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I found a potentially troubling thread with a link on the OD forum. I feel that it is definitely worth checking out.
http://www.njao.org/calltoaction.htm
http://www.njao.org/calltoaction.htm
Optometrists performing surgery.
- Thread starter LSUMED2006
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This is an ongoing issue. ODs have tried to gain more rights to surgical procedures and privileges for years. I think surgery will be far-fetched for individuals without further post-graduate training/residencies. Allowing people to perform surgery without the proper training and knowledge of managing the complications is criminal.
We'll have to stick together as a profession and demand high standards. Hopefully the public and legislators will listen.
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Because of my background, I can see appreciate the point of view of both parties. I can't really see any benefit in training optometrists to perform surgery in first world countries where there are generally more than enough ophthalmologists to serve the populace. The optometrists are caught between the Scylla and Charybdis; if they argue that with adequate training they could perform surgery, then a similar line of argument could be used against them to advocate refraction by opticians.
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how realistic is this to happen??
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well..that should really open the doors for every one else right?
btw, what is the average salary for these od's in oklahoma? how does it compare to OD's in other states?
btw, what is the average salary for these od's in oklahoma? how does it compare to OD's in other states?
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Not necessarily: it's tough to argue that there is a need for them to expand their role. I understand that the OD's of OK can use lasers, however they are limited to performing PRK, which has effectively fallen out of favour since the introduction LASIK. In the short term, I think that ophthalmology has nothing to worry about; the experience of therapeutics bills and optometry would suggest that few OD's would exercise such "rights". The problem will come in the medium to long term. One can certainly envisage a situation in which optometry schools could train students with a view to their performing certain surgeries (after they've completed an appropriate residency).
I'm uncertain of the average salary of OD's in OK.
I'm uncertain of the average salary of OD's in OK.
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Yeah, the majority of us up and comers just want to work WITH you guys and gals.
Eyegirl
Eyegirl
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Of course you can work with us. Stay at your glasses hut, and stay away from surgical lasers..they are dangerous in the hands of children!
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Blitzkrieg,
Well said. If you knew the clinical incompetence that exists among optometrists you really have nothing to worry about. Some of these young men and woman cannot perform accurate refractions and fit proper contact lenses. I'm not even talking about examining the peripheral retina for holes, tears, lattice and macular abnormalities along prescribing topical meds for anterior diseases- some of them can't do optometry right. I wouldn't worry too much about lasers in the hands of OD's. How many actually are going to use them ? Yag capsulotomies? Diabetic retinopathies? You gotta be kidding me - you have to inform the public and all your patience about this issue. How many OD's use lasers in Oklahoma? How many will use them in N.Jersey? Many states allow OD's to treat glaucoma both topically and orally. How many actually practice this? Not many. Unless they are affiliated with MD/OD clinic/ multidiscilpinary practice.
Eyegirl- you talk alot of hot air. Get your OD degree and then talk all the garbage you want. Also grow up!
Well said. If you knew the clinical incompetence that exists among optometrists you really have nothing to worry about. Some of these young men and woman cannot perform accurate refractions and fit proper contact lenses. I'm not even talking about examining the peripheral retina for holes, tears, lattice and macular abnormalities along prescribing topical meds for anterior diseases- some of them can't do optometry right. I wouldn't worry too much about lasers in the hands of OD's. How many actually are going to use them ? Yag capsulotomies? Diabetic retinopathies? You gotta be kidding me - you have to inform the public and all your patience about this issue. How many OD's use lasers in Oklahoma? How many will use them in N.Jersey? Many states allow OD's to treat glaucoma both topically and orally. How many actually practice this? Not many. Unless they are affiliated with MD/OD clinic/ multidiscilpinary practice.
Eyegirl- you talk alot of hot air. Get your OD degree and then talk all the garbage you want. Also grow up!
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I have to intervene here because this topic is headed towards a name calling session. Please refrain from attacking each other on this forum. Let's be civil and show each other respect.
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Hey umm...reality check..
I think Blitz meant to be amusing. (Note the laugh smilies).
Sometimes I feel really sorry for you.
Eyegirl
I think Blitz meant to be amusing. (Note the laugh smilies).
Sometimes I feel really sorry for you.
Eyegirl
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If there is something that I'm being a kid about, educate me. Give me an enlightening discussion. Currently you're not presenting your ideas in a way that helps me to learn.
Eyegirl
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I thought it was amusing.... haha..I guess some people fail to grasp sarcasm.. 
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Eyegirl 2K7 don't take my comments personally. Blitzkrieg's comment to your statement indeed came across as sarcastic as well as insulting. That's how I understood it. "glasses hut." Perhaps I may be mistaken but if that was said to me I find it insulting. Maybe that's just me. You shouldn't feel sorry for me. I got my OD degree. I make over 100 thousand dollars a year doing what I love to do best- practicing full scope optometry/therapeutics and helping people to the best of my ability. I'm not going to sit here and recall your past comments from all your posts but the majority of them sound childish. Hey, if I insulted you I'm sorry. In your clinical years in optometry school you'll get criticisms some with validity others without by your preceptors- learn to suck it up and handle yourself in a mature manner.
Peace!
Peace!
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As usual, any thread that is about the differences between OMDs and ODs goes too far.
Any surgery that O.D.s would be permitted to do would be minor. We aren't talking about cataracts or LASIK! Oklahoma ODs can do PRK but it is within the scope of practice of optometrists. It's not that complicated. There's no scalpel involved. There may be rare complications that cannot be handled buy ODs, and it's okay to send these patients to the OMDs. We send other hard cases now anyway.
Minor surgery would include chalazion removal, papilloma removal, iridotomy, YAG capsulotomy, etc. These are not major surgeries. These procedures can easily be learned.
Reality check: Your argument makes no sense. Here's what you said...
"Some of these young men and woman cannot perform accurate refractions and fit proper contact lenses. I'm not even talking about examining the peripheral retina for holes, tears, lattice and macular abnormalities along prescribing topical meds for anterior diseases- some of them can't do optometry right."
For every OD you name that is incompetant, I can name an M.D. who's incompetant as well. You just said "some optometrists." If you would have said ALL optometrists then you might have a point. We do not define our profession by the weakest links.
What it comes down to is loss of income. M.D.s are afraid of optometrists moving into their territory. This is understandable. We optometrists are afraid of opticians doing the same thing to us. Why don't we both just admit the truth? It all has to do with income.
But you know what? There's enough income for everyone if we just work together. Will that ever happen? Maybe. Who knows, maybe physicians and optometrists will eventually go to the same schools!
Any surgery that O.D.s would be permitted to do would be minor. We aren't talking about cataracts or LASIK! Oklahoma ODs can do PRK but it is within the scope of practice of optometrists. It's not that complicated. There's no scalpel involved. There may be rare complications that cannot be handled buy ODs, and it's okay to send these patients to the OMDs. We send other hard cases now anyway.
Minor surgery would include chalazion removal, papilloma removal, iridotomy, YAG capsulotomy, etc. These are not major surgeries. These procedures can easily be learned.
Reality check: Your argument makes no sense. Here's what you said...
"Some of these young men and woman cannot perform accurate refractions and fit proper contact lenses. I'm not even talking about examining the peripheral retina for holes, tears, lattice and macular abnormalities along prescribing topical meds for anterior diseases- some of them can't do optometry right."
For every OD you name that is incompetant, I can name an M.D. who's incompetant as well. You just said "some optometrists." If you would have said ALL optometrists then you might have a point. We do not define our profession by the weakest links.
What it comes down to is loss of income. M.D.s are afraid of optometrists moving into their territory. This is understandable. We optometrists are afraid of opticians doing the same thing to us. Why don't we both just admit the truth? It all has to do with income.
But you know what? There's enough income for everyone if we just work together. Will that ever happen? Maybe. Who knows, maybe physicians and optometrists will eventually go to the same schools!
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The problem with ODs doing surgery does not solely relate to the loss of income as you stated. This issue addresses what is really best for patients. I understand that the procedures OK ODs are performing may be "simple". However, your over simplification of the PRK lasers and other procedures underscores why we must be more careful when undertaking such procedures:
"Oklahoma ODs can do PRK but it is within the scope of practice of optometrists. It's not that complicated. There's no scalpel involved. "
Why is PRK lasers within the scope of practice for ODs? Does a weekend course make a person qualified to do laser surgery? In addition, just because a "scalpel" is not involved does not mean this is safe. You're using a laser to cut away healthy cornea tissue. In the wrong hands, lasers WILL BLIND. I would only get refractive surgery from a cornea specialist who has 4 years of residency training and 1+ year of cornea fellowship training. A cornea specialist will be better able to recognize pre-existing conditions that will worsen after refractive surgery. I don't buy the arguement that because no scalpel is involved then it's not complicated and therefore safe. Lasers are surgical instruments.
Will the OD's stop at PRK? Likely not. The optometry field is known to be very aggressive in pushing for more privileges even though the training is different and does not prepare them for the pathology. Reading about pathology in a text book is nothing compared to practicing medicine and managing the disease under the guidance of attendings during residency and fellowships.
Who knows, maybe physicians and optometrists will eventually go to the same schools!
This will only happend if ODs decide to attend medical school, then do a 4 year residency, and possibly fellowship. The training MDs receive is very different. The knowledge and experience gained during a residency and fellowship surpasses any knowledge or experience that is gained during a 4-year doctoral degree. Furthermore, in order to treat many of the diseases that manifest in the eye, one must complete medical school. Without the fundamental knowlege of human health, biology, and disease, the practice of medicine and surgery is dangerous and wrong.
Thus, optometrists should focus on what their training has prepared them for: basic ocular care & fitting of glasses and contact lenses. Weekend courses do not make individuals surgeons. We need to respect surgery and know the complications and harm that may result from it.
"Oklahoma ODs can do PRK but it is within the scope of practice of optometrists. It's not that complicated. There's no scalpel involved. "
Why is PRK lasers within the scope of practice for ODs? Does a weekend course make a person qualified to do laser surgery? In addition, just because a "scalpel" is not involved does not mean this is safe. You're using a laser to cut away healthy cornea tissue. In the wrong hands, lasers WILL BLIND. I would only get refractive surgery from a cornea specialist who has 4 years of residency training and 1+ year of cornea fellowship training. A cornea specialist will be better able to recognize pre-existing conditions that will worsen after refractive surgery. I don't buy the arguement that because no scalpel is involved then it's not complicated and therefore safe. Lasers are surgical instruments.
Will the OD's stop at PRK? Likely not. The optometry field is known to be very aggressive in pushing for more privileges even though the training is different and does not prepare them for the pathology. Reading about pathology in a text book is nothing compared to practicing medicine and managing the disease under the guidance of attendings during residency and fellowships.
Who knows, maybe physicians and optometrists will eventually go to the same schools!
This will only happend if ODs decide to attend medical school, then do a 4 year residency, and possibly fellowship. The training MDs receive is very different. The knowledge and experience gained during a residency and fellowship surpasses any knowledge or experience that is gained during a 4-year doctoral degree. Furthermore, in order to treat many of the diseases that manifest in the eye, one must complete medical school. Without the fundamental knowlege of human health, biology, and disease, the practice of medicine and surgery is dangerous and wrong.
Thus, optometrists should focus on what their training has prepared them for: basic ocular care & fitting of glasses and contact lenses. Weekend courses do not make individuals surgeons. We need to respect surgery and know the complications and harm that may result from it.
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This is simply ridiculous. I don't understand why some optometrists and optometry students are trying to become something they're not -- physicians. If you wanted to perform surgery, then you should've gone to medschool. I don't care if the procedures are easy, minor or not. Stop pretending. Argh!
Should a neurologist perform brain surgery instead of a neurosurgeon?
Should midwives perform c-sections and other complicated births as opposed to OB's?
Should a general dentist perform oral surgery?
Should a psychologist (PhD) prescribe drugs and replace psychiatrists?
Should a dental hygenist perform/replace the duties of a dentist? (afterall, the dental drill is being replaced by painless lasers)
Should paralegals replace lawyers?
Should a commerical airline pilot fly a stealth bomber over iraq on a bombing raid?
Should a Chimp be US president?
SHOULD AN OPTICIAN REPLACE THE DUTIES OF AN OPTOMETRIST (IN REGARDS TO REFRACTIONS AND CONTACT/SPECS FITTINGS)?!
Gimme a break. C'mon people. where does it end? The point is, although there are several occupations that overlap with others, the bottom line is the training is different. You are specifically trained to do something different/unique. Just because you know one thing or another doesn't make you qualified in a similar field.
I'm interested to hear from optometrists and optometry students why opticians should not perform the duties of optometrists. Afterall based on your arguments.... a couple of weekends of training coupled with the next generation auto-refractors should enable them to do refractions, fittings, prescribe glasses and contacts, right? Its not complicated and there's no scapel involved, right? Its easy and can be learned, no?
Should a neurologist perform brain surgery instead of a neurosurgeon?
Should midwives perform c-sections and other complicated births as opposed to OB's?
Should a general dentist perform oral surgery?
Should a psychologist (PhD) prescribe drugs and replace psychiatrists?
Should a dental hygenist perform/replace the duties of a dentist? (afterall, the dental drill is being replaced by painless lasers)
Should paralegals replace lawyers?
Should a commerical airline pilot fly a stealth bomber over iraq on a bombing raid?
Should a Chimp be US president?
SHOULD AN OPTICIAN REPLACE THE DUTIES OF AN OPTOMETRIST (IN REGARDS TO REFRACTIONS AND CONTACT/SPECS FITTINGS)?!
Gimme a break. C'mon people. where does it end? The point is, although there are several occupations that overlap with others, the bottom line is the training is different. You are specifically trained to do something different/unique. Just because you know one thing or another doesn't make you qualified in a similar field.
I'm interested to hear from optometrists and optometry students why opticians should not perform the duties of optometrists. Afterall based on your arguments.... a couple of weekends of training coupled with the next generation auto-refractors should enable them to do refractions, fittings, prescribe glasses and contacts, right? Its not complicated and there's no scapel involved, right? Its easy and can be learned, no?
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Ophtho_MudPhud and anyone else who wants to read this...
I didn?t want this to get into a discussion about PRK because I?m not a big fan of it. Destroying Bowman?s Membrane is not good for healing. The procedure itself is also not particularly good on patients since they sometimes have to endure six months of steroids and blurry vision. LASIK is the way to go nowadays, although I?m not convinced this is particularly a great procedure either. It?s good for some people though, but I?m not going to elaborate further.
I still maintain that PRK is not complicated. 1) The computer does most of the work. Even an OMD can get this wrong. 2) 90% of PRK screening involves history. Who can?t take a history? It?s a few questions. Have a pre-printed form with all the possible risks and you have most of what you need. Now it comes down to looking at the patient. We know what is normal and what is abnormal. That?s what we were trained for. OMDs spend a lot of time on diagnosis and treatment. We spend a lot of time on diagnosis. That?s all it takes to screen PRK patients. And anyone who invests in a million dollar instrument is going to damn well know what is normal and what isn?t. What we are talking about is doing PRK on normal, healthy people. If there is anything that appears suspicious, refer to a corneal OMD specialist. Get his or her opinion and if the risk is minimal, proceed with PRK. If not, get glasses. 3) Lasers can blind? Sure, but we are talking about the excimer laser. Show me a list of patients who have had their corneas penetrated by the excimer and that will prove that people go blind from PRK. Excimer lasers do not blind. If anything, it?s the steroid use that blinds. Steroids can cause cataracts, and OMDs are still using Pred Forte and other steroids that are well known for causing them. NSAIDs can cause corneal melts and that can blind too. Use either of these drugs too much and there is the potential for damage. ODs are fully trained to recognize when things are going awry and can make adjustments. As I say, PRK patients may have to endure six months of therapy. That?s the time to be most careful?not the surgery. 4) Corneal specialists are there to help us when things go awry during PRK. Since 99.9% of the time there will be no emergency that requires an M.D. to be on staff during PRK, a referral can be made if there are any complications.
Ophtho_MudPhud said, ?I don't buy the arguement that because no scalpel is involved then it's not complicated and therefore safe. Lasers are surgical instruments.? I could not agree more. However, I did not make the argument that because there is no scalpel it makes it safe. I don?t buy it either. I am saying that it does make it LESS complicated. There is less chance of operator error by making the laser do all the ?cutting.? (Excimer lasers don?t cut, they ablate?but you know what I mean).
What I don?t buy is this argument about what is best for the patient! Do we always do what is BEST for the patient or do we sometimes do what is best for us or what is best for the patient economically? I can give you countless examples of doctors of all professions who compromise patient safety in the name of personal gain or dollar saving. How about doing LASIK instead of giving the patient glasses? Now we get into the argument of the ethics of LASIK.because there is the potential for loss of vision for an elective procedure. What about writing an Rx for a drug that is under the patient?s insurance company formulary when the doctor knows there are more effective, newer medications on the market? Don?t give me this argument about doing what is best for the patient. It?s a nice thing to say but it?s not always true. OMDs want all the business of surgery, plain and simple. It?s an economic issue.
If it was about patient safety, then OMDs should not let their staff do refractions. They are incompetent! OMDs should refer all of their patients to us ODs for refractions and glasses. After all, if the refraction isn?t right, then isn?t that endangering the lives of other drivers? Isn?t that endangering the lives of our kids when they ride busses with bus drivers that got their exams from incompetent staff members? Where did they get their education? From a book? From a two hour class? If that!
This is not just an issue about PRK. It?s an issue about doing minor surgeries such as iridotomies, chalazion and papilloma removal. Can you tell me how dangerous these procedures are? Clearly the last two are not dangerous at all! You have to admit that.
I stand by what I said.
I?m not saying we ODs want to be OMDs. Far from it! In my case, I don?t want all the surgeries. I don?t want all the end-stage glaucoma cases, I don?t want the trauma, I don?t want the scarred corneas, I don?t want to do cataract surgery, and I don?t even want LASIK or PRK. If I wanted these things I would have gone to medical school (I?m sure you?ve heard this argument before too). I don?t want to be an OMD, thanks. Believe it or not, I think I can make more money as an OD than an OMD. That?s another topic for another day?
As such, we have what we have, and we want minor surgery.
I didn?t want this to get into a discussion about PRK because I?m not a big fan of it. Destroying Bowman?s Membrane is not good for healing. The procedure itself is also not particularly good on patients since they sometimes have to endure six months of steroids and blurry vision. LASIK is the way to go nowadays, although I?m not convinced this is particularly a great procedure either. It?s good for some people though, but I?m not going to elaborate further.
I still maintain that PRK is not complicated. 1) The computer does most of the work. Even an OMD can get this wrong. 2) 90% of PRK screening involves history. Who can?t take a history? It?s a few questions. Have a pre-printed form with all the possible risks and you have most of what you need. Now it comes down to looking at the patient. We know what is normal and what is abnormal. That?s what we were trained for. OMDs spend a lot of time on diagnosis and treatment. We spend a lot of time on diagnosis. That?s all it takes to screen PRK patients. And anyone who invests in a million dollar instrument is going to damn well know what is normal and what isn?t. What we are talking about is doing PRK on normal, healthy people. If there is anything that appears suspicious, refer to a corneal OMD specialist. Get his or her opinion and if the risk is minimal, proceed with PRK. If not, get glasses. 3) Lasers can blind? Sure, but we are talking about the excimer laser. Show me a list of patients who have had their corneas penetrated by the excimer and that will prove that people go blind from PRK. Excimer lasers do not blind. If anything, it?s the steroid use that blinds. Steroids can cause cataracts, and OMDs are still using Pred Forte and other steroids that are well known for causing them. NSAIDs can cause corneal melts and that can blind too. Use either of these drugs too much and there is the potential for damage. ODs are fully trained to recognize when things are going awry and can make adjustments. As I say, PRK patients may have to endure six months of therapy. That?s the time to be most careful?not the surgery. 4) Corneal specialists are there to help us when things go awry during PRK. Since 99.9% of the time there will be no emergency that requires an M.D. to be on staff during PRK, a referral can be made if there are any complications.
Ophtho_MudPhud said, ?I don't buy the arguement that because no scalpel is involved then it's not complicated and therefore safe. Lasers are surgical instruments.? I could not agree more. However, I did not make the argument that because there is no scalpel it makes it safe. I don?t buy it either. I am saying that it does make it LESS complicated. There is less chance of operator error by making the laser do all the ?cutting.? (Excimer lasers don?t cut, they ablate?but you know what I mean).
What I don?t buy is this argument about what is best for the patient! Do we always do what is BEST for the patient or do we sometimes do what is best for us or what is best for the patient economically? I can give you countless examples of doctors of all professions who compromise patient safety in the name of personal gain or dollar saving. How about doing LASIK instead of giving the patient glasses? Now we get into the argument of the ethics of LASIK.because there is the potential for loss of vision for an elective procedure. What about writing an Rx for a drug that is under the patient?s insurance company formulary when the doctor knows there are more effective, newer medications on the market? Don?t give me this argument about doing what is best for the patient. It?s a nice thing to say but it?s not always true. OMDs want all the business of surgery, plain and simple. It?s an economic issue.
If it was about patient safety, then OMDs should not let their staff do refractions. They are incompetent! OMDs should refer all of their patients to us ODs for refractions and glasses. After all, if the refraction isn?t right, then isn?t that endangering the lives of other drivers? Isn?t that endangering the lives of our kids when they ride busses with bus drivers that got their exams from incompetent staff members? Where did they get their education? From a book? From a two hour class? If that!
This is not just an issue about PRK. It?s an issue about doing minor surgeries such as iridotomies, chalazion and papilloma removal. Can you tell me how dangerous these procedures are? Clearly the last two are not dangerous at all! You have to admit that.
I stand by what I said.
I?m not saying we ODs want to be OMDs. Far from it! In my case, I don?t want all the surgeries. I don?t want all the end-stage glaucoma cases, I don?t want the trauma, I don?t want the scarred corneas, I don?t want to do cataract surgery, and I don?t even want LASIK or PRK. If I wanted these things I would have gone to medical school (I?m sure you?ve heard this argument before too). I don?t want to be an OMD, thanks. Believe it or not, I think I can make more money as an OD than an OMD. That?s another topic for another day?
As such, we have what we have, and we want minor surgery.
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Spinola said, "Why waste a chimp when a creature as simple as George W. Bush seems to be qualified (by popular opinion) for the job?"
Hate our president? He had a 70% approval rating the last time I checked. Funny how the hate seems to permeate every discussion in these forums.
Don't hate too much. It's not good for your health.
Personally, I think he's done a great job.
Hate our president? He had a 70% approval rating the last time I checked. Funny how the hate seems to permeate every discussion in these forums.
Don't hate too much. It's not good for your health.
Personally, I think he's done a great job.
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Just to summarize...
1) ODs don't want to be OMDs
2) We are only talking about minor surgery (take PRK out--we don't care about that one anyway)
3) Examples of minor surgery: iridotomies, chalazion and papilloma removal, YAG capsulotomy
4) Let the opticians have what they want--they will work at Wal-Mart and take all the crap we had to. We ODs will go into private practice and live it up on what we took from the OMDs. (just kidding)
We do not want to be OMDs. We just want to give our patient's a little extra to keep them happy. Why refer for a chalazion surgery when it is so easy? I don't think it's worth any OMDs time. Let them do the cataracts and all the other comlicated surgeries. That's what they went to school for--not to do routine, simple surgeries! Hell, I could do it at home on my dog if I wanted to.
Just thought I'd put this face in since it's kinda funny.
1) ODs don't want to be OMDs
2) We are only talking about minor surgery (take PRK out--we don't care about that one anyway)
3) Examples of minor surgery: iridotomies, chalazion and papilloma removal, YAG capsulotomy
4) Let the opticians have what they want--they will work at Wal-Mart and take all the crap we had to. We ODs will go into private practice and live it up on what we took from the OMDs. (just kidding)
We do not want to be OMDs. We just want to give our patient's a little extra to keep them happy. Why refer for a chalazion surgery when it is so easy? I don't think it's worth any OMDs time. Let them do the cataracts and all the other comlicated surgeries. That's what they went to school for--not to do routine, simple surgeries! Hell, I could do it at home on my dog if I wanted to.
Just thought I'd put this face in since it's kinda funny.- Joined
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Originally posted by docwatson
Spinola said, "Why waste a chimp when a creature as simple as George W. Bush seems to be qualified (by popular opinion) for the job?"
Hate our president? He had a 70% approval rating the last time I checked. Funny how the hate seems to permeate every discussion in these forums.
Don't hate too much. It's not good for your health.
Personally, I think he's done a great job.
Hate GW? I think you've got the wrong end of the stick, old sport. He's provided me with a lot of laughs.
What you do with your dog in your own time is none of our concern.
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PSEUDODOC WATSON-
YOUR POSTS REEK OF ENVY OF FELLOW EYE SURGEONS. PLEASE QUIT WASTING OUR TIME AND SPACE IN THIS MD THREAD WITH YOUR OPTOM RANTING AND RAVING.
KNOW YOUR PLACE IN SOCIETY, AND STAY THERE.
YOU WILL NEVER BE A PHYSICIAN(OR SURGEON) UNLESS YOU GO TO MED SCHOOL. YOU ARE ONE OF THE FEW PESKY OPTOMS THAT HAVE DEVELOPED TUNNEL VISION AS A RESULT OF YOUR FEELINGS OF INADEQUACY AND INFERIORITY. IF IT BOTHERS YOU THIS MUCH, APPLY TO MED SCHOOL.
OPTHOS ARE MEDICAL DOCTORS, MY FRIEND--THE BEST AND BRIGHTEST OUR SOCIETY HAS TO OFFER. OPTOMS ARE USUALLY THOSE WHO UNDERPERFORMED IN COLLEGE, AKA PRE-MED FAILURES. THIS IS WHY THEY OFTEN BECOME, AS YOU ARE, MD-WANNABES.
MEDSTUD
YOUR POSTS REEK OF ENVY OF FELLOW EYE SURGEONS. PLEASE QUIT WASTING OUR TIME AND SPACE IN THIS MD THREAD WITH YOUR OPTOM RANTING AND RAVING.
KNOW YOUR PLACE IN SOCIETY, AND STAY THERE.
YOU WILL NEVER BE A PHYSICIAN(OR SURGEON) UNLESS YOU GO TO MED SCHOOL. YOU ARE ONE OF THE FEW PESKY OPTOMS THAT HAVE DEVELOPED TUNNEL VISION AS A RESULT OF YOUR FEELINGS OF INADEQUACY AND INFERIORITY. IF IT BOTHERS YOU THIS MUCH, APPLY TO MED SCHOOL.
OPTHOS ARE MEDICAL DOCTORS, MY FRIEND--THE BEST AND BRIGHTEST OUR SOCIETY HAS TO OFFER. OPTOMS ARE USUALLY THOSE WHO UNDERPERFORMED IN COLLEGE, AKA PRE-MED FAILURES. THIS IS WHY THEY OFTEN BECOME, AS YOU ARE, MD-WANNABES.
MEDSTUD
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Hey docwatson,
1- I can tell you are not satisfied with your job
2- I can tell you have too much time to waste
3- Trying to impress me--NO--actually, you showed how much of an MD Wanabee you wanabee.
4- Therefore, please for the safety of all the drivers out there, quit your job and go to Medical School, i am not sure if you can get in though. At least, I think you should try.
5- ODs should not perform any surgeires, even minor ones.
Finally, quit your job and try to get into a medical school--like the Caribean ones (easier to get into).
Have a good day.
D
1- I can tell you are not satisfied with your job
2- I can tell you have too much time to waste
3- Trying to impress me--NO--actually, you showed how much of an MD Wanabee you wanabee.
4- Therefore, please for the safety of all the drivers out there, quit your job and go to Medical School, i am not sure if you can get in though. At least, I think you should try.
5- ODs should not perform any surgeires, even minor ones.
Finally, quit your job and try to get into a medical school--like the Caribean ones (easier to get into).
Have a good day.
D
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Docwatson,
Many of your comments hint that you have not seen many complications or very bad diseases. We all need to be careful and aware of the possible problems that can happen.
Most of medicine is "easy"; however, because 1% of what is usually routine may be really, really, really bad, this is why only specialists in the field should deal with the problem. I am a MD and my license "allows" me to do everything in medicine; however, I'm not moonlighting and doing central lines on the side. The compensation is big for central lines too and I could "share" some of the wealth with my internal medicine and surgical colleagues. I even had 2 months of experience (over 700 hours) in the ICU and cardiology service. This is more than any optometrist would dedicate in learning about laser procedures or lid bumps. I would not touch a central line with a ten foot pole. Nor would I try to manage diabetic ketoacidosis although I know how from my books and experience from internship. DKA management is "easy" too; you know, it's not me that is making the sugars go down, it's really the insulin.
Now let's take your case of chalazion surgery. Sure this is simple procedure. Most will be routine without problems. However, if a surgeon hasn't dealt with Masquerade-Syndrome before (which is very rare), then he/she may not suspect sebaceous cell carcinoma, which can kill. You make the diagnosis and the patient lives; you miss the diagnosis and the patient could lose an eye or die. This diagnosis can be easily missed even in the most experienced hands. With more and more training, I have respect even for the most simple presentations. I'm not obsessed about rare syndromes and diseases, but my differential expands a little when I see certain populations with a recurring chalazion. Yes, I agree with you that chalazion surgery is "simple"; however, one should always show respect and caution even for the most simple diseases. I'm also aware that ophthalmologists also miss diagnoses all the time. We're all human. However, I strongly believe that post-graduate training in the form of a residency/fellowship better prepares physicians for the challenges of caring for patients and the difficult diseases. This is about patient care and safety.
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This analogy has been used before, but why don't MD's get upset with dentistry? After all, they are not MD's, they go to their own schools, they use medications, injections and minor surgical procedures.
Is it because there is no MD's counterpart (financial)? How can dentists be adequately trained at their schools but optometrists can not?
OD's do "see" pathology in addition to reading it in a book.
With all due repect to those involved in the conversation here, it looks like many of you are students (undergrad or medical). You can't possibly know what you are talking about in the real world. All you people know it what someone has told you.
And unless you have been to both Optometry and Medical School, you really can't make a comparasion, can you?
Is it because there is no MD's counterpart (financial)? How can dentists be adequately trained at their schools but optometrists can not?
OD's do "see" pathology in addition to reading it in a book.
With all due repect to those involved in the conversation here, it looks like many of you are students (undergrad or medical). You can't possibly know what you are talking about in the real world. All you people know it what someone has told you.
And unless you have been to both Optometry and Medical School, you really can't make a comparasion, can you?
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Keith do you actually believe in what you are saying? "It's an economic issue?" If one of your family members or close relative had a complicated glaucoma case would you want an optometrist treating it or a glaucoma specialist - one with years of experience and competency? If your son or daughter wanted PRK or Lasik would you want an optometrist performing the procedure or the best corneal/refractive surgeon out there? Optometry is a wonderful profession Keith as you and I both know. It's easy work and yet at times challenging depending on how you practice it. If you wanted to challenge yourself further and aimed higher in life you should have become an ophthalmologist. It's as simple as that. Treating ALL diseases of the eye and performing even minor surgery is not in the realm of the optometric profession. If you were an OMD you would be going nuts realizing how much optometry has gained over the past decade or so. Keith you would enjoy and love working at a VA hospital doing what you want to do.
My advice to you: take MCAT's, apply to Med school, get in, do extremely well in academics, rock step I of Boards, publish or do some research in ophth electives in your 3td or 4th year of med school and hope you land an ophth residency during match time. Do 1 yr internal med, 3 yrs ophth residency and 1 or 2 years fellowship in whatever subspecialty you desire. At the end you will truly be content realizing you reached the summit rather than the base. You are truly an MD wannabe.
Regards,
RC
My advice to you: take MCAT's, apply to Med school, get in, do extremely well in academics, rock step I of Boards, publish or do some research in ophth electives in your 3td or 4th year of med school and hope you land an ophth residency during match time. Do 1 yr internal med, 3 yrs ophth residency and 1 or 2 years fellowship in whatever subspecialty you desire. At the end you will truly be content realizing you reached the summit rather than the base. You are truly an MD wannabe.
Regards,
RC
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All of you who have responded negatively to my comments are completely wrong about everything you have said--about OMDs, about ODs, and about me. Completely wrong!
No one is obviously listening.
I said: I do not want to be an OMD. I don't want to get into all the details as to why because clearly none of you would understand anyway. Besides, I don't think it would be a good idea to offend you personally which would happen with all the hostility here.
I'm very happy doing what I'm doing. I think optometry is far and away the better profession, but of course that's my opinion, and it's my choice of career. Clearly, all of you have chosen a different path.
Let me reiterate: I DO NOT WANT TO BE AN OMD! That means: OMD is not high on my list of occupations to consider. It never was. It's not about finding ways to challenge myself. I have plenty to do now. I do not want to treat all diseases! Again, I do not want to be an OMD! I only want to treat those things that are within our scope of practice as a way to give my patients an added skill that doesn't have to be referred out. Is anyone listening? Where did anyone get the idea I would want to work at a VA hospital??? WHAT? Where did this come from? I love private practice optometry!
It is an economic issue. Reality Check--you aren't listening. I said we should do the easy cases and we'll leave the difficult cases for the specialists. A complicated glaucoma case is a difficult case is it not? LASIK is not something that ODs will ever be able to do unless we go to MD school. Where did this come from? OMDs are afraid of ODs encroaching on their territory! Can we agree on at least one thing?
What is with all the hostility? Is it from all the gains optometry has made over the years? I am in no way attempting to offend anyone. Is there some reason certain people have to stoop to childish ranting and raving? Why can't we have a decent debate? Reality check has been somewhat gracious although as I say he did not even attempt to read anything that I posted. His comments do not make sense. Sorry, Reality Check, but it would help if you could listen to me first.
If no one can give me a compelling argument against my ideas then you are only engraining my beliefs even further. Try to convince me otherwise. Ranting and raving isn't going to do it. Telling me that I'm a failure when clearly I'm very successful is not going to do it either.
Getting hostile serves no purpose. If we can't learn to co-exist then there is no hope for either profession.
The way I look at forums is that if you can say these things to me in person then go ahead a flame away--but don't expect to receive anything in kind from me. If not, then you better think about modifying what you are saying. It's not fair when I'm attempting to communicate with you honestly. Debating is the name of the game, not flaming.
No one is obviously listening.
I said: I do not want to be an OMD. I don't want to get into all the details as to why because clearly none of you would understand anyway. Besides, I don't think it would be a good idea to offend you personally which would happen with all the hostility here.
I'm very happy doing what I'm doing. I think optometry is far and away the better profession, but of course that's my opinion, and it's my choice of career. Clearly, all of you have chosen a different path.
Let me reiterate: I DO NOT WANT TO BE AN OMD! That means: OMD is not high on my list of occupations to consider. It never was. It's not about finding ways to challenge myself. I have plenty to do now. I do not want to treat all diseases! Again, I do not want to be an OMD! I only want to treat those things that are within our scope of practice as a way to give my patients an added skill that doesn't have to be referred out. Is anyone listening? Where did anyone get the idea I would want to work at a VA hospital??? WHAT? Where did this come from? I love private practice optometry!
It is an economic issue. Reality Check--you aren't listening. I said we should do the easy cases and we'll leave the difficult cases for the specialists. A complicated glaucoma case is a difficult case is it not? LASIK is not something that ODs will ever be able to do unless we go to MD school. Where did this come from? OMDs are afraid of ODs encroaching on their territory! Can we agree on at least one thing?
What is with all the hostility? Is it from all the gains optometry has made over the years? I am in no way attempting to offend anyone. Is there some reason certain people have to stoop to childish ranting and raving? Why can't we have a decent debate? Reality check has been somewhat gracious although as I say he did not even attempt to read anything that I posted. His comments do not make sense. Sorry, Reality Check, but it would help if you could listen to me first.
If no one can give me a compelling argument against my ideas then you are only engraining my beliefs even further. Try to convince me otherwise. Ranting and raving isn't going to do it. Telling me that I'm a failure when clearly I'm very successful is not going to do it either.
Getting hostile serves no purpose. If we can't learn to co-exist then there is no hope for either profession.
The way I look at forums is that if you can say these things to me in person then go ahead a flame away--but don't expect to receive anything in kind from me. If not, then you better think about modifying what you are saying. It's not fair when I'm attempting to communicate with you honestly. Debating is the name of the game, not flaming.
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Tom,
I respect your opinions and appreciate your input.
why don't MD's get upset with dentistry? After all, they are not MD's, they go to their own schools, they use medications, injections and minor surgical procedures. Is it because there is no MD's counterpart (financial)? How can dentists be adequately trained at their schools but optometrists can not?
Dentristy has been a medical/surgical sub-speciality for hundreds of years. Their education is therefore tailored to prepare them for the care of dental health. In addition, most dentists stay within the scope of their training and education.
There are a sub-set of dentists, however, who are oral surgeons. This sub-set do overlap with ENT surgeons. In order to be trained for oral surgery, dentists pursue an internship/residency training program. This is the MD counterpart in dentistry, but these individuals have undergone the proper training before embarking on reconstructive oral surgery.
Historically, surgery has not been part of optometry training. It is only within the last decade that optometry has pushed for more privileges. You all point the finger at MDs, but the real reason for the push by optometrists is money. Right?
OD's do "see" pathology in addition to reading it in a book. .
You can't really state that the pathology seen and managed by students during a doctoral program is truly "seeing" pathology. I saw a lot of pathology during medical school too. I did three months of ophthalmology at Wilmer. What I learned from seeing pathology during medical school cannot compare to the degree that I learned during internship and residency. The amount of pathology seen during a 4-year doctoral program is also very minimum. The key to mastering a field is repetition and appreciation for the nuances in human diseases.
If optometrists really want to pursue surgery, then here is my recommendation. Change your education at your institutions so that you all can apply for medical internships and residencies. Then pursue 4 year residencies along with the rest of the MDs.
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The analogy of maxillofacial surgery is an interesting one. In Europe and Australasia, maxillofacial surgeons are required to be dually qualified in dentistry and medicine. In the USA, by contrast, dentists wanting to pursue a career in maxillofacial surgery don?t go to medical school (yes, the residency is long, but no longer than it is in Europe). Could anyone shed a light on the history behind this discrepancy?
As regards vanilla dentistry, I think that there are no objections from the medical profession because of historical reasons; in the renaissance, dentists were just as qualified as surgeons. Both were considered to be beneath physicians (in Northern Europe, that is: surgery and medicine were never really divided in Southern Europe, e.g. Italy). From about the 18th century, surgery was slowly incorporated into medicine: dentistry was not. The latter remained as an independent entity. In contrast, optometry wasn't a cohesive profession until the early 20th century; jewellers and pharmacists prescribed most spectacles before this date.
Optometrists have a lot of experience in primary eye care, and are better placed to provide this service to the public than a general (family) practitioner. However, I couldn't put my hand on my heart and say that I'd send my mother to be treated for glaucoma by her optometrist; I'd send her to an ophthalmologist specialising in the field. Could the current situation ever change? For the reasons I've written about before, I think that it is unlikely.
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Andrew, I agree with you more than I disagree. I do have the utmost respect for most Ophthalmologist and their training. I do. I work around some of the best Ophthalmologists in my state I feel. And for the record, I have no desire to perform any type of major eye surgery (The definition is up to debate I guess
All OD's students begin seeing patients during their final 2 years of school. During the last year, each student is required to spend most of the year outside the school in outside extern sites. They go to private practices, VA hospitals, OMD referral centers etc. In my particular case, I "externed" at an Army hospital working along site the OD and OMD's. I learned a tremendous amount there in 4 months. I then "externed" at a large private OD/OMD practice where I saw "pathology" patients in conjunction with the doctors every day, all day long. I enjoyed it so much that I spent the time between my graduation and after my licensure (and state board exam) working there (for peanuts) for a year overall.
This was about 2 years of practical experience.........not a residency and nowhere nearly as formal or probably intense....But I saw and learned to treat a great deal of cases.
I don't pretend to say I saw nearly as much as a resident will, but I saw enough, in my opinion, to know what I'm doing and tha past 3 years have increased my confidence. I work hard at staying up to date by reading jornals, attending meeting and staying alert. I also volunteered to work part-time in a referral center for 6 months.
So I guess what I'm saying is, while you are spending 3 year studying Ophthalmology and seeing many cases over and over, I am doing it a little differently...........on-the-job-training if you will. Your seeing patients with people looking over your shoulder. I'm seeing them in real life. Does quantity matter...eventually I will have seen as many as anyone?
I understand that we are not going to change anyone's mind here and I see that there are over 1,500 views to this topic so many people are reading but not responding. That's good.
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TomOD,
Your points are well taken. I anticipate that your thirst for knowledge is great and that you are always searching for opportunities to enhance your competency. However, I think your situation is unique because the majority of your colleagues do not do internships nor do they seek opportunities similar to yours. It is this majority who I fear when the field of optometry lobbies the federal and state governments for increased surgical privileges.
I work with many competent optometrists who I greatly respect. I'm not arguing for optometrists to be stripped of their medical privileges. I truly believe the field of optometry provides an extremely useful and much needed service to society. As primary care providers who can diagnose and treat common ocular disorders and fit glasses and contact lenses, optometrists are essential components in the delivery of ocular health.
The primary concern here is surgery. The field of optometry is pushing for more privileges without the proper training. This concerns me greatly. Let's look ahead hypothetically. If optometrists are allowed to use lasers now, then after 10 years you can almost be certain that the field will lobby for the use of lasers for retinal diseases. They'll argue that lasers are "safe" and "simple" to use. The law makers will see that optometrists have been using lasers for 10 years and therefore must be qualified to use the same lasers on the retina.
It is obvious today that no one should laser the retina without proper residency or fellowship training. However, will it be just as clear in the future after the field of optometry sell the idea that they have been using the laser and that it's "simple"? Likewise, it is just as feasible to envision the push for "simple" lid surgery such as ptosis repair and blepharoplasties. These concepts may sound unlikely today, but I'm not so sure it will in the future if optometry slowly introduces "simple" surgical procedures over time.
I think we all agree that surgery should be reserved for those with the proper training. I just hope we're all responsible enough to maintain these high standards for the sake of our patients.
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Just to start - As an ophthalmologist-to-be, I fail to see how screaming that ODs are just wannabe MDs is helping the MD case very much.
Anyway. . .
Tom, you certainly have some valid points. However, I have to agree with Andrew that surgeries need to be restricted to MDs who have gone through an appropriate residency and/or fellowship. You are obviously putting in a lot of time and effort to see patients, stay current, etc. However, there is no way to ensure that this is the case for all of your colleagues. The reason that surgery is currently limited to MDs is because there are licensing boards and organizations that oversee residency programs that ensure that every ophthalmology resident gets a minimum necessary training and academic experience. Yes, you are seeing patients and pathology in the field. At this point, I have no doubt in the world that you know infinitely more about the eye than I do. However, I will be entering my ophthalmology residency in July, and I trust that when i have finished I will have undergone all the necessary training to perform ocular surgery. My current general medicine internship and past medical school experience are all part of that.
There is currently no such process to license ODs to perform surgeries. Ultimately, the argument always boils down to whether the more limited training of an optometrist is sufficient for such procedures. Somehow, I doubt many people are going to change their mind based on an internet forum discussion. Still, it is hard to deny that optometrists do not have the same educational background as ophthalmologists. As Andrew has pointed out frequently, there is definitely less common pathology that it takes more extensive training to recognize. Since we already have a profession designed for the express purpose of treating this pathology, it seems both unnecessary and potentially dangerous to allow another, currently less rigourously monitored profession to do so also. As Andrew points out, it sets a risky precedent. Opening the door a little bit will only lead to more attempts to open it wider in the future, no matter how initially idealistic everybody is.
Sorry if I wasted anybody's time with this post, it seems kinda redundant after looking it over again. Oh well.
Anyway. . .
Tom, you certainly have some valid points. However, I have to agree with Andrew that surgeries need to be restricted to MDs who have gone through an appropriate residency and/or fellowship. You are obviously putting in a lot of time and effort to see patients, stay current, etc. However, there is no way to ensure that this is the case for all of your colleagues. The reason that surgery is currently limited to MDs is because there are licensing boards and organizations that oversee residency programs that ensure that every ophthalmology resident gets a minimum necessary training and academic experience. Yes, you are seeing patients and pathology in the field. At this point, I have no doubt in the world that you know infinitely more about the eye than I do. However, I will be entering my ophthalmology residency in July, and I trust that when i have finished I will have undergone all the necessary training to perform ocular surgery. My current general medicine internship and past medical school experience are all part of that.
There is currently no such process to license ODs to perform surgeries. Ultimately, the argument always boils down to whether the more limited training of an optometrist is sufficient for such procedures. Somehow, I doubt many people are going to change their mind based on an internet forum discussion. Still, it is hard to deny that optometrists do not have the same educational background as ophthalmologists. As Andrew has pointed out frequently, there is definitely less common pathology that it takes more extensive training to recognize. Since we already have a profession designed for the express purpose of treating this pathology, it seems both unnecessary and potentially dangerous to allow another, currently less rigourously monitored profession to do so also. As Andrew points out, it sets a risky precedent. Opening the door a little bit will only lead to more attempts to open it wider in the future, no matter how initially idealistic everybody is.
Sorry if I wasted anybody's time with this post, it seems kinda redundant after looking it over again. Oh well.
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To reality check.
Yep. I'm a kid. I'm a 22 year old pre-OD with little life experience, a liberal arts education, and a lot of idealism.
Still, contrary to your assumptions about me--I know a hell of a lot about "Sucking it up." I've had to fight hard for everything I've ever had. I'm not a rich college kid.
I find it a privilege to go to OD school. It's something I've fought for. And lucky for me, I don't want tons of money, I don't want to be the doctor with the shiniest car or the fanciest house. I just want to pay my bills. I want to spend time with eyes. I want to take care of people and make a difference. And I feel blesssed to have the opportunity.
That's me. If I'm chidish, immature etc....so what? i would rather be a child than a relentless cynic. I don't need to assauge my insecurities by attacking others on an anonymous forum. I consider my so called "idealsm" a strength, not a fallacy.
Eyegirl.
I didn't say I was insulted by your post. I just said I thought Blitz meant it as a joke. You couldn't possibly insult me. You're a random person on the internet.
Yep. I'm a kid. I'm a 22 year old pre-OD with little life experience, a liberal arts education, and a lot of idealism.
Still, contrary to your assumptions about me--I know a hell of a lot about "Sucking it up." I've had to fight hard for everything I've ever had. I'm not a rich college kid.
I find it a privilege to go to OD school. It's something I've fought for. And lucky for me, I don't want tons of money, I don't want to be the doctor with the shiniest car or the fanciest house. I just want to pay my bills. I want to spend time with eyes. I want to take care of people and make a difference. And I feel blesssed to have the opportunity.
That's me. If I'm chidish, immature etc....so what? i would rather be a child than a relentless cynic. I don't need to assauge my insecurities by attacking others on an anonymous forum. I consider my so called "idealsm" a strength, not a fallacy.
Eyegirl.
I didn't say I was insulted by your post. I just said I thought Blitz meant it as a joke. You couldn't possibly insult me. You're a random person on the internet.
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This is a really interesting point, and it raises the issue of informed consent. There is certainly a difference between "on the job training" and supervised training. The majority of patients seeing a resident will be aware of the relative inexperience of that resident (though they can be assured that the latter will have appropriate support, should they need it). Is the same true of patients who are seeing someone who is learning "on the job"?
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ALL optometry students are REQUIRED to do at least two internships. If you were thinking residency, Tom did not do a residency. Neither did I.
You keep referring to lasers and difficult eye surgeries like ptosis repair and blepharoplasties. I don't think an external hordeolum and a papilloma is necessarily going to need a ptosis repair or a blepharoplasty. Like I say, I don't want to do difficult surgeries. I just want to provide additional services for my patients. Let me say it again: I don't care about lasers. Nada, not gunna do it, no way, uh uh, nope...
Someone mentioned that surgery is a money issue for us. Hardly. You know how many hordeolum/chalazions I see? Maybe 2-3 a month. If that. I'm not going to make much from this. My income comes primary from routine exams and optical services. So if I don't get extra privileges, it's not going to hurt my feelings. Tom on the other hand does primarily health services. One of the few if not the only private practice optometrist in the US who does it this way.
I would like Georgia to adopt oral antibiotics to our formulary for the same reason that I would like simple surgeries--as an added benefit to my patients. It's very inconvenient for my patients to have to see an OMD to get an oral med for a hordeolum/chalazion that I could just as easily prescribe. Getting rid of the formulary would be a good thing too--just stating a class of drugs would be better. It silly that every new drug that comes out has to be "approved" by the state board. Talk about a waste of time and effort!
7ontheline said...
"Just to start - As an ophthalmologist-to-be, I fail to see how screaming that ODs are just wannabe MDs is helping the MD case very much."
Thank you for this comment. I'm glad you said this.
I appreciate all those who have debated this issue on an honest level. I hope that we have all learned something. I have.
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docwatson,
I think you misunderstood what I stated above. I never said that you or other optometrists want to do retinal lasers or lid surgeries TODAY; nor did I ever state that chalazions and papillomas will NEED ptosis repair or blephs.
I was making the point that optometry is not a surgical subspeciality, but the field, in general, is pushing very hard for surgical privileges. Therefore, by slowly introducing the "simple" surgical procedures now, optometry (as a field.. not you specifically) may and will likely argue for more privileges in the future. This is my point. Optometry is a non-surgical field that is trying to be a surgical profession without the formal training. From what I've read and seen, this is the long-term goal for optometry.
In addition, when I mentioned "internships", I am referring to post-doctoral training. Few optoms pursue this. I work with an optom who did one year of internship after graduating from OD school. I think what you're referring to as the two required "internships" are similar to the clinical rotations MDs do in medical school. As an OD, you don't need to do any post-graduate training before practicing. Am I wrong about this?
I think you misunderstood what I stated above. I never said that you or other optometrists want to do retinal lasers or lid surgeries TODAY; nor did I ever state that chalazions and papillomas will NEED ptosis repair or blephs.
I was making the point that optometry is not a surgical subspeciality, but the field, in general, is pushing very hard for surgical privileges. Therefore, by slowly introducing the "simple" surgical procedures now, optometry (as a field.. not you specifically) may and will likely argue for more privileges in the future. This is my point. Optometry is a non-surgical field that is trying to be a surgical profession without the formal training. From what I've read and seen, this is the long-term goal for optometry.
In addition, when I mentioned "internships", I am referring to post-doctoral training. Few optoms pursue this. I work with an optom who did one year of internship after graduating from OD school. I think what you're referring to as the two required "internships" are similar to the clinical rotations MDs do in medical school. As an OD, you don't need to do any post-graduate training before practicing. Am I wrong about this?
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Your right Andrew. There is a risk of some constantly wanting more. That's tricky.
The absolute biggest problem in Optometry today is the vast range of training and skills among all those holding the OD degree.
Some of those that graduated in the 1950's are still in practice today and honestly probably shouldn't be. Their training was vastly different then an OD within the past 10 years (although I am sure many have kept up with the changing times).
Just in my community, you can "step back in time" by viewing our oldest OD's and our oldest Ophthalmolgist. The OD who graduated in 1958 is by most definations, a refractionist (and a good one). He did jump through the required hoops in 1978 when NC OD's began using topical meds. He and all other OD's around the state had to basically close up their practice and travel to the University of North Carolina at Chapel Hill to get formal classroom training in Pharmacology and Systemic Implications.
Even so, he rarely treated anything and rarely dilated. He referred just about everything from a corneal abrasion to a single dot hemorrhage in the retina to a local Ophthalmologist. In turn, he never saw these patients back (and I'm not really sure he should have).
I know about this OD because I recently bought his records. The Ophthalmologist is still practicing, but doesn't get any OD referrals (they go to other more OD-friendly Ophthalmologists).
The two guys I talk about above are in a time-warp. The entire world around them has changed and they stopped progressing in about 1978. This Ophthalmologist believes his collegues are "reckless" because they do cataract surgeries in less than 1 hour
I see the patients from this recently retired OD and wonder how he ever kept his license. He missed glaucoma, diabetic retinopathy, macula degeneration........common stuff. He was definately 'old school'.
Like I said eariler, this is still our biggest problem. Old OD's are hanging on and refusing to retire. They are simply not as well trained and seem to be content on being refractionists who happen to see a problem here and there and refer out.
Eventually, when these guys retire, OD's will at least be on a level playing field and it will be easy to know exactly what an OD is. Just looking at general medical books in Barnes and Noble, it's incredible how they define Optometry. I can understand their confusion. And then we have commercial Optometry........that a whole different problem......
Sometimes we are our own worst enemy.
The absolute biggest problem in Optometry today is the vast range of training and skills among all those holding the OD degree.
Some of those that graduated in the 1950's are still in practice today and honestly probably shouldn't be. Their training was vastly different then an OD within the past 10 years (although I am sure many have kept up with the changing times).
Just in my community, you can "step back in time" by viewing our oldest OD's and our oldest Ophthalmolgist. The OD who graduated in 1958 is by most definations, a refractionist (and a good one). He did jump through the required hoops in 1978 when NC OD's began using topical meds. He and all other OD's around the state had to basically close up their practice and travel to the University of North Carolina at Chapel Hill to get formal classroom training in Pharmacology and Systemic Implications.
Even so, he rarely treated anything and rarely dilated. He referred just about everything from a corneal abrasion to a single dot hemorrhage in the retina to a local Ophthalmologist. In turn, he never saw these patients back (and I'm not really sure he should have).
I know about this OD because I recently bought his records. The Ophthalmologist is still practicing, but doesn't get any OD referrals (they go to other more OD-friendly Ophthalmologists).
The two guys I talk about above are in a time-warp. The entire world around them has changed and they stopped progressing in about 1978. This Ophthalmologist believes his collegues are "reckless" because they do cataract surgeries in less than 1 hour
I see the patients from this recently retired OD and wonder how he ever kept his license. He missed glaucoma, diabetic retinopathy, macula degeneration........common stuff. He was definately 'old school'.
Like I said eariler, this is still our biggest problem. Old OD's are hanging on and refusing to retire. They are simply not as well trained and seem to be content on being refractionists who happen to see a problem here and there and refer out.
Eventually, when these guys retire, OD's will at least be on a level playing field and it will be easy to know exactly what an OD is. Just looking at general medical books in Barnes and Noble, it's incredible how they define Optometry. I can understand their confusion. And then we have commercial Optometry........that a whole different problem......
Sometimes we are our own worst enemy.
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Optometry, like Tom stated has only recently begun to train its practioners to recognize abnormal pathology and treat it clinically. Before, it was very much a profession based on physics, math, and optics. Am I wrong when I say this? Therefore, how is it possible that one can compare the clinical skill of an OD to an MD/DO who has completed an ophthalmology residency?
Medical doctors trained in ophthalmology have been treating diverse ocular pathology for many years both pharmacologically and surgically.
The history of ophthalmology can be traced to as far back as the second century A.D. when several ophthalmology texts were written by Galen. Many ocular conditions such as blepharitis, chalazion, iritis, cataracts, trachoma, and ophthalmoplegia were already recognized entities.
The first cataract surgery was performed over 2000 years ago in India by a surgeon named Susruta.
Ophthalmology first became established as a medial specialty in the mid 19th century in England.
In 1864 the American Ophthalmologic Society was established as the first medical specialty organization in the United States. In 1917, ophthalmology became the first branch of medicine to develop thier own specialty board examinations.
A number of medical breakthroughs have been made as a result of research in ophthalmology. For example, the first successful use of antiviral agents was for the treatment of eye disease. In the area of surgery, corneal transplants were the first successful homotransplants.
Other surgical innovations include the development of laser photocoagulation, microsurgery, and the development of techniques for micromanipulation and laser photocoagulation from within the vitreous cavity itself. Modern diagnostic advances range from the use of ultrasound and fluorescein angiography to sophisticated electrophysiology and visual function studies.
The history of ophthalmology can also be attributed to the great institutions that have made it what it is today. Wilmer of Johns Hopkins, Bascolm Palmer of University of Miami, Wills Eye Hospital of Jefferson, Mass Eye and Ear Infirmary, New York Eye and Ear Infirmary, Doheny Eye of USC, Jules Stein of UCLA, Duke Eye Center, Kresge Eye of Wayne State, Kellog Eye of UMich...the list goes on and on.
Therefore, I conclude that their already exists an unequivocal specialty of medicine to handle the surgical treatment of abnormal ocular pathology. That specialty of medicine is OPHTHALMOLOGY
This does not mean I disregard the services and role of the optometrist. On the contrary, they serve every bit of an integral role as the ophthalmologist in the delivery of complete eye care to the patient. However, it is my opinion that this role is best served as the primary eye care provider. Therefore, leaving the more complicated pathology and surgical cases to the MD/DO trained ophthalmologist.
Medical doctors trained in ophthalmology have been treating diverse ocular pathology for many years both pharmacologically and surgically.
The history of ophthalmology can be traced to as far back as the second century A.D. when several ophthalmology texts were written by Galen. Many ocular conditions such as blepharitis, chalazion, iritis, cataracts, trachoma, and ophthalmoplegia were already recognized entities.
The first cataract surgery was performed over 2000 years ago in India by a surgeon named Susruta.
Ophthalmology first became established as a medial specialty in the mid 19th century in England.
In 1864 the American Ophthalmologic Society was established as the first medical specialty organization in the United States. In 1917, ophthalmology became the first branch of medicine to develop thier own specialty board examinations.
A number of medical breakthroughs have been made as a result of research in ophthalmology. For example, the first successful use of antiviral agents was for the treatment of eye disease. In the area of surgery, corneal transplants were the first successful homotransplants.
Other surgical innovations include the development of laser photocoagulation, microsurgery, and the development of techniques for micromanipulation and laser photocoagulation from within the vitreous cavity itself. Modern diagnostic advances range from the use of ultrasound and fluorescein angiography to sophisticated electrophysiology and visual function studies.
The history of ophthalmology can also be attributed to the great institutions that have made it what it is today. Wilmer of Johns Hopkins, Bascolm Palmer of University of Miami, Wills Eye Hospital of Jefferson, Mass Eye and Ear Infirmary, New York Eye and Ear Infirmary, Doheny Eye of USC, Jules Stein of UCLA, Duke Eye Center, Kresge Eye of Wayne State, Kellog Eye of UMich...the list goes on and on.
Therefore, I conclude that their already exists an unequivocal specialty of medicine to handle the surgical treatment of abnormal ocular pathology. That specialty of medicine is OPHTHALMOLOGY
This does not mean I disregard the services and role of the optometrist. On the contrary, they serve every bit of an integral role as the ophthalmologist in the delivery of complete eye care to the patient. However, it is my opinion that this role is best served as the primary eye care provider. Therefore, leaving the more complicated pathology and surgical cases to the MD/DO trained ophthalmologist.
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Fair enough.
Only one small correction. It is my understanding that OD's have been trained to recognize abnormal pathology from very early times. I actually saw the older OD's class notes from 1958 he had stuffed in a box. They learned most everything that was known at the time..........it was needed to know what was abnormal............to know when to refer.
Just for the record, in NC, OD's have been treating eye diseases since 1977 (26 yrs).
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Ironically this has already happened. In New Mexico there was a law passed recently that gives psychologists full prescription rights, effectively replacing psychiatrists.
They do have to take some additional coursework in pharmacology, but its not that much, maybe 50 hours or so.
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Originally posted by TomOD
Fair enough.
They learned most everything that was known at the time..........it was needed to know what was abnormal............to know when to refer.
My point exactly.
I understand the need for a profession to evolve and expand it's horizons. However, it makes no sense to me for a profession to expand it's scope of practice when there already exists a profession to fill that need. I know I am not making a profound statement. Nonetheless, it seems a lot of people just can't seem to make that connection. This truly blows me away.
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Furthermore, this has been expected of them for some time. The first case of professional negligence against an optometrist dates to the 1920's (in the UK). The accused optometrist had failed to detect keratoconus: there was a hypothesis at that time which suggested that the progression of keratoconus could be halted by avoiding sunlight. Because the accused had not detected the condition, the patient in question had not avoided sunlight, and the prosecution claimed that the plaintiff's vision had subsequently deteriorated. The defence maintained that optometrist's only duty was to provide an appropriate spectacle prescription. The optometrist was convicted.
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MPS,
Your contributions to this thread have been very fascinating. What is your background? You seem to have interesting and obscure historical details and anecdotes at your fingertips. I'm very impressed.
Caffeinated
Your contributions to this thread have been very fascinating. What is your background? You seem to have interesting and obscure historical details and anecdotes at your fingertips. I'm very impressed.
Caffeinated
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MPS is a great help on this forum. He's one smart Brit. Looking at his profile, he has a degree in optometry and MD-PhD degrees from Cambridge University.
Thanks for all your valuable contributions!
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MPS,
I, too, appreciate your insight here. Please forgive my ignorance but could you enlighten us a bit on the Optometric profession in Great Britain. It is my understanding that there are Opticians and therapeautic Opticians/Optometrists (or something like that). I may be wrong.
They don't have any therapeautic rights??
I don't think their training is comparable to those in the states. Is is a Bachelor's degree program?
Just curious.
I, too, appreciate your insight here. Please forgive my ignorance but could you enlighten us a bit on the Optometric profession in Great Britain. It is my understanding that there are Opticians and therapeautic Opticians/Optometrists (or something like that). I may be wrong.
They don't have any therapeautic rights??
I don't think their training is comparable to those in the states. Is is a Bachelor's degree program?
Just curious.
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I certainly enjoy reading the posts on this forum, even despite the occasional bouts of mud-slinging.
I hail from Australia, and did my optometry degree in Sydney, I then went on to do my PhD at Cambridge and I am actually still in the midst of the medical degree. I'm on a 4-year graduate medical program at Cambridge University and I would like to train in ophthalmology after I graduate.
Tom asked about the structure of optometry in the UK. The optometry degree in the UK is taken after you leave school; it takes three years to complete. Following this, students undertake one year of supervised training in practice and are then required to sit a series of ten examinations (called the professional qualifying examinations) before they can practice independently. The exams have a low pass rate (about 30% at first attempt). UK optometrists don't have therapeutic rights, and for various reasons aren't fighting hard to gain them. Optometrists were originally called "ophthalmic opticians"; despite the fact that the profession agreed that practitioners should be called "optometrists" about 80-odd years ago, the name hasn't fully caught on (I think you can guess what this says about optometry in the UK). Confusion arises because there are ?dispensing opticians? too; the latter fulfil the duties of what you'd call opticians in the USA.
The system in Australia is different again, the program is an undergraduate one of four or five years in duration, and has a broader coverage of the basic sciences. The registration examinations are effectively conducted within the Universities themselves. The only Australian state in which optometry has gained the right to prescribe therapeutics is Victoria; the others should follow soon(ish).
I hail from Australia, and did my optometry degree in Sydney, I then went on to do my PhD at Cambridge and I am actually still in the midst of the medical degree. I'm on a 4-year graduate medical program at Cambridge University and I would like to train in ophthalmology after I graduate.
Tom asked about the structure of optometry in the UK. The optometry degree in the UK is taken after you leave school; it takes three years to complete. Following this, students undertake one year of supervised training in practice and are then required to sit a series of ten examinations (called the professional qualifying examinations) before they can practice independently. The exams have a low pass rate (about 30% at first attempt). UK optometrists don't have therapeutic rights, and for various reasons aren't fighting hard to gain them. Optometrists were originally called "ophthalmic opticians"; despite the fact that the profession agreed that practitioners should be called "optometrists" about 80-odd years ago, the name hasn't fully caught on (I think you can guess what this says about optometry in the UK). Confusion arises because there are ?dispensing opticians? too; the latter fulfil the duties of what you'd call opticians in the USA.
The system in Australia is different again, the program is an undergraduate one of four or five years in duration, and has a broader coverage of the basic sciences. The registration examinations are effectively conducted within the Universities themselves. The only Australian state in which optometry has gained the right to prescribe therapeutics is Victoria; the others should follow soon(ish).