Optometry, Pearl Vision, and others.

[exmike]

Did anybody ever say that it was?

I am not at all disappointed by the fact that surgery is not the only difference in the training of an ophthalmologist and an optometrist. ODs learn far more about Optics, Physiological Optics, Ophthalmic Materials, Sports Vision, Binocular Vision, Low Vision, Contact Lenses, etc...etc...

But to say that a program that includes all 3rd and 4th year clerkships and passing the USMLE.... followed by 3 years in ophthalmology residency after having already completed optometry school is not adequate to then be an ophthalmologist is ridiculous. In such a residency program I would forsee that the ODs entering into these programs would complete residency right along side ophthalmologists completing traditional training. That is to say no new residency programs would have to be created after completion of the MS-4 rotations an MD would be granted to the former OD and at the start of the Ophthalmology residency they would be considered 100% equal with those entering the residency through the traditional route. Equal except for the fact that the new MD/OD would already be highly experienced on day 1, no need to train them how to do use the slit lamp, BIO, DFE, Refract and the list goes on and on.

You just dont get it do you. There is no need to reinvent the wheel. There is already a way to train eye surgeons, and there is no shortage of eye surgeons.

Perhaps we should create a new route into optometry for opticians. Since they already know how to refract and peek at eyes, all they have to do is take some basic science courses at night, some clinics, and pass the NBEO exam. Then whey will be considered 100% equal with optometrists! They'll show up on day 1 "highly trained" since they already know how to refract, check pupils, and perform tonometry!

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[qwopty99]

wow. lots to comment on.

Perhaps we should create a new route into optometry for opticians.

hey, why stop there? why don't we give opticians prescribing and surgical rights as well? i'm all for it. (yuk yuk) if opticians can do cataract surgery, that would be a great lobby for optometrists getting cataract surgery too.

it makes no sense to turn away a medical student who is really interested in eyes through the harder regular match and let an optom in through an easier alternative route who most likely could not make it into medical school in the first place.

when u applied, were u rejected by any medical schools? if so, some medical schools deemed u unfit to be their medical student.

that said, i agree the AVERAGE optom student basically doesn't have the numbers (GPA, MCAT or otherwise) to get into medical school. that doesn't necessarily suggest they couldn't succeed in a medical curriculum, but they wouldn't likely be accepted in the first place.

it is possible that only the best and brightest of the OD students would have any remote chance of passing Part I of the USMLE. for the record, i think its a longshot for ANY OD student to pass Part I based on his/her knowledge of the 1st two years of OD curriculum. i have some pretty bright friends who went through meds and got barely-passing scores on Part I. so any suggestion that ODs could pass Part I in great numbers, i think is greatly exaggerated.

now, to suggest two years of OD curriculum will prepare you to get a high score on Part I that would make you competitive for an ophthalmology match... honestly, not gonna happen. (of course, if they did their own studying etc. then the sky is the limit. but we're talking about OD-school prep)

as for the proposed OD through med-residency surgery thing, i really don't know.

as for PDT who thinks ODs can't diagnose glaucoma, well - there are MDs who can't diagnose astigmatism.

 

[Ben Chudner]

When the patient doesn't have glaucoma.

Impressive response.

 

[qwopty99]

this is becoming too typical of the average Optom/Ophth fight thread.

Blah blah blah.

Optometry bad.

Ophthalmology good.

Blah blah blah.

Ophthalmology bad.

Optometry good.

Blah blah blah.

I'm smarter than you.

No, you're stupid and I'm smart.

Blah blah blah.

Cry, whine, act like little kids. Call names, puff chests.

Thread closed, suspensions given.

New thread opened.

Blah blah blah.

 

[DiveMD]

No... Had you read the previous posts in essence nothing would be skipped. Such a program would be essentially identical in structure to the 6 year OMFS MD/DDS programs. These programs include some didactic that might have been missed during optometry school in the first year along with clincal training. a the end of year 1 Passing of Step I of the USMLE grants you advanced standing as an MS-3. completion of MS-3 and MS-4 clerkships, followed 3 years of training in surgery. The result as in such OMFS program would be an MD/OD. What was skipped?

This entire "alternate route" concept sounds fascinating but you are forgetting a few minor details:

1)Passing the USMLE's is not enough to match in ophthalmology; you need to nail them.
2)You underestimate the intricacies of the ophthalmology matching process. Read this forums and your will understand why it's so difficult to match in ophthalmology.
3)Ophthalmology will continue to control all residency programs. Thus, OD's coming from an "alternate route" will have very low possibilities of matching.
4)We already have a primary and proven pathway for eye surgery. We don't need to fix what isn't broken. Especially to benefit people that will bypass the medical school filter.

 

[UABopt]

here are a few things you need to understand...

ophthalmology match is highly competitive. Many well qualified medical students each year do not get accepted and have to end up doing other medical specialties.

tell me, how would less qualified individuals becoming ophthalmologists through an alternative route benefit society when we have enough well qualified ophthalmologists already, and who I might add, did it the "right" way.

it makes no sense to turn away a medical student who is really interested in eyes through the harder regular match and let an optom in through an easier alternative route who most likely could not make it into medical school in the first place.

sorry to be blunt, but i am sick and tired of hearing about yous people using a backdoor to practice medicine...yea ophthalmology is medicine. BTW, you can have your low vision training...

I do "get it."

Just because the route is established does not make it "right" or "better". What kind of an argument is we have always done it this way so it must be the best way? It would make perfect sense to turn away a medical student who is really interested in the eyes and happend to do well on USMLE in favor of a student who did equally well on the USMLE and is not only "really interested in the eyes" but also actually knows something about eyes.

In fact all other things being equal if you had two applicants in front of you that both went all the way through medical school and both did equally well on USMLE, but one went through optometry school and the other had no prior training and limited exposure to eye care, which applicant would you pick?

If my proposed route to becoming an ophthalmologist were the established method then people might be asking why a medical student with very little eye specific training is allowed into a program to do surgery on the eyes. It is all a matter of perspective. You dont see med students without any training in dentistry first, going on to a OMFS residency, do you? Why? Because at the end of 4 years of medical school a student does not know jack squat about the oral cavity in comparison to a graduate of a dental school.

 

[DrEyeBall]

At the risk of continuing to beat a dead horse....

I think this of course would never happen but I think just the discussion shows some common ground. In theory I would be very supportive of such a system. As mentioned in earlier posts, the largest issue would be how you need to handle an "acceptance" in a residency at the time of application before the medical school clinical years are complete. In theory this system would:

Attract bright OD students who may have picked optometry school without realizing they wanted a larger scope of practice.

Ackowledge that there are many ODs who could certainly practice ophthalmology with the training needed.

Acknowledge that medical school training is an absoulte requirement to become an ophthalmologist

Acknowledge that ODs receive education in the first two years that could be used to complete a medical school curriculum.

Allow people to make a career chhange without having 2 additional years of debt that they do not need.

I think if we as ophthalmologists look at this issue, there are many good points to it. Most ophthalmologists feel strongly that medical school and residency is needed to do what we do. Many ODs feel strongly that they receive training that in some ways duplicates ours. This system would acknowledge both sides. It would stress the importance of the medical school curriculum as well as provide a route for ODs to expand their ability to practice if they so desire.

Lastly, I think it is arrogant to think that the only reason that ODs went to optometry school is because they failed to get into medical school. Many people make career decisions too early or without full knowledge of what those careers with let them do. It is very possible that some ODs did not realize they would like to perform eye surgery before entering school and become interested in it later.

 

[I Surgeon]

I do "get it."

Just because the route is established does not make it "right" or "better". What kind of an argument is we have always done it this way so it must be the best way? It would make perfect sense to turn away a medical student who is really interested in the eyes and happend to do well on USMLE in favor of a student who did equally well on the USMLE and is not only "really interested in the eyes" but also actually knows something about eyes.

In fact all other things being equal if you had two applicants in front of you that both went all the way through medical school and both did equally well on USMLE, but one went through optometry school and the other had no prior training and limited exposure to eye care, which applicant would you pick?

If my proposed route to becoming an ophthalmologist were the established method then people might be asking why a medical student with very little eye specific training is allowed into a program to do surgery on the eyes. It is all a matter of perspective. You dont see med students without any training in dentistry first, going on to a OMFS residency, do you? Why? Because at the end of 4 years of medical school a student does not know jack squat about the oral cavity in comparison to a graduate of a dental school.

I would choose the student who went to medical school for SURGERY instead of one who waited for legislation to provide an alternate route to practice SURGERY and MEDICINE.

 

[exmike]

You dont see med students without any training in dentistry first, going on to a OMFS residency, do you? Why? Because at the end of 4 years of medical school a student does not know jack squat about the oral cavity in comparison to a graduate of a dental school.

Actually, its b/c med students decided from the beginning they didnt like teeth (and the vast majority of med students would have made it into dental school), and we can do ENT, Plastics, and numerous other specialties/fellowships if we want to mess with the face. Your example is non contributive.

I urge pre-optom students to do the same. If you think you might have any desire to do surgery one day, go to medical school. Then you wont have to deal with 'legistlating' your way into the OR.

 

[qwopty99]

At the risk of continuing to beat a dead horse....

without directly commenting on the merits of your post, i'd like to say it was a very balanced one (one could argue, that compared to the status quo, it's favourable to optometry in fact)

i still don't know where i stand on the issue. would i apply for such a slot if it came up? absolutely. is it something i specifically desire? not necessarily.

but u know, if there were a few ODs who went that route to become "optometric-ophthalmologic surgeons", it would really would take the teeth out of the optometry-surgery lobby. this isn't to suggest, however, such a path should therefore be created. i really don't know.

i should also mention that this "alternate path" ISN'T want optometrists are lobbying for. they are lobbying for surgical rights directly. so though eye MDs are cold to the idea of an OD-to-MD route, it in fact might be in your best interests to have one since its not what optometry is legislating for, but u are also giving them a (very difficult) means to acquire what they are asking for.

 

[speyeder]

All this talk about alternate paths to eye surgery is gibberish. People who chose to go into optometry clearly understood that it's a primary care field. That means No Surgery. Just because a handful of ODs realize later in life that they made a mistake and want to become ophthalmologists doesn't mean that we should turn the system around to accommodate them.

To ignore the fact that there's no shortage of eye surgeons and to ignore the fact that there is already an established system in place to train eye surgeons is selfish. It places the interests of a few above society's needs.

 

[Ben Chudner]

All this talk about alternate paths to eye surgery is gibberish. People who chose to go into optometry clearly understood that it's a primary care field. That means No Surgery. Just because a handful of ODs realize later in life that they made a mistake and want to become ophthalmologists doesn't mean that we should turn the system around to accommodate them.

To ignore the fact that there's no shortage of eye surgeons and to ignore the fact that there is already an established system in place to train eye surgeons is selfish. It places the interests of a few above society's needs.

As an OD, I agree with this. I have made no secret that I feel OD's should be allowed to perform anterior segment laser, although I believe very few OD's would have anywhere near the volume required to justify the cost of the equpiment, but there is no need for OD's to perform more invasive procedures. We already have programs in place for OD's to get the advanced training they need to become surgeons. All they have to do is go back to medical school. I have 2 friends that went back after optometry school and became ophthalmologists. They are doing just fine and do not feel they wasted time or money by becomming an OD first. I think it's time to let this thread die.

 

[DiveMD]

All this talk about alternate paths to eye surgery is gibberish. People who chose to go into optometry clearly understood that it's a primary care field. That means No Surgery. Just because a handful of ODs realize later in life that they made a mistake and want to become ophthalmologists doesn't mean that we should turn the system around to accommodate them.

To ignore the fact that there's no shortage of eye surgeons and to ignore the fact that there is already an established system in place to train eye surgeons is selfish. It places the interests of a few above society's needs.

This is precisely my perspective on this matter.

 

[Pigmentosa]

first of all, I dont think ODs should be treating glaucoma. They are optometrist... Go to a dictionary that defines optometry... They could argue that their scope has expanded and that they define their profesion, but also a surgical tech academy could certainly define their profesion to include emergency appendectomy, etc... bla bla bla...

What we have in front of us are a bunch of politicians that are playing as the Board of Medicine... they dont know anything about medicine though... We should have a board of Medicine of all specialties that is approved by legislation and that dictates what is appropiate for the medical field... When you are ignorant and you dont know the full scope of a situation is easy to say, that you are caplable. But only people above you could see that you might just be unqualified.

How many cataracts do you have to do in residency to be qualified. I guess that the Ophthalmologists have one number and the ODs have another. Who watches out for quality control??? I gues the power of $$$ and politicians... They know a lot about that.

If you become and OD and then want to be an MD. Go to med school. If you are an MD and want to become an OD, then go to Optometry school. If you are a PHD audiologist and want to become an ENT go to Med school and so on... Do you want people to be sorry for going into something and then changing your mind??? People make mistakes, and they live with them.

Look at what is happening. OD schools are graduating an excess of students in order to have more political power. The more ODs in the street, the more the PAC receives. What will happen when all of these ODs acquire surgical rights? Does the word market flooding sound familiar??? Once legislation is established, suddenly all the ODs schools will cut down the number of spots for students in order to acommodate the market needs... Its all about money...

The good side for MDs. Medicine has plenty of Eye MDs and the market, as it is, is very competitive. When ODs come into the MDs realm they will not be able to compete. Then all the true canibalism & competitiveness of the MDs will come into play. Then all of you ODs will start to know how gunners play the game. What would you prefer: playing major league baseball and be always in the bench, or be at another division and be an all-star???

What we need is more true ODs. People that go into OD and want to practice the classical OD role. This will not happen if legislation becomes a reality. What student will actually choose to practice the classical OD role if she has undergone ophthalmology training in OD school... Its like saying, what Eye MD do you know that after residency all he/she does is refract and treat glaucoma???

All of a sudden the market will be in need of "true classical" ODs and Opticians will be more than glad to fill that role. As opticians fill the role of optometrists, ODs will be in the middle of the sandwich. ODs will eventually be in a market battle with Eye MDs and Opticians. If I was an OD right know I would actually be thinking twice for what I wish for. I think the nitch that ODs have right now is the best bet for the future. And, I am sure, that Insurance Companies will benefit from all this market flood for eye doctors...

Comments are very very welcomed!!!!!

 

[Pigmentosa]

And, by the way... Dont say that ODs just want to be a primary care provider for the eye... that is nonsence... just say, ODs want to become ophthalmologists...

Ophthalmologists are the primary care providers for the eye...

 

[old_boy]

Back to the original topic...

Pearle probably makes most of their money off of selling frames and contacts, no? And they are big corporation that has lots of franchise stores around the US which I'm sure eats up a lot of the profits that individually owned franchisees make. Optometrists that work for Pearle make low money and have little autonomy - prescribing classes for the man, essentially, with little continuity of care.

...so...

Instead of bickering, why don't ophthalmologists and optometrists go into business together. Sell lots of frames, optos can do eye exams and primary eye care, refer surgery and more complicated cases to the ophthos within the same practice. It seems that with shared overhead and equipment, $$$ from glasses shop, optimal specialization of labor, and no corporate fees to Pearle, both optos and ophthos would do well and much better than under the current system of seperate practices and bickering. I'm not sure that Pearle is even such a great brand - stealing customers from them seems do-able, since the full-service care they'd be receiving would be superior to Pearle. It would be like MLK's "I have a dream" speech, with optometrists and ophthalmologists laughing and singing and prancing around a big pile of money, while happy patients/customers cheered and clapped.

Does this arrangement happen in the real world?

 

[VA Hopeful Dr]

first of all, I dont think ODs should be treating glaucoma. They are optometrist... Go to a dictionary that defines optometry... They could argue that their scope has expanded and that they define their profesion, but also a surgical tech academy could certainly define their profesion to include emergency appendectomy, etc... bla bla bla...

That is certainly your opinion. But you have to keep in mind, the ODs are trained to diagnose and medically treat lots of problems including glaucoma. It'd be like the endocrine guys saying to the family practice folks "sorry, we're better and managing diabetes than you are so we're not going to let you do it anymore."

What we have in front of us are a bunch of politicians that are playing as the Board of Medicine... they dont know anything about medicine though... We should have a board of Medicine of all specialties that is approved by legislation and that dictates what is appropiate for the medical field... When you are ignorant and you dont know the full scope of a situation is easy to say, that you are caplable. But only people above you could see that you might just be unqualified.

There are turf issues even within medicine, so you'll just change from ODs pushing for more to things like FPs and internists wanting more.

How many cataracts do you have to do in residency to be qualified. I guess that the Ophthalmologists have one number and the ODs have another. Who watches out for quality control??? I gues the power of $$$ and politicians... They know a lot about that.

Actually this brings up an excellent point. From what I understand, in dental school you are required to do a certain number of each procedure in order to graduate. Why don't we do the same with our surgeons? X cataracts, Y YAGs, and so on.

If you become and OD and then want to be an MD. Go to med school. If you are an MD and want to become an OD, then go to Optometry school. If you are a PHD audiologist and want to become an ENT go to Med school and so on... Do you want people to be sorry for going into something and then changing your mind??? People make mistakes, and they live with them.

Mostly agree here.

Look at what is happening. OD schools are graduating an excess of students in order to have more political power. The more ODs in the street, the more the PAC receives. What will happen when all of these ODs acquire surgical rights? Does the word market flooding sound familiar??? Once legislation is established, suddenly all the ODs schools will cut down the number of spots for students in order to acommodate the market needs... Its all about money...

Most ODs agree that there are too many schools with too many grads. If you know how to stop that, let them know.

The good side for MDs. Medicine has plenty of Eye MDs and the market, as it is, is very competitive. When ODs come into the MDs realm they will not be able to compete. Then all the true canibalism & competitiveness of the MDs will come into play. Then all of you ODs will start to know how gunners play the game. What would you prefer: playing major league baseball and be always in the bench, or be at another division and be an all-star???

Actually you've hit on my biggest issue with ODs doing procedures. I don't doubt for a minute that a well trained OD could do YAGs all day long with no problems. But, isn't it likely that the local MD has done more of them?

What we need is more true ODs. People that go into OD and want to practice the classical OD role. This will not happen if legislation becomes a reality. What student will actually choose to practice the classical OD role if she has undergone ophthalmology training in OD school... Its like saying, what Eye MD do you know that after residency all he/she does is refract and treat glaucoma???

All of a sudden the market will be in need of "true classical" ODs and Opticians will be more than glad to fill that role. As opticians fill the role of optometrists, ODs will be in the middle of the sandwich. ODs will eventually be in a market battle with Eye MDs and Opticians. If I was an OD right know I would actually be thinking twice for what I wish for. I think the nitch that ODs have right now is the best bet for the future. And, I am sure, that Insurance Companies will benefit from all this market flood for eye doctors...

Comments are very very welcomed!!!!!

I think having ODs as the vision (glasses/CL) specialists with some primary care thrown in is a great place for them to be. I suspect the second half of what I said might not agree with you, but I think we'll have to agree to disagree.

As for insurance companies cashing in on the oversupply of ODs.... ask any practicing OD how they like vision insurance. Some of those reimburse, for a basic vision exam, around $30.

 

[VA Hopeful Dr]

Back to the original topic...

Pearle probably makes most of their money off of selling frames and contacts, no? And they are big corporation that has lots of franchise stores around the US which I'm sure eats up a lot of the profits that individually owned franchisees make. Optometrists that work for Pearle make low money and have little autonomy - prescribing classes for the man, essentially, with little continuity of care.

...so...

Instead of bickering, why don't ophthalmologists and optometrists go into business together. Sell lots of frames, optos can do eye exams and primary eye care, refer surgery and more complicated cases to the ophthos within the same practice. It seems that with shared overhead and equipment, $$$ from glasses shop, optimal specialization of labor, and no corporate fees to Pearle, both optos and ophthos would do well and much better than under the current system of seperate practices and bickering. I'm not sure that Pearle is even such a great brand - stealing customers from them seems do-able, since the full-service care they'd be receiving would be superior to Pearle. It would be like MLK's "I have a dream" speech, with optometrists and ophthalmologists laughing and singing and prancing around a big pile of money, while happy patients/customers cheered and clapped.

Does this arrangement happen in the real world?

Yes, it does. And from the OD end (from what I've been told), they seem to really enjoy the professional relationships in those types of settings.

 

[PBEA]

first of all, I dont think ODs should be treating glaucoma. They are optometrist... Go to a dictionary that defines optometry... They could argue that their scope has expanded and that they define their profesion, but also a surgical tech academy could certainly define their profesion to include emergency appendectomy, etc... bla bla bla...

Yikes, this post is rambling incoherent nonsense. But thanks for showing your true colors. Your statement about glaucoma is the real clincher, IMO. My feeling regarding this latest ODvsOMD debate, is that it has little to do with "surgery", and everything to do with examining and/or treating the eye "medically". For the anti-OD camp it boils down to one basic concept: ODs are only good for refraction and everything else (glaucoma, diabetes, red eyes, etc) can either be handled by the PCP (what a joke) or referred to the OMD. The "surgery by surgeons" warcry is little more then fearmongering crap that helps rally the troops. Wake up ODs THIS IS NOT ABOUT SURGERY. Ophthalmology's main goal is to eliminate ODs from treating the eye medically. Although they have failed miserably thus far, they are by no means giving up this goal. Evidenced clearly by the inebriated brainwashed postings of pigmentoasted.

 

[Pigmentosa]

About quality control:

Who should define how many glaucoma patients, and complications you have to see and treat before being able to manage glaucoma. How many glaucoma/ retina, glaucoma/ocular genetic disease, glaucoma/pediatric, glaucoma/systemic combinations, glaucoma/surgery do you have to see before being competent at managing glaucoma? I guess Eye MDs have one number and ODs have another. The clinical exposure that ODs have is minimal compared to the Eye MDs. But, I guess progressive ODs think they are competent. I guess quality control will never happen because ODs will always be pushing for more.

As for surgery rights. Anybody can operate. Even a monkey. Anybody can give glaucoma drops also. The dilemma is: when to do and when not to do... Only when you have the full breath of pathologic management that you aquire in medical school and residency can you begin to understand how to make "good" medical decisions... Even then MDs can make mistakes...

I ask again, who should be the Board of Eye Diseases??? Subspecialized Expert ophthalmologists or optometrists??? You always want the experts making the most important decisions. Right now the experts in Eye Diseases are called politicians... And that is very pleasing ...

 

[updoc]

do you even need a college degree to be an optometrist? and you want to be surgeons? how people who dont graduate college are given the responsibility to write prescrptions for some of these medications is beyond me...if patients were educated on who their health care providers were and what their qualifications are, this topic would be squashed...remember people to educate your patients, no one else will.

 

[orangezero]

yikes, what an interesting read.

I'm glad I don't need your approval to show up to work every day

I think these discussions would be much more meaningful if we could see the age, year in school, or year in practice. This would shed a whole new light on this conversation.

The MAJOR flaw in this whole theory (going back to the first post) is that lasik is actually wanted by the majority of people in the US. Make it $4 an eye and you'd still have tons and tons of people wearing glasses.

Where did therapeutic glaucoma management come from??? Jeeze, I don't tell ophthalmologists not to prescribe prism or do low vision... And as much as I'd like, I don't run around to the local ER and tell the docs there what they are doing wrong whenever they see eye trauma. Lets not ivory tower this. Who DO we compare optometrists to? family physicians? ophthalmologists who are 3 hrs away? I just sent a patient out for a second opinion and they sent her back saying there was no retinal specialist in the area... There are only family physicians treating diabetics in my area. There are no board certified glaucoma specialists in my area, but plenty who will do lasik. Should we let the family physicians treat glaucoma now, after all they went to medical school and know about all that anatimy and fizziology stuff...

Optometry has low malpractice rates for a reason: patients like us, we solve their problems, we prevent vision loss, and we rarely mess up. Optometrists rarely cause actual patient harm, despite what fears your professors may try to drum up. The truth is, the biggest threat to ophthalmology from optometry is realistically almost purely ECONOMIC in nature. The modern optometrist can do 80-90% of eye care just fine, and the vast majority of optometrists are happy to send out the rare condition or cataract for surgery when needed. Sure, maybe there's one OD who wishes he could perform an SLT, but I highly doubt this is on the AOA radar for even the next 25 years. There are so many other problems with eye care...

But you guys keep arguing about optometry wanting to do cataract surgery and lasik and missing the point.

My respect for organized medicine continues to drop as I read the posts on these websites. I've always openly stood up for the medical community when issues of money comes up, but I'm going to have to rethink how I look at things if this is how the majority of physicians feel.

I personally find it sad the local ophthalmologists in my area feel the need to point out to patients they have to see ophthalmologists (and not optometrists) for dry eye, allergic conjunctivitis, diabetes, amblyopia, etc. how 1950s... I NEVER point out they have a tech coming up with the prescription that is put in their $600 glasses, wonder why they come to me with visual problems... professionalism is certainly relative...

having said all that, I know tons and tons of optometrists and opthalmologists who ARE working under the same roof. It can work so much better that way.

cheers.

 

[orangezero]

do you even need a college degree to be an optometrist? and you want to be surgeons? how people who dont graduate college are given the responsibility to write prescrptions for some of these medications is beyond me...if patients were educated on who their health care providers were and what their qualifications are, this topic would be squashed...remember people to educate your patients, no one else will.

The vast majority of ODs graduating today have 8 years of post high school education, some have more. You can attend some OD schools after 3 years of college, but the only ones I know who did it in my class went to summer school every summer of college. Don't they have the same thing at some medical schools? I actually had to take an extra class after my liberal arts college education so I would have all the requirements to enter my optometry school.

No, most don't want to be surgeons. Oh, unless you are talking about the ability to remove eyelashes, which technically is surgery according to most insurance panels. Nice use of semantics.

Good arguments...

 

[Pigmentosa]

Anyways, my origial thread was headed for the debate of wether Pearl and other lookalikes want a piece of the pie of Lasik.

Seems to me that they know that eventually the surgical correction of refractive errors will be very accessible and feasable to the majority (I am looking at long term) and therefore eyeglasses sales will drop significatly. It will be very easy for them to buy Lasik technology since they have tons of cash. The only piece of the pussle needed to make it work would be a refractive surgeon.

Anyone could argue that this role could be filled by an Ophthalmologist, but the reality is that the market for Ophthalmology is good enough right now that such role is not considered by Eye MDs. MDs have enough volume to be able to buy Lasik technology and set up their own shop. However, ODs dont have such volume. If legislation allows OD to do Lasik, Pearl could easily invest in OD because they can pay an OD a lot less. Pearl also has the volume needed to make it economically profitable.

I might be hallucinating here, but seems to me that there are MAJOR INFLUENCES backing up the Optometry cause and not just the Academy of Optometry... What entities, that have big bucks, could be financing the fight for surgical rights cause???...

 

[orangezero]

Anyways, my origial thread was headed for the debate of wether Pearl and other lookalikes want a piece of the pie of Lasik.

Seems to me that they know that eventually the surgical correction of refractive errors will be very accessible and feasable to the majority (I am looking at long term) and therefore eyeglasses sales will drop significatly. It will be very easy for them to buy Lasik technology since they have tons of cash. The only piece of the pussle needed to make it work would be a refractive surgeon.

Anyone could argue that this role could be filled by an Ophthalmologist, but the reality is that the market for Ophthalmology is good enough right now that such role is not considered by Eye MDs. MDs have enough volume to be able to buy Lasik technology and set up their own shop. However, ODs dont have such volume. If legislation allows OD to do Lasik, Pearl could easily invest in OD because they can pay an OD a lot less. Pearl also has the volume needed to make it economically profitable.

I might be hallucinating here, but seems to me that there are MAJOR INFLUENCES backing up the Optometry cause and not just the Academy of Optometry... What entities, that have big bucks, could be financing the fight for surgical rights cause???...

Good we are back on topic.

#1: people still want sunglasses, fasion glasses, reading, computer glasses, the optical market is HUGE and isn't getting blown away by refractive surgery. I don't see this changing anytime soon.

#2: few people are totally independent of glasses later in life, presbyopic surgerical corrections may improve dramatically and still allow for glasses wear

#3: pearle won't do anything TO optometry or for optometry's own good

#4: ODs (I hope) are smart enough to ask for ophthalmology type reimbursement for all the extra training required, and pearle will only get those willing to play ball. ie crappy docs who will scare patients

#5: Month to month paychecks: too few people have the money to really "afford" glasses, much less elective surgery. sears' optical major draw is their ability to accept the sears charge card so patients dont' have to pay full price at one time for glasses. If people can't save $200-400 for an exam and cheap pair of glasses, how are they going to be expected to save $1000 for lowball lasik?

#6: as much as people advertise it as a "procedure," lasik is still surgery. people rarely want surgery in a mall.

#7: If all these other things were overcome, I still don't see the benefit for optometry in all of this. I don't see enough optometrists wanting to do this for the money they would give.


I haven't looked at these numbers lately, how much growth is their expected to be in the lasik/refractive surgery market in the next few years, realistically?

 

[Pigmentosa]

BTW, where I live there are plenty of ophthalmologists in every specialty, but OD pushed for "their" rights and now prescribe. We had and have no need for extra ophthalmologists or ODs with prescribing rights but since in every other state it was legal it became legal here. That is the normal political current.

Anyways, if you need more ophthalmologist you make more residency spots. Its retrograde thinking to say "just upgrade the next in line of knowledge to fill the need"...

Lets upgrade neurologists becasue we need more neurosurgeons... Just make them take a few tutorials...

There are mechanisms to fill the void of Eye MDs.

I dont want to continue this issue of "upgrade" because it has been discussed to its maximum at other previous posts.

The issue of malpractice has also been discussed to its maximum and I think the majority knows that it has to do with the amount of patients and type of patients that an ophthalmologists sees. Eye MD sees the sick patients that cant be managed by ODs and are sent to Eye MDs. Eye MDs are manytimes the last line of referal and remember that MDs cant refer the patient to God; therefore, when something goes naturally wrong who gets the blame.... The last in line....Eye MDs

 

[JMK2005]

​

Optometry has low malpractice rates for a reason: patients like us, we solve their problems, we prevent vision loss, and we rarely mess up.

I also think that optometry's patient population are generally healthier with lower risk involved.

 

[Pigmentosa]

VA Hopeful:

Can you rephrase the question? I dont understand the question...

 

[orangezero]

​

I also think that optometry's patient population are generally healthier with lower risk involved.

That is probably most often true. However, my point was in regards to glaucoma therapy. There has not been the huge outbreak in malpractice suits and nationwide blindings (predicted by organized ophthalmology) because optometry has had therapeutic glaucoma prescribing rights for the last several decades. I didn't mean that as a cut on ophthalmology, and their higher malpractice insurance. And I think the point could generally be made that optometry has had a much more positive than negative affect on glaucoma treatment in the US.

The other thing to keep in mind is this. IF an optometrist does go to court, the "expert" is going to be an ophthalmologist who is board certified in that specialty, and will dictate the optometrist did not follow the standard of care even if the majority of local ophthalmologists would have done the exact same thing. Do you think optometrists are really so careless as to not have malpractice constantly on their minds, especially when the "expert" will not even be one of his peers? And you think we want to do surgery, with all the further antagonizing this will cause, not to mention the extra risk (all the while with lowering reimbursement)?

I'd be happy if I could bill a dry eye workup successfully under certain insurance plans.

Before optometry school, I went to an ophthalmologist for almost 20 years. Been there, done that. I'm more than happy to provide "primary" eye care (whatever that means...) to those unhappy with the current climate in big ophthalmological offices And I'll be more than happy to send a patient to an ophthalmologist when needed who at least has the decency to not bad mouth optometry in front of my patients.

You are correct, there are more than enough threads on this. Sorry to be distracting here.

But I think your lack of understanding of current optometry is clouding your views on the issues you brought up initially. Thats the only reason I chimed in. take care.

 

[UABopt]

do you even need a college degree to be an optometrist? and you want to be surgeons? how people who dont graduate college are given the responsibility to write prescrptions for some of these medications is beyond me...if patients were educated on who their health care providers were and what their qualifications are, this topic would be squashed...remember people to educate your patients, no one else will.

I REALLY REALLY SINCERLY hope this is some sad attempt at sarcasm. Either that or the comment was intended to rouse some anger. It takes 8 years of school to become an OD. 4 years of undergrad and 4 years of optometry school. If not then I think it is you who needs to be educated on "who health care providers are and what their qualifications are." Last year 95% of all optometry students had at LEAST a bachelor's degree. Among the 40 people in my class there were a few with MPHs, PhDs, and several people that had completed masters degrees. Not that undergradute school has anything to do with perscribing medications anyhow.

 

[UABopt]

sorry dbl post.

 

[broadway]

Thats the biggest problem (getting paid $30 for an eye exam) which no-one talks about. aprox. 90% of patients that visit ods visit them for glasses or cls.Treating glaucoma is nice but it's not going to pay the bills.

 

[rubensan]

yawn. have you now stooped to crticizing our members' screen names? who is grinding the axe here?

You really do have an axe to grind, dont you?

Maybe you and I can share PMs so that you might get some facts straight. Lets start publicly with how effective photodynamic therapy really is. Ill go first: photodynamic therapy 4 choroidal neovascularization suks monkey toes. Now its your turn.

 

[PBEA]

yawn. have you now stooped to crticizing our members' screen names? who is grinding the axe here?

guilty as charged, sorry but pdt4cnv is an extremist. My axe is already pretty sharp but could always use some more sharpening. Heres a bone for you, I love most of the intricacies that are involved in ophthalmic care, one of my favorites is a positive outcome to a referral made to an OMD for a specific condition. As an OD, I will always want this and will always appreciate and respect this.

 

[IndianaOD]

do you even need a college degree to be an optometrist? and you want to be surgeons? how people who dont graduate college are given the responsibility to write prescrptions for some of these medications is beyond me...if patients were educated on who their health care providers were and what their qualifications are, this topic would be squashed...remember people to educate your patients, no one else will.

Wow, this person is clueless. There are 6 year combined MD programs.
I am one of many ODs who came out of a good undergrad with a 3.8+. I never want to do surgery, but people should have options. I know an OMD who decided at the last moment he wanted to do it. He didn't know he wanted to when he started med-school, so should all ODs? There are plenty of 4.0 students in optometry schools.
Optometry keeps getting ranked as one of the best professions to go into. Several Med-schools aren't all that competitive to get in.

To the other person, optometry is the primary eye care profession. OMDs aren't trained adequately in all aspects of vision for primary care. Just because you can identify a catarct and use a slit-lamp doesn't make you a primary care doc. An OMD is a branch of surgery remember, good at one thing not all? It doesn't take much asking to get an OMD to tell you they don't know crap about refractions, contact lenses, and binocular vision. Personally, I don't care if my surgeon knows this stuff as long as he is good at the surgery I refered my patient for. Binocular vision problems are much more common than ocular disease and cause real life problems such as significant headaches and terrible academic performance.

I've spent significant time with OMDs of several specialties and I really don't see all this great med-school training coming through. They do the 5 minute exam and move on to the next patient trying to find the next surgery to schedule.

These talks are all the same, OMDs and residents claiming the same thing over and over with zero facts. All safety studies after OD scope expansions have shown that ODs do a great job, a lot of times with better outcomes that the norms.

A few months back there was also a thread that said that 80% plus of med-students who wanted an OMD placement got one.

Carry on, let me hear: Go to Med school! a few more times. Oh wait, I'm an eye doctor.

 

[speyeder]

guilty as charged, sorry but pdt4cnv is an extremist. My axe is already pretty sharp but could always use some more sharpening. Heres a bone for you, I love most of the intricacies that are involved in ophthalmic care, one of my favorites is a positive outcome to a referral made to an OMD for a specific condition. As an OD, I will always want this and will always appreciate and respect this.

It's pretty ironic that you're labeling others 'extremist'.

 

[KHE]

yawn. have you now stooped to crticizing our members' screen names? who is grinding the axe here?

What a horribly tedious thread....complete with lame attacks on spelling, other peoples' screen names, and the usual blather about who said which insulting thing first and "started this" or "caused that."

I'm seriously embarassed for every single one of you. You should all be ashamed of yourselves.

 

[KHE]

I've spent significant time with OMDs of several specialties and I really don't see all this great med-school training coming through. They do the 5 minute exam and move on to the next patient trying to find the next surgery to schedule.

As a resident in vision therapy, under what context have you spent "significant time with OMDs of several specialties?"

 

[qwopty99]

do you even need a college degree to be an optometrist? and you want to be surgeons? how people who dont graduate college are given the responsibility to write prescrptions for some of these medications is beyond me...

geez. i never realized the University of California, Berkeley wasn't a university. what medical school did you graduate from?

if patients were educated on who their health care providers were and what their qualifications are, this topic would be squashed...

if its as easy as you say, then go do it. u imply ur so smart, so why are u letting a bunch of college drop-outs out do you in public perception?

did u actually learn anything in medical school, or did u have to cheat your way through?

 

[KHE]

geez. i never realized the University of California, Berkeley wasn't a university. what medical school did you graduate from?



if its as easy as you say, then go do it. u imply ur so smart, so why are u letting a bunch of college drop-outs out do you in public perception?

did u actually learn anything in medical school, or did u have to cheat your way through?

Are you serious? What is this... the 3rd grade here? My GOD.

How much longer is it going to be before someone says "I know you are but what am I" or says "I'm NOT touching you" while holding their finger an inch away from someones face?

Wow.

 

[updoc]

just to clarify- you do not need to have a college degree to be an optometrist-this was news to me- so is it safe to say 5% of optometrists have never finished college, as UABopt quoted?-interesting-
and 7 year MD programs graduates receive a bachelors, as well, so i am not sure why the comparison...

 

[KHE]

just to clarify- you do not need to have a college degree to be an optometrist-this was news to me- so is it safe to say 5% of optometrists have never finished college, as UABopt quoted?-interesting-
and 7 year MD programs graduates receive a bachelors, as well, so i am not sure why the comparison...

Of the 5% or so admitted without bachelors degrees, the majority of them are people who use some of their optometry school credits towards their bachelors degree and end up graduating with their OD and their bachelors degree, just like the 7 year MDs. Usually only top students are admitted to this track.

The few others are usually students with post-secondary credentials from foreign countries who may not meet the definition of a "bachelors degree" here in the United States. The one fellow in my class who was in this category was MUCH smarter than anyone in the class who attended an American school, including myself.

The majority of optometry schools have classes of students much less than 100. So when you are talking about 5%, you are essentially talking about 1 or 2 people in a class.

 

[qwopty99]

just to clarify- you do not need to have a college degree to be an optometrist-this was news to me- so is it safe to say 5% of optometrists have never finished college, as UABopt quoted?-interesting-
and 7 year MD programs graduates receive a bachelors, as well, so i am not sure why the comparison...

let's clarify further. u don't specifically need (at most schools) a college degree to be an optometry student.

but the optometry degree itself, i believe, is considered a college (graduate) degree.

i hope that's clear.

do ALL medical students have college undergraduate degrees? i know in Canada, many do, but not all do (as a comparison, much less than 95%).

 

[AwesomeSauce]

THIS IS NOT ABOUT SURGERY. Ophthalmology's main goal is to eliminate ODs from treating the eye medically. Although they have failed miserably thus far, they are by no means giving up this goal. Evidenced clearly by the inebriated brainwashed postings of pigmentoasted.

Yes, yes, yes!

If there is any "grand plan" for optometry, I am convinced that gaining surgical rights has nothing to do with actually performing surgeries. This forces the OMD lobby to expend all their energy and efforts stopping surgery. Meanwhile, the ODs are practicing full-scope optometry. The OMDs won’t waste any effort trying to take travatan bottles away from ODs as long as they think that lasik is on the table. When the dust settles, ODs will have what they want: to practice at the level they were all trained to do. And they will have been doing it for far too long for the OMDs to be able to legislate it away.

 

[jefguth]

just to clarify- you do not need to have a college degree to be an optometrist-this was news to me- so is it safe to say 5% of optometrists have never finished college, as UABopt quoted?-interesting-
and 7 year MD programs graduates receive a bachelors, as well, so i am not sure why the comparison...

Whats your point? All medical and optometry schools uniformly require at minimum either 90 credit hours (3 years) or a bachelors degree from an accredited university. I can't say I know anything about these 7yr MD programs that also award a BS, but if you really think that counts for something ... you might be interested in knowing that many OD school do the same.

I matriculated into optometry school after 3 years of my BSc; 5 of 6 friends of mine that entered medicine did the same - most attend medical school in Canada, one in the USA without an undergraduate degree.

 

[rubensan]

I love most of the intricacies that are involved in ophthalmic care, one of my favorites is a positive outcome to a referral made to an OMD for a specific condition. As an OD, I will always want this and will always appreciate and respect this.

me too. perhaps my experience today touches on your sentiments.

very pleaseant female patient who originally presented with:

Va
OD: 20/200 NIPH


SLE

K: nasal pterygium encroaching pupillary margin OD.

2 months after bilateral pterygium excision

OD: 20/60 20/25 with PH


nice woman who loves her optometrist, happy with the results and I referred her back to her OD. i guess he got my number off of an old Rx for predforte but he wanted me to understand how much he really appreciated that i referred the patient back.

is this what you meant?

 

[rubensan]

optometrists are doctors: doctors of optometry. i guess i would just caution you on this line of reasoning. not only do some find it imflammatory, your post, incidently has been reported to the moderators of this forum, but i do not think it is completely accurate. educating the public that ophthalmic surgery should be performed by ophthalmologists did not help our cause in new mexico. we lost that battle and we should learn from some key mistakes that we made in that state.

again, i maintain that much of what is said on this forum means little. outside of this forum, i have never met an optometrist who wants anything more than to practice to the level that they were trained. the push and rationale for ophthalmic surgery by optometrists is the desire of a few not the whole.

do you even need a college degree to be an optometrist? and you want to be surgeons? how people who dont graduate college are given the responsibility to write prescrptions for some of these medications is beyond me...if patients were educated on who their health care providers were and what their qualifications are, this topic would be squashed...remember people to educate your patients, no one else will.

 

[Pigmentosa]

About quality control:

Who should define how many glaucoma patients, and complications you have to see and treat before being able to manage glaucoma. How many glaucoma/ retina, glaucoma/ocular genetic disease, glaucoma/pediatric, glaucoma/systemic combinations, glaucoma/surgery do you have to see before being competent at managing glaucoma? I guess Eye MDs have one number and ODs have another. The clinical exposure that ODs have is minimal compared to the Eye MDs. But, I guess progressive ODs think they are competent. I guess quality control will never happen because ODs will always be pushing for more.

As for surgery rights. Anybody can operate. Even a monkey. Anybody can give glaucoma drops also. The dilemma is: when to do and when not to do... Only when you have the full breath of pathologic management that you aquire in medical school and residency can you begin to understand how to make "good" medical decisions... Even then MDs can make mistakes...

I ask again, who should be the Board of Eye Diseases??? Subspecialized Expert ophthalmologists or optometrists??? You always want the experts making the most important decisions. Right now the experts in Eye Diseases are called politicians... And that is very pleasing ...

Can we keep the thread at a higher level and not go into baby talk???????

 

[AwesomeSauce]

Can we keep the thread at a higher level and not go into baby talk???????

umm, did you just complain about your own post?

 

[VA Hopeful Dr]

VA Hopeful:

Can you rephrase the question? I dont understand the question...

Which one, I posed several?