Optometry and Prescriptions

[Mirror Form]

Optometry school, Dental School, and Podiatry School are all extremely rigorous and making a blanket statement like you have is erroneous. The rigors of Medicine? How about the rigors of Dentistry? All these fields have similar RIGORS!

Gaining an OD degree may require rigors, but it doesn't require anywhere near the rigors that gaining an MD does. You graduate training is literally half as long as that of ophthalmologist's, and less time intensive during that period! Given that fact, it's not surprising that a lot of MD's are going to be pissed and look down at OD's who try to invade the MD's turf.

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[I Surgeon]

I just got off the phone with my brother who is SURGEON and he just remarked how he just came back from his eye doctor---his OPTOMETRIST and said that it will be really nice in 5 years when I graduate from OPTOMETRY School and become an eye doctor---the first one in the family. When I sprained my ankle----I went to my foot doctor---yep you guessed it ----my podiatrist---yes he is a doctor too! You really want to open this semantical pandoras box? Optometry school, Dental School, and Podiatry School are all extremely rigorous and making a blanket statement like you have is erroneous. The rigors of Medicine? How about the rigors of Dentistry? All these fields have similar RIGORS! lol Medicine is a very generalized term---all doctoral level professionals practice "medicine" in their own form and you need to just stop this semantical elitism. I have the utmost respect for MD's and DO's---my family has numerous iterations of the two degrees. Did you go to Dental School? or Optometry School? or Podiatry School? NO----you did not... You have no personal reference point to make a comparison....And by the way------IN THE HISTORICAL PAST THE TERM DOCTOR WAS USED ORIGINALY BY PHD'S NOT ALLOPATHY, OSTEOPATHY, CHIROPRACTIC, PODIATRY, OPTOMETRY, DENTISTRY, ETC....all these fields adopted the term doctor for the respect it carried....Allopathic medicine has done a very good job of marketing it's business over the last century and I have to give them credit for it...but the minute you try to say, incorrectly I might add, that DDS's, OD's, and DPM's are not doctors you appear to be very disrespectful to these specialists and to me----(I am working my ass off to get into a program and will continue that until I am an eye doctor and after that.) It is people like you that create the Oklahoma's (in regard to OD surgery) because of your elitist attitude...Now I respect your academic accomplishment but let's get real here and accept the fact that Dentistry is a field of medicine that is totally independent of your field.......Your field is NOT medicine in the generic--------it is ALLOPATHIC MEDICINE......You are an ALLOPATH---no more a doctor or less than a Dentist---(DOCTOR OF DENTAL SURGERY--DDS or DOCTOR OF DENTAL MEDICINE---DMD) I do respect your opinion and training.


PS---I checked----less than 40% of Oral Surgeons have MD's most of them only carry the OMFS designation---that must be soooooooooo scary to all those patients that are in danger because they don't have MD's We had better call the morgue and get all the slabs ready!

I Optometry and Ophthalmology

What planet are you from? When a child says I want to grow up to be a doctor, everyone (the public, parents, etc.) knows what they mean--a physician (MD). A child does not say I want to grow up to be an allopathic doctor.

I don't care who calls themselves doctor, but why don't you just be proud to be called an "optometrist". Whats wrong with that, seriously.
Everyone knows that people don't feel optometrists are real doctors...unless you lie and present yourself as one (fraud). If you don't believe me, ask them. They know MD/DO don't work at Walmart/Costco. Your relatives say your are because...their your relatives.

You believe we are called doctors because doctors (allopathic, for you) have done a good job marketing. I DONT THINK SO. Maybe its because, any ***** can see they SAVE lives and people respect physicians especially when their lives are in danger. NO OTHER TYPE OF "DOCTOR" SAVES LIVES!

You say that I have no point of comparison-you have'nt even been to optometry school, what point do you have to comment on anyones schooling.
We have more education as a whole than any "doctor", so don't give me this bull**** about how hard you have it or will(which you don' t know, you only heard about). IT IS 7 YEARS MINIMUM FOR ANY MEDICAL SPECIALTY.


Its not people like me why ODs what to do surgery...The reasons are because they what to make more money (greedy), want to confuse the patients of want a real doctor is (MD vs, OD), don't want to have proper training (8 years min.), and would rather destroy someones eye for the sake of being called a real doctor (pride).

If you are looking for a fight, you will get one.....stop trolling!

Next time mind your own business. I'm Out.

 

[Ben Chudner]

I don't care who calls themselves doctor, but why don't you just be proud to be called an "optometrist". Whats wrong with that, seriously.
Everyone knows that people don't feel optometrists are real doctors...unless you lie and present yourself as one (fraud). If you don't believe me, ask them. They know MD/DO don't work at Walmart/Costco. Your relatives say your are because...their your relatives.

I didn't want to jump in here, but you forced me to. For your information the definition of:

MD = Doctor of Medicine
OD = Doctor of Optometry

You may choose to think we are not "real" doctors, but I can tell you that even patients at Wal-Mart know they are seeing a doctor.

Its not people like me why ODs what to do surgery...The reasons are because they what to make more money (greedy), want to confuse the patients of want a real doctor is (MD vs, OD), don't want to have proper training (8 years min.), and would rather destroy someones eye for the sake of being called a real doctor (pride).

There are many reasons why some OD's are pushing for expanded scope and I can assure you that none of them include greed, confusing patients, or pride. If you would actually have a discussion with one of the OD's on this forum rather than continue to state how much education you've had, how much harder it is to get into med school, or how much respect you deserve you might understand the real issues.

 

[Mirror Form]

I didn't want to jump in here, but you forced me to. For your information the definition of:

MD = Doctor of Medicine
OD = Doctor of Optometry

You may choose to think we are not "real" doctors, but I can tell you that even patients at Wal-Mart know they are seeing a doctor.

Technically, you are completely correct. However, the term "doctor" has been used frequently for more then a century to refer to doctors of medicine. That is the connotation that the word has. While it's true that the term's dictionary definition is different, many laymen still use the term "doctor" to refer to MD's. Many ophthalmologists feel that some optometrists have been exploiting the confusion and not being forthright to their patients and the public about the differences b/w their training and an MD's training.

There are many reasons why some OD's are pushing for expanded scope and I can assure you that none of them include greed,

Oh please, now you're embarrasing yourself. Do you honestly believe that if there was no increased income potential linked to an expanded scope, that optometrists would still be pushing for an expanded scope in 1/10th as strong a manner? If so, then you're very naive. The optometrists are putting a lot of time, energy, and $$$ into their pushes for scope expansion. It's not just b/c they are a large group of amazing philanthropists who are really that desperate to be able to provide more care. This is about control of the field and cash.

confusing patients, or pride. If you would actually have a discussion with one of the OD's on this forum rather than continue to state how much education you've had, how much harder it is to get into med school, or how much respect you deserve you might understand the real issues.

I agree that we need to try and be more civil. But keep in mind that most people in med school went through enormous amounts of work and stress just to get in, let alone graduate. Then most MD graduates applying for ophthalmology had to again be super competitive and go through enormous amounts of stress just to get in, let alone finish internship, residency, etc. So when optometrists (who like it or not, have not had to under go nearly as much stress and work) begin to brush off our educations, it REALLY PUSHES OUR BUTTONS, and it's guaranteed to provoke lots of nasty remarks from the ophtho people. So if you optometrists want to argue that your training is sufficient to do a certain procedure (or rx, etc) please don't do so in a way that makes it look like the opthalmologists were just wasting our time and lives by going through all that ****.

 

[Ben Chudner]

Technically, you are completely correct. However, the term "doctor" has been used frequently for more then a century to refer to doctors of medicine. That is the connotation that the word has. While it's true that the term's dictionary definition is different, many laymen still use the term "doctor" to refer to MD's. Many ophthalmologists feel that some optometrists have been exploiting the confusion and not being forthright to their patients and the public about the differences b/w their training and an MD's training.

So I guess dentists, podiatrists, etc are not doctors. As for OD's exploiting the confusion, you will need to provide some examples. How about this one. Aren't OMD's exploiting the confusion by prescribing eyeglasses. I mean, do most OMD's really know anything about eyeglasses other than their optical can be profitable?

Oh please, now you're embarrasing yourself. Do you honestly believe that if there was no increased income potential linked to an expanded scope, that optometrists would still be pushing for an expanded scope in 1/10th as strong a manner? If so, then you're very naive. The optometrists are putting a lot of time, energy, and $$$ into their pushes for scope expansion. It's not just b/c they are a large group of amazing philanthropists who are really that desperate to be able to provide more care. This is about control of the field and cash.

I don't know how many times I have to explain this. Expanded scope does not make OD's a lot of money. I know this because I am actually in practice. Where do you think the income potential is in prescibing oral antibiotics? Where is the income potential in prescibing oral steroids? Where is the income potential of performing one or two YAG's per month at $128 each (that won't cover the lease payment). The issue has nothing to do with money. The majority of OD's want to expand their scope of practice to be able to provide care to their patients without having to refer cases that they can manage. This makes health care delivery more convenient for patients and less expensive. Yes, there are some fringe OD's that believe we should be doing surgery, and as usual they seem to be the ones that get the most publicity. These are fringe ideas. Just like the fringe OMD's that think OD's should not be able to recommend OTC artificial tears (California), treat glaucoma (New York), insert punctal plugs (Washington), etc.

If you want to really talk about cash, let's talk about OMD's owning opticals. Granted, we are not talking life or death, but why do OMD's need to sell glasses? It certainly isn't because they are group of amazing philanthropists.

I agree that we need to try and be more civil. But keep in mind that most people in med school went through enormous amounts of work and stress just to get in, let alone graduate. Then most MD graduates applying for ophthalmology had to again be super competitive and go through enormous amounts of stress just to get in, let alone finish internship, residency, etc. So when optometrists (who like it or not, have not had to under go nearly as much stress and work) begin to brush off our educations, it REALLY PUSHES OUR BUTTONS, and it's guaranteed to provoke lots of nasty remarks from the ophtho people. So if you optometrists want to argue that your training is sufficient to do a certain procedure (or rx, etc) please don't do so in a way that makes it look like the opthalmologists were just wasting our time and lives by going through all that ****.

I am not arguing that our training is the same. What I will say is that in every state that there has been expanded scope, there has not been any evidence presented that patients have been harmed. This includes OK. That is why there has never been a state to permanently reverse an expanded scope bill.

 

[rubensan]

If you are looking for a fight, you will get one.....stop trolling!

Next time mind your own business. I'm Out.

2 questions:

1. to the OMDs: why does it matter what Ben or futuredoctorOD or any other non-OMDs on this forum think? I thought andrew doan and many others had great solutions to this ophtho vs. opto debate: "draw the line at surgey," get involved at the level of the AAO and our state and federal governments (letters, PAC contributions, etc) and protect our field. Same old arguments? yes, but some great soutions to the problem are very accomplishable. arguing about how prestigious an MD is should be something that we inherently know, all i need to do is see the look at my patients' faces to not only know what a prestigious job i have, but also that all the "****" i went through to get here was well worth it. i don't need to prove that to Ben or futuredoctorOD.

2. to the non-OMDs who frequent this forum: why do you like to come here anyway? i really am curious. are you not being satisfied by your own forums? honest question, no sarcasm. i've noticed that many of you enjoy coming to this MD/DO forum and lecturing us on "being professional" and stating over and over again that "the MD degree is not the only path to enlightenment, ODs are doctors too, etc, etc" I agree with you on these points, but I can not help but feel that many of you just like to come here and pick a fight. is it just me?

 

[Tom_Stickel]

2. to the non-OMDs who frequent this forum: why do you like to come here anyway? i really am curious. are you not being satisfied by your own forums? honest question, no sarcasm. i've noticed that many of you enjoy coming to this MD/DO forum and lecturing us on "being professional" and stating over and over again that "the MD degree is not the only path to enlightenment, ODs are doctors too, etc, etc" I agree with you on these points, but I can not help but feel that many of you just like to come here and pick a fight. is it just me?

Ruben,

In all honesty, I come here because of threads with names like "Do you support Optometrists doing surgery? - ODs allowed to do scalpel surgery in OK!" and "Optometry and Prescriptions" and "Let's end the war..." and on an on. These are threads started by OMDs but specifically about the OD/OMD relations, and they can get negative about ODs. The ODs and students feel inclined to respond.

Why the dentists spend their time cruising these forums is a mystery to me still. Perhaps with no allopathic specialty overlapping their field, their forum is boring because there's no one to argue with?

As you know, Optometry and Ophthalmology occupy very overlapping territory, for the most part, and probably more so than any other two fields (if I can use that word anymore ). We're going to butt heads, we're going to argue. We do argue out in the real world, in state assemblies, and in D.C. We're just practicing here.

Why some people are so confrontational and denigrating to the other side while arguing is a big second mystery to me.

Tom Stickel
Indiana U. School of Optometry 2001

 

[JennyW]

2 questions:

1. to the OMDs: why does it matter what Ben or futuredoctorOD or any other non-OMDs on this forum think? I thought andrew doan and many others had great solutions to this ophtho vs. opto debate: "draw the line at surgey," get involved at the level of the AAO and our state and federal governments (letters, PAC contributions, etc) and protect our field. Same old arguments? yes, but some great soutions to the problem are very accomplishable. arguing about how prestigious an MD is should be something that we inherently know, all i need to do is see the look at my patients' faces to not only know what a prestigious job i have, but also that all the "****" i went through to get here was well worth it. i don't need to prove that to Ben or futuredoctorOD.

2. to the non-OMDs who frequent this forum: why do you like to come here anyway? i really am curious. are you not being satisfied by your own forums? honest question, no sarcasm. i've noticed that many of you enjoy coming to this MD/DO forum and lecturing us on "being professional" and stating over and over again that "the MD degree is not the only path to enlightenment, ODs are doctors too, etc, etc" I agree with you on these points, but I can not help but feel that many of you just like to come here and pick a fight. is it just me?

I first came to SDN because I used to be on the admissions committee of an optometry school and I was encouraged to sign up and I answered some private emails.

I found the ophthalmology forums because I was interested in some of the grand rounds cases that Dr. Doan put up, particularly the ones that had a "neuro" slant to them because I do a fair amount of vision therapy.

Like Dr. Stickel I too saw some of the thread names and began reading some of them. There were so many of them that were so filled with inaccuracies and shrill rehetoric about the optometric profession, optometrists themselves, and optometric education in particular. I was very hesitant to respond because I knew it would just degnerate the way that it did. I knew this because I used to work and teach in a VA hospital where I tought BOTH optometry students and ophthalmology residents as well as medical students rotating through and I learned very quickly that the most arrogant group of people you will ever meet in your life are first year residents. The 2nd most arrogant are 4th year medical students. Unfortunately, that's the population that makes up the bulk of these forums. For better or for worse, I responded trying to clear up some of the misconceptions and while I have had good responses and dialogue with Dr. Doan and mdkurt, most of it is just the same old crap rehashed again and again and again.

I've been practicing for almost 15 years now so I've been through the wars. I recall OMDs testifying in the state legislatures that optometrists would be blinding their patients with proparaciane or killing them with tropicamide if ODs were allowed to use these "very powerful and dangerous" drugs as one OMD referred to them. I recall a time when OMDs could be disciplined by their academy if they taught in a school of optometry. As I have documented on here many times, I've lived through the wars here in New York where OMD are constantly trying to repeal scope of practice legislation in a state that already has one of the most restricvite in the nation.

With respect to Dr. Chudners post, I don't agree that expanded scope isn't about money. Of course it is. It's not about greed, because as he points out the money to be made by doing YAGs and PIs is not enough to cover the lease or cost of a laser in an optometry office, even if a bunch of ODs banded together and started their own ASC. The money comes not from doing a few procedures, but from not having to refer patients out never to be seen again when ODs could have easily and competently provided the care themselves. Yes, keeping the patients in our offices keeps us busier and makes us more money. So in that sense, yes, it is about money.

I think futuredoctorOD should not post on this forum. He doesn't have much of a frame of reference since he's not even in optometry school yet. His only perspective seems to be working alongside of an OD who prescribed some oral medications a few times and for some reason seems more concerned about whether non physician providers should be referred to as "doctors" or not. That's hardly the biggest issue on this forum yet he continues to harp on it. I usually skip his posts.

Jenny

 

[Ben Chudner]

With respect to Dr. Chudners post, I don't agree that expanded scope isn't about money. Of course it is. It's not about greed, because as he points out the money to be made by doing YAGs and PIs is not enough to cover the lease or cost of a laser in an optometry office, even if a bunch of ODs banded together and started their own ASC. The money comes not from doing a few procedures, but from not having to refer patients out never to be seen again when ODs could have easily and competently provided the care themselves. Yes, keeping the patients in our offices keeps us busier and makes us more money. So in that sense, yes, it is about money.

I agree with this. In the the sense that we do not want to lose our patients to OMD's that provide primary care, yes it is about money. I should have said, it has nothing to do with greed, but I was a little fired up. Thanks for the clarification.

 

[Ben Chudner]

2. to the non-OMDs who frequent this forum: why do you like to come here anyway? i really am curious. are you not being satisfied by your own forums? honest question, no sarcasm. i've noticed that many of you enjoy coming to this MD/DO forum and lecturing us on "being professional" and stating over and over again that "the MD degree is not the only path to enlightenment, ODs are doctors too, etc, etc" I agree with you on these points, but I can not help but feel that many of you just like to come here and pick a fight. is it just me?

Ruben, I cannot speak for the other OD's, but I have no intention of picking fights. I do, however, feel obligated to respond to certain posts.

I came across this forum, much like Jenny did. I speak to OD students for one of the contact lens companies, and I was interested in what they think are important issues. While scrolling down the main forum page I found the OMD forum and took a look. What I found was very different from the OD forum in that the thread titles were very inflammatory. My favorite was the "Optometrist are a joke, not a threat" thread. I believe the forum is at its best when opposing sides can discuss these issues rather than have one side simply voicing their approval of the thread. I agree, sometimes we get a little testy, but that shows we are passionate about the subject. I hope my posts have not come off as rude, because that is not my intention.

 

[rubensan]

Okay, I have a better understanding now. Thanks for your replies.

Why some people are so confrontational and denigrating to the other side while arguing is a big second mystery to me.

me too.

I used to work and teach in a VA hospital where I tought BOTH optometry students and ophthalmology residents as well as medical students rotating through and I learned very quickly that the most arrogant group of people you will ever meet in your life are first year residents. The 2nd most arrogant are 4th year medical students.

i find it unfortunate that we have jaded you. but, you don't know me and i think there a lot of down-to-earth eye doctors of the allopathic persuasion who post on this forum.

I found the ophthalmology forums because I was interested in some of the grand rounds cases that Dr. Doan put up, particularly the ones that had a "neuro" slant to them because I do a fair amount of vision therapy.

that's great! I think this along with ophtho residency matching advice
is what draws most people to this forum. i would really like to see more energy put into those 2 issues.

For better or for worse, I responded trying to clear up some of the misconceptions .

all in all, for better. i enjoy reading what you post for the most part. i also hope futuredoctorOD will contribute meaningful contributions to this forum when he is a little further along. that being said, i still have quite a way to go myself.

I believe the forum is at its best when opposing sides can discuss these issues rather than have one side simply voicing their approval of the thread.

me too and i hope we can continue. perhaps we should adopt jenny's policy of ignoring posts from certain individuals (OD and OMDs, past, present and future). but then again, what do I know?

I hope my posts have not come off as rude, because that is not my intention.

you're not the only one guilty of this, i think we can all (OMDs especially included) do a better job with this.

thanks for answering my questions. happy posting!

 

[futuredoctorOD]

I first came to SDN because I used to be on the admissions committee of an optometry school and I was encouraged to sign up and I answered some private emails.

I found the ophthalmology forums because I was interested in some of the grand rounds cases that Dr. Doan put up, particularly the ones that had a "neuro" slant to them because I do a fair amount of vision therapy.

Like Dr. Stickel I too saw some of the thread names and began reading some of them. There were so many of them that were so filled with inaccuracies and shrill rehetoric about the optometric profession, optometrists themselves, and optometric education in particular. I was very hesitant to respond because I knew it would just degnerate the way that it did. I knew this because I used to work and teach in a VA hospital where I tought BOTH optometry students and ophthalmology residents as well as medical students rotating through and I learned very quickly that the most arrogant group of people you will ever meet in your life are first year residents. The 2nd most arrogant are 4th year medical students. Unfortunately, that's the population that makes up the bulk of these forums. For better or for worse, I responded trying to clear up some of the misconceptions and while I have had good responses and dialogue with Dr. Doan and mdkurt, most of it is just the same old crap rehashed again and again and again.

I've been practicing for almost 15 years now so I've been through the wars. I recall OMDs testifying in the state legislatures that optometrists would be blinding their patients with proparaciane or killing them with tropicamide if ODs were allowed to use these "very powerful and dangerous" drugs as one OMD referred to them. I recall a time when OMDs could be disciplined by their academy if they taught in a school of optometry. As I have documented on here many times, I've lived through the wars here in New York where OMD are constantly trying to repeal scope of practice legislation in a state that already has one of the most restricvite in the nation.

With respect to Dr. Chudners post, I don't agree that expanded scope isn't about money. Of course it is. It's not about greed, because as he points out the money to be made by doing YAGs and PIs is not enough to cover the lease or cost of a laser in an optometry office, even if a bunch of ODs banded together and started their own ASC. The money comes not from doing a few procedures, but from not having to refer patients out never to be seen again when ODs could have easily and competently provided the care themselves. Yes, keeping the patients in our offices keeps us busier and makes us more money. So in that sense, yes, it is about money.

I think futuredoctorOD should not post on this forum. He doesn't have much of a frame of reference since he's not even in optometry school yet. His only perspective seems to be working alongside of an OD who prescribed some oral medications a few times and for some reason seems more concerned about whether non physician providers should be referred to as "doctors" or not. That's hardly the biggest issue on this forum yet he continues to harp on it. I usually skip his posts.

Jenny

With all due respect I have to I have to disagree with you. I have been immersed in medicine my entire life in one way shape or form. You do not know my background so why do you make a generalization? I spend 99% of my time devoted to my pre-optometry duties but I have a passion for debate and know where I am going in my life. Again you are incorrect as to my "only" interest being the debate over semantics (physcian versus non-physician, doctor...etc.) I am actually more concerned about --99% getting in a Program!!!! After this I am concerned about OD's having a uniform scope of practice nationwide, having all the tools necessary (formulary and procedures) to perform primary eye care, and improving 3rd party pay plans and other insurance matters. If you knew anything about my background you would understand but that is my personal business and not yours. This ophthalmology forum is a wonderful forum and interests me tremedously--I am much more interested in spending the spare moments I have in this forum or even the opto forum debating "real life" issues than emailing back and forth with 22 year olds (all due respect to them) about things I am well aware of because I want to gather knowledge about opthalmic health, political issues, etc. If you skip my posts, that is fine. I read whatever I get my hands on!
I will make a difference in Optometry down the road---this I promise you.

 

[futuredoctorOD]

Okay, I have a better understanding now. Thanks for your replies.



me too.



i find it unfortunate that we have jaded you. but, you don't know me and i think there a lot of down-to-earth eye doctors of the allopathic persuasion who post on this forum.



that's great! I think this along with ophtho residency matching advice
is what draws most people to this forum. i would really like to see more energy put into those 2 issues.



all in all, for better. i enjoy reading what you post for the most part. i also hope futuredoctorOD will contribute meaningful contributions to this forum when he is a little further along. that being said, i still have quite a way to go myself.



me too and i hope we can continue. perhaps we should adopt jenny's policy of ignoring posts from certain individuals (OD and OMDs, past, present and future). but then again, what do I know?



you're not the only one guilty of this, i think we can all (OMDs especially included) do a better job with this.

thanks for answering my questions. happy posting!

You are the best moderator on here!

 

[futuredoctorOD]

With all due respect I have to I have to disagree with you. I have been immersed in medicine my entire life in one way shape or form. You do not know my background so why do you make a generalization? I spend 99% of my time devoted to my pre-optometry duties but I have a passion for debate and know where I am going in my life. Again you are incorrect as to my "only" interest being the debate over semantics (physcian versus non-physician, doctor...etc.) I am actually more concerned about --99% getting in a Program!!!! After this I am concerned about OD's having a uniform scope of practice nationwide, having all the tools necessary (formulary and procedures) to perform primary eye care, and improving 3rd party pay plans and other insurance matters. If you knew anything about my background you would understand but that is my personal business and not yours. This ophthalmology forum is a wonderful forum and interests me tremedously--I am much more interested in spending the spare moments I have in this forum or even the opto forum debating "real life" issues than emailing back and forth with 22 year olds (all due respect to them) about things I am well aware of because I want to gather knowledge about opthalmic health, political issues, etc. If you skip my posts, that is fine. I read whatever I get my hands on!
I will make a difference in Optometry down the road---this I promise you.

 

[JennyW]

With all due respect I have to I have to disagree with you. I have been immersed in medicine my entire life in one way shape or form. You do not know my background so why do you make a generalization? I spend 99% of my time devoted to my pre-optometry duties but I have a passion for debate and know where I am going in my life. Again you are incorrect as to my "only" interest being the debate over semantics (physcian versus non-physician, doctor...etc.) I am actually more concerned about --99% getting in a Program!!!! After this I am concerned about OD's having a uniform scope of practice nationwide, having all the tools necessary (formulary and procedures) to perform primary eye care, and improving 3rd party pay plans and other insurance matters. If you knew anything about my background you would understand but that is my personal business and not yours. This ophthalmology forum is a wonderful forum and interests me tremedously--I am much more interested in spending the spare moments I have in this forum or even the opto forum debating "real life" issues than emailing back and forth with 22 year olds (all due respect to them) about things I am well aware of because I want to gather knowledge about opthalmic health, political issues, etc. If you skip my posts, that is fine. I read whatever I get my hands on!
I will make a difference in Optometry down the road---this I promise you.

You can correct me if I'm wrong, but my impression from reading your posts is that your "immersion" in medicine seems to be having some relatives who are MDs. I would say that that is hardly "immersion." Given that, and the fact that you are not even enrolled in optometry school and your only experience in optometry seems to be having shadowed and/or worked for an OD, (again, correct me if I'm wrong) I would suggest that you don't have the experience or in depth knowledge of the issues facing the profession to comment on them. Even if you did, I don't think you have an adequate frame of reference in which to have a reasonable debate.

I'm sure you'll be a credit to the profession one day. Until you are at least enrolled in school, you are probably doing more harm than trying to debate OMDs. When I used to read your posts, I would cringe.

 

[smiegal]

I just got off the phone with my brother who is SURGEON and he just remarked how he just came back from his eye doctor---his OPTOMETRIST and said that it will be really nice in 5 years when I graduate from OPTOMETRY School and become an eye doctor---the first one in the family. When I sprained my ankle----I went to my foot doctor---yep you guessed it ----my podiatrist---yes he is a doctor too! You really want to open this semantical pandoras box? Optometry school, Dental School, and Podiatry School are all extremely rigorous and making a blanket statement like you have is erroneous. The rigors of Medicine? How about the rigors of Dentistry? All these fields have similar RIGORS! lol Medicine is a very generalized term---all doctoral level professionals practice "medicine" in their own form and you need to just stop this semantical elitism. I have the utmost respect for MD's and DO's---my family has numerous iterations of the two degrees. Did you go to Dental School? or Optometry School? or Podiatry School? NO----you did not... You have no personal reference point to make a comparison....And by the way------IN THE HISTORICAL PAST THE TERM DOCTOR WAS USED ORIGINALY BY PHD'S NOT ALLOPATHY, OSTEOPATHY, CHIROPRACTIC, PODIATRY, OPTOMETRY, DENTISTRY, ETC....all these fields adopted the term doctor for the respect it carried....Allopathic medicine has done a very good job of marketing it's business over the last century and I have to give them credit for it...but the minute you try to say, incorrectly I might add, that DDS's, OD's, and DPM's are not doctors you appear to be very disrespectful to these specialists and to me----(I am working my ass off to get into a program and will continue that until I am an eye doctor and after that.) It is people like you that create the Oklahoma's (in regard to OD surgery) because of your elitist attitude...Now I respect your academic accomplishment but let's get real here and accept the fact that Dentistry is a field of medicine that is totally independent of your field.......Your field is NOT medicine in the generic--------it is ALLOPATHIC MEDICINE......You are an ALLOPATH---no more a doctor or less than a Dentist---(DOCTOR OF DENTAL SURGERY--DDS or DOCTOR OF DENTAL MEDICINE---DMD) I do respect your opinion and training.


PS---I checked----less than 40% of Oral Surgeons have MD's most of them only carry the OMFS designation---that must be soooooooooo scary to all those patients that are in danger because they don't have MD's We had better call the morgue and get all the slabs ready!

I Optometry and Ophthalmology

Is this a "professional" exchange? I would be upset about the "doctor" part if I were you, too (but still question "optometric physician").

Please explain further your perspective on "elitism" by MD's causing the Oklahoma situation (political pro-surgery maneuver by OD's).

 

[smiegal]

What planet are you from? When a child says I want to grow up to be a doctor, everyone (the public, parents, etc.) knows what they mean--a physician (MD). A child does not say I want to grow up to be an allopathic doctor.

I don't care who calls themselves doctor, but why don't you just be proud to be called an "optometrist". Whats wrong with that, seriously.
Everyone knows that people don't feel optometrists are real doctors...unless you lie and present yourself as one (fraud). If you don't believe me, ask them. They know MD/DO don't work at Walmart/Costco. Your relatives say your are because...their your relatives.

You believe we are called doctors because doctors (allopathic, for you) have done a good job marketing. I DONT THINK SO. Maybe its because, any ***** can see they SAVE lives and people respect physicians especially when their lives are in danger. NO OTHER TYPE OF "DOCTOR" SAVES LIVES!

You say that I have no point of comparison-you have'nt even been to optometry school, what point do you have to comment on anyones schooling.
We have more education as a whole than any "doctor", so don't give me this bull**** about how hard you have it or will(which you don' t know, you only heard about). IT IS 7 YEARS MINIMUM FOR ANY MEDICAL SPECIALTY.


Its not people like me why ODs what to do surgery...The reasons are because they what to make more money (greedy), want to confuse the patients of want a real doctor is (MD vs, OD), don't want to have proper training (8 years min.), and would rather destroy someones eye for the sake of being called a real doctor (pride).

If you are looking for a fight, you will get one.....stop trolling!

Next time mind your own business. I'm Out.

You must be a medical student. Just stop it. You are making the rest of us look bad. They are doctors. period. If you said physicians, that would be different.

 

[I Surgeon]

You must be a medical student. Just stop it. You are making the rest of us look bad. They are doctors. period. If you said physicians, that would be different.

You need to read the whole thread. FuturedocOD did say that Dentists and optometrists are physicians.

Sorry to make you look bad...they're trying to make us look bad.
If you don't like it, don't read this thread. Thanks.

 

[futuredoctorOD]

Is this a "professional" exchange? I would be upset about the "doctor" part if I were you, too (but still question "optometric physician").

Please explain further your perspective on "elitism" by MD's causing the Oklahoma situation (political pro-surgery maneuver by OD's).

First I will say that I appreciate your being civil with me on here and will gladly answer your question Dr. For many years, especially since 1972---the first year optometrists pursued having prescription rights for medications (it took 25 years of legal battlest to accomplish this in every state) , optometry has fought with medicine to attain **fundemental** privilages to practice and treat as primary eye doctors. The list of "battles" is too long and numerous to list, Jenny would know because she has been in practice for 15 years and has commented on the subject before. Collectively, wouldn't you think that any field after being in battle for sooo long with allopathy would not take every opportunity to improve it's position?-----case in point in Oklahoma. We are all human biengs and have flaws as a result....emotions and spite can motivate people and "health professionals" alike. I know that if I was confronted with practitioners with the attitude that I2I has, I would not listent to his opinion or ideas because he has an elitist and allopathic-centric (I made up this word..lol) attitude. No one is doubting that the doctor of ophthalmology is the ultimate expert-----because he/she is BUT semantics are important and when someone with a contrite attitude tries to question the fact that Optometrists ARE doctors.....I feel compelled to respond--even though I have not accomplished my goals of being accepted to a program, earning my OD degree, and doing a 1 year residency in ocular disease ( ie--like the one in Bascom Palmer or the Hunington VMAC.) As to the whole Optometric Physician thing, this is a term used in some states to assure insurance reimbursement......I think of doctor and physician as analagous terms.....Now medical doctor and or medical physician which only allopaths and osteopaths can use are independent of any other profession.

 

[futuredoctorOD]

You need to read the whole thread. FuturedocOD did say that Dentists and optometrists are physicians.

Sorry to make you look bad...they're trying to make us look bad.
If you don't like it, don't read this thread. Thanks.

With all due respect I use the term physician and doctor interchangeably. This is not meant in disrespect.

 

[futuredoctorOD]

What planet are you from? When a child says I want to grow up to be a doctor, everyone (the public, parents, etc.) knows what they mean--a physician (MD). A child does not say I want to grow up to be an allopathic doctor.

I don't care who calls themselves doctor, but why don't you just be proud to be called an "optometrist". Whats wrong with that, seriously.
Everyone knows that people don't feel optometrists are real doctors...unless you lie and present yourself as one (fraud). If you don't believe me, ask them. They know MD/DO don't work at Walmart/Costco. Your relatives say your are because...their your relatives.

You believe we are called doctors because doctors (allopathic, for you) have done a good job marketing. I DONT THINK SO. Maybe its because, any ***** can see they SAVE lives and people respect physicians especially when their lives are in danger. NO OTHER TYPE OF "DOCTOR" SAVES LIVES!

You say that I have no point of comparison-you have'nt even been to optometry school, what point do you have to comment on anyones schooling.
We have more education as a whole than any "doctor", so don't give me this bull**** about how hard you have it or will(which you don' t know, you only heard about). IT IS 7 YEARS MINIMUM FOR ANY MEDICAL SPECIALTY.


Its not people like me why ODs what to do surgery...The reasons are because they what to make more money (greedy), want to confuse the patients of want a real doctor is (MD vs, OD), don't want to have proper training (8 years min.), and would rather destroy someones eye for the sake of being called a real doctor (pride).

If you are looking for a fight, you will get one.....stop trolling!

Next time mind your own business. I'm Out.

That is interesting....So if an optometrist diagnosed a life-threatening illness (like a brain tumor) in its early stage---that is not saving someone's life? Screening for illness and attacking it before it gets out of hand can be crucial. Look I am not going to argue with you----the whole universe and probably every profession recognized the Doctor of Optometry as an Eye Doctor---so I am not going to argue with you!!!! I am going to rise above because I respect Ophthalmologists as the experts in eye care and Optometrists as the gatekeepers...I am not on here to fight with you.

 

[smiegal]

With all due respect I use the term physician and doctor interchangeably. This is not meant in disrespect.

A PhD working on string theory is certainly a doctor but not a physician (likewise for other PhD's). I, personally, have always thought that only MD's/DO's were physicians. Ok, that's it, no more posts from me on this type of peripheral issue.

 

[Mirror Form]

I don't know how many times I have to explain this. Expanded scope does not make OD's a lot of money. I know this because I am actually in practice. Where do you think the income potential is in prescibing oral antibiotics? Where is the income potential in prescibing oral steroids? Where is the income potential of performing one or two YAG's per month at $128 each (that won't cover the lease payment).

I don't understand how someone can keep living this lie. Of course expanded scope will make more money! BTW, YAG capsulotomies, which OD's are pushing for, pay a hell of a lot more then $128 bucks each. Medicaire pays over 800 bucks for one of them, which makes it one of the most profitable areas of ophthalmology (far more profitable then cataracts, which only reimburse about 600 something and require much more overhead). So the idea that pushing for expanded scope to do one of the most profitable procedures possible "won't make OD's money" is complete BS.

BTW, where did this notion that only one OD would use one YAG come from? Obviously, many OD's form larger groups, and then buying a yag would be incredibely profitable.

 

[JennyW]

I don't understand how someone can keep living this lie. Of course expanded scope will make more money! BTW, YAG capsulotomies, which OD's are pushing for, pay a hell of a lot more then $128 bucks each. Medicaire pays over 800 bucks for one of them, which makes it one of the most profitable areas of ophthalmology (far more profitable then cataracts, which only reimburse about 600 something and require much more overhead). So the idea that pushing for expanded scope to do one of the most profitable procedures possible "won't make OD's money" is complete BS.

BTW, where did this notion that only one OD would use one YAG come from? Obviously, many OD's form larger groups, and then buying a yag would be incredibely profitable.

Wow.

DIE THREAD, DIE!!!!!!!

The power of Christ compels you!!
THE POWER OF CHRIST COMPELS YOU!!!

(sprinkles Holy water on evil thread!)

 

[JennyW]

I don't understand how someone can keep living this lie. Of course expanded scope will make more money! BTW, YAG capsulotomies, which OD's are pushing for, pay a hell of a lot more then $128 bucks each. Medicaire pays over 800 bucks for one of them, which makes it one of the most profitable areas of ophthalmology (far more profitable then cataracts, which only reimburse about 600 something and require much more overhead). So the idea that pushing for expanded scope to do one of the most profitable procedures possible "won't make OD's money" is complete BS.

BTW, where did this notion that only one OD would use one YAG come from? Obviously, many OD's form larger groups, and then buying a yag would be incredibely profitable.

Can you explain then, this chart which comes from the AAO itself?

http://www.aao.org/news/release/20041103.cfm

It would appear that the reimbursement is $248.23 in 2005.

That would be for straight medicare. If a patient is enrolled in a medicare HMO, I would guess that the reimbursement would be a lot LESS than this.

Jenny

 

[Ben Chudner]

I don't understand how someone can keep living this lie. Of course expanded scope will make more money! BTW, YAG capsulotomies, which OD's are pushing for, pay a hell of a lot more then $128 bucks each. Medicaire pays over 800 bucks for one of them, which makes it one of the most profitable areas of ophthalmology (far more profitable then cataracts, which only reimburse about 600 something and require much more overhead).

With the exception of refractive surgery of course.

I agree, I wish this thread would die, but since it hasn't I looked up the latest reimbursments for my area:

66984 Catract Surgery - $674.14
66821 Yag Cap - $243.60

I must have looked at the wrong line when I saw $128, but even at $243, this is not a profitable procedure. I have a fairly busy OD practice and I only refer out about 3-5 YAG's per month. The local cataract doc does about 7 YAG's per week in between his 16 cataracts and he draws from 10 OD offices plus his own clinic. At $243, I would collect about $14,000 a year before expenses (at 5 every month). I make 3 times that with my digital camera taking fundus photos with far less expense. This is not a profitable procedure for OD's.

BTW, where did this notion that only one OD would use one YAG come from? Obviously, many OD's form larger groups, and then buying a yag would be incredibely profitable.

Even if 5 docs got together and bought a laser and each did 5 per month we would each make only $14K. For that small amount we would have to deal with the headache of either moving the laser between the offices, renting a space to house it (more expense), or still referring to another office for the procedure.

 

[VA Hopeful Dr]

Its possible that the YAGs pay $800 (as quoted by Sledge) if you include facility fees. Just a thought, I could be wrong and it might not make any difference, but I'm throwing it out there anyway

 

[Ben Chudner]

Its possible that the YAGs pay $800 (as quoted by Sledge) if you include facility fees. Just a thought, I could be wrong and it might not make any difference, but I'm throwing it out there anyway

The facility fee in my Medicare area (rest of Washington State) for Yag Cap is $226.23. So the total would be $469.83. Of course Medicare will not pay a facility fee for a Yag unless it is in a separate facility such as an ASC. For an Argon laser, Medicare will pay a facility fee even if it is within the doctor's office. Therefore, for OD's to double their money on Yag reimbursements they would have to open an ASC which in some states would require a CON. Those can cost up to $100,000 in legal fees depending on whether the local hospital and the other ASC's choose to fight it. Then of course there is the building costs, or at least the rent, staff, utilities, increased liability, etc. Lots of money to spend just to get an additional $14K a year ($28K total).

 

[Mirror Form]

Can you explain then, this chart which comes from the AAO itself?

http://www.aao.org/news/release/20041103.cfm

It would appear that the reimbursement is $248.23 in 2005.

That would be for straight medicare. If a patient is enrolled in a medicare HMO, I would guess that the reimbursement would be a lot LESS than this.

Jenny

Ophthalmology attendings I've worked with have told me that they get over 800 bucks for a yag cap before overhead. One attending went on for a fairly long time about yag cap reimbursment, and how there is a problem with a few dirt bag ophthalmologists putting in the old silicon lenses just so there is a higher chance of needing to do a yag. Perhaps the attendings meant over 800 dollars per patient (since many patients get both cataracts removed). However, it doesn't change the fact that they're an extremely profitable area of ophthalmology, and would almost certainly be a profitable procedure for many optometrists. Think about it, a cataract operation pays about 600 bucks, and takes much longer and has much more overhead. Whereas, a yag only takes 10 minutes without any overhead other then the cost of the machine. If you do 7 yags a week, by the end of the year you'd be making 170,000 dollars!

 

[Ben Chudner]

Ophthalmology attendings I've worked with have told me that they get over 800 bucks for a yag cap before overhead. One attending went on for a fairly long time about yag cap reimbursment, and how there is a problem with a few dirt bag ophthalmologists putting in the old silicon lenses just so there is a higher chance of needing to do a yag. Perhaps the attendings meant over 800 dollars per patient (since many patients get both cataracts removed). However, it doesn't change the fact that they're an extremely profitable area of ophthalmology, and would almost certainly be a profitable procedure for many optometrists. Think about it, a cataract operation pays about 600 bucks, and takes much longer and has much more overhead. Whereas, a yag only takes 10 minutes without any overhead other then the cost of the machine. If you do 7 yags a week, by the end of the year you'd be making 170,000 dollars!

7 yags at $243 per yag = $1701 per week
$1701 per week for 52 weeks = $88,452

That's assuming you can schedule 7 per week, every week. A typical OD practice does not see enough patients to generate 7 yags per week. I know several busy OMD practices that require outside referrals to generate 7 yags per week.

BTW, there is very little overhead associated with cataract surgery for the surgeon. Yes, there is the 90 days of post-op, but an uneventful cataract surgery may only require 3 post-op visits which are very short visits and can be placed in between normal appointment spots. The overhead comes from the surgery center which gets paid separately from the surgeon.

 

[JennyW]

Ophthalmology attendings I've worked with have told me that they get over 800 bucks for a yag cap before overhead. One attending went on for a fairly long time about yag cap reimbursment, and how there is a problem with a few dirt bag ophthalmologists putting in the old silicon lenses just so there is a higher chance of needing to do a yag. Perhaps the attendings meant over 800 dollars per patient (since many patients get both cataracts removed). However, it doesn't change the fact that they're an extremely profitable area of ophthalmology, and would almost certainly be a profitable procedure for many optometrists. Think about it, a cataract operation pays about 600 bucks, and takes much longer and has much more overhead. Whereas, a yag only takes 10 minutes without any overhead other then the cost of the machine. If you do 7 yags a week, by the end of the year you'd be making 170,000 dollars!

Cmon, Sledge. Surely you can do better than "an attending told me" when discussing this issue.

Here is a link to the CMS website:

http://www.cms.hhs.gov/physicians/mpfsapp/step3.asp

Entering code 66821 and selecting "all modifiers" shows a range of reimbursements for this procedure. Most of them are in the low to mid 200s. The highest one that I see is $327. The lowest that I see is $199. Again, this is for straight medicare. If the patient has a medicare HMO, the reimbursement is likely to be a LOT lower.

There is no way that this is a profitable venture for optometrists. I worked full time in a busy VA hospital for almost 4 years. We had no full time ophthalmologists on staff. The residents would come in a few days a month to handle the surgical cases. All examinations were conducted by staff ODs and/or optometry interns including pre op examinations and all post op exams including one days.

We would see at best, 5 or 6 people a MONTH amongst ALL of us who would benefit from a YAG. And that's working in a facility made up of elderly people almost exclusively.

Now I'm in private practice. The number of patients I see who could benefit from a YAG is a small handful per year. Hardly worth the headache, even if I was to go in on a laser with a bunch of other ODs.

Jenny

 

[rubensan]

Wow.

DIE THREAD, DIE!!!!!!!

The power of Christ compels you!!
THE POWER OF CHRIST COMPELS YOU!!!

(sprinkles Holy water on evil thread!)

 

[Mirror Form]

BTW, there is very little overhead associated with cataract surgery for the surgeon. Yes, there is the 90 days of post-op, but an uneventful cataract surgery may only require 3 post-op visits which are very short visits and can be placed in between normal appointment spots. The overhead comes from the surgery center which gets paid separately from the surgeon.

The overhead for cataracts is much more then for yag caps. Yes, there is the cost of the OR, anesthesia, tech's, equipment (more expensive then a yag laser), preop visit, post op visits, etc. What's the overhead for a yag? Cost of the machine, that's it!

 

[Mirror Form]

Cmon, Sledge. Surely you can do better than "an attending told me" when discussing this issue.

Well, since these are attendings who do yags and deal with the billing aspects, I'll take their word for it. Perhaps they were exagerating the amount of money, but there is no denying that yags are one of the more profitable areas of ophthalmology. Any optometry group could probaby make a decent profit off of them since each laser lasts for some time. You can pay the machine off in one year, and after that it's just a straight up several hundred dollars profit off of each 10 minute laser. No potential for higher income? yeah right!

Now I'm in private practice. The number of patients I see who could benefit from a YAG is a small handful per year. Hardly worth the headache, even if I was to go in on a laser with a bunch of other ODs.

Jenny

Well, since the OD groups have been pushing for rights to do yags, I find it hard to believe that no OD's would want to do them. Why would you refer patients to an ophthalmologist for something an OD can do? Eventually OD's would buy yag lasers and that would be that.

 

[JennyW]

Well, since these are attendings who do yags and deal with the billing aspects, I'll take their word for it. Perhaps they were exagerating the amount of money, but there is no denying that yags are one of the more profitable areas of ophthalmology. Any optometry group could probaby make a decent profit off of them since each laser lasts for some time. You can pay the machine off in one year, and after that it's just a straight up several hundred dollars profit off of each 10 minute laser. No potential for higher income? yeah right!




Well, since the OD groups have been pushing for rights to do yags, I find it hard to believe that no OD's would want to do them. Why would you refer patients to an ophthalmologist for something an OD can do? Eventually OD's would buy yag lasers and that would be that.

Sledge,

YAGs might be one of the most profitable areas of ophtalmology, but just because that may be the case doesn't mean it would be one of the most profitable areas of optometry.

I don't think you have a good handle on the average optometry practice or what goes on in one. Optometry practices do not have tremendous amounts of YAG patients running around that are in constant need of referral and ODs want to treat them. Even when I was at the VA, as I've already told you we were not overrun with YAG patients.

 

[Andrew_Doan]

With the new intraocular lenses used today, we don't see many PCOs. At Iowa, we only see a handful of patients needing YAG capsulotomies per week.

I don't think YAGs are that lucrative. Surgeons make more money doing cataract surgeries. The surgeon fee is $600 for cataract surgery, but the patient also pays for ASC and other fees too. The total bill for cataract surgery is over $2000.

 

[Ben Chudner]

With the new intraocular lenses used today, we don't see many PCOs. At Iowa, we only see a handful of patients needing YAG capsulotomies per week.

I don't think YAGs are that lucrative. Surgeons make more money doing cataract surgeries. The surgeon fee is $600 for cataract surgery, but the patient also pays for ASC and other fees too. The total bill for cataract surgery is over $2000.

Which goes to my point about overhead for cataract surgery. The overhead for a cataract surgery is much higher for the ASC than the surgeon.

The overhead for cataracts is much more then for yag caps. Yes, there is the cost of the OR, anesthesia, tech's, equipment (more expensive then a yag laser), preop visit, post op visits, etc.

The OR, anesthesia, tech's, and equipment are overhead for the ASC or hospital, not the surgeon. As Dr. Doan stated, they get paid above and beyond the ~$600 the surgeon gets. As for the pre-op visits, the initial consultation is a billiable exam (if referred in rather than from the OMD's clinic population it pays more) and the A-scan is a billable procedure. Those are also above and beyond the $600. The post-op visits are covered by the $600, but with the skill of today's surgeons, these visits take up very little time and cost very little in the whole scheme of things.

OD's are pushing for YAG's because they believe they are qualified (right or wrong) and they would prefer to keep these patients in their clinic rather than potentially lose them to the OMD down the street that also provides routine eyecare.

 

[diabeticfootdr]

Podiatrists, Dentists, and Optometrists all prescribe systemic drugs within a limited formulary designated by their scope of practice. :

Podiatrists and dentists have an unlimited license to prescribe medications. Not a limited formulary.

LCR

 

[cpw]

Podiatrists and dentists have an unlimited license to prescribe medications. Not a limited formulary.

LCR

And not ALL ODs can write for systemic meds... it's not allowed in the state of Florida and four other states.