But financially it does not make sense for me to go an additional $200K+ in loans, grueling board exams and cut throat competition, all to be able to perform a few more procedures.

I chose not to go to medical school because I was not interested in invasive surgery and on call lifestyle. But I definitely did not become an optometrist to refract only.

Kentucky and Oklahoma were able to pass such laws because they can always say there are patients in rural areas that can not receive care. States with large metropolitan cities can not say the same. Hence my disappointment.

 

[200UL]

Meibomian - can you describe your optometric surgical training - we are still waiting. Does it include actual humans? What year does it start? What are the final numbers on each procedure listed in the KY law.

Please be specific.

I am sorry your "surgery" skills are under used and you do not make enough money. They lied to you!

 

[Meibomian SxN]

Meibomian - can you describe your optometric surgical training - we are still waiting. Does it include actual humans? What year does it start? What are the final numbers on each procedure listed in the KY law.

Please be specific.

I am sorry your "surgery" skills are under used and you do not make enough money. They lied to you!

Are you a patient of mines? I do not answer to ophthalmologists. I answer to the state laws.

 

[geronamo26]

WELL I went to medical school THIS! And I went to medical school THAT! Medical school! Medical school! Medical school! Who Cares??!! This is a great day for Optometrists! Be happy for them! I personally can't wait to get my OD degree! >

 

[orbitsurgMD]

WELL I went to medical school THIS! And I went to medical school THAT! Medical school! Medical school! Medical school! Who Cares??!! This is a great day for Optometrists! Be happy for them! I personally can't wait to get my OD degree! >

Keep workin' on that "pre-health" for now.

 

[Meibomian SxN]

Keep workin' on that "pre-health" for now.

And you keep thinking that arriving to an office with donuts is 'graft'...

 

[Frumps]

Still sickened by the passage of the bill. The regulation of optometric surgery is now under the control of the KY board of optometry. That makes complete sense, to have the regulation of eye surgery by a board that does not do eye surgery. We could let the opticians start doing eye surgery and regulate themselves as well. The saving grace is that the optometry board is overseen by the governor

I also love the debates prior to the passage of this bill. The optometrist here reminds of a car dealer, or lawyer (can't quite put my finger on it). I love how he loves to talk about his residency AND fellowship experience. He does a good job trying to sound like an MD...but when you get right down to it, he is not. This bill may help his insecurity though. The patients of KY...well that's another story.

http://politics.mycn2.com/2011/02/1...-through-frankfort-doctors-debate-its-effect/

 

[orbitsurgMD]

And you keep thinking that arriving to an office with donuts is 'graft'...

Seems like the Kentucky optometric community did raise the bar on that. We now know the purchase price of the Kentucky legislature, pretty cheap, when you think about it. Do you think they will have to pay even more to prevent a repeal of the bill? The good legislators may just have got themselves an annuity for the price of letting non-surgeons do surgery.

I don't know that they should be celebrating just yet. I suspect the state's practitioners will see what their underwriters think of this in the coming year. Their rates will go up; their days of three-figure annual malpractice premiums are surely over, for good, even for those who never pick up a scalpel or touch a laser.

 

[VA Hopeful Dr]

Although I don't expect this bill to be altered (whatsoever) ... this isn't the way the game is played. You guys used shady politics to jam it through, and now the party who opposes it gets to use shady politics to try and break it down and make it a shell of what it was.

Do keep us updated though Visionary

Actually, this is exactly how the game is played. Let's hope everyone learns at least that take home point from all of this.

 

[geronamo26]

Thanks! I will. And when I become an OD...MOVE OVER!

 

[Meibomian SxN]

Seems like the Kentucky optometric community did raise the bar on that. We now know the purchase price of the Kentucky legislature, pretty cheap, when you think about it. Do you think they will have to pay even more to prevent a repeal of the bill? The good legislators may just have got themselves an annuity for the price of letting non-surgeons do surgery.

I don't know that they should be celebrating just yet. I suspect the state's practitioners will see what their underwriters think of this in the coming year. Their rates will go up; their days of three-figure annual malpractice premiums are surely over, for good, even for those who never pick up a scalpel or touch a laser.

LOL! Good point! I guess malpractice insurance companies are laughing in the background.

I'd be pissed to pay an increased premium all for the right of cutting 'lumps & bumps', when the reality will show that most ODs will continue to practice as they have been.

 

[Meibomian SxN]

Listen to the moot ophthalmology arguments and watch them get DISMISSED!

http://www.ket.org/cgi-bin/cheetah/watch_video.pl?nola=KKYTO+001816&altdir=&template

A discussion about the optometry bill passed by the General Assembly and sent to the governor. Guests: Ben Gaddie, O.D., president-elect of the Kentucky Optometric Association; David Cockrell, O.D., a member of the board of trustees of the American Optometric Association; Cynthia Bradford, M.D., senior secretary for advocacy with the American Academy of Ophthalmology; and Woodford VanMeter, M.D., president of the Kentucky Academy of Eye Physicians and Surgeons.

 

[JaggerPlate]

Listen to the moot ophthalmology arguments and watch them get DISMISSED!

http://www.ket.org/cgi-bin/cheetah/watch_video.pl?nola=KKYTO+001816&altdir=&template

A discussion about the optometry bill passed by the General Assembly and sent to the governor. Guests: Ben Gaddie, O.D., president-elect of the Kentucky Optometric Association; David Cockrell, O.D., a member of the board of trustees of the American Optometric Association; Cynthia Bradford, M.D., senior secretary for advocacy with the American Academy of Ophthalmology; and Woodford VanMeter, M.D., president of the Kentucky Academy of Eye Physicians and Surgeons.

That video is like 56 minutes long ... can you summarize the 'dismissals?'

 

[Meibomian SxN]

That video is like 56 minutes long ... can you summarize the 'dismissals?'

You should actually look at it. It has 2 outstanding optometrists who are certified to perform certain laser procedures and some 'lumps & bumps' surgeries.

The 2 ophthalmologists argued the same points that are argued on this forum, but the optometrists spoke from their own experience in dismissing the 'concerning' points of organized ophthalmology.

 

[orbitsurgMD]

You should actually look at it. It has 2 outstanding optometrists who are certified to perform certain laser procedures and some 'lumps & bumps' surgeries.

The 2 ophthalmologists argued the same points that are argued on this forum, but the optometrists spoke from their own experience in dismissing the 'concerning' points of organized ophthalmology.

That's a relief.

 

[jsh1986]

I don't believe we covered "lumps and bumps" in pathophysiology at my medical school . I watched the obese Kentucky lawmakers refer to optometrists getting to operate on these (but not perform LASIX I'm sorry, its just too easy/painful)

Can anyone explain to me what the hell a lump or bump is using language that actually mean something, 'cause when on the wards my patients tell me they had a "bump" removed on their hand, bum, eyelid...you know, I think its sort of important to know if this was a melanoma lumpy bumpys, squam lumpy bumpys, or a papilloma.

I'm told that understanding the pathophys and clinical history of metastatic melanoma for example is important if one is going to be cutting them out in the clinic. I've seen on the medicine wards and I think it will help me be a better ophtho. So, I don't mean to sound rude, but I honestly am wondering what the scope of "lump and bump" excisions really is. Surgeons aren't just technicians...

 

[Meibomian SxN]

I don't believe we covered "lumps and bumps" in pathophysiology at my medical school . I watched the obese Kentucky lawmakers refer to optometrists getting to operate on these (but not perform LASIX I'm sorry, its just too easy/painful)

Can anyone explain to me what the hell a lump or bump is using language that actually mean something, 'cause when on the wards my patients tell me they had a "bump" removed on their hand, bum, eyelid...you know, I think its sort of important to know if this was a melanoma lumpy bumpys, squam lumpy bumpys, or a papilloma.

I'm told that understanding the pathophys and clinical history of metastatic melanoma for example is important if one is going to be cutting them out in the clinic. I've seen on the medicine wards and I think it will help me be a better ophtho. So, I don't mean to sound rude, but I honestly am wondering what the scope of "lump and bump" excisions really is. Surgeons aren't just technicians...

I agree! For all I know, a bump is what a woman feel on her 'boob'; can I cut them too?

 

[jsh1986]

Sure why not, it's all the same right? In fact, why don't we just let paramedics do chest tubes and crics. Or let chiros do neurosurg. Or scrub techs do hip replacements. If only we had more lobbyists.

I honestly don't know if this has been spelled out somewhere before, or if the language really has been left this vague. Certainly, the language/attitude I have seen has been extraordinarily uninspiring-- maybe I should just give all my patients tomorrow who have "germs" a Zpak. Surely that'll fix it.

So sadly, my question still goes unanswered.

You should actually look at it. It has 2 outstanding optometrists who are certified to perform certain laser procedures and some 'lumps & bumps' surgeries.

The 2 ophthalmologists argued the same points that are argued on this forum, but the optometrists spoke from their own experience in dismissing the 'concerning' points of organized ophthalmology.

 

[Frumps]

They can't answer it jsh. There is literally no argument. The interesting thing is that the man "Ben Gaddie OD" who the optometrists had represent them, trained in Oklahoma. He has multiple clinics in Louisville. The whole reason the optometry bill was proposed was to provide care to rural areas without an ophthalmologist. You know who is going to be the first OD doing laser procedures in KY...take a guess. Access to care my a**. What a joke

Here is a great article
http://www.theatlantic.com/national...ye-surgeons-no-medical-degree-required/71758/