So much for only a few optometrists seeking surgical rights. Look at New Mexico!

[Andrew_Doan]

Press Release from the AAO - 2/18/2005

The optometrists are backing a campaign that would allow them to perform several laser procedures, including laser posterior capsulotomy, laser trabeculoplasty, laser irridotomy, photorefractive keratectomy and phototherapeutic keratectomy. Alarmingly, this is just the beginning. They also want the right to slice, including the removal of potentially cancerous growths on the eyelid. The New Mexico Ophthalmological Society is fighting back hard, but our help is needed. The Surgical Scope Fund provides assistance to states facing such threats to patient care. With your help and support, we will ensure surgery by surgeons for all Americans.

http://www.abqtrib.com/albq/cda/article_print/0,2558,ALBQ_19866_3517831_ARTICLE-DETAIL-PRINT,00.html

What happened to only a 'few' optometrists wanting to do surgery?

To the optometrists sitting back and watching, your apathy is your support of the state-by-state surgical expansion. If you truly don't care about surgical rights, then this is the prime example of 'bystander apathy'.

For the optometrists who are dreaming to do surgery, I know these developments excites you.

If you don't know this terminology, then Google it! http://www.google.com/search?hl=en&lr=&q=bystander+apathy

---

Members don't see this ad.

 

[John_Doe]

Yesterday optometry won the house hearings in NM 8-4; hopefully this gets stopped soon and not turn into another OK.

Press Release from the AAO - 2/18/2005

The optometrists are backing a campaign that would allow them to perform several laser procedures, including laser posterior capsulotomy, laser trabeculoplasty, laser irridotomy, photorefractive keratectomy and phototherapeutic keratectomy. Alarmingly, this is just the beginning. They also want the right to slice, including the removal of potentially cancerous growths on the eyelid. The New Mexico Ophthalmological Society is fighting back hard, but our help is needed. The Surgical Scope Fund provides assistance to states facing such threats to patient care. With your help and support, we will ensure surgery by surgeons for all Americans.

http://www.abqtrib.com/albq/cda/article_print/0,2558,ALBQ_19866_3517831_ARTICLE-DETAIL-PRINT,00.html

What happened to only a 'few' optometrists wanting to do surgery?

To the optometrists sitting back and watching, your apathy is your support of the state-by-state surgical expansion. If you truly don't care about surgical rights, then this is the prime example of 'bystander apathy'.

For the optometrists who are dreaming to do surgery, I know these developments excites you.

If you don't know this terminology, then Google it! http://www.google.com/search?hl=en&lr=&q=bystander+apathy

 

[JR]

I found this on the NM Legislature website.

http://legis.state.nm.us/Sessions/05 Regular/bills/house/HB0199.pdf

"practice of optometry" means: ...the use of surgical procedures and
injections for the correction, relief, treatment or referral of
visual defects or abnormal conditions of the human eye and its
adnexa, including the use of an injection to treat anaphylactic
reaction but excluding full thickness incision surgery, vitreo
retinal surgery or intraocular injections or retro-bulbar
injections in the treatment of eye disease...

Well, at least they won't be allowed fix retinal detachments.


The board shall issue certification for use of analgesic medications, including
schedules III through V controlled substances, as provided in
the Controlled Substances Act] except for those classified as
Schedule I or II controlled substances in the Controlled
Substances Act.
The board shall issue certification for the
use of oral pharmaceutical agents as set forth in Subsection
A of this section to optometrists [currently] who were
licensed by the board prior to July 1, 1996 and who are
certified for the use of topical ocular pharmaceutical
agents. To be certified, an optometrist shall submit to the
board proof of having satisfactorily completed a course in
pharmacology as applied to optometry, with particular
emphasis on the administration of oral pharmaceutical agents
for the purpose of examination of the human eye, and analysis
of ocular functions and treatment of visual defects or
abnormal conditions of the human eye and its adnexa. The
course shall constitute a minimum of twenty hours of
instruction in clinical pharmacology, including systemic
pharmacology as applied to optometry, and shall be taught by
an accredited institution approved by the board.

20 hours ????? That's it???? It took me more time to learn how to Salsa dance.

 

[CJMPre-Med]

Seriously-- what is that, like 1/100th of the amount of time (if that) that physicians spend learning the ins and outs of pharmacology between med school and residency?

 

[JR]

Seriously-- what is that, like 1/100th of the amount of time (if that) that physicians spend learning the ins and outs of pharmacology between med school and residency?

Apparently this is good enough for people of OK and NM.

 

[ecoscuba]

Being relatively new to the feild, how severe is this? Does this threaten general opthos, or fellowship opthos (neuro, occuloplastics, retinal specialist, etc.)? I understand the concept behind setting a precedent, but I am not familiar with a lot of the procedures that you guys throw back and forth yet. In other words, can someone spell out the scope of this legislation to a n00b like myself? Are optometrists currently shooting for general optho procedures, or are they going for the whole shebang? thanks.

 

[Andrew_Doan]

Being relatively new to the feild, how severe is this? Does this threaten general opthos, or fellowship opthos (neuro, occuloplastics, retinal specialist, etc.)? I understand the concept behind setting a precedent, but I am not familiar with a lot of the procedures that you guys throw back and forth yet. In other words, can someone spell out the scope of this legislation to a n00b like myself? Are optometrists currently shooting for general optho procedures, or are they going for the whole shebang? thanks.

In Oklahoma, optometrists have expressed desires to be general ophthalmologists. They want to do intraocular surgery. If they do intraocular surgery, then eventually they will want to do all of it.

Although you may not see this in every state during your lifetime, states like Oklahoma set dangerous precedence.

Read these articles by Dr. Brennan (Eye Physician & Surgeon)

http://www.escrs.org/Publications/Eurotimes/04October/pdf/regmatters.pdf

http://www.crstoday.com/PDF Articles/1004/Brennan.html

 

[John_Doe]

Here is a site that can be used to follow the NM Bill 199, that may make NM the next OK - I will just leave a link to last decision made regarding the Bill: http://legis.state.nm.us//Sessions/05 Regular/bills/house/HB0199BI1.html

and also this one
http://legis.state.nm.us:8080/lcsbillsearch/session.jsp?year=2005R&type=B&chamber=H&number=199

 

[dk23]

What can we do to help the NMMS?

 

[Mirror Form]

Does this threaten general opthos, or fellowship opthos (neuro, occuloplastics, retinal specialist, etc.)?

Yes, it's a major theat. However, I think ophthalmologists will win this war. Even if a few optometrists begin doing surgery, it would be very expensive for them to train other optometrists (whereas medicaire pays hospitals 100,000 bucks per year for every opthalmology resident they're training). Furthermore, the optometric surgeons will have their own finacial goals in mind. So there is noway that they'll start training huge numbers of optometric surgeons and saturating the market. They'll keep their own numbers down to make sure they can have enough business.

 

[Andrew_Doan]

Yes, it's a major theat. However, I think ophthalmologists will win this war. Even if a few optometrists begin doing surgery,

NO! Please do not have this attitude. Optometry doesn't want surgical rights in 1-5 years. They are looking for surgical privileges in 20 or 30 years.

We draw the line at surgery. There are non-surgeon (optometry), and there are the physicians & surgeons (ophthalmologists). We must fight this very hard. We can't let even a few optometrists to venture into ocular surgery.

Also, my friend, you forget optometrists out number ophthalmologists 3 to 1. This means they control the patients and consults.

I am going to figure out a way to form a group to act as mediators. I want to work with optometry to educate them to be more competent primary eye doctors; however, I must draw the line at surgery.

Instead of fighting about this, we need moderators, for instance, who will allow optometrists to prescribe new glaucoma medications in NY. I think it's silly to prevent optometrists from prescribing travoprost when they can already prescribe latanoprost. Why waste energy and money in battles like this? Focus our money, efforts, and energy in defeating every surgical scope bill optometry tries to 'sneak' into law, but allow optometry to be primary eye care doctors.

 

[Andrew_Doan]

New Mexico surgery bill passes House, goes to Senate
Optometrists are pushing legislators in New Mexico to allow them to perform several laser procedures as well as the right to use a scalpel to excise potentially cancerous lesions around the eye. This legislation is on the march – the bill passed the House by a vote of 60 to 8. It now moves to the Senate. It’s critically important that every ophthalmologist become involved in this battle

Every year, there is another bill. This is endless.

 

[USFOptho]

Disgusting. I feel bad for the patients who will be subjected to a 20 hour "doc in the box" OD, all the while trusting him as if he was a trained eye surgeon. We must fight back!

It may come to the point when, we, in private practice, have to actively (via advertising, etc) show that we are eye surgeons, and that the optomertrists are not....Oooh, that would really get to them, but hey, they open pandora's box, what did they think was going to come out...the optometry genie that gives away free glasses and glaucoma screenings to the masses?

 

[ecoscuba]

What can we do to help? I mean above and beyond donations?

 

[EYESURG]

What can we do to help? I mean above and beyond donations?

Seriously....

 

[EYESURG]

Disgusting. I feel bad for the patients who will be subjected to a 20 hour "doc in the box" OD, all the while trusting him as if he was a trained eye surgeon. We must fight back!

It may come to the point when, we, in private practice, have to actively (via advertising, etc) show that we are eye surgeons, and that the optomertrists are not....Oooh, that would really get to them, but hey, they open pandora's box, what did they think was going to come out...the optometry genie that gives away free glasses and glaucoma screenings to the masses?

Why the AAO is not already advertising about the differences b/w the two? Are they waiting until it's too late or what?

 

[mdkurt]

Why the AAO is not already advertising about the differences b/w the two? Are they waiting until it's too late or what?

Actually, they aired some radio commercials in OK pointing out specifically the differences between the two fields. This helped me to donate to the surgical fund, because it was such a relief to see the AAO stop playing nice and start flexing some muscle.

In addition to contributing to the SSF, letters to the editors of NM newspapers always help (but no slobbering rants please, no matter how PO'd you are).

 

[mdkurt]

Even if a few optometrists begin doing surgery, it would be very expensive for them to train other optometrists (whereas medicaire pays hospitals 100,000 bucks per year for every opthalmology resident they're training).

That 100,000 bucks goes toward subsidizing thousands of patient contacts and surgeries in an inpatient and outpatient setting. Optometry will train their surgeons more cheaply because they aren't planning on having all that expensive and time-consuming experience. Currently, the mechanisms in place in OK involve a little more lecture time. After that, your first few lasers have to be under a preceptor, then you're on your own. Is the quality the same? Heck no, but who cares about that?

 

[Andrew_Doan]

Why the AAO is not already advertising about the differences b/w the two? Are they waiting until it's too late or what?

The AAO is involved now.

The AAO's eyeOrbit site is a perfect 'blogging' site to spreading the message. Read this: http://www.eyeorbit.org/article.php?story=20050115002855732

Search Google or Yahoo! "optometrists doing surgery" and you'll understand the true power of the keyboard and the internet!

http://search.yahoo.com/search?p=optometrists+doing+surgery&fr=FP-tab-web-t-211&toggle=1&ei=UTF-8

http://www.google.com/search?hl=en&q=optometrists+doing+surgery&btnG=Google+Search

 

[futuredoctorOD]

NO! Please do not have this attitude. Optometry doesn't want surgical rights in 1-5 years. They are looking for surgical privileges in 20 or 30 years.

We draw the line at surgery. There are non-surgeon (optometry), and there are the physicians & surgeons (ophthalmologists). We must fight this very hard. We can't let even a few optometrists to venture into ocular surgery.

Also, my friend, you forget optometrists out number ophthalmologists 3 to 1. This means they control the patients and consults.

I am going to figure out a way to form a group to act as mediators. I want to work with optometry to educate them to be more competent primary eye doctors; however, I must draw the line at surgery.

Instead of fighting about this, we need moderators, for instance, who will allow optometrists to prescribe new glaucoma medications in NY. I think it's silly to prevent optometrists from prescribing travoprost when they can already prescribe latanoprost. Why waste energy and money in battles like this? Focus our money, efforts, and energy in defeating every surgical scope bill optometry tries to 'sneak' into law, but allow optometry to be primary eye care doctors.

I love this post.......Is there a solution to this?--or is Optometry and Opthalmology going to fight a turf battle for years to come?

 

[John_Doe]

Actually, they aired some radio commercials in OK pointing out specifically the differences between the two fields. This helped me to donate to the surgical fund, because it was such a relief to see the AAO stop playing nice and start flexing some muscle.

In addition to contributing to the SSF, letters to the editors of NM newspapers always help (but no slobbering rants please, no matter how PO'd you are).

http://www.okeyenet.org/membersonly/radio/

 

[JR]

This is great. I wonder if we can get other radiostations to play this as a public service or something. How about bringing this up at the mid-year forum in D.C. ?

http://www.okeyenet.org/membersonly/radio/

 

[EYESURG]

The AAO is involved now.

The AAO's eyeOrbit site is a perfect 'blogging' site to spreading the message. Read this: http://www.eyeorbit.org/article.php?story=20050115002855732

Search Google or Yahoo! "optometrists doing surgery" and you'll understand the true power of the keyboard and the internet!

http://search.yahoo.com/search?p=optometrists+doing+surgery&fr=FP-tab-web-t-211&toggle=1&ei=UTF-8

http://www.google.com/search?hl=en&q=optometrists+doing+surgery&btnG=Google+Search

Thank you.

 

[EYESURG]

http://www.okeyenet.org/membersonly/radio/

This is great! Unfortunately, we still lost...

 

[JR]

Take a look at this thread, especially the second post. This guy has worked with an optometrist for some time and can offer an inside perspective on what is happening with the field of optometry today. In my opinion, it sheds some light on the true reasons for scope expansion push of the organized optometry.

http://forums.studentdoctor.net/showthread.php?t=177521

 

[John_Doe]

HB-199, which paves the road for optometrists to do surgery, passed out of its last committee hearing Sunday night, despite great testimony from ophthalmologists and medical students, an all-out, on-going public relations campaign and an endorsement from the Albuquerque Journal against the bill. The bill will be on the floor of the House Wednesday, February 23, where we expect to loose [it did get defeated by a landslide] because of the influence of Rep. Terry Marquardt, an optometrist and leading proponent of the measure. The focus now is on the Senate.

ACTION NEEDED: Call 505-986-4300. Call your senator and ask him/her to NOT SUPPORT HB-199. Tell them surgery is for surgeons.

These calls make all the difference. Please call today and often. Ask your friends, co-workers and patients to do the same. Our legislators need to know that if allied health professionals want the same privileges we have, they should go to medical school!!!!!!

----------------------
If this passes, then I am almost certain that it will be much easier and more likely for similar bills to pass in other states with the same kind of health care delivery characteristics (few large cities providing most of the care for the surrounding rural communities - even in this case it was argued that the majority of patients were within one hour of a surgeon if surgery was needed - and they still lost)

 

[Loncifer]

Take a look at this thread, especially the second post. This guy has worked with an optometrist for some time and can offer an inside perspective on what is happening with the field of optometry today. In my opinion, it sheds some light on the true reasons for scope expansion push of the organized optometry.

http://forums.studentdoctor.net/showthread.php?t=177521

JR,
I don't believe this view of optometry is shared by most OD's, anymore than most OMD's share this poster's view of ophthalmology:

http://forums.studentdoctor.net/showthread.php?t=176941

 

[JR]

OMDs, however, are not trying to expand their scope of practice into other specialities.

 

[Tokey]

OMDs, however, are not trying to expand their scope of practice into other specialities.

What about OMDs who have dispensaries? or those that do not do surgery, only medical management? One might argue that these OMDs are infringing into primary care, instead of being tertiary care specialists in cases such as these.

 

[jefguth]

Or those OMD's who are providing cosmetic procedures like botox injections...

 

[Loncifer]

OMDs, however, are not trying to expand their scope of practice into other specialities.

JR,
I went back and re-read the posts from the link you provided and couldn't find anything about optometrists expanding their scope of practice. It seemed to be a lament of commercial vs. private optometry.

 

[JR]

Thank you for pointing that out! You have found one thread that does not deal with optometric scope expansion! But look at the name of a thread you are currently posting in .

JR,
I went back and re-read the posts from the link you provided and couldn't find anything about optometrists expanding their scope of practice. It seemed to be a lament of commercial vs. private optometry.

 

[JR]

I don't think you can equate the two. We are trained to prescribe glasses and contacts. Optometrists are not medical doctors and are not trained to do surgery. That's a fact.

What about OMDs who have dispensaries? or those that do not do surgery, only medical management? One might argue that these OMDs are infringing into primary care, instead of being tertiary care specialists in cases such as these.

 

[carrigallen]

The problem is that there is really not much we can do as students, is there?

I predict this kind of legislation spreading quickly in other states, particularly in rural states that have a shortage of ophthalmologists (and therefore demonstrate a need).

 

[Loncifer]

Thank you for pointing that out! You have found one thread that does not deal with optometric scope expansion! But look at the name of a thread you are currently posting in .

JR,
You were the one who referenced that post, not me. I was simply trying to understand what the post that you provided a link to had to do with this thread. Apparently nothing, as you have pointed out. I get the distinct impression you would like to exclude ODs/OD students from this thread and this forum. I'll make no further contributions here, lest you become inconvenienced.

 

[Chr147]

Take a look at this thread, especially the second post. This guy has worked with an optometrist for some time and can offer an inside perspective on what is happening with the field of optometry today. In my opinion, it sheds some light on the true reasons for scope expansion push of the organized optometry.

http://forums.studentdoctor.net/showthread.php?t=177521

lol, that guy is me!
I do work at an optometrists office (not cause i want to be one, but the hours work for me and i need the money badly, and i get free contacts....).
Anyways, I was just commenting on how crappy some optometry jobs are these days.

 

[CJMPre-Med]

lol, that guy is me!
I do work at an optometrists office (not cause i want to be one, but the hours work for me and i need the money badly, and i get free contacts....).
Anyways, I was just commenting on how crappy some optometry jobs are these days.

No offense, but you consider $150K+ (and $200K on the coast) for an optometrist to be "crappy"? That's more than most pediatricians, FP's, and internists make, and they're, you know, actually physicians. Cry me a river.

 

[Chr147]

well, relative to what he use to make, yes, it is crappy.

I have never been so offended in my life.

 

[Andrew_Doan]

Or those OMD's who are providing cosmetic procedures like botox injections...

I am TRAINED TO GIVE BOTOX. I've seen and given over 100 botox injections to patients to treat blepharospams, hemifacial spasms, and some cosmetic injections.

Do optometrists give botox during their training?!

What about OMDs who have dispensaries? or those that do not do surgery, only medical management? One might argue that these OMDs are infringing into primary care, instead of being tertiary care specialists in cases such as these.

I am trained to do all this too. I've seen over 10,000 primary care and medically complex cases. I've refracted over 3000 patients. I agree that OMDs should back down and give you all a bone by not having dispensaries, but to argue that we're NOT qualified to do primary care is GARBAGE too. OMDs are trained to do BOTH medical and surgical ophthalmology. Optometrists are ONLY trained to do primary care at best.

 

[CJMPre-Med]

well, relative to what he use to make, yes, it is crappy.

I have never been so offended in my life.

Well, you hould find something better to be offended about, then. $150-200K for an optometrist is more than enough; anyone who thinks otherwise is silly. Does every physician deserve to make $400K+, then? Because if an optometrist deserves to make $200K, then that's what even primary care physicians deserve to make based on their training and the demands of the profession. If you say "yes", then great-- at least you're consistent. But the fact is that the median income for pediatricians is ~$140K, for internists about $155K, and for family practitioners, about $145K. So an optometrist griping about making $150-200K strikes me as a bit absurd, quite honestly.

 

[Chr147]

I am still blinded by the way I have been offended. Never in my life have I ever been so offended.

I await an apology.

 

[Loncifer]

I am still blinded by the way I have been offended. Never in my life have I ever been so offended.

I await an apology.

Chr147,
Bless ye, you are the Woody Allen of eye care debate.

 

[PDT4CNV]

Or those OMD's who are providing cosmetic procedures like botox injections...

Idiot, it was an ophthalmologist who originally developed the medical applications of botox. Ophthalmology has been using botox longer than any other medical specialty.

 

[mdkurt]

Idiot, it was an ophthalmologist who originally developed the medical applications of botox. Ophthalmology has been using botox longer than any other medical specialty.

I second that.

I also find it absurd that ophthalmologists should not be primary eye doctors. This demonstrates a fundamental lack of understanding with regard to what it is to be an ophthalmologist.

 

[futuredoctorOD]

I second that.

I also find it absurd that ophthalmologists should not be primary eye doctors. This demonstrates a fundamental lack of understanding with regard to what it is to be an ophthalmologist.

I agree.
Opthalmologists are trained to do whatever they wish--primary, secondary, and tertiary care...It it just that the trend is more towards subspecialty while optometry does primary care exclusively and for every 1 Opthalmologist out there there are 3 Optometrists. This is why the perception is skewed BUT I know a few Opthalmologists (General Opthalmologists that do EVERYTHING.)

I will be happy doing primary care......

 

[Andrew_Doan]

Actually, there are many general ophthalmologists. MOST are general ophthalmologists.

 

[futuredoctorOD]

Actually, there are many general ophthalmologists. MOST are general ophthalmologists.

Wow, I never realized that.....I guess you learn something new every day!

Dr. Doan--I have a question you would probably know....I am doing a research paper on Glaucoma...Do you know 2 premier researchers (whatever the credential MD, PhD, OD, DO)--in the area of glaucoma? I mean big guns---scientists that have contributed a lot to the study of this illness.

Thank you.....

 

[ecoscuba]

Can someone list the surgical procedures that ophthalmologists can do, and then put an asterick next to the ones that ODs will be able to do with passing of this new bill? Will they be able to do all of the surgical procedures that general ophthos can do? Will they be able to do the surgical procedures that retina and occuloplastics and other surgical fellowships can do?

 

[Andrew_Doan]

The list of our surgical procedures is several pages long. With the new laws in OK, this is what ODs can legally do:

Laser Surgery
Laser capsulotomy
Laser iridotomy
Laser trabeculoplasty
Photorefractive keratectomy (PRK)
Phototherapeutic keratectomy (PTK)
LASEK (LASIK is excluded)
Laser ablation of vitreous strand

Incisional Surgery
Radial keratotomy
Astigmatic keratotomy
Pterygium excision without graft or flap
Chalazion incision and drainage
Entropion repair
Ectropion repair
Anterior chamber paracentesis for emergency IOP reduction

Injection Procedures
Periocular (no limitation as to drug type)
Intraocular (no limitation as to drug type)

Other Surgery
Retinal detachment repair by
scleral buckle,
injection of air, gas, or other substance

There is no exclusion for cataract removal by laser technology in the future.
NOTE: A one-word change in the Oklahoma guidelines to remove ?retinal? exceptions to laser procedures would allow PRP, focal laser, and PDT.

______________________________

http://forums.studentdoctor.net/showthread.php?t=119156

I also find it alarming that in my informal poll above, although optometrists publicaly say they do NOT want to do surgery, in an anonymous poll, the number of optometrists and optometry students expressing desires to do surgery if there was an optometric surgery residency out numbers the optometrists who do NOT want to do surgery by 4 to 1!

I think optometrists on SDN are telling us their true goals and ambitions. On the one hand, we hear, "we only want to do epilations and FB removal"; however, deep inside, many are silently cheering on the few leaders in their field to expand optometry's scope of practice. Just look at the data above: http://forums.studentdoctor.net/showthread.php?t=119156

 

[John_Doe]

New Mexico surgery bill may be on its way to defeat, but the fight continues
Great progress has been made in the fight to preserve Surgery by Surgeons in New Mexico, where a bill that would have allowed New Mexico optometrists to perform surgery with lasers and scalpels was tabled in a key senate committee. But the need to fight on continues. Since the vote earlier this week, optometry has been pressing hard to get the bill reconsidered. The legislative session ends March 19, so optometry could still succeed. Your continued support is appreciated and needed. You can make a difference! Contribute to the Surgical Scope Fund today.