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Is the AAO doing anything about this?
http://forums.studentdoctor.net/showthread.php?p=11552766#post11552766
http://forums.studentdoctor.net/showthread.php?p=11552766#post11552766
There is already at least one state where optoms can operate. how many are actually doing it?
Just because they have the legal right, that doesn't make it economically feasible.
2 states now and counting: Oklahoma and Kentucky.
I'm sure they will pass no problem. It's a hard code to crack, but once you figure out the correct balance of money + slimy politicians + a lack of any semblance of ethics ... you're golden.
2 states now and counting: Oklahoma and Kentucky.
As I previously said, I very much doubt that the SC one will pass. The Nebraska and Texas ones are both very expansive, and those tend to be much more difficult to pass.
I hope like hell they don't pass; I'm a broke student and i'll donate money to help them not pass ... But just based off recent history with various groups trying this pathetic bull****, I have little faith they will fail.
OK, so in this past legislative year there was 1 large gain by optometry. In my state alone, we fought off 2 bills that were very similar. So at best, we're talking a 50/50 shot of this stuff getting passed. But I'm sure there were many other states where the OD bills stalled. Historically, and even recently, optometry has to submit a similar bill multiple times before it comes even close to passing.
Not saying we shouldn't keep an eye out for these things, but I think you're being a tad chicken-littley about this.
A few things that we should be honest about: An OD through their concentrated curriculum and additional training is qualified to perform PI, SLT, ALT, and Yag lasers. In addition, they also have more than enough training to be doing steroid inj into the lids.
When ODs first got the right to use diagnostic drugs people were going to be falling over in the streets, then topical therapeutics...which definitely was going to kill and blind patients....then comes orals blah blah blah........and then we come to lasers and injections.
I DO NOT believe that ODs should ever be performing complicated invasive procedures such as the cataract surg, intraocular inj, and so on..
Perhaps you think that way now, but consider this:
Among many of the other concerns that have been stated on this thread and countless others, this is one of my primary concerns. That is, OD's getting the right to prescribe topical drugs...then oral drugs...now minimally invasive procedures...you get the progression here. Next will undoubtedly be more invasive procedures such as cataracts, injections etc. It's shortsided to think only of what they are asking for now, but consider what they could be asking for 5...10...15 years down the road.
I hate to use "n=1" as an argument for that, but that really is an isolated opinion. There are plenty of ophthalmologists at the university I attend that care about a great deal of organs besides the eye, and frequently have made systemic diagnoses. There are two areas where this can pop up that I can think of off the top of my head:- "You cease being a real doctor. I actually think of this as a positive, but I've heard this complaint from some of my co-trainees in the past. After your intern year, you gradually forget everything else about the human body except for the details you need to know that are directly related to the eye. Because the eye is so specialized, I often consider "eye-dentist" a more accurate term for what I do. My general medical knowledge is gone. Again, I see this as a positive thing; I really have no interest in managing anything other than eye diseases and send everything else back to primary care."
Saw this on another very recent thread in this forum....any other ophthalmologist care to comment on this statement. How would one reconcile this statement with the multitude of threads that use the argument that ODs should not be allowed to do much of anything medically in eye care due to their gross lack of general medical knowledge which can only be gained in medical school. Eye knowledge and systemic knowledge related to the eye is just so sub par in the views of many on this thread as to be laughable.
Not trying to start a fight, not interested in surgery, love my job with my current scope...just curious, cause I know that this post (by probably a great ophthalmologist) states the current situation of many ( and I do know many great ophthalmologists on a personal and professional level).
Cheers
Speaking of short sighted....The AOA continues to promote the oversupply of ODs thus over saturating the eye care provider market, and leading to inevitable over-reach for scope expansion of optometry. These kids out of school need to pay their student loans (which are now not commensurate with their starting income) and they will increasingly continue to poach procedures and therefore income from Ophthalmology. Right or Wrong, sleazy methods or legitimate arguments, it doesn't matter. More ODs equals more need to scope expand, and also more ODs to donate and fund PACs in order to expand a legislated profession. This is a threat to all of us OD and MD alike.
I hate to use "n=1" as an argument for that, but that really is an isolated opinion. There are plenty of ophthalmologists at the university I attend that care about a great deal of organs besides the eye, and frequently have made systemic diagnoses. There are two areas where this can pop up that I can think of off the top of my head:
1) consults -- to provide a proper consult for another service (e.g., Internal Med), one would have to know their structure, protocol, and what's important/feasible in a way that's not possible if one only has knowledge of the eye. All physicians have rotated through an IM clerkship, and (should) have a knowledge of how to provide an effective consult -- nothing is more frustrating than a consult that shows clearly no knowledge of the patient's other problems.
2) operative risk -- both in terms of anesthesia, and for a feel for when operation is worthwhile, vs when a patient's comorbidities make it silly to take his cataracts out.
It's a lot of small things, but small things done right = good patient care. Not that ODs can't do it necessarily, but the formal training is not there.
It is great to hear all the bantering about how those "slimy" ODs passed a bill under the radar.
I hope someone on this thread is a medical student at the UF to verify what I am about to tell you to show just how upstanding organized medicine is.
Dr. Alan Mendelsohn is an OMD from Hollywood Fl that in 2001 tried and fortunately failed at passing a post-op bill that would have kept ODs from managing their patients following surgery, and was instrumental in keeping ODs from prescribing orals with his deep involvement as the PAC leader of the Florida Medical Association and Florida Society of Ophthalmology.
Now, this same man is serving a 4 year sentence in jail for fraud with an involvement in a ponzi scheme that took money from individuals and bribed sate leaders to vote medicine's way on many issues (list is to long to name but you get the point, and I admit not all of it was against optometry). This money was also spent to by his mistress a house and car.
This man's son also is attending medical school at UF after never taking the MCAT and raised a huge s**t fit that was so bad that the dean of the college got fired. Obviously you can understand what kind of person we are dealing with here.
Again I know...its those dirty, not smart enough to go to med school ODs that are the problem.
I also am confident in the State board of optometry in KY will regulate what is allowed in a reasonable manner. (no OD will be doing Avastin injections and eyelid lifts)
Again, the demand for an OMD is not going to be affected by these few changes, that not to mention have low reimbursement rates.
The only question I have left is, who gave the MDs the right to be the final say on what is right vs wrong over all medical fields? I guess the members of the State Boards of Optometry are either untrustworthy or incompetent.
Forgive my ignorance, if this has been discussed elsewhere.
Has there ever been discussion of creating combined OD/MD programs for ODs or OD students that want to expand their scope to include surgical procedures? I know that for dental students who decide that they want to become oral surgeons, they can apply for program in which they earn and MD and get surgical training. I think the dental programs range from 4-6 years after dental school and include portions of medical school and residency combined into those years.
I understand why you would think this, but dental school i way more rooted in medicine than optometry. I have seen the dental curriculum my friends follow- physiology biochem pharm and anatomy might be slightly more watered down but they are still gettng a good basic science foundation, not to mention highly detailed head and neck knowledge. Therefor with the programs you are talking about for dentistry...the transition to the 2 year clinical medicine curriculum is much more natural- they have to take step 1 of boards to get there.
Except that at this point expansion of scope isn't going to help OD's. For one thing, ophthalmology is just as saturated. Second, no procedures are profitable anymore compared to seeing patients in clinic unless you're doing a lot of that procedure.
Remember that ophthalmologists have the legal right to do any procedure. How many non retina specialists are doing focal laser and intravitreal injections? Most general ophthalmologists are well trained for both, and both have great reimbursement. Yet not that many comprehensive ophthalmologists do them because the overhead is too high unless you have a large patient load that needs them.
Just wondering if you have seen the optometry curriculum, or even better than to see it, matriculate through it? With your proclaimed knowledge of curriculi, can you explain why optometry students are not getting a "good basic science foundation".
Why don't you provide an objective, side-by-side comparison between medical and optometry curricula and let the community review the information?
Additionally, the MD provided to dental students is obtained through a grueling OMFS residency that many describe as one of the most intense, 6 year programs in medicine. If ODs were interested in completing a 6 year program after a full OD program and OD residency, I don't think many MDs would object.
Just wondering if you have seen the optometry curriculum, or even better than to see it, matriculate through it? With your proclaimed knowledge of curriculi, can you explain why optometry students are not getting a "good basic science foundation".
I don't claim to know much about the optometry curriculum, but then I doubt you know much about our training. There have been a few posters on this site who have finished optometry school, then gone to medical school (vtrain comes to mind). All of them have stated that the training in medical school/internship/residency far surpasses any optometric training. They are better suited to speak on the subject than either of us.
It is well-known, however, that an ophthalmologist has more than 10 times the clinical training of an optometrist in terms of patient contact, much of which is surgical. The Kentucky Optometric Board has determined that a 32 hour course with a supervised surgical procedure on one human eye is sufficient to be certified to treat the public. The argument made is that ophthalmologists add new procedures to their practice through similar short courses. The difference is that ophthalmologists' training has a surgical foundation comprised of hundreds of varied surgical procedures, whereas optometrists' training clearly does not. If you don't have such a foundation to build on, I would argue that you cannot justify a short course for certification for any procedure.
Forgive my ignorance, if this has been discussed elsewhere.
Has there ever been discussion of creating combined OD/MD programs for ODs or OD students that want to expand their scope to include surgical procedures?
I hope that when I decide to get back to my real life I don't have over 8,000 posts on an anonymous internet site, but to indulge you... If you read the post I was responding to, it was concerning a comparison of dental and optometry pre-residency schooling. Since your leading question involves none of those things do you still want a side by side comparison?
As a first year I am taking Gross Anatomy, lab and lecture (we have to know everything superior of the diaphragm except for the arms and we have real cadavers) Integrated Optics, lab and lecture, Human Bioscience, lecture, Systemic Ocular Disease lab, Optometric Theory and Procedures, lab and lecture, Ocular Biochemistry and Physiology, lecture. As a side note, our entering class average GPA now is 3.57 and we take the same pharmacology course as medical students our second year (yet we still are too incompetent to prescribe orals in New York somehow, only 3/50 states that disallow us to do this)
(yet we still are too incompetent to prescribe orals in New York somehow, only 3/50 states that disallow us to do this)
The difference is that ophthalmologists' training has a surgical foundation comprised of hundreds of varied surgical procedures, whereas optometrists' training clearly does not.
Are you serious??? Listen to yourself rant! Hundreds of surgical procedures? So I guess you can also perform craniotomies, stents and C-sections?
You scare me more than you think....
The optometry curriculum gives excellent foundation on performing many eye surgical procedures. So yes, a 32hr course is good enough.
You should seek help from your psychiatry colleagues, that ego is not good for you....
I have assisted in C-sections, but not craniotomies or stents. Of course, I was speaking of more eye-specific surgical procedures.
Perhaps you can share with us your extensive supervised surgical training . . . on actual patients. :rolleyes:
I saw someone get LASIK on Dr. Oz. That counts, right?
I have assisted in C-sections, but not craniotomies or stents. Of course, I was speaking of more eye-specific surgical procedures.
Perhaps you can share with us your extensive supervised surgical training . . . on actual patients.
Sure thing. I have performed on several patients: SLT, ALT & MLT and a few LPIs (only because it wasn't too common).
That's just with lasers. No, I am not an "expert" in the field, but I am definitely not a wet behind the ears new graduate (OD or MD) nor am I a 'spin and grin' OD.
I may be unhappy with my profession's political & career path, but I am good at what I do and would never jeopardize my patients well being. Good luck with your cesarians....
So yes, a 32hr course is good enough.
You should hang that on your door. I'm sure patients will be lining up.
Have you performed the CXL procedure yet? On how many patients? What about the latest excimer lasers for refractive surgery? Have you used the new LenSx system yet? I wonder how and WHERE you'll learn how to.....
I guess you were already trained to do these procedures even before they originated? Wow, what a genius! I'll send my nana over to you first thing Monday morning for a demo...
While most seem to be focusing on the technical aspects of performing these procedures, it is really not that part that scares me the most. Is it technically that challenging to perform a PI or do and ALT? The truth is they are not. Of course, I have the perspective of performing other more challenging procedures such as phaco, vitrectomy etc. so this is relative but still. The real challenge, the part that involves more knowledge, experience, training and skill than anything else is knowing who to perfom these procedures on, under what circumstances, and more importantly who to NOT perform certain procedures on.
It is the why, when and who that is much more important than the how...and no 32 hour course will teach you that.