Optometry scope: a help or a hindrance?

[MR1]

AND THEY'RE OFF!!

Out of the gate it's med school, med school starts out strong foll......ahh forget it.

Ahh, I was actually looking forward to this getting finished. Seriously these always crack me up

As far as the med student interested in ophtho, medicine is being attacked on multiple levels and every field is affected. Bottom line do what you love because if you do something you hate but no one is after your job and you make good money b\c you don't have to screw with medicare, I still bet you will be more unhappy.

---

Members don't see this ad.

 

[Booyamc]

How is a OD gonna hurt someone?....poking his finger in their eye while putting on their glasses? Pull your head out of your ass

 

[FutureCTDoc]

How is a OD gonna hurt someone?....poking his finger in their eye while putting on their glasses? Pull your head out of your ass

Here's one way PT comes into my father, had seen an OD who said nothing was wrong, went again same response. His CC shadow over the lower part of his vision. He had an RD, had gone at least 2X in three months, they missed it every time. Luckily he is back to 20/25 in that eye post vitrectomy at 9 months out. Usually this is how ODs do harm, not knowing what they're seeing and not referring out. I've also seen this with glaucoma, not referring out cataracts until they were rocks, endophthalmitis etc.

 

[FutureCTDoc]

http://www.portal.state.pa.us/portal/server.pt/community/disciplinary_actions/12528

Looking at June there were no disciplinary actions for ODs. 0, nil, zip.
In regards to MDs (or DOs), the list goes on & on every month...

This thread is dead at this point. I end with this and look forward to a more educated and academic discussion in the future.

How many ODs per MD/DO? There were 13 MD/DO actions in the state of PA, 5 of which were of OOS MD/DOs. Considering that there are relatively few ODs per MD/DO, this is hardly surprising and not terribly useful as a gauge of anything. Also look at the DCs with no violations, some boards are known for being lax about persecuting violators.

 

[VA Hopeful Dr]

The material changes and why should the format change? It's still more than any other profession

Is a minimum of 7+ years post undergrad not enough???? We are seeing more fellowship pursuit anyway if that's not enough

I'd be curious to know the avg # of years spent in training post med school, varies by specialty but still curious

Of course the material changes, there's a reason I didn't mention that. I also didn't say the format was bad, just that the structure of it hadn't changed much.

In brief:

Family/peds/internal/EM = 3 years
anesthesia/rads/derm/ophtho/ob = 4 years, though the first is an intern year in either medicine or surgery for most of those.
G-surg/ENT/Neuro surg/ortho = 5 years, though some have an extra research year tacked in there.

Given the large numbers of people in the 3 year category, I'd bet the average hovers about 3.5-4.

 

[VA Hopeful Dr]

How many ODs per MD/DO? There were 13 MD/DO actions in the state of PA, 5 of which were of OOS MD/DOs. Considering that there are relatively few ODs per MD/DO, this is hardly surprising and not terribly useful as a gauge of anything. Also look at the DCs with no violations, some boards are known for being lax about persecuting violators.

In my state, something like 80%+ of disciplinary actions are the result of messing around with controlled substances in one way or another. Due to limitations in the scope of practice, ODs are much less likely to have problems with that from the start.

 

[Visionary]

I do not wish to contribute to the current discussion or to fan the flames. I only felt compelled to break my silence to say that as a current 3rd year medical student who has followed the specialty forums on SDN for the past several years, the level of fighting, discontent, and animosity on this board has made me question (or at the very least raise an eyebrow at) my choice to apply to ophthalmology residency this summer. I've spent the past year doing ophthalmology research and have worked with many ophtho docs in an academic setting. I am very interested in the diseases of the eye and enjoy the mixture of clinic, imaging, and surgical procedures. I have talked to the docs at my home program, but I also look on SDN for opinions of docs elsewhere. Compared to other specialty boards, the ophthalmology forum seems especially contentious. Is this board representative of the real world? Do optometrists represent a constant threat to ophthalmologists' livelihood? Are salaries and the job market truly dismal? Will medicare changes leave us all in the cold? Do evil old-school ophthalmologists make it impossible for young graduates to enter the market or obtain reasonable jobs? I suspect that the answer to these questions is "no", but I am still disheartened with what I have read here. Please remember the purpose of these boards as a place to educate, inform, and encourage. We medical students are very impressionable and are sometimes unable to discern the truth in what we read. Thank you - that is all! (stepping down from soapbox)

While many of the issues discussed on this forum (and others) are real, don't mistake this place for the real world. Many on here are inflammatory, sensationalist, bitter, and at times uninformed. Most of us in practice are doing just fine. There are stressors from time-to-time, notably the recent SGR mess, but I love coming to work every day. I honestly wouldn't want to do anything else.

 

[odieoh]

We medical students are very impressionable and are sometimes unable to discern the truth in what we read. Thank you - that is all! (stepping down from soapbox)

Guys tone it down, the kids are still awake!!!

 

[FutureCTDoc]

In my state, something like 80%+ of disciplinary actions are the result of messing around with controlled substances in one way or another. Due to limitations in the scope of practice, ODs are much less likely to have problems with that from the start.

I think this is really dependent on your state board, for some it's not reporting an action in another state, others have it for drugs, gross negligence etc. It really depends on how active a board they are.

 

[Booyamc]

Why should the format change????

They're are many and multiple fellowships to supplement and modernize.... more than 3.5-4 probably

 

[Meibomian SxN]

...Due to limitations in the scope of practice, ODs are much less likely to have problems with that from the start.

What limitations? I have a DEA# and Schedules II-V. OD's are just morally responsible professionals

 

[FutureCTDoc]

What limitations? I have a DEA# and Schedules II-V. OD's are just morally responsible professionals

There were 13 MDs/DOs on the list you presented, 5 of whom were OOS. Per the BLS 700,000 MD/DOs and 35,000 ODs a 20:1 ratio. It's hardly surprising none were disciplined, it's a numbers game. Stop trolling on the ophtho boards.

 

[MR1]

OD's are just morally responsible professionals

Come on, are you saying MD's are not and all OD's are.

The reason OD's don't get sued as much is simple, one there are less of you than MD's and the more important one, you just simply don't see the pathology. People sue when something bad happens, if I see 40 patients a day and everyone has a medical diagnosis and you see ?how many medical patients a day?. Well as I have said before, the OD's here seem to see more medical stuff but in general OD's don't. The ones I know see all glasses and contacts (not that there is anything wrong with that). Finally when you do see something really bad most refer and then when the s*** hits the fan it is usually us that is manning the ship and therefore gets sued.

It is apples and oranges and don't try to make it otherwise

 

[VA Hopeful Dr]

What limitations? I have a DEA# and Schedules II-V. OD's are just morally responsible professionals

In my state schedule II isn't allowed and schedule III is limited to a one week supply.

Why on earth would you need to give a patient oxycodone or dilaudid?

 

[KHE]

Come on, are you saying MD's are not and all OD's are.

The reason OD's don't get sued as much is simple, one there are less of you than MD's and the more important one, you just simply don't see the pathology. People sue when something bad happens, if I see 40 patients a day and everyone has a medical diagnosis and you see ?how many medical patients a day?. Well as I have said before, the OD's here seem to see more medical stuff but in general OD's don't. The ones I know see all glasses and contacts (not that there is anything wrong with that). Finally when you do see something really bad most refer and then when the s*** hits the fan it is usually us that is manning the ship and therefore gets sued.

It is apples and oranges and don't try to make it otherwise

In general, it's the ones that just sell glasses and contact lenses that get themselves into the most trouble. At least according to the literature in our field.

 

[KHE]

In my state schedule II isn't allowed and schedule III is limited to a one week supply.

Why on earth would you need to give a patient oxycodone or dilaudid?

I have given oxycontin once in my >10 year career. 500 tabs to myself.

I"M KIDDING. I'M KIDDING. lol

Seriously though, only once. To a 2 day post PRK patient who was a big baby. Other than that, the usually the only times I ever use narcotics is for bad abrasions and even then, it doens't help much for the pain. It just helps the patient get to sleep so the eye can heal itself on it's own. At most, I write for 3 days worth.

Which is always funny when my Rx pad gets stolen because the drug seekers always seem to write out for 200! They're never subtle about it.

 

[Meibomian SxN]

In my state schedule II isn't allowed and schedule III is limited to a one week supply.

Why on earth would you need to give a patient oxycodone or dilaudid?

Maybe if you were an eye doctor you would know....

Sometimes with s/p refractive procedures I Rx Oxy/APAP; depends on the patient and their pain tolerance...

Also to educate you: 1 week supply of Schedule III Vicodin = 42pills; that's more than enough for an corneal abrasion, don't you think?

 

[MR1]

In general, it's the ones that just sell glasses and contact lenses that get themselves into the most trouble. At least according to the literature in our field.

Really, why is that. Are they the ones that don't know what they are doing and miss things or don't refer??

As far as Oxycodone, any OD's reading this listen to KHE, DON'T write for this for many reasons, almost NO eye patient needs it. Hydrocodone maybe but I only give it rarely, tylenol #3 is my favorite.

 

[MR1]

Maybe if you were an eye doctor you would know....

I maybe wrong but I think he was an OD that went to med school, although not doing ophtho

 

[KHE]

Really, why is that. Are they the ones that don't know what they are doing and miss things or don't refer??

Most malpractice issues in eye care (or at least in optometry) are usually the result of failure to diagnose, not because of bad intervention. Detached retina and glaucoma are the two biggest ones with other retinal diseases after that.

These are almost always missed by the "eyeglass guys" because they don't even really look for them. As they used to say "seven and four and out the door."

I don't believe that very many ODs who actually LOOK for these conditions will miss them too often.

 

[VA Hopeful Dr]

Maybe if you were an eye doctor you would know....

Sometimes with s/p refractive procedures I Rx Oxy/APAP; depends on the patient and their pain tolerance...

Also to educate you: 1 week supply of Schedule III Vicodin = 42pills; that's more than enough for an corneal abrasion, don't you think?

That's exactly why schedule III was restricted to a week when the law was written. I would also point out that two other eye doctors suggest against really using schedule II, the one who does the surgery even more so.

 

[VA Hopeful Dr]

I maybe wrong but I think he was an OD that went to med school, although not doing ophtho

Nope, just med school. Though my dad and both his parents were ODs and between dinner conversation and working in various eye doc offices for around 10 years, I picked up a few things.

 

[hello07]

Oculomotor,

How you doing? How did that scleral buck procedure turn out with pt X? Did you at least save the macula ?

How did the filter procedure go after the trabeculectomy on pt Y?

How did the strab surgery turn out on baby Z?

How did the pt W do with the periocular injection ? did you help?

I'm sure you were so busy with all this medical and surgical tx as an intern all your refractions and CL' s fittings were send out to your local OD huh?

You big time OD you.