Kentucky: The Latest Battleground for Optometric Scope Expansion

[VA Hopeful Dr]

For the love of Pete! The gall is simply unbelievable.

"By the time an optometric physician completes 8+ years of pre-professional [i.e., college] and professional Optometric education including 4 years of clinical training at NSU-OCO, he or she has more didactic classroom hours, direct observational encounters, and actual clinical experience in performing ophthalmic office procedures than any U.S. Medical or Osteopathic graduate."

Depends on how you look at it. If you compare and OD student fresh out of school and an MD student fresh out of school (not residency), the OD student is going to have more experience dealing with the eye.

Not sure that's what is meant here, but you never know.

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[bungo]

For the love of Pete! The gall is simply unbelievable.

"By the time an optometric physician completes 8+ years of pre-professional [i.e., college] and professional Optometric education including 4 years of clinical training at NSU-OCO, he or she has more didactic classroom hours, direct observational encounters, and actual clinical experience in performing ophthalmic office procedures than any U.S. Medical or Osteopathic graduate."

If you are an optometrist actually providing good medical eye care how can you not be embarrassed by your profession right now? All mid-levels lie to some extent when trying to expand their scope, but optometrists are definitely the new masters of it. At what point does even the general public stop believing them? I would argue they have already roared passed it based on polls in Kentucky.

edit: read mean

 

[orbitsurgMD]

For the love of Pete! The gall is simply unbelievable.

"By the time an optometric physician completes 8+ years of pre-professional [i.e., college] and professional Optometric education including 4 years of clinical training at NSU-OCO, he or she has more didactic classroom hours, direct observational encounters, and actual clinical experience in performing ophthalmic office procedures than any U.S. Medical or Osteopathic graduate."

Every U.S. ophthalmologist who graduated from a U.S. medical school and completed a residency has more clinical and surgical experience than any of these pretenders by an order of magnitude, so exactly how is it that they are excluded from the "U.S. Medical or Osteopathic graduate?"

It is deliberately misleading. It suggests the choice of surgical provider must be between a graduate of an optometric school and a fresh graduate from medical school with no residency training.

This kind of stuff brings optometry into disrepute. This is a ridiculous pretense, that a four year optometry degree (less even, in some places) is the professional equivalent of a medical school graduate with four years of surgical residency training and board-eligibility, and worse, that it was always thus (because they say so.) It really is a disgrace, and shows the contempt some members of that profession have for their public, thinking to fool them with those specious claims.

 

[Shnurek]

"By the time an optometric physician completes 8+ years of pre-professional [i.e., college] and professional Optometric education including 4 years of clinical training at NSU-OCO, he or she has more didactic classroom hours, direct observational encounters, and actual clinical experience in performing ophthalmic office procedures than any U.S. Medical or Osteopathic graduate."

This quote is completely true. See below for explanation.

I know. I just really can't believe it. I love how they add "including 4 years of clinical training" (ie, the 4 years of optometry school you already mentioned in the 8+years of preprofessional). Somehow the student does 4 years of optometry school and they try to make it sound like they have had over 12 years of eye-specific training. Good grief!

If you had any real language skills you would notice that the word including refers to the 4 years of clinical training taking place at the same time as the 8 years of pre-professional training. Kind of like in a vacation ad that states airfare is included that does not mean you have to pay extra. If airfare is excluded then yes you have to pay more. So no they are not stating they have 12 years of training.

Depends on how you look at it. If you compare and OD student fresh out of school and an MD student fresh out of school (not residency), the OD student is going to have more experience dealing with the eye.

Not sure that's what is meant here, but you never know.

Someone gets it, thank you.

"...experience in performing ophthalmic office procedures than any U.S. Medical or Osteopathic graduate."

Notice the word graduate. When an OD just graduates they can do tonometry, slit lamp examinations, indirect ophthalmoscopy, treatment and management of ocular disease with drugs and more. When an allopathic graduate or osteopathic graduate comes out of school they are pretty green when it comes to slit lamps or other ophthalmic equipment/procedures. (I saw this myself when the VA optometrist I was shadowing was training the ophthalmology first year resident)

Is it misleading? Yes. Is it true? Absolutely.

 

[speyeder]

"By the time an optometric physician completes 8+ years of pre-professional [i.e., college] and professional Optometric education including 4 years of clinical training at NSU-OCO, he or she has more didactic classroom hours, direct observational encounters, and actual clinical experience in performing ophthalmic office procedures than any U.S. Medical or Osteopathic graduate."

This quote is completely true. See below for explanation.



If you had any real language skills you would notice that the word including refers to the 4 years of clinical training taking place at the same time as the 8 years of pre-professional training. Kind of like in a vacation ad that states airfare is included that does not mean you have to pay extra. If airfare is excluded then yes you have to pay more. So no they are not stating they have 12 years of training.


Someone gets it, thank you.

"...experience in performing ophthalmic office procedures than any U.S. Medical or Osteopathic graduate."

Notice the word graduate. When an OD just graduates they can do tonometry, slit lamp examinations, indirect ophthalmoscopy, treatment and management of ocular disease with drugs and more. When an allopathic graduate or osteopathic graduate comes out of school they are pretty green when it comes to slit lamps or other ophthalmic equipment/procedures. (I saw this myself when the VA optometrist I was shadowing was training the ophthalmology first year resident)

Is it misleading? Yes. Is it true? Absolutely.

Why stop there? I think they should change the brochure so they can state that these optometric physicians have more experience in performing ophthalmic procedures than any high school graduate in America, period.. How's that for bragging rights???

 

[orbitsurgMD]

"By the time an optometric physician completes 8+ years of pre-professional [i.e., college] and professional Optometric education including 4 years of clinical training at NSU-OCO, he or she has more didactic classroom hours, direct observational encounters, and actual clinical experience in performing ophthalmic office procedures than any U.S. Medical or Osteopathic graduate."

This quote is completely true. See below for explanation.



If you had any real language skills you would notice that the word including refers to the 4 years of clinical training taking place at the same time as the 8 years of pre-professional training. Kind of like in a vacation ad that states airfare is included that does not mean you have to pay extra. If airfare is excluded then yes you have to pay more. So no they are not stating they have 12 years of training.


Someone gets it, thank you.

"...experience in performing ophthalmic office procedures than any U.S. Medical or Osteopathic graduate."

Notice the word graduate. When an OD just graduates they can do tonometry, slit lamp examinations, indirect ophthalmoscopy, treatment and management of ocular disease with drugs and more. When an allopathic graduate or osteopathic graduate comes out of school they are pretty green when it comes to slit lamps or other ophthalmic equipment/procedures. (I saw this myself when the VA optometrist I was shadowing was training the ophthalmology first year resident)

Is it misleading? Yes. Is it true? Absolutely.

[emphasis mine]

It is blatantly false and misleading. Ophthalmologists do not cease to be graduates by virtue of time or anything that follows (even retirement), yet they have an order of magnitude more training in any procedure than do fresh graduates of medical school or optometry school. No amount of parsing words or hair-splitting makes it true. So this claim is false, and making it publicly is an attempt to deceive a gullible and uninformed public.
Nice. Very professional.

 

[KHE]

Every U.S. ophthalmologist who graduated from a U.S. medical school and completed a residency has more clinical and surgical experience than any of these pretenders by an order of magnitude, so exactly how is it that they are excluded from the "U.S. Medical or Osteopathic graduate?"

It is deliberately misleading. It suggests the choice of surgical provider must be between a graduate of an optometric school and a fresh graduate from medical school with no residency training.

This kind of stuff brings optometry into disrepute. This is a ridiculous pretense, that a four year optometry degree (less even, in some places) is the professional equivalent of a medical school graduate with four years of surgical residency training and board-eligibility, and worse, that it was always thus (because they say so.) It really is a disgrace, and shows the contempt some members of that profession have for their public, thinking to fool them with those specious claims.

Yes, I would agree that that is deliberately misleading.

However, I would also point out that optometrists don't have the market cornered on that kind of deception.

I've seen all sorts of ophthalmology articles comparing the two professions that say things like "optometrists go to school for four years" whereas ophthalmologists go to school for 12, 13 or 14 years.

Basically in those cases, optometry gets credit for optometry school but ophthalmology gets credit for college, medical school, and residency.

So come on. If we want to total it ALL up why don't we include high school and middle school. I grew up in Canada. When I went to high school we went for FIVE years so I guess I should be able to say I went for an extra year.

 

[SurgbySurgeons]

Is it misleading? Yes. Is it true? Absolutely.

That was exactly my point. If I was an optometrist, I would be embarrassed by this. Maybe you'll advertise your practice the same way. All of these moves by optometry are done to fool the public and state officials. The vast majority of people reading this do not know the differences in training of an ophthalmologist, optometrist, optician, etc. Why do you think there has been a recent push for "board certification" lately. It's also a reason for these weekend courses being offered by this Oklahoma program. That way, when they push for surgical expansion or advertise, they can say "we are board certified and have surgical training, just like an ophthalmologist does." Technically not a lie, but really!?!

I'm very interested to see what the failure rate will be for the new optometry boards. The ophthalmology board fails ~28% of people that take the written exam and another 10% when they take the oral exam. Is optometry going to do the same?

 

[SurgbySurgeons]

Yes, I would agree that that is deliberately misleading.

However, I would also point out that optometrists don't have the market cornered on that kind of deception.

I've seen all sorts of ophthalmology articles comparing the two professions that say things like "optometrists go to school for four years" whereas ophthalmologists go to school for 12, 13 or 14 years.

I for one have never seen this advertised. Find me an example please.

After college, an ophthalmologist goes to 4 years of medical school, 4 years of residency, and 55% do a fellowship for 1-2 years. So over half have training of 9-10 years, less than half have 8 years total.

After college, optometrists do 4 years of optometry education and 15% do a residency of 1 year. Those are the stats. I'm sure there are some exceptions to both.

Ophthalmology 8-10 years, optometry 4-5 years. I would also argue that the actual training is quite different, but that is beside the point.

 

[Visionary]

Depends on how you look at it. If you compare and OD student fresh out of school and an MD student fresh out of school (not residency), the OD student is going to have more experience dealing with the eye.

Not sure that's what is meant here, but you never know.

Details not lost on me. Point is that it's purposely misleading. That's where the gall comes in. Hey, let's just lie to the public. That'll make up for our inferior training. Yeah, good idea....

 

[Visionary]

I for one have never seen this advertised. Find me an example please.

After college, an ophthalmologist goes to 4 years of medical school, 4 years of residency, and 55% do a fellowship for 1-2 years. So over half have training of 9-10 years, less than half have 8 years total.

After college, optometrists do 4 years of optometry education and 15% do a residency of 1 year. Those are the stats. I'm sure there are some exceptions to both.

Ophthalmology 8-10 years, optometry 4-5 years. I would also argue that the actual training is quite different, but that is beside the point.

You don't get it yet? Optometrists are just smarter. They only need half the overall training and a tenth of the clinical training to do what we do. We need all that extra time, because we're so dumb. I'm such a stupid dummy. Man!

 

[SurgbySurgeons]

And of course the biggest difference between the two:

Ophthalmology residency (fellowship has no minimum requirements)
ACGME requirements
Must be the primary surgeon in a MINIMUM of 364 procedures and assistant surgeon in 474. Each subspecialty requires a certain number of procedures (including cornea, cataract, strabismus, glaucoma, lasers, retina, oculoplastics and orbit, refractive surgery, and globe trauma).

Optometry school
Zero surgical requirements
optometric residency or fellowship (I'll let the optometrists on this forum speak from their experience here)

 

[Meibomian SxN]

http://www.msnbc.msn.com/id/43535553

In the 35th-floor conference room of a Manhattan high-rise, two of Gov. Andrew M. Cuomo’s most trusted advisers held a secret meeting a few weeks ago with a group of super-rich Republican donors....

But the donors in the room — the billionaire Paul Singer, whose son is gay, joined by the hedge fund managers Cliff Asness and Dan Loeb — had the influence and the money to insulate nervous senators from conservative backlash if they supported the marriage measure. And they were inclined to see the issue as one of personal freedom, consistent with their more libertarian views...

Within days, the wealthy Republicans sent back word: They were on board. Each of them cut six-figure checks to the lobbying campaign that eventually totaled more than $1 million.

 

[Shnurek]

[YOUTUBE]http://www.youtube.com/watch?v=bjZRAvsZf1g[/YOUTUBE]

 

[JaggerPlate]

http://www.msnbc.msn.com/id/43535553

In the 35th-floor conference room of a Manhattan high-rise, two of Gov. Andrew M. Cuomo’s most trusted advisers held a secret meeting a few weeks ago with a group of super-rich Republican donors....

But the donors in the room — the billionaire Paul Singer, whose son is gay, joined by the hedge fund managers Cliff Asness and Dan Loeb — had the influence and the money to insulate nervous senators from conservative backlash if they supported the marriage measure. And they were inclined to see the issue as one of personal freedom, consistent with their more libertarian views...

Within days, the wealthy Republicans sent back word: They were on board. Each of them cut six-figure checks to the lobbying campaign that eventually totaled more than $1 million.

Sleezy, dirty politics have existed for as long as politics have existed. At least this push is for something worthwhile ...

 

[anotheruserid]

I am sorry but the bills in like those in Kentucky would make me embarrassed if I was an optometrist. They are just so ridiculous…

In the current form optometrist will have the right to:

1. Provide all forms of anesthesia except for general: Stuff like this makes me laugh. Depending on specialty/practice, the majority of MDs (not just ophthalmologists) do not feel comfortable giving IV sedation (and all of these doctors were ACLS certified and ran many codes in there life). Why? because unpredictable things can happen with anesthesia. Is it really true that optometric training has improved so much that graduates can run codes on the day of graduation with no prior experience running a code?

2. Perform laser cataract surgery (perhaps organized optometry should start teaching the MDs this one since there are only a few ophthalmologists in the world who have used such technology. Maybe all optometry students are being trained in intraocular surgery (on humans) now. Please speak up you are at one of these programs– perhaps some ophthalmology programs would like to model this curriculum. Do optometrists realize the cataract just doesn’t get obliterated by the laser – lens material still needs to be removed. And sorry doing it on a pig eye alone is not enough in my opinion.

Organized optometry looks incredibly pathetic to an educated observer with such requests. While the “ask for the stars and hope we just get just a little approach” may be good politics, it makes your profession look very desperate. If patients/legislators truly knew what this bill was asking for, they too would lose respect. Again, as stated above, I doubt if many optometrists in practice in Kentucky truly know what the bill is asking for….

I know many ODs, myself being ophthalmologist. Almost all the ODs I talk with are very reasonable about what they can do and what they are comfortable with. It seems like with many political situations, that a few [politico ODs do what does irritate ophthalmologists, things which confuse the public such as optometric glaucoma specialist versus ophthalmologist (who had an glaucoma fellowship that may not be advertised). In any case, ODs voice to me that they are not interested or feel comfortalbe doing this things certain politico ODs are fighting for. My point being that I think politico ODs fighting for silly things and making stupid comparision between training give the majority of ODs a bad image in the eys of us opthalmologists. And that as an ophthalmologist I am always trying to keep that in mind so that I don't prejudge my OD colleages.

 

[anotheruserid]

sorry I wan't meaning to reply to you 200UL, i was just making a general comment. but I agree that the bill is crazy and I think that most eye care professionals can see that (or hope so)

 

[Shnurek]

sorry I wan't meaning to reply to you 200UL, i was just making a general comment. but I agree that the bill is crazy and I think that most eye care professionals can see that (or hope so)

What's crazy is non-progressive people that want to keep a monopoly on medicine and the antiquated and rigid educational system. Clearly something is wrong with the system as it is now. If everything was fine there would be no DOs, DPTs, DNPs, ODs, NPs, DCs, DPMs and more. The bill was thankfully passed and the inter medical professional conflicts seen here are not unique to optometry vs. ophthalmology. If you want to make good money in ophthalmology, work with optometrists don't work against them. And when ophthalmologists make comments like "Optometrists are just glasses salesman." That just makes me want to fight more against them.

 

[Dermpath]

What's crazy is non-progressive people that want to keep a monopoly on medicine and the antiquated and rigid educational system. Clearly something is wrong with the system as it is now. If everything was fine there would be no DOs, DPTs, DNPs, ODs, NPs, DCs, DPMs and more. The bill was thankfully passed and the inter medical professional conflicts seen here are not unique to optometry vs. ophthalmology. If you want to make good money in ophthalmology, work with optometrists don't work against them. And when ophthalmologists make comments like "Optometrists are just glasses salesman." That just makes me want to fight more against them.

What I don't understand is-if you want the same rights as an ophthalmologist, why not go to medical school? Why do you and other optometrists get to perform the same procedures/work as the ophthalmologist with the same pay but less work? Does that make sense?

We live in an environment where everyone believes they are entitled to the same rewards, 6 figures, etc. So if you are a nurse, no you don't get to call yourself doctor and make the same as a doctor. If you are an optometrist, be happy to be an optometrist. If you want to be an ophthalmologist, go to med school. Why in the world would you want to get the same rights? And no, i'm not an opthalmologist. To me, it's saying-I could not get in med school and become and ophthalmologist, but I want the same rewards. That's crazy. Do you see paralegals wanting the same rights as lawyers or dental hygienists wanting the same monetary compensation as dentists? No.

Everyone has a place, but people should learn to GRACIOUSLY accept it. Who in their right mind would want to go to an optometrist for serious eye problems? No one, unless you are intending on deceiving your patients. Why not just be happy with your role and accept it graciously? It boggles the mind.

 

[Shnurek]

To me, it's saying-I could not get in med school and become and ophthalmologist, but I want the same rewards.

Here is your major fallacy. You cannot assume all optometry students could not get into med school.

 

[jsh1986]

don't feed the troll!

 

[xanthomondo]

What's crazy is non-progressive people that want to keep a monopoly on medicine and the antiquated and rigid educational system. Clearly something is wrong with the system as it is now. If everything was fine there would be no DOs, DPTs, DNPs, ODs, NPs, DCs, DPMs and more. The bill was thankfully passed and the inter medical professional conflicts seen here are not unique to optometry vs. ophthalmology. If you want to make good money in ophthalmology, work with optometrists don't work against them. And when ophthalmologists make comments like "Optometrists are just glasses salesman." That just makes me want to fight more against them.

Your logic is flawed.

All of the new types of "doctors" are a perfect example of living the American dream - you can find shortcuts, not work as hard as you need to, and you STILL get whatever title you would like and think of yourself as equivelant to the people who worked the hardest and are the top of the field.

DPMs and DPTs do not belong with the rest in that group, though.

 

[xanthomondo]

Here is your major fallacy. You cannot assume all optometry students could not get into med school.

I think if he reworded it and said "can't or is not willing to undergo the rigors and demands of a comprehensive education that is required of an ophthalmologist for whatever reason (time, family, money, etc)" he would have been spot on.

 

[MR1]

I won't call you an eye glass salesman only but then you can't say you are the same as us minus surgery. Neither is true

 

[Shnurek]

I won't call you an eye glass salesman only but then you can't say you are the same as us minus surgery. Neither is true

Opticians are eye glass salesman. Wouldn't you as an ophthalmologist find it offensive if someone said all you do is say one or two all day? Both comments are skewed towards the most simplistic part of our skills spectrum.

I can argue you on that one based on the law. As the law grants optometrists to do everything except major surgery in almost all states and in all states ophthalmologists can do everything up to and including major surgery. So legally the only major interprofessional difference is major surgery except for in a minority of states (~6 or 7) where ODs can't RX narcotics yet and 3 where orals are not allowed to be prescribed by ODs.

 

[MR1]

I'm glad the law says that. Makes me feel better.

Yes legally you can do all we can minus surgery. What I am saying is that still doesn't make you equivalent to us in knowledge of eye pathology.

 

[xanthomondo]

Opticians are eye glass salesman. Wouldn't you as an ophthalmologist find it offensive if someone said all you do is say one or two all day? Both comments are skewed towards the most simplistic part of our skills spectrum.

I can argue you on that one based on the law. As the law grants optometrists to do everything except major surgery in almost all states and in all states ophthalmologists can do everything up to and including major surgery. So legally the only major interprofessional difference is major surgery except for in a minority of states (~6 or 7) where ODs can't RX narcotics yet and 3 where orals are not allowed to be prescribed by ODs.

This just proves that ODs are better at swaying corrupt politicians than MDs are.

 

[LightBox]

Opticians are eye glass salesman. Wouldn't you as an ophthalmologist find it offensive if someone said all you do is say one or two all day? Both comments are skewed towards the most simplistic part of our skills spectrum.

I can argue you on that one based on the law. As the law grants optometrists to do everything except major surgery in almost all states and in all states ophthalmologists can do everything up to and including major surgery. So legally the only major interprofessional difference is major surgery except for in a minority of states (~6 or 7) where ODs can't RX narcotics yet and 3 where orals are not allowed to be prescribed by ODs.

Shnurek -- man, you have a lot of free time to troll these forums! Perhaps open a book instead?

 

[PBEA]

What I am saying is that still doesn't make you equivalent to us in knowledge of eye pathology.

Ahhh, there it is.

Let me get this straight, ODs shouldnt treat lets say....glaucoma because ODs dont have equivalent knowledge of glaucoma, as compared to an MD?.........Really?

You know what I agree with you in one sense, I ALSO am glad the law "says that". Makes me feel better knowing petty turf complaints, dirty politics, innuendo, and other associated bullshiit, dont entirely determine what kind of care I can deliver to pts.

 

[LightBox]

The real problem facing optometrists is that your schools are pumping out WAY TOO MANY GRADUATES. This has forced you all to try to expand your scope of practice since the pot of other sources of revenue have shrunk. If I were an optometrist, I would lobby your AOA or whoever to stop opening up so many optom schools!

 

[RestoreSight]

You don't get it yet? Optometrists are just smarter. They only need half the overall training and a tenth of the clinical training to do what we do. We need all that extra time, because we're so dumb. I'm such a stupid dummy. Man!

 

[MR1]

Ahhh, there it is.

Let me get this straight, ODs shouldnt treat lets say....glaucoma because ODs dont have equivalent knowledge of glaucoma, as compared to an MD?.........Really?

You know what I agree with you in one sense, I ALSO am glad the law "says that". Makes me feel better knowing petty turf complaints, dirty politics, innuendo, and other associated bullshiit, dont entirely determine what kind of care I can deliver to pts.

So no, I never said nor will I that OD's shouldn't treat glaucoma.

What I am saying is there are levels of knowledge. Comprehensive ophthalmologist don't have the level of knowledge of fellowship trained folks and in that same regard, OD's don't have the same general fund of knowledge compared to comprehensive ophtho's.

Glaucoma knowlege (glaucoma specialist > ophtho > optometrist) for example

Just the way it is

What he said that optometrist are the same as general ophtho's minus surgery is like saying general ophtho's are the same as retina specialist's minus retina surgey.

 

[Shnurek]

You don't get it yet? Optometrists are just smarter. They only need half the overall training and a tenth of the clinical training to do what we do. We need all that extra time, because we're so dumb. I'm such a stupid dummy. Man!

Well apparently when I had a debate with you over laser physics. Your multiple degrees and massive clinic time wasn't that significant. You definitely know more than me in an array of subjects but that doesn't mean that I don't know squat about certain things just because I don't have an M.D. or a Ph.D. behind my name.

 

[PBEA]

So no, I never said nor will I that OD's shouldn't treat glaucoma.

What I am saying is there are levels of knowledge. Comprehensive ophthalmologist don't have the level of knowledge of fellowship trained folks and in that same regard, OD's don't have the same general fund of knowledge compared to comprehensive ophtho's.

Glaucoma knowlege (glaucoma specialist > ophtho > optometrist) for example

Just the way it is

What he said that optometrist are the same as general ophtho's minus surgery is like saying general ophtho's are the same as retina specialist's minus retina surgey.

I do know what you meant, and in the proper context I agree with you. To be fair though I would take the ODs opinion regarding proper CL for a kcone over a retina docs any day of the week, or the general ophtho's opinion regarding IOL lenses over a retina docs. So the relative strengths of one vs the other is dependent on the case. I think for everybody it comes down to the "low hanging fruit", and the knowledge you speak of has more to do with knowing your own limitations then anything else.

 

[guttata]

The training between optometry and ophthalmology is vastly different even though there is some overlap.

Ophthalmology is a surgical specialty from day one. The first day we are on call, we are evaluating orbital fractures, facial trauma, ruptured globes, lid lacerations, eye trauma, etc. Most residency programs are associated with level I trauma centers, meaning busy calls. So, it is disingenuous for optometry to ask for surgical privileges. You were not train as surgeons, but now you want surgical privileges? You can argue all day about newer technology and surgical techniques that ophthalmologists adopt, but we are trained as surgeons from the beginning. We have a surgical foundation - that is a major difference.
If you want the privilege, do the training - there is nothing stopping you.

Secondly, most ophthalmology residency programs are associated with major medical centers, VA centers, or Universities. They are pathology magnets. Truth be told, we see sicker patients and sicker eyes. In a typical retina clinic, we would see 80-100 patients a day, and have 50-75% of patients needing treatment (laser, injections). How can optometrists see the same amount of pathology - how are they getting the referrals since they cannot treat DME or PDR? I don't understand.

The number of patient encounters is significantly higher in ophthalmology training, perhaps on the order of ten fold higher or 1000% more. I did not keep count, but I probably saw more than 20,000 patients during residency. Why? Ophthalmology clinics are busier and longer. ER and after-hour coverage is 24/7. Inpatients consults were also 24/7 and did not end at 4pm or during the weekend. How many encounters did you have in optometry school?

So, is this equivalent training to you?

Furthermore, after training, ophthalmologists continue to have more patient encounters than optometrists (on average). So, how can equality be obtained?

 

[MR1]

I agree 100%. We all have something we are good at. It is knowing that AND being content in that which matters.

The knowing your limitations is ALL I ask. The thing though is unless you do real surgery and see the power of that first hand then it is hard to know that limit.

ODs don't operate and therefore don't appreciate this limitation. At least the ones that want to operate. Not all ODs obviously.

 

[Visionary]

Well apparently when I had a debate with you over laser physics. Your multiple degrees and massive clinic time wasn't that significant. You definitely know more than me in an array of subjects but that doesn't mean that I don't know squat about certain things just because I don't have an M.D. or a Ph.D. behind my name.

Yeah, you punked me on an area in which I don't even practice and have minimal practical experience. I bow to your superior intellect.

Keep sportin' the e-cred.

 

[mydodger]

The training between optometry and ophthalmology is vastly different even though there is some overlap.

Ophthalmology is a surgical specialty from day one. The first day we are on call, we are evaluating orbital fractures, facial trauma, ruptured globes, lid lacerations, eye trauma, etc. Most residency programs are associated with level I trauma centers, meaning busy calls. So, it is disingenuous for optometry to ask for surgical privileges. You were not train as surgeons, but now you want surgical privileges? You can argue all day about newer technology and surgical techniques that ophthalmologists adopt, but we are trained as surgeons from the beginning. We have a surgical foundation - that is a major difference.
If you want the privilege, do the training - there is nothing stopping you.

Secondly, most ophthalmology residency programs are associated with major medical centers, VA centers, or Universities. They are pathology magnets. Truth be told, we see sicker patients and sicker eyes. In a typical retina clinic, we would see 80-100 patients a day, and have 50-75% of patients needing treatment (laser, injections). How can optometrists see the same amount of pathology - how are they getting the referrals since they cannot treat DME or PDR? I don't understand.

The number of patient encounters is significantly higher in ophthalmology training, perhaps on the order of ten fold higher or 1000% more. I did not keep count, but I probably saw more than 20,000 patients during residency. Why? Ophthalmology clinics are busier and longer. ER and after-hour coverage is 24/7. Inpatients consults were also 24/7 and did not end at 4pm or during the weekend. How many encounters did you have in optometry school?

So, is this equivalent training to you?

Furthermore, after training, ophthalmologists continue to have more patient encounters than optometrists (on average). So, how can equality be obtained?

Seriously. I wish some of the Optometry students on the boards would take a week and spend it side by side with an Ophtho resident. I'm fairly certain they'd all quit going on and on about how the training is the same. It's not even close.

 

[Shnurek]

Seriously. I wish some of the Optometry students on the boards would take a week and spend it side by side with an Ophtho resident. I'm fairly certain they'd all quit going on and on about how the training is the same. It's not even close.

I've spent many months side by side with ophthalmologists as a technician. Also I shadowed in the OR.

The majority of what they do is what ODs do. Refract, fit CLs, prescribe topical medications, do some epilations, order tests: visual fields, octs, autorefractors, fundus photography, they step back and think about a case if it is complicated, etc etc.

The training is not the same. It is different. More direct. That is the whole point of the argument.

 

[xanthomondo]

I've spent many months side by side with ophthalmologists as a technician. Also I shadowed in the OR.

The majority of what they do is what ODs do. Refract, fit CLs, prescribe topical medications, do some epilations, order tests: visual fields, octs, autorefractors, fundus photography, they step back and think about a case if it is complicated, etc etc.

The training is not the same. It is different. More direct. That is the whole point of the argument.

You're a joke.

Just keep sticking your fingers in your ears and repeat "we're just as good....we're just as good....we're just as good....it's the system that doesn't recognize our talents"

 

[Shnurek]

You're a joke.

Just keep sticking your fingers in your ears and repeat "we're just as good....we're just as good....we're just as good....it's the system that doesn't recognize our talents"

You are oblivious to any of the arguments. The system actually recognizes our talents. The laws give ODs many more privileges than most people know about. Its the public that does not yet fully recognize our talents.

 

[xanthomondo]

You are oblivious to any of the arguments. The system actually recognizes our talents. The laws give ODs many more privileges than most people know about. Its the public that does not yet fully recognize our talents.

You cherry pick which arguments you want to respond to.

It's already been said on here: The fact that ODs throw tons of money at politicians so that they write laws to expand their scope of practice does not mean that they are anywhere close to equivalent to MDs.

Unfortunately most of the public doesn't understand the difference between optometry and ophthalmology and that they're two different professions.

 

[EyeFlyGuy]

My first time to read in this site....... It is surprising how MUCH the ophthalmology students already know about how much Optometrists DON'T know.
I'm a 24 year practicing Doctor of Optometry. I've managd a large number of glaucoma patients for decades, done post-cataract care, foreign body surgeries, naso-lacrimal procedures, corneal debridements, prescribed topical and oral meds (yes, I'm DEA certified through Schedule III) and other procedures some of the oph students on here have yet to master. I've instructed Optometric externs, given lectures to pre-Optometry students
I now can perform capsulotomies and SLT procedures and PI's. I'm sorry to minimize the complexity of the "wondrous world of lasers", but if you find those anterior segment procedures to be complex, you might be Very challenged when you begin more invasive procedures.

Now my point.... It has been my observation that the OMDs who have trained with Optometry (as at UAB and others) tend to be much more accepting of Optometry evolving in its training and clinical practices. I think most of those on this board who wrongly underrate the training of today's Optometrists have never been involved with them or one of their educational programs. Perhaps an actual visit to an Optometry school or residency program would be enlightening and serve as a good bridge to the young pups of both disciplines.

I'll be retiring soon, with my small grin still in place as I realize I had much to learn at the student-age, too. Actually, I still have much to learn.... and am glad my profession has defended its right to continue advancing in knowledge. Good luck to all you students!

 

[0phthalmologist]

We got to get Rand Paul to deal with these people lol

 

[Shnurek]

My first time to read in this site....... It is surprising how MUCH the ophthalmology students already know about how much Optometrists DON'T know.
I'm a 24 year practicing Doctor of Optometry. I've managd a large number of glaucoma patients for decades, done post-cataract care, foreign body surgeries, naso-lacrimal procedures, corneal debridements, prescribed topical and oral meds (yes, I'm DEA certified through Schedule III) and other procedures some of the oph students on here have yet to master. I've instructed Optometric externs, given lectures to pre-Optometry students
I now can perform capsulotomies and SLT procedures and PI's. I'm sorry to minimize the complexity of the "wondrous world of lasers", but if you find those anterior segment procedures to be complex, you might be Very challenged when you begin more invasive procedures.

Now my point.... It has been my observation that the OMDs who have trained with Optometry (as at UAB and others) tend to be much more accepting of Optometry evolving in its training and clinical practices. I think most of those on this board who wrongly underrate the training of today's Optometrists have never been involved with them or one of their educational programs. Perhaps an actual visit to an Optometry school or residency program would be enlightening and serve as a good bridge to the young pups of both disciplines.

I'll be retiring soon, with my small grin still in place as I realize I had much to learn at the student-age, too. Actually, I still have much to learn.... and am glad my profession has defended its right to continue advancing in knowledge. Good luck to all you students!

Thank you. May I do my externship at your practice? It really is a shame that more Eye M.D.s don't associate with schools of Optometry. We are nerds just like you.

You have to realize that M.D.s did not expand their schools for basically the past 30 years. (Source: http://nces.ed.gov/programs/digest/d10/tables/dt10_290.asp?referrer=list)
1981: 15,505 M.D. graduates
2009: 15,987 M.D. graduates

So many qualified individuals have to go elsewhere to gain a very similar education.

 

[dantt]

Now my point.... It has been my observation that the OMDs who have trained with Optometry (as at UAB and others) tend to be much more accepting of Optometry evolving in its training and clinical practices.

Now you're making stuff up. While UAB has a school of optometry as well as an ophthalmology department, the OMDs there have NO relation whatsoever to the optometrists across the street. The optometrists there for refer all patients to an outside cataract group (which they not so incidently own a stake in).

 

[Visionary]

Now you're making stuff up. While UAB has a school of optometry as well as an ophthalmology department, the OMDs there have NO relation whatsoever to the optometrists across the street. The optometrists there for refer all patients to an outside cataract group (which they not so incidently own a stake in).

This was my understanding, as well. I've heard there is a lot of animosity between the School of Optometry and the Ophthalmology Dept at UAB. I almost went there for grad school.

 

[Hightide12]

Forget optometrists, what about ER docs doing ocular surgeries? I was wondering what all the OMD's think about ER docs doing emergency paracentesis, for example? My brother is an ER resident and he says that's their protocol for IOP's greater than 50 (tonopen, mind you, not applanation). I love him, but he sounded like an idiot when he thought he could learn how to use a slit lamp in a weekend, and I think everyone can agree that he has far less knowledge of the eye than an Optometrist let alone an Ophthalmologist. Btw, as an OD, I am NOT in favor of Optometrists performing surgeries and am not trying to use this as a "point" for OD's to do surgeries. This just sounds crazy to me.

 

[Zorro12]

Forget optometrists, what about ER docs doing ocular surgeries? I was wondering what all the OMD's think about ER docs doing emergency paracentesis, for example? My brother is an ER resident and he says that's their protocol for IOP's greater than 50 (tonopen, mind you, not applanation). I love him, but he sounded like an idiot when he thought he could learn how to use a slit lamp in a weekend, and I think everyone can agree that he has far less knowledge of the eye than an Optometrist let alone an Ophthalmologist. Btw, as an OD, I am NOT in favor of Optometrists performing surgeries and am not trying to use this as a "point" for OD's to do surgeries. This just sounds crazy to me.

Whoever wrote that protocol is crazy. An IOP of 70 can be managed with topical, oral or IV meds in the short term. If the person is in angle closure paracentesis is not very easy (I have done it, but it is not much fun with a cloudy cornea and most likely a phakic patient). If it is NVG you will decompress the eye quickly and may end up with a hyphema. If it is an IOP of 50 with POAG, why do a para? Not only is it poor patient care, but I don't know how they would defend in court doing a para in OAG with subsequent perfing of the anterior capsule. Of course if they are planning on not paging me in the middle of the night....

 

[Visionary]

Whoever wrote that protocol is crazy. An IOP of 70 can be managed with topical, oral or IV meds in the short term. If the person is in angle closure paracentesis is not very easy (I have done it, but it is not much fun with a cloudy cornea and most likely a phakic patient). If it is NVG you will decompress the eye quickly and may end up with a hyphema. If it is an IOP of 50 with POAG, why do a para? Not only is it poor patient care, but I don't know how they would defend in court doing a para in OAG with subsequent perfing of the anterior capsule. Of course if they are planning on not paging me in the middle of the night....

Agreed. I've had to do a paracentesis for IOP a grand total of twice in 7.5 years. Without understanding the mechanism of the IOP elevation, you will likely end up causing more harm than good by doing a paracentesis.