Dropping CEC's for OD's

[Homer]

Still around ..... but a little off axis.

Haven't spent much time here lately but here is my latest .......

Optometry in Colorado is now in the Sunset Review process. Their present statute ends July 1, 2002.

The Board of Regulatory Agencies has not only recommended that optometry continue to be licensed in colorado but has suggested that:

1. Their scope of practice is expanded to include oral antivirals

2. They drop the requirement for CECs. (reasoning is that professionals know what they don't know and will educate themselves)

Your comments please.

If anyone is interested in my personal response to the Board of Regulatory Agencies, just request it by e-mail.

Homer

[Judy Canty]

I couldn't help but smile...first they oppose educating Opticians and now they oppose educating themselves and STILL want to expand their scope of practice. Go figure! I would like to see your response, of course.

[Darris Chambless]

Hmmmm....

OK I'll throw my rant in here for a few minutes. Take a seat and get comfortable if you will. :)

Eh hm...I have no doubt that Optometrists are educated. I have no doubt that many know quite a bit more than their general scope of practice. I have a great respect for many Optometrists that I know and would consider them over and above many MD's for many things, HOWEVER...OD's should not be prescribing or dispensing medications to the public. That is what MD's are for and the reason one goes to Ophthamology school vs. Optometry school.

So that any OD on this board understands where I sit on this, I believe in pecking order; MD's prescribe, dispense medications and do surgery, OD's diagnose, refract and prescribe vision correction, Opticians fill prescriptions and trouble shoot. Each avenue is very important to the other but theraputic licensing for OD's is overstepping the boundaries of ones education. Now that Colorado is trying to lift even more restrictions for OD's without educating them to do so, I think it is ludicrous.

I've stated many times that my position is against dispensing medication unless you went to medical school. I'm also against doing refractions or eye exams unless you've gone to Optometry school.

This is another clear cut case of legislation without education and is in fact saying "No additional education is necessary. Just do what you want without any education to support your actions." It is complete irresponsible as well as stupid and dangerous.

I do not hate Optometrists but I do hate what Optometry as a whole is doing. It isn't right nor is it ethical.

Being from Texas I'm still hoping they drop this stupid Two Door Law. Dispensing medication without education is fine but an Optometric practice that is not seperate and apart from the operation of a dispensing optician could be detrimental to the public? Go figure. This stuff just burns me up. I think instead of Neuro Surgery I'll go into law and specialize in suing the Optometry board for things like this not necessarily to win but to point out how stupid and irresponsible these actions truly are.

Well that's my anti-pharmaceuticals for Optometrists shpiel for the day.

Darris C.

[Darris Chambless]

Yes Pete,

Everything after your admition of disagreement is erronious and you will now have to be punished for it verbally :) Actually I think that it is okay for an OD to administer and or prescribe Tobradex, Tetrocycline and or dialating drops for exam purposes as long as they understand the interactions or these drugs and can handle them propperly, past that I say no because that is what an MD is for.

I hope that any OD's around here understand that I'm not saying this to be mean spirited in anyway. Also I could really care less that there is so much hypocracy in the way Optometry is handing it's broadening scope that it could choke an elephant. My concern is that (regardless of what my colleague Mr. Pete said with regard to "(Optometry school seems to have evolved into a quasi-med school experience over the years)." Optometry school curriculums, at least in Texas, have not changed since before therapeutic licensing was introduced. How do I know this? Because I compared the curriculums from then and now some time back and it's no different. There isn't even an increase in clinical or pharmacological study, no additional pathology, nothing.

What's done is done and I'm not trying to change these things back, but they're not right in terms of education and doctorate degree. Again, I'm not saying that OD's are not smart enough to understand medications but I am saying that if you wanted to practice medicine you should have gone to medical school. That is the right and ethical thing to do for the safety of the general public.

If you feel that you are capable of making educated decisions on prescriptions for your patients then you should have thought about that when you chose your carreer path and shot for MD instead. If you feel you are smart enough to practice medicine then prove it by going to medical school. I hear the arguement all the time from OD's of "I didn't want to do surgery, I wanted to be an Optometrist." I think that is an admirable decision but stop practicing medicine without going through medical school then. An OD is not an MD so get the education and stop the legislation

We're working with fast food medicine here and it will end up causing so many problems in the long run that no one else sees. Believe what you will. Know what you think you know and I'll see you on the other side ;)

Take care,

Darris C.

PS. Hypothetically speaking: If Optometry can practice medicine without the education shouldn't Opticians be allowed as well as capable of doing eye exams including internals? And shouldn't the use of dialation as a means by which to get the full scope of the diagnosis also be allowed? Licensed Opticians and certified opticians alike either have or can get the education to do a full exam without going through Optometry school, and like Pete said and as Colorado Optometry has stated since they may not know something they can always self teach it.

Something to think about.

[NC-OD]

Hmmmmm........interesting.

[Homer]

if OD's want to do the prescribing that has traditionally been limited to medical doctors, then they sould be licensed under the Board of Medical Examiners in their state! Not too different thant DO's a few years ago.

And ..................

Since the dispensing of a traditionally "controlled substance", such as ophthalmic lenses, has been proven to be a harmless activity, ( which is on state recrords as the testimony of professional, licensed, almost-a-doctor, optometry against the need to license opticianry), it would follow that ophthalmic lenses should be completely deregulated and become over-the-counter applications that can be safely dispensed by certified opticians.

Now let's see how NC-OD responds. That probably twould be a really big, Hmmmmmmmmmmmmmmmmmm............... interesting........... I guess.

[NC-OD]

Well I don't know Homer. What would you like me to say?
I feel VERY well trained to do what I do, which is "Full-Scope Optometry". You might want to review the curriculum of modern-day optometry schools.

It sounds to me like a little frustration on your part for picking the wrong profession. If you don't like what your doing, I would recommend doing something else.

Most opticians I have met are pleased with their profession and do a great job.

I have no doubt that any person with average intelligence could do brain surgeon with enough training and practice. And no doubt that most OD's could do anything an ophthalmologist can do with enough training. And likewise, most opticians could as well.

I think what your arguing about is legislation. What optometry did (mostly before my time) was to improve our education and training AND THEN try to expand our scope of practice.

Optometry schools today teach classes not only on general eye care and refraction but also in Biochemistry, Human Physiology, General Pathology, Organ System Pathology, Neuroanatomy, Pharmocology, Clinical Medicine and Physical Diagnosis, Epidemiology, Human Gross Anatomy, Histology, etc.

We didn't exactly just decide we were going to treat glaucoma and start doing it.

Should dentists not perform mouth surgery? Should podiatrist not be allowed to care for feet because they didn't go to med school?

I think it is a bad idea for any state to do away with CE credits. Not because we can't learn without going to them. But most of the learning at these meetings takes place by talking to other OD's and comparing ideas.

I love my job. I feel bad for you if your doing something you really don't enjoy.

[Homer]

NC-OD, by and large I agree with your response and appreciate your point of view, except ...... where did you get the idea the I was unhappy and frustrated with my profession?

If there is unhappiness and frustration within myself and some other opticians, it probably relates to the seeming double-speak of optometry in general, not necessarly you in particular.

It is true that Optometry has educated and prepared itself quite well for their expasions of scope of practice. As the curriculum of modern optometry continues to prepared them for the next level of expansion, the have also been forced to drop those courses which were directly related to the fabrication, dispensing and maintainance of eyeglasses. Their lack of knowledge in this area is a matter of public record in at least one state.


Legislation IS the issue. Political power IS the point.....

In the past, in many states where opticianry has attempted to become licensed or add more continuing education to their present situation, optometry has always come out against them. Why?? Most of their argument is centered around the "fact" that opticianry can cause no harm, therefore does not need to be licensed. If that is the actual belief and practice of optometry, it would follow that ophthalmic lenses should be completely deregulated and become an over-the-counter item. A Doctor would write a "suggested prescription" for lenses and the optician would fine-tune it as a pharmacist (sometimes even a clerk) might make a suggestion as to the brand and strength of asprin or cortisone cream.

My point in the original posting this was partly to see how the OD's who contribute and lurk here might respond to the dropping of CE's in Colorado and in the same breath as for expanded scope of practice.

My second point is to say that there is no longer a need to have a separate board of Optometric Examiners in each state since they are generally prepared for and preforming medical treatments and procedures wich could be adequetly monitored by the Board of Medical Examiners or such the like. DO's used to be separate but now are licensed as medical doctors. That is where optometry is preparing itslef to go - that's where it should be.

One of the other agruments that optometry has put forth in the opticianry licensing opposition was that State Government did not need another licensing board. We don't need more government, but less. This would also be a point for the elimination of State Boards of Optometric Examiners.

By the way, I love the work I do and have continued to find it intriguing and facinating for the past 37 years.

Homer

[NC-OD]

Homer, I appreciate your point of view and think were are more in agreement than in opposition.

I try real hard to see both sides of the coin, so to speak. I do agree that the three professions -ophthalmology, optometry, and opticianary are becoming more alike each year.

Optometry schools are wrestling with trying to cram more and more information into 4 years. And some say the increased emphasis on ocular disease has pushed some more traditional skills aside......like vision therapy and optical dispensing.

Today, we have a WIDE range of optometrist practicing. From those who graduated in the 1950's who still don't have TPA or DPA rights,who are essentially refractionists, to newer graduates who are trained in the latest methods to treat and manage a wide range of eye disease. Also OD's work in a wide range of situations from the commercial (prositution rings) where their sole purpose in life is to write eyeglass rx's for the "store" to sell glasses. Then there is an increasing number of OD's working with (for) ophthalmologist in a referral centers performing the pre and post-op work of the surgeon. Then there are those in between who own their own "more traditional" private practices. Optometry has an identity complex in my opinion. We want to be considered "real doctors" but then they work at WalMart.....Hello, you work at Wal-mart.....give me a break.

Also, ophthalmology has change dramatically over the last few years. General ophthalmologist are a dying breed. The successful ones are now specialist (glaucoma, retinal, corneal etc.). We still have a few older OMD's around here that don't do surgery. They are essentially OD's now. Ophthalmologist are probably WAY overtrained for what they do. 4 years of medical school covering general medicine is mostly useless. How many ophthalmogist do you know that treat ear infections or set broken bones. NONE that I know. They treat eye problems. After 4 years of general medical training, they get 1 year of general internship in medicine and THEN 3 years of "eye training". We get 4 years of "eye training". My point here is that I respect most MD's but medical schools don't have a monopoly on education.

And I do agree with you that organized optometry is hypocritical with repect to opticians expanding their role. BUT I also don't think Ophthalmology, who is moving more and more into refracting and dispensing, would sit back and "let" you guys expand your scope. You really have alot of opposition against you and I don't know what the answer is.

But I do appreciate you comments.:p

[Homer]

Aren't you being a little hard on your brothers and sisters?

I know plenty of optometrists who's main goal in life is more optical sales. They operate independent practices and hide behind the shirts of "public health and patient welfare".

I think if one is going to be a prostitute, they can do it wearing long skirts and button-to-the neck blouses or they can just let it all hang out. The covering isn't the issue, the actions are! Some of the best OD's I have worked with were young, conscientious "employees" of chains.

While general ophthalmology is becoming a dying breed, so is the independent, private practice OD. Those OD's who graduated in the 50 are either about to retire, dead or pimps for the young graduates. We will just let them fade away and redraw the rules of engagement ------ in the process ya'll get to be REAL DOCTORS! (your words)

So, Ncod, you will be willing to give public testimony to support the case of opticians at the next hearing we have regarding licensure?

[Alan W]

Hi, folks. I've been away for a while building a new practice here in Seabrook. But, when I saw this thread I decided to put down my hammer and hit the keys.

To me allowing ANY individual entrusted with public health responsibilities (i.e. treating for disease with drugs), to go without mandatory continuing and monitored off campus education, is pure bull. But, then, it appears that too many doctors don't seem to feel they should be held accountable to anyone but themselves, anyway. I see it as an act of arrogance rather than willingness to be held publically accountable.

I am also EXTREMELY OFFENDED that someone whos practically non-existent education in craftsmanship, as exists in optometry school, should evaluate a craftsmans perception and editorialize it as having a motivational deficit.

Perhaps NCOD should spend as many years as Homer as a fine craftsman and technician before venturing out of his realm. There needs to be a higher level of respect for accomplished technicians than I see demonstrated here.

My apologies for the reaction. Let me go now and plaster down the hairs on the back of my neck.

[Pete Hanlin]

I don't think working at Walmart necessarily makes one less of a professional (after all, I'm sure the pharmacist who works there is quite capable of dispensing medications). It does make it harder on the private practices in the area, but then again, Walmart makes it tough on all the small businesses in its area of influence!

As for individual professionals, I'm sure there are ODs who are better capable of managing glaucoma than some MDs, and I'm sure there are Opticians who are better refractionists than some ODs... In general, however, it comes down to what each group has been able to legislate into their scope of practice...

[NC-OD]

[I am also EXTREMELY OFFENDED that someone whos practically non-existent education in craftsmanship, as exists in optometry school, should evaluate a craftsmans perception and editorialize it as having a motivational deficit.

Perhaps NCOD should spend as many years as Homer as a fine craftsman and technician before venturing out of his realm. There needs to be a higher level of respect for accomplished technicians than I see demonstrated here.

[/B][/QUOTE]

What are talking about????? I think I missed something. What did I say that got you in such a huff?

As I said before. I am against any state doing away with continuing education. I don't think Colorado said they are doing away with them. They are contemplating it. Might not even happen.

IN fact, I think OD's should have MORE C.E. Here in NC we have 20 hours per year....50 would be better. I learn much more on my own but still I think a formal class in better.


Question is how many people do we need treating eye disease? And how many people do we need doing refractions? I don't know. Maybe the more the better????

But a more important issue is the attempt for some to try to bring themselves up by trying to beat others down. Trying to degrade another profession will not make your look better. It didn't work for ophthalmology who tried to convice everyone that optometrists would make people go blind if we were able to dilate patients. Most intelligent people saw right through that as simply a money issue. AND in most cases it is........100% a money issue. We all know this. Homer and Alan W, there is no doubt in my mind that either of you could do what I do. I just jumped through the hoops that needed to be jumped through. I just don't think you should fault a profession for working hard and doing the right things. All it took was organization.......something I think is somewhat lacking in opticianary.


Remember, you can't hold a man down without staying down with him.

[Steve Machol]

I'm with NC-OD on this. Why on earth did this have to degenerate into another attack on a fellow eyecare professional?

[Joann Raytar]

2. They drop the requirement for CECs. (reasoning is that professionals know what they don't know and will educate themselves)

Could you folks fill me in on the quality of CEC's being discussed?

I am wondering if the reason folks are considering dropping CE requirements for OD's is because of the quality of the courses. For example, there are quite a few quality ABO approved courses out there where you can actually pick up good information. However, there are also a ton of courses for opticians that would fall into the category of being product "infomercials" and fluff. If the quality of the OD courses is fluff and they really don't benefit the OD or the public then there isn't much of a difference if they are dropped. This doesn't mean that there shouldn't be some form of continuing education; all of us need to stay abreast of new technology and there is always something new to learn. It just means perhaps the current system isn't what it should be.

[Johns]

I think all the responses to this thread should have started with "Hmmmm....interesting..." At least it would make it appear that some thought had gone into a reponse.

I'm with NC OD on this one. If you're an optician, don't throw your weight against ODs and MDs, throw it with opticians. Don't look at what they can do or want to do, look at what we want to do, and then plan to do it. I think that is where the anger is coming from; the other professionals appear to be cohesive and one, while opticians are seemingly splintered. The ODs seem to find ways to achieve their legislative success, we all know why we can't.

I am an optician, I am proud to be an optician, and when it is no longer fun, (yes I do have much fun whle earning a living), I'll find something else to do.

[Homer]

Recommendation # 5 in the Colorado Department of Regulatory Agencies Sunset Review Report:

"Section 12-40-113(1)(f), C.R.S. requires that every optometrist, upon renewal (every two years), complete 24 hours of board approved continuing education."

"A sunset review must examine if the regulation under review is the least restrictive form of regulation consistent with the public interest. Continuing education requirement do not meet that burden. Therefore, is is the recommendation of this review that the General Assembly eliminate the continuing education requirement for Colorado optometrists."


"Also, the Board (of Examiners) has attempted to reduce the often onerous task of monitoring continuing education by instituting an audit system which samples approximately 5 percent of all renewasl to insure compliance with state law."

"However, the literature regarding continuing competence, as well as Colorado's direct experience with elimination of continuing education requirements for physicians and nurses demonstrate that the continuing education of optometrists can be repealed withou jeopardizing the safety or welfare of the Colorado public."

This is quoted from the DORA document which has be submitted to the General Assembly and will be discussed this Spring.

In my mind it only further supports the argument that State Board of Examiners of Optometry shold be completely abolished and Optometry should be licensed as a catagory under the Board of Medical Examiners.

Now, please, let's get back to the point of the discussion and not into character assination. (if the shoe fits - wear it! If it doesn't then I anin't talkin' to you)

Homer

PS: NC-OD, I must admit embarssment at a few of the responses. I apologize. I think most of us are still in the discussion.

[Darris Chambless]

Hello to All,

I would first like to say to NC-OD that I mean no malice by my statements and actually tend to agree with you more than not. I also understand where you are coming from and want you to know I direct my comments and statements more at Optometry rather than individual Optometrists. I am going to use a few of the things you've said because they do show a typical ideology that I see so often.

" You might want to review the curriculum of modern-day optometry schools." As I said in one of my posts I have reviewed the curriculum for Texas Optometry school and the only thing that I found to be a significant change was that the number of hours required for Pharmacology studies had actually decreased. I need to go back and review it again to see if any changes have come about within the last two years though.

"Ophthalmologist are probably WAY overtrained for what they do. 4 years of medical school covering general medicine is mostly useless. How many ophthalmogist do you know that treat ear infections or set broken bones. NONE that I know. They treat eye problems. After 4 years of general medical training, they get 1 year of general internship in medicine and THEN 3 years of "eye training". We get 4 years of "eye training"." I'm going to use an analogy here so that everyone can understand my point on this one. I do a lot of mechanic work as well as a lot of other things so I'm going to talk about timing advancements made on vehicles to optomize performance and efficiency.

If you were to take a trainnee and teach him or her that by advancing the ignition timing on a vehicle to 2 degrees over the rated timing position you could increase the performance of an engine to it's maximum potential they could be considered knowledgeable from that standpoint. Then teach him/her how it was done on each and every vehicle including electronically controlled cars and you would have a well rounded Timing Technician, right? There's only one problem. If you don't know what else this will do to other components of an engine and or don't know what to modify to make the optomization effective the Tech could be doing more harm than good by "optomizing" via his narrow scope of training. If you don't know that you have to use a long duration or short duration cam to offset valve timing to prevent detination and loss of power you did your job but you didn't do the vehicle any good.

For Ophthalmology they have to know the wholelistic design of their scope of medicine to keep from causing problems with the patients. Think about this as an extreme example: What if Optometry were to one day be able to send their patients in for X-rays for whatever reason, would you know that you are not to do X-rays on a pregnant woman? You might, but how many of your colleagues could you sit back and say that wouldn't? Pregnancy isn't a part of your training and since you would only "refer" the patient to the Radiologist, Radiology isn't a part of your training either. It's all cause and effect that I'm referring to here.

There are so many aspects that have to be taken into consideration. Unfortunately the language has been changed to suit in more areas than just Optometry, but I won't get into those at present.

Homer, I'm going to have to single this part out "My second point is to say that there is no longer a need to have a separate board of Optometric Examiners in each state since they are generally prepared for and preforming medical treatments and procedures wich could be adequetly monitored by the Board of Medical Examiners or such the like." Although I understand what you're saying I must point out that regardless of the board monitoring this scope of practice, Optometry is not "generally prepared for ...medical treatments and procedures" If they're going to Practice medicine then I agree Optometrists must be monitored. But, I have to say for the record that they should not have to be monitored because I believe for them to be practicing medicine should require them to go through medical school. A monitoring agency or board should not negate the necessity for a full education.

I'm sure that many if not all Optometrists feel more than capable of doing what they do in their practices. The problem is that if I'm that Timing Advancement Tech for automobiles I too would feel very confident in my abilities to do my job. The problems doesn't lie in my ability to do what I'm trained for, it lies in my lack of knowledge beyond that which I'm trianed for.

So are MD's better educated than OD's? That could be debated, but MD's ARE better prepared to handle things as they come along. That is my point in all of this. "2. They drop the requirement for CECs. (reasoning is that professionals know what they don't know and will educate themselves)" So what do OD's know that they don't know and how will they educate themselves on it? NC I also realize that you're all for more education for OD's not less but you are one of only a few. Sad but true. I respect your opinions, knowledge and your input.

Thanks and take care,

Darris C.

[Joann Raytar]

Homer:

One more for you. What procedures are OD's in Colorado allowed to do?

I believe I just read in Optometry Today that they want to make it against regulations for OD's in New York to do minor surgical procedures such as inserting punctal plugs. If OD's are doing minor surgery, then perhaps you are correct and they should be considered medical. Of course, if they are performing out-patient surgery then I also don't think CE requirements should be dropped.

[Cindy Hamlin]

Originally posted by NC-OD
From Also OD's work in a wide range of situations from the commercial (prositution rings) where their sole purpose in life is to write eyeglass rx's for the "store" to sell glasses. Then there is an increasing number of OD's working with (for) ophthalmologist in a referral centers performing the pre and post-op work of the surgeon. Then there are those in between who own their own "more traditional" private practices. Optometry has an identity complex in my opinion. We want to be considered "real doctors" but then they work at WalMart.....Hello, you work at Wal-mart.....give me a break.

With all due respect, I OBJECT to your Wal-Mart reference. There are many wonderful OD's and even a few MD's that work next to our vision centers and I resent your reference to "prostitution rings". Evidently, for some reason, you have a chip on your shoulder about Wal-Mart and I wish, out of respect for your peers, that you would refrain from attacking in derogitory terms there chosen practice location!

REAL DOCTORS DO AND ARE WORKING FOR WAL-MART!

Can't we all just get along??????????

[NC-OD]

Homer and all,

Not to worry, no offense taken. I truly do enjoy discussing these topics here and consider this forum to be filled by the pinnacle of opticianary. I learn a great deal from you all.......(Maybe I could consider this a form of C.E. credit):D

But to Darris's analogy about the timing of an automobile (good one too). Would you only take your chevy to a mechanic that is a GMAC-certified mechanic.? Is he the only one who is qualified to work on your car? What about the guy who owns a garage down the street who has an excellent reputation for doing terriffic work? Just because he did get an associate degree in automotive technology and become officially certified - does that mean he doesn't know what he is doing? Are the thousands of satisfied customers wrong for going to him?

OD's in most states (and certainly in NC) are more or less at the mercy of the medical board. We can not just go out and decide we are going to do surgery.......well we could but the medical board would have us in court quite quickly. I would have no problem if optometry were to become part of the medical board. I think it would make things easier for us instead of harder.


And about the holistic view......First there is rarely, if ever a need for an x-ray in eyecare. Maybe for a crushing blow to the face but even then an MRI or CAT scan is usually more appropriate. AND yes I do order MRI's and CAT scans whenver needed.....

A true story.... 2 months ago a lady came into my office for an exam. She had light perception OD and 20/200 OS. Her eyes looked perfect inside and out. It didn't take a genious (or an ophthalmologist) to send her out to an imaging center for an MRI.....I mean she was essentially blind for no apparant reason. Long story short, the imaging center called me that afternoon and said they found a mid-brain aneurysm above her pituatary gland. I referred her to an neuro-surgeon.......the exact same as any OMD would do. The interesting thing about this story is that she had just had an eye exam 2 weeks prior by an ophthalmologist in the Virgin Islands. I think he should have caught this with a visual field (which he didn't do). He didn't even have the gonads to admit his mistake. If an optometrist were to have messed up like this, people (read that ophthalmologists) would have been all over him. So I could make the argument that because optometry is more "under the scrutiny" and we know we are being watched, we are perhaps MORE careful.....and maybe even provide better care because of it.


Also I took my mother-in-law to a reputable retinal specialist last week for what I thought was ischemic optic neuropathy. He wanted to order a CBC and and ESR and was going to send her to a local hospital to get the blood test done (but I had already ordered these test). My point is, ophthalmologist are not practicing the type of general medicine that you think. He was going to send her out for blood work just exactly like I did.

And I wouldn't mind one bit if optometry broke into two different and distict groups. The refractionist (at Walmart, Costco, Lenscrafter, etc.) and the real optometric physicians. Like I said before and someone else here said, I think, there is a VAST range of optometrists and their skills. Some, like me, enjoy treating almost anything my patient has. And others, who have 5 pt.s waiting on them to get eyeglasses just want to refract them as fast as possible so they can get home by 5 p.m.

The original push for therapeautic rights by OD's happened as a result of OD's seeing patients all the time for something like a corneal abrasion. He (or she) would have to say, "Sorry Ms. Jones, you have a corneal abrasion. You need topical erythromycin, a cycloplegic and a pressure patch but I can't help you. You will have to make an appt. with Dr. Ophthalmologist and wait two weeks and pay again (probably more).

It got to be more of a hassle to the patient more than anything else........probably the same as one of your patients who, you know, simply need an extra -0.25 D but you can't give it to them. Thats got to be frustating......

But............It's the holiday season.............All is well.

[NC-OD]

I would say I was sorry but I just call it like I see it. The OD's who work at Walmart are simply there because they think it is easy money. I have never seen an ophthalmologist at a Walmart but I believe you if you say they are there. I would not have an ounce of respect for them either.

I don't think they are worse doctors. In fact most are probably better than me but they are hurting our (my) profession by being there. It's hard to be taken serious if you work as a health care professional in a department store. Pharmacists sure didn't fair well by leaving their professional status behind and going to work at "the store". I have talked to many who hate their job. They are treated like ****, work long hours and get treated......like an "associate". It is getting rarer and rarer to find an independent pharmacist anymore....at least here.

The OD's at Walmart and the like are doing what is best for them and only them. What puts the most money in their pockets? And they are saying screw the profession. And I don't buy the high cost of education forcing them to go into commercial stores. I have as much educatal debt as probably anyone and still found enough money to open my own practice. It wasn't easy. I could have sold-out and just went and collected a pay check.

I have filled in for other OD's at both Walmart and Sears optical. Have to say I had to take a shower after leaving those stores. They hearded "heads" in as fast as they could for me to "refract" because the store needed sales. Never mind the guy needed to be dilated because he had diabetes.

So I stand by my prostitution statement. These are not bad OD's just bad decision makers...........and absolutely SELFISH.

[Pete Hanlin]

This might (or might not) be a good spot to bring up that the AOA wanted to create a nationwide Board Certification earlier this year (I believe it was voted down eventually). Any ODs out there wish to address the merits or arguments against a National Board Certification?

[Homer]

Yes! and so it should be!! .. for both Optometrists and Opticians!
A poll published in Optometric Management a few years ago stated that about 50% of Optometry was for National Certification - which would in effect be a kind of national licensing because all they would have to do is present their credentials to the State and the State would make sure that they had no mal-practice suits, were not felons or dead-beat parents and boom, they would be licensed in every state where they applied.

Guess why the don't have it. The money is power and the money is old - and still in charge.

Opticianry should have national certification / licensure also, but the old licensed states would be the first ones to object - and they claim to be for opticianry - go figure!

I think the OD's who graduated after 1980 and Opticianry and the national optical chains could agree on a national certification for both Optometry and Opticianry.

Glad the conversation continues

Homer

PS: NC-OD, I still think you are being unfair to those who choose to work in a different situation. I know plenty of independent OD's who are the personification of SELFISH! I also know some exemplary OD's who are a credit to humanity and to their profession. My suggestion that the former equals the latter.

[Cindy Hamlin]

[i]
I have filled in for other OD's at both Walmart and Sears optical. Have to say I had to take a shower after leaving those stores. They hearded "heads" in as fast as they could for me to "refract" because the store needed sales. Never mind the guy needed to be dilated because he had diabetes.

So I stand by my prostitution statement. These are not bad OD's just bad decision makers...........and absolutely SELFISH. [/B]

I respectfullt disagree with you! Prostitution happens at the chains as well as the independent practices!

May I ask if you shop at a Wal-mart? Remember, you may be insulting the patients that come to you for eyecare that also shop at the Wal-Mart!