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Party pooper lol
Ophtho is overrated
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Kiddies out there... realize that every specialty can post a similar list for how "awesome" their field is. I don't see how this is an argument for opthalmology (or any other field), as you're basically just preaching to the choir.
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Sorry, but as Mirror Form explained, you're incorrect. Medicine isn't based on a simple supply and demand economic model. It's modified fee-for-service, with reimbursement based on supply and equipment costs, time involved, and training required. Medicare pretty much sets the rates, and the private carriers reimburse as a percentage of Medicare allowable (i.e., socialized medicine). The private carriers do want to limit payments, but they also need providers to take their insurance plans. If a carrier significantly reduced payments, providers would drop it like it's hot.
To your point about optometrists, why would you even think that they would go through years of extra training to do surgery for "pennies on the dollar?" They aren't stupid. In fact, I'd argue that most optometrists are more business savvy than ophthalmologists. Their field has historically been more commercial than ours, and I think they get more training in that regard (correct me, if I'm wrong, my optometrist colleagues).
The fact is that just because you flood the market with providers, doesn't mean reimbursements will plummet, unless you're talking about non-medical, cosmetic procedures, like LASIK. The LASIK bubble already burst when a great number of comprehensive ophthalmologists, rather than just cornea specialists, started routinely doing it.
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Not very accurate without further explication.
I often looked at surveys like this when I was a 3rd year med student narrowing down my field choice. (I am now an Ophthalmologist in private practice.)
I found that there are five main problems with surveys like this:
1.) They give you an average salary for all responders within Ophthalmology, including all Ophthalmic subspecialists. This gives you a distorted view of the overall field's compensation.
This average salary includes a smaller number of high-earning subspecialists within Ophthalmology (Retinologists, High-Volume Refractive Surgeons, High-Volume Cataract Surgeons) who are making $600k or up to $1 million or even more (see point #4), and then it includes a whole lot of General Ophthalmologists (Yes, I know I'm supposed to say "Comprehensive"...) who are plodding along making $150k to $250k or so, and it even includes a few Eye MDs who make less than $100k (some Pediatric Ophthalmologists I have known, Medical Ophthalmologists, especially part-timers).
This holds true for other medical specialties on such salary surveys. I remember (a decade ago) meeting an OB/GYN who was just finishing up a Gyn/Onc fellowship. His first job offer out of fellowship was $700k. A decade ago! At that time a regular OB/Gyn resident was getting first offers a third of that number. So unless the salary survey splits out the high-earning sub-specialties within each medical specialty, you must take the survey data with a grain of salt.
2.) There is, in general, a financial penalty for practicing in a highly-desirable city area, and a financial bonus for practicing in a less-desired rural area. The same Retina Doc who makes $600k in the competitive city might make $900 in the boonies. The General guy making $150k to $250k in the city would make $350 in the boonies.
3.) There is--as in all medical fields--the fact that the average academic Ophthalmologist (not the department head) probably makes less than his average private practice colleague.
4.) Financial success in (private practice) Ophthalmology--perhaps more than in most other medical specialties--depends upon how good a businessman you are. This is an important point to consider: Do some "soul searching." Are you a bold self-promoter who is driven by monetary gain? Do you dream of building an "Eye Institute" named after yourself? If so, it is good that you know this about yourself, and Yes, there is a specific well-trodden path within Ophthalmology for you to express that side of yourself and to do very well. I'm thinking of an Ophthalmologist I know who does high-volume cataract surgery with a large Optometric referral network. He owns his own practice, which has 4 offices surrounding a major city, he also owns (by himself) a surgery center that he had built, he also owns a few Optometric offices that sell spectacles and contacts and refer cataract patients to him. He also owns the lab that makes the spectacle lenses. There is more, but I think I have made the point. His income of over a million dollars a year (I assume) from his various medical and business sources might go into the average that you read on surveys like this. On the other hand, please remember that colleagues think of him thus: "As an Ophthalmologist: he is a great businessman."
(Please note that there is plenty of success and satisfaction to be had within Ophthalmology for the less business-minded. It is a very satisfying and interesting field--certainly within the academic route--but even in private practice there are opportunities to do research and teaching and treat interesting patients and feel good about helping them with something crucial to their happiness, while also making a fine living for yourself. But this thread is about salary surveys, so I am concentrating my answer here on monetary matters.
I myself in the end chose Ophthalmology over Anesthesiology, a field which would have been much more financially rewarding and (as a hospital-based specialty) would have shielded me somewhat from having to be an aggressive businessman, which is not my strength. But in the end I realized that whichever field I chose, I would have to read about for the rest of my life. No offense Anesthesiologists--you guys are brilliant, and life-savers--but I just found Ophth so much more interesting, to me.)
5.) These surveys tally the responses of all the Eye MDs that bothered to reply to the survey, NOT all the Eye MDs working out there. So, what bias exists in responders? Do high earners respond more often (pride)? Do high earners respond less often (secrecy/protecting their wealth from scrutiny)? Do similar biases exist in low earners (Embarrassed to respond)? Who knows?
So anyway. Take salary surveys with a grain of salt. I have seen some surveys that break it down to 2 categories: Retinologists, and all other Ophthalmologists. This is somewhat more accurate for the reasons stated, but still problematic for the other reasons stated above.
In the end, if money is a higher priority in your specialty-choice decision matrix, then feel good: There are still several ways to make a very high income in Ophthalmology.
(Nothing wrong with that. This is America. Capitalism. Reward for excellence.)
If money is less important and interest in the field and meaningful work are higher on your list, then feel good: Ophthalmology is very rich in such rewards.
(Nothing wrong with that. This is your life. Get out of it what is important to you. You keep score, not others.)
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TwentyFifteenMD hit it on the head.
Income earned in ophthalmology is dependent on factros beyond surgical/medical skills - especially in private practice. This may be less true for retina doctors (only doctor in town that can treat RDs), but it is definately true for cataract/lasik doctors.
The other factor is that one must be very very good at their trade to become rich in ophthalmology. You cannot fake excellent results with intraocular surgery. I feel some fields in medicine allow the doctor to "hide" a bit more (be no more than average and still draw a big salary for simply going through the cases/patients). We can all probably envision some of these fields (psych, rads, anesthesia, path come to mind for me...).
Income earned in ophthalmology is dependent on factros beyond surgical/medical skills - especially in private practice. This may be less true for retina doctors (only doctor in town that can treat RDs), but it is definately true for cataract/lasik doctors.
The other factor is that one must be very very good at their trade to become rich in ophthalmology. You cannot fake excellent results with intraocular surgery. I feel some fields in medicine allow the doctor to "hide" a bit more (be no more than average and still draw a big salary for simply going through the cases/patients). We can all probably envision some of these fields (psych, rads, anesthesia, path come to mind for me...).
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Seriously? This just shows how ignorant you really are. The reimbursement fees are set by Medicaire. And they've already been slashed pretty heavily. Any further reductions will likely make them hardly more lucrative than fitting contact lenses if you take into account the overhead and liability.
And once again you display your ignorance. OD's don't charge any less than MD's for treatment. If an OD performs an exam or procedure on a patient instead of an MD, it's the exact same cost. Do you think insurance companies just automatically pay MD's more b/c of different letters behind our names? Sorry!
Actually, I've heard of one study that demonstrated OD's lead to higher costs because they tend to order more ancillary tests.
Regarding your 2nd point:
(Disclaimer: I am a 3rd year medical student going into ophtho)
I certainly believe it is possible that some ODs can cost more because of ancillary tests. I see it all the time now with NPs ordering ridiculous workups because they simply "do not know how little they know." So we have no disagreement there. (To be fair, a lot of physicians in all specialties are actually quite dumb and also order ridiculous workups because they are too lazy. Please don't flame me for suggesting that MDs get it right 100% of the time. They dont, but its certainly worse the lower you go down the training food chain, ie attndg<resident<intern<NP....and therefore I would certainly expect it to be the same with eMDs and ODs.
However, I think it is possible that ODs, if they started doing surgery, could charge less than MDs and get away with it in a very big way.
The concern I raise is that what if our profession begins to look like how psychiatry did 20 years ago, when therapists/psych PhDs started charging less than MDs to do talk therapy...and then studies showed that outcomes for disorders were no different than if the pt was treated by an MD. It has turned the psych profession really upside down (as a recent NYT article showed so well) and many psychiatrists lament now that they can only do very rapid "psychopharm" visits because the money isn't there to do talk therapy, despite them wanting the balance.
As a rhetorical thought, what if, therefore, ODs expanded their surgical rights more significantly and then charged less than MDs? Though I think realistically it is no more likely that ODs will get into the eye anymore than NPs, etc will do bone or abdominal surgery, simply as a thought exercise I think it is worth indulging and considering the possibility.
(Disclaimer: I am a 3rd year medical student going into ophtho)
I certainly believe it is possible that some ODs can cost more because of ancillary tests. I see it all the time now with NPs ordering ridiculous workups because they simply "do not know how little they know." So we have no disagreement there. (To be fair, a lot of physicians in all specialties are actually quite dumb and also order ridiculous workups because they are too lazy. Please don't flame me for suggesting that MDs get it right 100% of the time. They dont, but its certainly worse the lower you go down the training food chain, ie attndg<resident<intern<NP....and therefore I would certainly expect it to be the same with eMDs and ODs.
However, I think it is possible that ODs, if they started doing surgery, could charge less than MDs and get away with it in a very big way.
The concern I raise is that what if our profession begins to look like how psychiatry did 20 years ago, when therapists/psych PhDs started charging less than MDs to do talk therapy...and then studies showed that outcomes for disorders were no different than if the pt was treated by an MD. It has turned the psych profession really upside down (as a recent NYT article showed so well) and many psychiatrists lament now that they can only do very rapid "psychopharm" visits because the money isn't there to do talk therapy, despite them wanting the balance.
As a rhetorical thought, what if, therefore, ODs expanded their surgical rights more significantly and then charged less than MDs? Though I think realistically it is no more likely that ODs will get into the eye anymore than NPs, etc will do bone or abdominal surgery, simply as a thought exercise I think it is worth indulging and considering the possibility.
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HA. They can always be slashed more. It's like the limbo.
That's actually a lot more common than you think. I am paid less for many procedures by many insurance companies than ophthalmologists. Medicare however is not one of them.
If you have a link, that would be helpful.
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I don't know if we get more training per se. We take a couple of practice management courses as part of our training and issues related to practice management are frequently discussed if there's a slow day in clinic or whatever the training is fairly loosey-goosey. Unfortunately, practice management is one of those things that you really need to learn by "doing" not just discussing.
Eye surgery is different than bone or abdominal surgery. The procedures are generally shorter, there is a much lower risk of bleeding, and there is less patient follow-up for life-threatening complications (VTE, infections, etc.).
Keep in mind that dentists and podiatrists already perform complex surgeries (with surgical fellowships), and no one seems to be complaining about that. Why is it such a stretch to think that optometrists could perform surgeries following a surgical fellowship?
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You are correct, dentists and podiatrists do perform some minor surgical procedures. But if you were to have a screw up by one of the aforementioned, would you rather be missing a couple of toes, teeth, or an eye? In polls, people would rather be paralyzed than blind, so yes eye surgery is important.
But a much higher risk of BLINDNESS
Blindness < Death
Post operative ophtho patients get very close follow up for SIGHT threatening complications, and regularly get follow up after that
Optometrists are experts in sight. They learn about nothing but the eye for 4 years. With an additional 3 year fellowship in eye surgery, isn't it possible that optometrists could provide competent post-op care?
Being an ophthalmologist is more than just doing eye surgery, you diagnose and treat ALL diseases of the eye, which requires an understanding of medicine in GENERAL, hence the MD.
That's not the point. The point was whether or not an optometrist could be able to safely perform eye surgery following a surgical fellowship, just like dentists and podiatrists do.
The eye is NOT isolated from the rest medical school education nor the rest of the body. Almost every systemic disease can have some affect on the eye.
I agree. So learn the ocular manifestations of those systemic diseases. You don't need to learn every aspect of SLE. Just enough to recognize it and refer to a rheumatologist.
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Troll.
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Negative, you just call troll because he/she is bringing up competent points. OD's already do provide pre/post-operative care, learn all ocular pharmacology in all colleges of optometry (no matter the state laws), and learn manifestations of systemic disease in the eyes.
And I totally agree, a lengthy residency should be required for any non-basic surgery beyond things such as tear duct irrigation/corneal foreign body removal (that is already done routinely by OD's).
Nothing new here. You are not convincing anyone, even if you use a different username and call yourself a "medical student".
The designation of the commenter is irrelevant. If you believe that optometrists should not perform surgery after a surgery fellowship, then please present your case rather than simply falling back on ad hominems. I am interested to hear your point of view and am open-minded on the issue.
There is absolutely no need for a second pathway for eye surgery. If you want to do eye surgery, you should know that medical school is the first step. Buyer's remorse is not a valid reason.
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But going to medical school and completing residency / fellowship training is hard work....
Saving a handful of optometrists who regret their career decisions the expense, time and hard work of going through medical school and ophthalmology residency is not a valid reason to create an alternate pathway to becoming an ophthalmic surgeon.
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Why not? There is a Physician Assistant to Doctor of Osteopathy pathway that recently came about: http://www.lecom.edu/index.php/leco...d-physician-assistant-pathway/76/0/1919/18477
Why does everything in medicine have to be so hard wired, why can't it be a ladder like most other professions?
I am not saying I will ever want to deal with complicated eye surgeries, but I know that if you dead-end a group of intelligent people in their professions they will fight to get what they desire one way or another...just a thought.
And teaming up with opticians to do a Sun Tzu style art of war against ODs is really showing desperation on the OMDs part. "The enemy of your enemy is your friend". "Lets give the power of refraction to the opticians!".
If optometrist were given a choice to go through 3 years of medical school, internship, and residency, would they do it???
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The only remote 2nd pathway that would make any sense and be FAIR is: pass step 1, do 3rd and 4th year of medical school, pass step 2, apply for ophtho residency, get in, etc. Any pathway that didn't require applying for an ophtho residency like every other med student would create second class eye surgeons no matter how you look at it. Also there is no need for more eye surgeons so we don't need to create more.
There are a couple of flaws in your arguments. First, there is a shortage of primary care providers. This is a valid reason to open up an alternative pathway to meet this shortage. There is not a shortage of ophthalmologists. Second, these physician assistants will actually be going to medical school. Your plan to have optometrists complete 'optometric surgical fellowships' bypasses medical school completely.
And I love how 'why not' has become a reason to create a second class of eye surgeons. Should we have an alternate pathway to becoming a supreme court justice too, one that doesn't require going through law school? Why not?
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The only fellowship for optometrists doing surgery I could ever support is similar to the heavier training DMDs do to become surgeons. It would be 5 years, can do whatever order they would like but would need to be equivalent to this.
2 Years equivalent years 3-4 medical school passing all steps of USMLE. (4th year can be heavy in ophthalmology elective rotations)
1 Year of medical/surgical internship.
2 years dedicated eye surgical/medical training.
They could then graduate their fellowships with an MD degree as well. That would be a suitable fellowship. Hoever the need for such a fellowship is definitely debateable.
2 Years equivalent years 3-4 medical school passing all steps of USMLE. (4th year can be heavy in ophthalmology elective rotations)
1 Year of medical/surgical internship.
2 years dedicated eye surgical/medical training.
They could then graduate their fellowships with an MD degree as well. That would be a suitable fellowship. Hoever the need for such a fellowship is definitely debateable.
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Why is it necessary to complete medical school to do eye surgery? Dentists and podiatrists perform surgery following a surgical fellowship, yet they never complete medical school.
Why don't you give me a convincing reason there is a need for an alternate pathway to eye surgery. Access to care they use in Oklahoma and Kentucky is not convincing.
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Dude joined this month, and 6 of his 7 posts are in this thread. That's pretty trollish behavior.
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Because their basic training incorporates surgery already. A general dentist can actually do a fair amount of oral surgery without any residency.
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Don't forget that Dentists get hands on training with actual sick patients during dental school. How much pathology does optometry school really provide for their students?
In terms of why there isn't an alternative pathway:
The people who possess the knowledge and skills you desire do not want to teach you or any optometrist. The only way to create a subclass of optometric surgeons is through legislative scope expansion then experimenting on an unsuspecting public. Every charity/non-paying case is already covered by some ophtho program.
Optometry provides one of the best career paths out there. It looks like a pretty sweet job from my perspective. I understand wanting to do whatever you want and define the scope of your field, but limitations are placed on every profession to protect the public.
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"Shortage of doctors" should never be used to justify the need for less training in any healthcare profession. Citizens of the united states should not receive medical care from poorly trained practitioners simply based on their zip code. Can a nurse practitioner or PA check blood lipids and prescribe lipitor with an MDs assistance - probably - but this is very different than eye surgery. I also feel it is ridiculous that optometry uses the "distance to an ophthalmologist" argument. We all pay taxes this has provided a robust system of highways in this country - patients should be expected to occasionally use these and drive more than 5 minutes from their home when they need things like "free" eye surgery (keep in mind that the government pays for >80% of bill for eye surgeries in the Medicare population).
I agree any optometrist that wants to perform surgery should be expected to complete more than a 1 year fellowship with Ben Gaddie. Passing the 3 steps of the USMLE would be a start, but they would also need to participate in a training program at a hospital that cared for sick patients and provided experiences with eye patients with complex pathology - fitting contact lenses in college students or doing 50 diabetic screening exams will not cut it. These experiences would be needed before the training in eye surgery ever started. In other words, there would need to be a radical change in the current optometric training programs. Optometry is obviously unwilling to do this as the current programs continue to increase spots and dilute training experiences (the exact opposite of what is happening in ophthalmology where the numbers of trainees is smaller than during the 1980s and where the required procedure numbers and experiences continues to grow. In other words, if ophthalmology training programs went the way of optometry, all of the training programs would be on probation.).
We all (ophthalmology and optometry) know that optometry training programs would never be able provide the same level of training that ophthalmologists get with any "alternative track." The schools simply cannot provide the experiences and sorry, experience does matter. Therefore, I honestly feel the easier route for an optometrist that want to perform surgery and medical care at the level of an ophthalmologist would be to simply apply to medical school and perform and ophthalmology residency. Anything short of this will create a second class "surgeon."
I agree any optometrist that wants to perform surgery should be expected to complete more than a 1 year fellowship with Ben Gaddie. Passing the 3 steps of the USMLE would be a start, but they would also need to participate in a training program at a hospital that cared for sick patients and provided experiences with eye patients with complex pathology - fitting contact lenses in college students or doing 50 diabetic screening exams will not cut it. These experiences would be needed before the training in eye surgery ever started. In other words, there would need to be a radical change in the current optometric training programs. Optometry is obviously unwilling to do this as the current programs continue to increase spots and dilute training experiences (the exact opposite of what is happening in ophthalmology where the numbers of trainees is smaller than during the 1980s and where the required procedure numbers and experiences continues to grow. In other words, if ophthalmology training programs went the way of optometry, all of the training programs would be on probation.).
We all (ophthalmology and optometry) know that optometry training programs would never be able provide the same level of training that ophthalmologists get with any "alternative track." The schools simply cannot provide the experiences and sorry, experience does matter. Therefore, I honestly feel the easier route for an optometrist that want to perform surgery and medical care at the level of an ophthalmologist would be to simply apply to medical school and perform and ophthalmology residency. Anything short of this will create a second class "surgeon."
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There are obviously MDs willing to teach ODs, the Oklahoma ODs didn't just start lasering on their own.
Second, its my understanding that ODs see quite a bit of pathology. Not as much as MDs, but more than enough to be competent at what they do.
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I guess we will see what the future holds. When I first started learning about the health-care system, I saw it as a huge mess. Doctors arguing with each other over who can remove a wart on an ankle for example (DPM vs. derms or w/e) lol
At my age I do not know quite a lot about the system but I know as everything else in America, it is over-legislated. I swear if I ever had a position of power I would definitely push for cooperation, integration and streamlining.
Everything below is considered controversial and slightly off-topic. I am SURE I have not covered all the bases so please ignore if you wish.
-Get rid of the DNP/DO degree and train most of them to become MD's or specialists (as described below). NP's and PA's would be given the opportunity to train to MD or downgrade to RN. I would basically double or triple the amount of MD's though, expanding primary care greatly. Therefore making the MD a little easier to obtain than currently.
The MD would just be a general medical degree. If advancement is highly desired then special (longer) bridge programs would exist to all specialties mentioned below:
Specialists ( Specialist Medical Doctor -or- Doctor of Specialized Medicine [SMD]) would almost all follow the dental model (ophthalmologists,podiatrists,otolaryngologists,dermatologists,neurologists/neurological surgeons etc.) with higher levels of residency attainment = increased privileges (increasing complication of surgery etc.)
This would effectively make the ODs into low level OMDs with possibility of advancement (if stringent testing requirements are passed), same thing for audiologists to ENT's, podiatrists to orthopaedic surgeons, etc.
All specialists will be privileged to sub-specialties as they are now.
The only healthcare degrees would be MD, SMD, RN and techs making it a lot easier for the public to decipher the alphabet soup.
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I believe early specialization will create better doctors because extraneous information will not be taught and the neuroplasticity of a younger brain is greater than an older brain. There could be a lot less "turf wars" between professions as a federally outlined system could delineate a lot more clearly the scope of practice for each specialist rather than state laws. I think this is what the Obama administration should have done. I believe healthcare in general will lean towards something like this anyway as medicine gets increasingly more and more complicated.
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Anywho, implementation of this would take decades so I realize it's not very realistic but sometimes I enjoy late night ranting.
End
But for now I'll just bite the bullet and see how needlessly more complicated we can make our health-care system.
At my age I do not know quite a lot about the system but I know as everything else in America, it is over-legislated. I swear if I ever had a position of power I would definitely push for cooperation, integration and streamlining.
Everything below is considered controversial and slightly off-topic. I am SURE I have not covered all the bases so please ignore if you wish.
-Get rid of the DNP/DO degree and train most of them to become MD's or specialists (as described below). NP's and PA's would be given the opportunity to train to MD or downgrade to RN. I would basically double or triple the amount of MD's though, expanding primary care greatly. Therefore making the MD a little easier to obtain than currently.
The MD would just be a general medical degree. If advancement is highly desired then special (longer) bridge programs would exist to all specialties mentioned below:
Specialists ( Specialist Medical Doctor -or- Doctor of Specialized Medicine [SMD]) would almost all follow the dental model (ophthalmologists,podiatrists,otolaryngologists,dermatologists,neurologists/neurological surgeons etc.) with higher levels of residency attainment = increased privileges (increasing complication of surgery etc.)
This would effectively make the ODs into low level OMDs with possibility of advancement (if stringent testing requirements are passed), same thing for audiologists to ENT's, podiatrists to orthopaedic surgeons, etc.
All specialists will be privileged to sub-specialties as they are now.
The only healthcare degrees would be MD, SMD, RN and techs making it a lot easier for the public to decipher the alphabet soup.
---
I believe early specialization will create better doctors because extraneous information will not be taught and the neuroplasticity of a younger brain is greater than an older brain. There could be a lot less "turf wars" between professions as a federally outlined system could delineate a lot more clearly the scope of practice for each specialist rather than state laws. I think this is what the Obama administration should have done. I believe healthcare in general will lean towards something like this anyway as medicine gets increasingly more and more complicated.
---
Anywho, implementation of this would take decades so I realize it's not very realistic but sometimes I enjoy late night ranting.
End
But for now I'll just bite the bullet and see how needlessly more complicated we can make our health-care system.
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Clearly, that's not what our society is about. You're describing some sort of socialist utopia. You a commie or sumthin?
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Clearly, that's not what our society is about. You're describing some sort of socialist utopia. You a commie or sumthin?
Haha maybe, perhaps more in line with Platonism. But my parents come from a socialist country so over there a doctor made as much as a guy digging a ditch by the highway so I don't want to go that way either
No wonder it failed
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And how exactly would optometrists charge less than OMD's? Fees are reimbursed by medicaire and insurance companies. One could argue that an increased number of providers would drive down the reimbursement fees, but there is already a pretty heavy over-saturation of ophthalmologists in most areas. Half of the ophthalmologists in most major cities could disappear tomorrow and there most likely wouldn't be any access to care issues for cataract surgery. Also, due to liability, overhead, etc., the efficiency of cataract surgery goes way up the more cases you do. Having even more cataract surgeons would decrease efficiency and not impact access to care.
Also, given that Medicaire reimburses a cool 650 bucks for the pre-op, surgery, and 90 days of post-op care, I doubt that many optometrists will be lining up to do years of surgical training so that they can do an occasional cataract (and especially not for less money). Who would pay for the training? Where would the patient's come from? Unless the optometrist has some sort of guaranteed pipeline of cataract patients, it would be a significant financial loss.
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Yeah you're probably right. But currently there isn't much room for more cuts before routine cataract surgery would only be practical for very high volume practices. At that point access to care would be affected. Since cataracts are considered one of the most important surgical procedures by the government (and by patients), that is unlikely to happen.
Most ophthalmologists I've talked to have said 500 bucks (about a 15% reduction) would be their breaking point. Perhaps many would go less, but there is only so much room for more cuts. It's not like the old days where a routine CE/IOL reimbursed $2000 and you could get rich doing a few every week.
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Haha maybe, perhaps more in line with Platonism. But my parents come from a socialist country so over there a doctor made as much as a guy digging a ditch by the highway so I don't want to go that way either
I hear ya. Some of the docs in my area do mission work in a former Soviet state. The cab drivers get paid more than the ophthalmologists there--seriously.
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The life expectancy of a Russian cab driver is probably about a month.
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Thank you. I've been saying that for years on here. Optometry as a profession gets that. We really really do. So when everyone gets into a twist over "surgical rights" I don't know what else I can say to make people understand that it isn't about cataracts or YAGs or LASIK or any of that.
Someone along the way asked for OD input, so I'll give it a try.
1. Optometrists are not looking to do ocular surgery that opens the globe. Shouting to the whole world that we are is like the boy who cried wolf. This doesn't help your cause. It hasn't worked in the past.
2. We often do get paid less for exams and procedures,...and sometimes not at all, because of medical lobbying against us.
3. We already have been entrusted with sorting out patient symptoms and findings, to root out ocular disease vs. simple refractive findings vs. ocular side effects of systemic disease vs. systemic disease with ocular findings, and to determine when to refer for general medical or surgical care...and we have been treating this way with topical and oral medications for as long as 25 to 30 years. Our malpractice insurance rates are VERY LOW. You're going to have to get over this...we've already proven we can diagnose and treat without going to medical school.
4. Medicine (with a capital M) does not hold a monopoly on education, learning, or intelligence.
5. Our business skills???...if you ask optometrists, young and old, the single recurring theme is that we didn't get enough training about the business world.
6. We're all commercial when you get down to it whether we are selling contact lenses, multi-focal implants, teeth whitening, derm-abrasion or whatever.
1. Optometrists are not looking to do ocular surgery that opens the globe. Shouting to the whole world that we are is like the boy who cried wolf. This doesn't help your cause. It hasn't worked in the past.
2. We often do get paid less for exams and procedures,...and sometimes not at all, because of medical lobbying against us.
3. We already have been entrusted with sorting out patient symptoms and findings, to root out ocular disease vs. simple refractive findings vs. ocular side effects of systemic disease vs. systemic disease with ocular findings, and to determine when to refer for general medical or surgical care...and we have been treating this way with topical and oral medications for as long as 25 to 30 years. Our malpractice insurance rates are VERY LOW. You're going to have to get over this...we've already proven we can diagnose and treat without going to medical school.
4. Medicine (with a capital M) does not hold a monopoly on education, learning, or intelligence.
5. Our business skills???...if you ask optometrists, young and old, the single recurring theme is that we didn't get enough training about the business world.
6. We're all commercial when you get down to it whether we are selling contact lenses, multi-focal implants, teeth whitening, derm-abrasion or whatever.
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fjpod, I think you made your point on the other thread. It was a great point in my opinion that does not need to be repeated here in a lesser quality version. Lets not overdo it and spark criticism from the other side which I predict will happen very soon
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fjpod, I think you made your point on the other thread. It was a great point in my opinion that does not need to be repeated here in a lesser quality version. Lets not overdo it and spark criticism from the other side which I predict will happen very soon
Ooooh, I am so glad you guys found a common ground
. However, I am more glad about things like this:[FONT=Verdana, Arial, Helvetica, sans-serif]Major Patient Safety Legislation Enacted in Oklahoma.[FONT=Verdana, Arial, Helvetica, sans-serif]
A legislative breakthrough in the Academys efforts to restore patient surgical protections in Oklahoma recently passed and was signed into law by Oklahoma Gov. Mary Fallin. HB 1044 represents a major victory for the surgical safety coalition, as it provides an important check on independent board action by ensuring that proposed scope regulations are vetted and approved by the legislature before they can be implemented. Along with the House and Senate authors, 13 legislators signed on to co-sponsor HB 1044. These members of the House and Senate strong advocates of patient safety and quality of care worked in partnership with the Oklahoma Academy of Ophthalmology, the Oklahoma State Medical Association and Academy to include language in the bill that has a direct impact on health licensure boards rule-making.
HB 1044 states that any rule by an agency, board or commission shall require approval by the legislature (House and Senate) by joint resolution. If the legislature fails to approve the rule on or before the last day of the legislative session, the rule shall be deemed disapproved. Thus, all future regulations promulgated by the Oklahoma Board of Optometry and other mid-level practitioner boards seeking to expand scope by rule must be reviewed and approved by the state legislature..
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Cool, this is about to get good....
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Heh, that is quite brash. I'll agree that OMD's have greater training but really most people with above average intelligence can become OMD's with the right dedication/motivation. Also note that people like Bill Gates never finished college and look at his success. Having a higher degree just shows you are more of a workaholic rather than it being a distinct measure of intelligence. Although in GENERAL, IQ does play a role as people that do well on standardized tests have the option to go onto higher degrees. I belong to the group of good test takers but I value lifestyle very much.
Really? Most people with above average intelligence don't even graduate college. Only 25-30% of adults in the United States hold a bachelor's degree. I guess the rest just skipped college and went straight to ophthalmology school.
