Proposed law for optometric surgery.

[Tired]

So yes, a 32hr course is good enough.

I have nothing to do with eyes, but wanted to point out that this line gave me a much-needed belly laugh.

---

Members don't see this ad.

 

[Mirror Form]

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.....

When you do hundreds and hundreds of eye surgeries during residency, you build up a good foundation for learning how to safely perform additional ocular procedures.

 

[peanutbutterman]

When ophthalmologists talk about the "foundation" that help us in learning new procedures down the road, we're talking about thousands of hours of actual patient care.

In a debate over the KY optom law, it was quoted that ophthalmology residents get 17,000 hours of patient care in their residency and internship. That assumes an 80hr work week 52 weeks/yr. I'm at a very busy residency with high surgical volume. I will end my residency with an estimated ~13,000 patient hours. That is my foundation.

This does not include my patient hours from medical school which is likely a lot closer to the estimated OD student's patient hours also quoted in the aforementioned debate: ~2000.

 

[Meibomian SxN]

When you do hundreds and hundreds of eye surgeries during residency, you build up a good foundation for learning how to safely perform additional ocular procedures.

The foundation for ODs performing the additional procedures is already there through the curriculum. Only needs clinical reinforcement. I'm sure you didn't do "100's and 100's of LASIK procedures upon completing your 3yr residency, so stop with the fluff. I'd respect you if you call this what it is and leave it as that: a turf war. Instead you just sound plain foolish.

.....I'm at a very busy residency with high surgical volume. I will end my residency with an estimated ~13,000 patient hours. That is my foundation.

This does not include my patient hours from medical school which is likely a lot closer to the estimated OD student's patient hours also quoted in the aforementioned debate: ~2000.

Who says 2,000 hrs is insufficient? Have you ever heard of" more is not always better"? Medical school is 4 yrs traditionally and now they're thinking of cutting it down to a 3yr program; also some residencies are restructuring the amount of years it was traditionally.

You egotists seem to be the only ones not able to accept change...

 

[Meibomian SxN]

I have read both threads in the opto forum and this one as well on the current subject and the profound lack of knowledge I see on the opto side is embarrassing to their profession. I am not trying to be offensive but it may come off like it and I do apologize. The example of NVI and NVG glaucoma is ridiculous. Obviously a PI would not help NVI in a pt with NVG (unless its pupillary block which is rare in NVI). This reminds me of an example the same poster posted a while ago about how he would refer a retrobulbar hematoma to a retina specialist. I see a very scary future for patients and this person keeps proving it over and over. I feel the only way people will realize what is happening is when they or someone they love literally goes blind. I know optos believe that there have never been any complications and all that but when they were given rights to Rx glaucoma drops, a whole slew of patients went blind in Oklahoma. It is just scary to imagine how many patients are going to be hurt by this. Reimbursement in medicine (no matter what field you are in) is going to decline... that will be a null point soon enough. I just feel like everyone is looking for a pot of gold that will not be there by the time they reach their goals. I have a good friend who is in PA school and the first thing they said in his school before they started was "You guys do 4 years of medical school in 2 years." They are fed this from the beginning. I actually tutor him and the amount of information they go through barely skims the surface of what MDs go through. I know this because, 3 years out of medical school I still remember all the basics and this is what he is tested on. But I digress, these grad school teach their students that they are have an amazing scope and could do whatever they want once they get out, but unfortunately thats not reality. Doing thing you are not TRAINED TO DO ON REAL PATIENTS is dangerous and people will get hurt. You are not going to be ready to handle the complications that can and will eventually happen...

Fact remains: Change is eminent. So regardless what you "think" or "feel" with your theories, ODs will and are performing minimally invasive surgeries. Live with it....

 

[Tired]

Fact remains: Change is eminent. So regardless what you "think" or "feel" with your theories, ODs will and are performing minimally invasive surgeries. Live with it....

Sure, because the guy who gives me at my glasses at Wal-Mart says so.

Question: If the old lady who greets me at the door says I can bill Medicare patients in excess of what the program will reimburse, can that be true too?

 

[jdh71]

I have nothing to do with eyes, but wanted to point out that this line gave me a much-needed belly laugh.

This thread makes me wonder if us internists could get involved in this eye surgery stuff if all we need a 32 hours course . . .

 

[Shnurek]

Sure, because the guy who gives me at my glasses at Wal-Mart says so.

Why would you go to Wal-Mart to get your eyes checked? Shows how smart you are...

 

[Tired]

Why would you go to Wal-Mart to get your eyes checked? Shows how smart you are...

I do go to Wal-Mart. They are fast, friendly, and inexpensive.

There's a reason the whole "independent optometrist office" is dying.

 

[Tired]

This thread makes me wonder if us internists could get involved in this eye surgery stuff if all we need a 32 hours course . . .

They could hold the course at a Holiday Inn Express!

 

[200UL]

Why would you go to Wal-Mart to get your eyes checked? Shows how smart you are...

Yes - what is wrong with going to walmart for an eye exam and glasses or contacts? Are the contact lenses sold at walmart inferior to those sold in my office?

I know of several outstanding optometrists who work for walmart....

Please explain why a 20 year old with healthy eyes / no systemic conditions cannot receive eye care at walmart?

 

[Mirror Form]

The foundation for ODs performing the additional procedures is already there through the curriculum. Only needs clinical reinforcement. I'm sure you didn't do "100's and 100's of LASIK procedures upon completing your 3yr residency, so stop with the fluff. I'd respect you if you call this what it is and leave it as that: a turf war. Instead you just sound plain foolish.

First, I did refractive surgery (intralase lasik and PRK) on over a hundred eyes during residency. That's not the norm, but lasik is still easy for ophthalmologists to learn b/c we have a foundation of hundreds of eye surgeries to build on. It seems like you're trying really hard to dodge that issue. There is certainly a turf war going on, but this is a lot more than just a turf war. If you think that's all it is, then you have no clue what it takes to perform surgery safely.

 

[Mirror Form]

Please explain why a 20 year old with healthy eyes / no systemic conditions cannot receive eye care at walmart?

Because when they develop a eye problem like glaucoma, it never gets picked up. That's not the case with all the optoms who work at walmart of course, but I've seen it happen several times.

If you're going to get an eye exam, then you might as well get a decent eye exam.

 

[Shnurek]

Because when they develop a eye problem like glaucoma, it never gets picked up. That's not the case with all the optoms who work at walmart of course, but I've seen it happen several times.

If you're going to get an eye exam, then you might as well get a decent eye exam.

There is a huge conflict of interest when it comes to ripping people off and making sure they buy spectacles that are in fact lower quality or unnecessary, or CL's that may not be the best for your eyes and your refraction is a half-assed rushed effort. Also some OD's are bitched at because they dilate people and then they cannot buy anything at the store because they cannot see well.

I think the heart of the problem with optometry lies in that there are thousands of highly educated individuals that simply cannot walk away to another field. They are "stuck" in a sense. So what happens? They are forced to appeal the law and expand it to maintain a stable career. Your career is what puts bread on the table. It is your life and ODs won't go down easily.

E.g. many cardiac surgeons walked away from doing bypasses because stents became the norm. Optometrists do not have this luxury without huge sacrifice.

 

[badasshairday]

The optometry curriculum gives excellent foundation on performing many eye surgical procedures. So yes, a 32hr course is good enough.

lmao. Medical curriculum gives excellent foundation in performing eye exams and refraction, so we should be able to do refraction with a 32 hour course. The is surely good enough.

 

[Shnurek]

lmao. Medical curriculum gives excellent foundation in performing eye exams and refraction, so we should be able to do refraction with a 32 hour course. The is surely good enough.

Listen, if you guys don't know the details then don't talk. Many optometry schools in the south have rotations where students go to Oklahoma and practice lasers on real patients. ODs down there are already experienced in this so a 32 hour refresher course isn't so crazy. Also, optometry residencies in Oklahoma have laser training on patients. I highly doubt the Kentucky board would let some OD with absolutely no idea how to use lasers take the 32 hr course and just get certified. It would cause crazy malpractice issues and would be a detriment to the profession. You take ODs for complete fools?

 

[mydodger]

This thread makes me wonder if us internists could get involved in this eye surgery stuff if all we need a 32 hours course . . .

Back off jackhole! Don't you know this is just a turf war!? Of course you could do cataracts with a training course, all these ophthos just do hundreds of eye surgeries in residency because they love the pay and the hours! They know you internists could do phacos and laparoscopic appendectomies, they aren't worried about patients it's just their bottom line!

 

[JaggerPlate]

I have nothing to do with eyes, but wanted to point out that this line gave me a much-needed belly laugh.

Follow his posts for a bit ... this isn't even one of the greatest hits.

I think the heart of the problem with optometry lies in that there are thousands of highly educated individuals that simply cannot walk away to another field. They are "stuck" in a sense. So what happens? They are forced to appeal the law and expand it to maintain a stable career. Your career is what puts bread on the table. It is your life and ODs won't go down easily.

So moral of the story: If your profession is ruined by oversupply and big chains ruining the independent model, you should grease politicians to bend laws and make money??? I wonder why the AOA doesn't utilize this slogan when pitching the idea to the general public.

My Dad is in sales and says it's really rough right now ... I wonder if he could lobby a few congressmen to "appeal" a law and allow people with a BS in Biz Econ to shoot botox and do breast augs??? I mean, it would put food on the table, right?

I'm not making enough money ... change the law so I can make more. Are you joking?

I highly doubt the Kentucky board would let some OD with absolutely no idea how to use lasers take the 32 hr course and just get certified

Highly doubt? Until there is something, in writing, preventing it ... assumptions don't mean much.

 

[MstaKing10]

Listen, if you guys don't know the details then don't talk. Many optometry schools in the south have rotations where students go to Oklahoma and practice lasers on real patients. ODs down there are already experienced in this so a 32 hour refresher course isn't so crazy. Also, optometry residencies in Oklahoma have laser training on patients. I highly doubt the Kentucky board would let some OD with absolutely no idea how to use lasers take the 32 hr course and just get certified. It would cause crazy malpractice issues and would be a detriment to the profession. You take ODs for complete fools?

again, the issue isn't weather you can learn the technical skills to perform a laser. I'm sure after doing a few on real patients and a refresher course you may be qualified to perform them (I have my doubts about that but just humoring you for the sake of making an argument). The real issue is not the technical skills required but more importantly the knowledge and experience to know on who to perform them on, in what situations, when to avoid them, and how to manage them pre and post op for extended periods of time. Your training simply cannot provide you that most important bit because it is not long enough or detailed enough in this regard. Before you go on about my lack of understanding of optometric training, you should know that my sister in law and cousin are both optometrists, recently graduated from very respectable optometry schools. While I have nothing but the utmost respect for them and their abilities, I would not want them performing these procedures, nor would they for that matter.

 

[Visionary]

Listen, if you guys don't know the details then don't talk. Many optometry schools in the south have rotations where students go to Oklahoma and practice lasers on real patients. ODs down there are already experienced in this so a 32 hour refresher course isn't so crazy. Also, optometry residencies in Oklahoma have laser training on patients. I highly doubt the Kentucky board would let some OD with absolutely no idea how to use lasers take the 32 hr course and just get certified. It would cause crazy malpractice issues and would be a detriment to the profession. You take ODs for complete fools?

This is, in fact, exactly the case. There is no requirement that the optometrist have prior laser experience.

 

[Visionary]

again, the issue isn't weather you can learn the technical skills to perform a laser. I'm sure after doing a few on real patients and a refresher course you may be qualified to perform them (I have my doubts about that but just humoring you for the sake of making an argument). The real issue is not the technical skills required but more importantly the knowledge and experience to know on who to perform them on, in what situations, when to avoid them, and how to manage them pre and post op for extended periods of time. Your training simply cannot provide you that most important bit because it is not long enough or detailed enough in this regard. Before you go on about my lack of understanding of optometric training, you should know that my sister in law and cousin are both optometrists, recently graduated from very respectable optometry schools. While I have nothing but the utmost respect for them and their abilities, I would not want them performing these procedures, nor would they for that matter.

This. I knew a heck of a lot of retina coming out of residency, but it was gleaned from relatively short rotations on the retina service and scattered retina exposure in the general clinics. The long-term follow-up was simply not there. That's where you get a real feel for disease management. Fellowship was a tremendous leap forward in that regard. That's where the clinical exposure of ophthalmology absolutely trumps optometry. Experience matters, my friends.

 

[speyeder]

I think the heart of the problem with optometry lies in that there are thousands of highly educated individuals that simply cannot walk away to another field. They are "stuck" in a sense. So what happens? They are forced to appeal the law and expand it to maintain a stable career. Your career is what puts bread on the table. It is your life and ODs won't go down easily.

I love this logic. The AOA fails to stop the unnecessary opening of new schools and fails to address the oversupply issue, therefore, it is "forced" to expand its scope of practice through unethical means, even though there is no need for additional eye surgeons. I hope you won't be a hypocrite about this if opticians win the right to refract and fit contacts.

 

[Meibomian SxN]

This. I knew a heck of a lot of retina coming out of residency, but it was gleaned from relatively short rotations on the retina service and scattered retina exposure in the general clinics. The long-term follow-up was simply not there. That's where you get a real feel for disease management. Fellowship was a tremendous leap forward in that regard. That's where the clinical exposure of ophthalmology absolutely trumps optometry. Experience matters, my friends.

How many people went blind in Oklahoma with their laser privileges? Its been law for more than 10years so its the perfect example to show elected officials that the "all knowing MD scare" is just that, a scare tactic.

meet you at the next Holiday Inn Express or Motel 6 conference homie!

 

[Shnurek]

I love this logic. The AOA fails to stop the unnecessary opening of new schools and fails to address the oversupply issue, therefore, it is "forced" to expand its scope of practice through unethical means, even though there is no need for additional eye surgeons. I hope you won't be a hypocrite about this if opticians win the right to refract and fit contacts.

Why would you want opticians to refract anyway? You wouldn't mind if patients walked away with a new pair of glasses but also with undetected glaucoma? This to me is "unethical" as you put it. Therefore allowing opticians to refract would be unethical for patients so it would not be hypocritical for optometrists to disallow it. I love your logic too.

The fact that the AMA has orthopedic surgeons testifying against optometrists in Albany, NY to not give us oral medication rx rights shows us that it is merely a turf war about $$$. Your comments about letting high school graduate opticians refract shows you don't give a damn about patients or their conditions. Which is honestly not at all surprising to me as most people go the MD route for the respect/money.

 

[Shnurek]

How many people went blind in Oklahoma with their laser privileges? Its been law for more than 10years so its the perfect example to show elected officials that the "all knowing MD scare" is just that, a scare tactic.

Yup, Oklahoma Optometrists have been billing surgical codes for 20 years

 

[JaggerPlate]

"all knowing MD scare" is just that, a scare tactic.

Which is honestly not at all surprising to me as most people go the MD route for the respect/money.

Conspiracy theories! Always the most thorough and foolproof line of logic. You guys have really lost it now. There was a point where this discussion actually had merit; now it's just a few bitter ODs/OD students ranting about 'the future,' 'dealing with it,' 'the training already being there (32 hours),' and changing laws to 'make money (though it's the evil MDs who are in it for the money, right?)'

You've completely lost all merit in this argument and I'm 90% certain the average OD would be embarrassed by the behavior demonstrated by a select few bitter, regretful members of their own guild.

Pathetic.

 

[Meibomian SxN]

....You've completely lost all merit in this argument and I'm 90% certain the average OD would be embarrassed by the behavior demonstrated by a select few bitter, regretful members of their own guild.
Pathetic.

Does it matter what the 90% have to say? Lets deal with facts and not your sour emotions! Whether MDs/ODs like it or not, the profession is moving itself into the turf of some laser & injection procedures. As was the case x20yrs ago with therapeutics, so will be the case here.

Live with it!

I love this logic. The AOA fails to stop the unnecessary opening of new schools and fails to address the oversupply issue, therefore, it is "forced" to expand its scope of practice through unethical means, even though there is no need for additional eye surgeons. I hope you won't be a hypocrite about this if opticians win the right to refract and fit contacts.

I won't. I'll be busy giving my POAG Px's the "Drop, drop zap" regimen! Might add a couple zipped up NVG Px's on that list too if I'm "lucky" LMAO!

 

[DrOptimist]

.

 

[DrOptimist]

.

 

[JaggerPlate]

Does it matter what the 90% have to say? Lets deal with facts and not your sour emotions! Whether MDs/ODs like it or not, the profession is moving itself into the turf of some laser & injection procedures. As was the case x20yrs ago with therapeutics, so will be the case here.

Live with it!

Lol ... 'live with it;' wish I'd brought this up before.

I can't tell which thread is more amusing - the one where you continually rant about forcing unwanted and unsafe change because you made a career miscalculation (something you've blatantly admitted to on these boards before) or the one (in OD) where you continually muddle ophthalmology facts and get shut down by fellow ODs, ophthalmologists, etc (all in an attempt to prove your merit).

Regardless, it's pathetic, and, as I said before, 95% of sane, content ODs would call you a fool (much like a colleague is doing in the OD thread you created).

EDIT: Furthermore, as far as 'facts' versus 'emotions' are concerned (hilarious enough in and of itself, but I digress), I think it may be a bit pre-mature to file your 'facts' and start playing Jedi knight with lasers just yet.

 

[Meibomian SxN]

....Why go to a low level optometry who screens for diseases when you can just go to an comprehensive ophthalmologist for one stop shop whos prices are comparable these days. If healthcare ever budges towards being more like a free market and ophthalmologists and optometrists are directly competing for patients, who do you think patients will go to if the cost difference is negligible? hmmmm.....

We don't screen patients at the practice I'm at. We diagnose treat and manage them.

I'm sure companies like SightPath will make it easier for us to "compete". And being that you and the others failed your "drop the ego 101" course, I'm sure we can guess where the Px's will go....

....Regardless, it's pathetic, and, as I said before, 95% of sane, content ODs would call you a fool (much like a colleague is doing in the OD thread you created)......

Call me what you want and get your knickers all bunched up like your ego homies, but one thing remains: I'm a Jedi Knight in 2 states and more to come....and by the time you graduate and aquire that "12,000hrs of foundation", I'll be learning how to use the latest femtosecond laser for refractive AND maybe cataract purposes! All at the 32hr fun in the sun weekend course! Holla back!

 

[JaggerPlate]

Call me what you want and get your knickers all bunched up like your ego homies

LOL, yup ... all about the 'MD ego.' Forget the fact that you believe you can attain the skill of a 4 year surgical residency (post 4 years medical education) in a 32 hour course and the fact that you've continually fumbled facts that most residents and fellows seem to correct with ease YET refuse to admit any sort of knowledge gap ... it's all about the 'MD ego.'

I wonder if you even hear yourself at this point.

but one thing remains: I'm a Jedi Knight in 2 states and more to come....

2/50 ... with 1 piece of legislation still not finalized. Definitely time to pop the champagne. Trust me, I have a lot of faith in your professional body's apparent lack of ethics and the greed of misinformed politicians, but I don't exactly think you should be dancing on rooftops quite yet.

and by the time you graduate and aquire that "12,000hrs of foundation", I'll be learning how to use the latest femtosecond laser for refractive AND maybe cataract purposes! All at the 32hr fun in the sun weekend course! Holla back!

Foolish 12,000 hours of hands-on clinical education! 'MD ego' at its finest!

Additionally, I have no doubt that you'll move to one of the very, very few states where you can act like a big boy and play with a laser to try and satisfy your crippling insecurity. I wonder if this will make you feel better about the situation? Hopefully!

However, hopefully this will satisfy your urge to become something 'else,' and you'll leave it at that and not turn lasers on medicare patients after your 32 hour certification course at the La Quinta Inn, KY.

Again, I hope more mature, adult ODs chime in here soon and properly represent their chosen profession. Because right now, you and a select few are making ODs look like insecure fools who openly admit they care more about money and settling some score with egotistical physicians than patient care and ethical practice.

Pathetic.

 

[speyeder]

Why would you want opticians to refract anyway? You wouldn't mind if patients walked away with a new pair of glasses but also with undetected glaucoma? This to me is "unethical" as you put it. Therefore allowing opticians to refract would be unethical for patients so it would not be hypocritical for optometrists to disallow it. I love your logic too.

The fact that the AMA has orthopedic surgeons testifying against optometrists in Albany, NY to not give us oral medication rx rights shows us that it is merely a turf war about $$$. Your comments about letting high school graduate opticians refract shows you don't give a damn about patients or their conditions. Which is honestly not at all surprising to me as most people go the MD route for the respect/money.

Hey genius, did I write that I wanted opticians to refract? I never said I supported that. I'm simply saying that if optometry expands their scope of practice using unethical means, then don't cry foul if opticians do the same by invading optometry's turf.

 

[Shnurek]

LOL, yup ... all about the 'MD ego.' Forget the fact that you believe you can attain the skill of a 4 year surgical residency (post 4 years medical education) in a 32 hour course

First of all its a 3 year mostly surgical residency. You learn everything OD's already know in 3 years PLUS surgery. And OD's teach ophthalmology PGY-2's how to use slit lamps and B.I.O.'s etc. Seems like a short time period to me. I'd think that eyes would be more important and they'd have you guys do longer residencies but apparently its not as important as general surgery in terms of length of training.

Secondly, please get into your DO ophthalmology residency, then you'll have my respect, otherwise please stop blabbing.

 

[Shnurek]

Hey genius, did I write that I wanted opticians to refract? I never said I supported that. I'm simply saying that if optometry expands their scope of practice using unethical means, then don't cry foul if opticians do the same by invading optometry's turf.

Hah, maybe not you specifically but I doubt you'd stand in their way. Ophthalmologists love teaming up with opticians to try to subdue the annoying optometrists in a two front war. There are multiple accounts of opticians using OMD licenses to refract patients when for example, the OMD is 2 hours away in a different office and almost never shows up at the optician's office.

 

[speyeder]

Hah, maybe not you specifically but I doubt you'd stand in their way. Ophthalmologists love teaming up with opticians to try to subdue the annoying optometrists in a two front war. There are multiple accounts of opticians using OMD licenses to refract patients when for example, the OMD is 2 hours away in a different office and almost never shows up at the optician's office.

Never mind if I support this or not. Do you? What if opticians had to take a "32 hour" course on refracting and contact lens dispensing? Still no? Well now you know how ophthalmologists feel when ODs claim that weekend laser and minor surgery courses make them competent to perform these procedures.

 

[Shnurek]

There is a huge disparity in educational requirements between an optician and an optometrist. The disparity between an optometrist and an ophthalmologist is not as great.

OK lets just all agree that the healthcare system in America is f***ed. Lets all just become homeopaths and prescribe dandelion nectar diluted 10^6 times and get mad $$.

In all honesty though if optometric laws become equalized in terms of states then nationalized residency programs will provide the necessary extra training for more invasive procedures. For now it is on an individual OD basis.

 

[JaggerPlate]

First of all its a 3 year mostly surgical residency.

Well, med/surg internship + 3 years ... 4 years total post-graduate training.

And OD's teach ophthalmology PGY-2's how to use slit lamps and B.I.O.'s etc. Seems like a short time period to me. I'd think that eyes would be more important and they'd have you guys do longer residencies but apparently its not as important as general surgery in terms of length of training.

I'm confused ... a "3 year" (we'll focus just on the actual ophthalmology training) eye med/surg residency at an academic medical center with a huge patient load and lots of pathology isn't enough training for a DO/MD to properly treat, but a 0-1 year OD residency (which is likely far less regulated) + a 32 hour laser training course is sufficient???

I'm not even trying to be flippant here ... I'm honestly just confused about what you're saying.

Secondly, please get into your DO ophthalmology residency, then you'll have my respect, otherwise please stop blabbing.

What makes you think I'm interested in Ophthalmology? Despite what you may think, many medical students, residents, and attendings look at this issue as far more than people encroaching upon a desired field and decreased salary. I discuss these issues because they are disadvantageous to patients and disruptive to the physician profession as a whole.

Furthermore, I'm not overtly concerned about your respect. A select few ODs and OD trainees have really demonstrated (to me at least) a total lack of respect for their own profession, patient care, and physician training ('we should bend the laws to make more money,' 'whatever puts food on the table,' 'this whole thing is an MD conspiracy to protect ego,' etc), and having the approval of this type of mentality isn't important to me.

So feel free to keep it, and I'll keep 'blabbing.'

 

[JaggerPlate]

Never mind if I support this or not. Do you? What if opticians had to take a "32 hour" course on refracting and contact lens dispensing? Still no? Well now you know how ophthalmologists feel when ODs claim that weekend laser and minor surgery courses make them competent to perform these procedures.

There's a name for that ... "giving someone a taste of their own, something??"

What is it again?

 

[Shnurek]

I'm confused ... a "3 year" (we'll focus just on the actual ophthalmology training) eye med/surg residency at an academic medical center with a huge patient load and lots of pathology isn't enough training for a DO/MD to properly treat, but a 0-1 year OD residency (which is likely far less regulated) + a 32 hour laser training course is sufficient???

You are forgetting the focused nature of an optometric education. OD graduates come out knowing exactly how to provide medical and visual eye care. Let me remind you they spend 4 years learning just about the eye. So thats 4-7 years of training. (4 years of opto schools, 1 year residencies, 2 year fellowships) MD/DO's go through a lot of extraneous rotations and have to memorize and spit out a lot of extraneous information that they will never use in their lifetimes as an ophthalmologist. (This was confirmed by your colleagues stating that they are merely "eye dentists").

So I'd say those 4 years in medical school is more like 2 years if you cut it down to what they actually use in practice. 2 years + 1 year surgical/med residency which is NOT focused on the eye so I'll give the equivalency of that to 0.5 years(rough numbers). So 2.5 + 3 years ophthalmology residency + 2 year fellowships so that's 5.5-7.5 years so comes out to about the same but that is not adjusted for neuroplasticity as I shall discuss below. I'll agree that the training is more rigorous that's why OD's should not be doing cataract surgery, enucleations or other very invasive procedures.

Also not to mention OMD's never take 2 years of formal optics like optometrists take. How can you do an accurate visual field if you cannot do an accurate refraction?

And finally my last point is one that is centered on neurology. Look at other country's physician training programs. Their medical studies start earlier at a time when the neuroplasticity of the young mind is greater. Starting to specialize in the field you wish to pursue for your lifetime is superior when done at a younger age. Nobody has disputed this point of mine yet.

Optometry is the future.

 

[JaggerPlate]

You are forgetting the focused nature of an optometric education. OD graduates come out knowing exactly how to provide medical and visual eye care. Let me remind you they spend 4 years learning just about the eye. So thats 4-7 years of training. (4 years of opto schools, 1 year residencies, 2 year fellowships) MD/DO's go through a lot of extraneous rotations and have to memorize and spit out a lot of extraneous information that they will never use in their lifetimes as an ophthalmologist. (This was confirmed by your colleagues stating that they are merely "eye dentists").

So I'd say those 4 years in medical school is more like 2 years if you cut it down to what they actually use in practice. 2 years + 1 year surgical/med residency which is NOT focused on the eye so I'll give the equivalency of that to 0.5 years(rough numbers). So 2.5 + 3 years ophthalmology residency + 2 year fellowships so that's 5.5-7.5 years so comes out to about the same but that is not adjusted for neuroplasticity as I shall discuss below. I'll agree that the training is more rigorous that's why OD's should not be doing cataract surgery, enucleations or other very invasive procedures.

Also not to mention OMD's never take 2 years of formal optics like optometrists take. How can you do an accurate visual field if you cannot do an accurate refraction?

And finally my last point is one that is centered on neurology. Look at other country's physician training programs. Their medical studies start earlier at a time when the neuroplasticity of the young mind is greater. Starting to specialize in the field you wish to pursue for your lifetime is superior when done at a younger age. Nobody has disputed this point of mine yet.

LOL 1

I can't even comment on the enormous number of liberties and assumptions you've taken here between the two models and how these inane calculations are based off nothing besides trying to make your own point.

Optometry is the future.

LOL 2

You guys have truly lost it. Future of what? If all the OD optimists want is to leave the dying corpse of Optometry at the door and continually push and shove until it's 'Ophthalmology light,' what kind of future is this? Sounds like the future of those who thought Optometry was one thing, realized it wasn't Ophthalmology, and want to change the system to their perspective and pretend it's some logical progression of change.

Want your career to have a future? Stop the huge oversupply glut of new ODs; stop the degree mills that are ruining any sort of competition you guys have in the market; quit practicing in Wal Mart; demonstrate to patients that you offer a service that can't be obtained through channels like Lens Crafters, 1-800-Optometry (err whatever), clinics in Sam's Club, etc.

This is preserving the future of your career. What you propose is using shady, unethical methods to push your way into an arena where you have no business with an admitted TOTAL disregard for any standard of care.

If this is what you want ... good luck. I highly recommend cutting your losses and going to medical school and hoping for a Ophthalmology residency. It will honestly be far easier and quicker than some imagined revolution where ODs are laser eye surgeons in all 50 states in the next 5 years.

However, I still contend that a good majority of ODs out there want to practice Optometry and would be embarrassed by the side-show in these threads and the shady push into surgery. I know I'd be.

 

[speyeder]

There is a huge disparity in educational requirements between an optician and an optometrist.

Let me guess. You feel that if opticians want to refract and dispense contacts, they should go to optometry school and go through the same training you do, right? Sound like a familiar argument?

 

[Slide]

Secondly, please get into your DO ophthalmology residency, then you'll have my respect, otherwise please stop blabbing.

I find this quite ironic you say this, when
a) the poster you are talking about has more clinical experience in both medicine and ophthalmology than you, and
b) despite saying that, you have a total disregard and lack of respect to those senior to your position if they run even slightly contrary to your opinions.

You are forgetting the focused nature of an optometric education. OD graduates come out knowing exactly how to provide medical and visual eye care. Let me remind you they spend 4 years learning just about the eye. So thats 4-7 years of training. (4 years of opto schools, 1 year residencies, 2 year fellowships) MD/DO's go through a lot of extraneous rotations and have to memorize and spit out a lot of extraneous information that they will never use in their lifetimes as an ophthalmologist. (This was confirmed by your colleagues stating that they are merely "eye dentists").

Actually I'm starting on my ophthalmology rotations as a PGY-1 and I'm still using a good portion of the clinical foundation I worked on as a medical student and on my medicine ward months. It's also pretty important in understanding the developments behind new medications that can affect the eye, intentionally or not. Once you build a clinical framework of knowledge, it's easier to pick up on certain fields. Plus, your eye is connected to your body, you can't always treat it in isolation. If you remember from your anatomy course, things called nerves, arteries, veins, bone, muscle, etc. interconnect the eye and rest of the body. The whole body has to be accounted for sometimes for when considering eye pathology.

Office work-up like using a slit lamp or a phoropter can be picked up easily as well. Hell, one of the techs in our department refracts just as well as any other optometrist in our city, and she only went to nursing school.

So I'd say those 4 years in medical school is more like 2 years if you cut it down to what they actually use in practice. 2 years + 1 year surgical/med residency which is NOT focused on the eye so I'll give the equivalency of that to 0.5 years(rough numbers). So 2.5 + 3 years ophthalmology residency + 2 year fellowships so that's 5.5-7.5 years so comes out to about the same but that is not adjusted for neuroplasticity as I shall discuss below.

This is a ridiculous comparison. A lot of the skills you pick up during the basic science and clinical years helps a lot during ophthalmology. The pathophysiologic process you learn in medical school can be applied in medicine, surgery, psychiatry, and ophthalmology. Knowing how to present well and to recognize sick and non-sick patients has universal utility in any field of medicine. The whole point of the intern year is to develop your clinical instincts about patients; you can't always refer to a textbook or pubmed for your next decision.

The neuroplasticity argument is also really bunk in the time frame you're talking about. By the time you're around 21 your neuroplasticity isn't going to be any significantly better than it will be four or five years later. To take advantage of this process you'd have to start vocational school at a much younger age.

I'll agree that the training is more rigorous that's why OD's should not be doing cataract surgery, enucleations or other very invasive procedures.

Something I think we can all agree upon.

 

[MastahRiz]

Who exactly teaches the 32 hour course that was being discussed above? Is it MDs or ODs?

 

[MstaKing10]

You are forgetting the focused nature of an optometric education. OD graduates come out knowing exactly how to provide medical and visual eye care. Let me remind you they spend 4 years learning just about the eye. So thats 4-7 years of training. (4 years of opto schools, 1 year residencies, 2 year fellowships) MD/DO's go through a lot of extraneous rotations and have to memorize and spit out a lot of extraneous information that they will never use in their lifetimes as an ophthalmologist. (This was confirmed by your colleagues stating that they are merely "eye dentists").

So I'd say those 4 years in medical school is more like 2 years if you cut it down to what they actually use in practice. 2 years + 1 year surgical/med residency which is NOT focused on the eye so I'll give the equivalency of that to 0.5 years(rough numbers). So 2.5 + 3 years ophthalmology residency + 2 year fellowships so that's 5.5-7.5 years so comes out to about the same but that is not adjusted for neuroplasticity as I shall discuss below. I'll agree that the training is more rigorous that's why OD's should not be doing cataract surgery, enucleations or other very invasive procedures.

Also not to mention OMD's never take 2 years of formal optics like optometrists take. How can you do an accurate visual field if you cannot do an accurate refraction?

And finally my last point is one that is centered on neurology. Look at other country's physician training programs. Their medical studies start earlier at a time when the neuroplasticity of the young mind is greater. Starting to specialize in the field you wish to pursue for your lifetime is superior when done at a younger age. Nobody has disputed this point of mine yet.

Optometry is the future.

1. The information that you feel is "extraneous" is in fact what distinguishes MD's from OD's, that is, our knowledge of general medical and surgical fields and their applications to ophthalmology. Not a day goes by that I don't use it in clinic, operating rooms, consulting with other physicians etc. That fact that you see this as extraneous only further demonstrates your ignorance of the importance of this knowledge

2. Not sure about your funny math, but I don't believe there is any equivalency in our training based on your flawed calculations

3. Keep in mind it is not only the acquisition of knowledge which makes for a great physician. In fact, I know plenty of smart individuals with terrific memories who make awful docs. It is the application, synthesis, and practice of this knowledge that makes for a skilled physician. This only comes with time, maturity and experience. The latter far outweighs the neuroplasticity issue you speak of.

 

[Mirror Form]

Whether MDs/ODs like it or not, the profession is moving itself into the turf of some laser & injection procedures. As was the case x20yrs ago with therapeutics, so will be the case here.

Most comprehensive ophthalmologists do zero injections and few lasers despite adequate training for both. The problem is the economics. How many OD's do you think will actually being lasers and injections?

What percentage?

 

[Shnurek]

Most comprehensive ophthalmologists do zero injections and few lasers despite adequate training for both. The problem is the economics. How many OD's do you think will actually being lasers and injections?

What percentage?

Even doing a few injections for chalazions every month is better than having your hands tied. Injections are not that expensive and you can just buy them and administer them. Lasers are different because they are very expensive but some people will still buy them just so they know they can perform these procedures themselves and have the satisfaction in doing so. Honestly, if more OMDs moved to rural areas where ODs do most of the providing then these rural ODs who are leading the pack wouldn't need to.

 

[Slide]

Even doing a few injections for chalazions every month is better than having your hands tied. Injections are not that expensive and you can just buy them and administer them. Lasers are different because they are very expensive but some people will still buy them just so they know they can perform these procedures themselves and have the satisfaction in doing so. Honestly, if more OMDs moved to rural areas where ODs do most of the providing then these rural ODs who are leading the pack wouldn't need to.

This is extremely false. Our state has a huge rural population but the people in these rural areas have no problem coming to our hospital for procedures. If your doctors are known for their competence, they will be willing to spend a few more hours on the road for better treatment.

The point about buying lasers is also bunk. You may feel satisfaction when you buy your first laser but when you still can't pay it off after 10 years you will feel stupid. It's simply easier to refer patients to someone who has experience in a major center doing this, and it's better patient care too. Even so, ODs won't be flocking to rural areas for the same reasons OMDs aren't flocking to some rural areas; it's just not nice living there. You really need to rethink your logic on several posts.

 

[Shnurek]

Even so, ODs won't be flocking to rural areas for the same reasons OMDs aren't flocking to some rural areas; it's just not nice living there. You really need to rethink your logic on several posts.

I mean that's subjective. Some people enjoy the boonies some people enjoy smelling the bums in the city. Its your own personal preference. My reasoning is also subjective but hey at least I stirred up some responses

 

[JaggerPlate]

Even doing a few injections for chalazions every month is better than having your hands tied. Injections are not that expensive and you can just buy them and administer them. Lasers are different because they are very expensive but some people will still buy them just so they know they can perform these procedures themselves and have the satisfaction in doing so.

If these lasers are anything like other 'lasers' I've encountered/read about in clinical medicine, they cost thousands, upon thousands of dollars and actually purchasing one just to have the satisfaction of training is annual balance sheet suicide.

Why would anyone do this?

Honestly, if more OMDs moved to rural areas where ODs do most of the providing then these rural ODs who are leading the pack wouldn't need to.

Do you have any conclusive proof that ODs are more likely to practice in rural and underserved areas? I hear this argument with a lot of health professions seeking scope expansion, but once new privileges are granted, the new practitioners flock to the cities like everyone else. Is there any sort of break down in Oklahoma (being the official OD laser state) that shows a greater number of ODs performing laser procedures in rural/underserved areas compared to larger urban/suburban locales?