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re: Are we sure optometrists should do eye surgery w/o going to medical school?
Posted on 5/15/14 at 3:29 pm to NC_Tigah
Posted on 5/15/14 at 3:29 pm to NC_Tigah
1. why is residency-equivalent instruction (necessarily) necessary? because a body of authority says so? who's on that board? what do they stand to lose?
2. if something can be safely performed at a lower cost, the option for that service should be there. just because that hasn't been the case until now doesn't matter. tech/ processes improve all the time and everywhere, and this can put some procedures in reach of lower-level practitioners- there's the "change".
3. how patients would be helped is obvious. it is also obvious how ophthalmologists in this case would stand to lose.
my perspective is that of a prospective consumer. i could be overlooking something, but i think the burden of proof should be on those trying to protect their turf at the expense of those paying the price for their service.
2. if something can be safely performed at a lower cost, the option for that service should be there. just because that hasn't been the case until now doesn't matter. tech/ processes improve all the time and everywhere, and this can put some procedures in reach of lower-level practitioners- there's the "change".
3. how patients would be helped is obvious. it is also obvious how ophthalmologists in this case would stand to lose.
quote:
I do not see a legit assurance/answer to any of those.
my perspective is that of a prospective consumer. i could be overlooking something, but i think the burden of proof should be on those trying to protect their turf at the expense of those paying the price for their service.
1
Posted on 5/15/14 at 3:33 pm to 90proofprofessional
You sound like a collectivist. While you are losing this hypothetical "Marginal improvement" on average, for the population, you might get some individuals with life-alteringly negative outcomes. Do no harm. For every patient.
This post was edited on 5/15/14 at 7:01 pm
Posted on 5/15/14 at 3:35 pm to LATigerdoc
quote:
You sound like a collectivist.
you sound like a monopolist.
eta
quote:
Do no harm. For every patient.
what about the patients that can't afford you but could afford an optometrist?
This post was edited on 5/15/14 at 3:37 pm
Posted on 5/15/14 at 3:36 pm to Roger Klarvin
quote:
In an attempt to limit costs, unqualified chiropractors, nurse practitioners, optometrists, etc. will be allowed in increasing numbers in the coming years to deal with conditions they have no business dealing with.
Thanks Obama
As long as it's affordable, and a doctor isn't prone to amputate my foot for obscene profits, I guess I'll have to be OK with it.
Posted on 5/15/14 at 3:39 pm to NC_Tigah
quote:
(2) As the field has never seen need to train optometrists for the particular procedures, the interested parties should identify what's changed to necessitate them doing it now.
Of course, the true answer is that they see new potential revenue streams for their profession. Optometry and routine eye care is highly competitive and profitable business. They now have to compete with the likes of wal-mart, online glasses suppliers etc. Any new edge they can get to get patients to walk in the door would be huge for them.
Posted on 5/15/14 at 3:49 pm to TigerRad
Who has said they would do the lasers for any different cost than an MD? I think they passed a law a couple years ago saying it was illegal for insurance companies to discriminate in reimbursement for an eye exam by an OD or MD..
Posted on 5/15/14 at 3:54 pm to 90proofprofessional
quote:So if I sell you some nicely bottled "190 proof" whitelightning for half normal price, that's a good deal as a consumer, until you wake up blind. If I sell you some ground meat for cheap, and you die of massive enteritis after consuming it, it's not a great deal. Right?
my perspective is that of a prospective consumer
So your disregard for safety as a consumer with no safety assurances is a bit irrational.
quote:Because it assures quality.
why is residency-equivalent instruction (necessarily) necessary?
quote:What board?
who's on that board?
quote:¿Que?
what do they stand to lose?
Let's be clear here.
An Optometrist wants to do something he was never trained to do. Translation, his training profs are not expert either. He'd need to gain qualification from someone with expertise. So the legislation would dictate qualifications be granted after certain specific criterion were met. i.e., 15-20 procedures proctored by a residency attending.
quote:¿Que?
at a lower cost,
I missed the lower cost thing. Where is that legislated?
quote:Not at all. How would patients be helped?
how patients would be helped is obvious.
Posted on 5/15/14 at 3:58 pm to TigerRad
quote:Cannot be about them.
Any new edge they can get to get patients to walk in the door would be huge for them.
Cannot be about their competitors.
This is a matter of whether they can perform a patientcare service with results comparable to or better than those currently offered. That's it.
Posted on 5/15/14 at 4:00 pm to Scruffy
quote:
Surgical procedures involving the eye are not like most other areas of the body. You screw up, it is essentially an amputation. The patient is now blind in that eye. There really isn't much middle ground like with many other surgeries. When dealing with the concept of patient safety, I do not feel that individuals should be permitted to perform these surgeries with only the bare minimum training optometrists obtain. There is a reason that ophthalmology is a multi-year residency program.
Seriously, it probably takes years just to learn how to work with 10-0 silk, optometrists shouldnt be doing stuff like this.
Posted on 5/15/14 at 5:59 pm to NC_Tigah
quote:
So if I sell you some nicely bottled "190 proof" whitelightning for half normal price, that's a good deal as a consumer, until you wake up blind. If I sell you some ground meat for cheap, and you die of massive enteritis after consuming it, it's not a great deal. Right?
So your disregard for safety as a consumer with no safety assurances is a bit irrational.
the bad outcome happens in your scenario with a probability of 1.
is that analogy supposed to represent the risk being brought on by the SB/HB's proposal?
quote:
Because it assures quality.
just because it's YOUR preferred method doesn't mean it has to be the way quality is assured, nor does it mean that it is an efficient level of assurance. it could be drastic overkill.
quote:
¿Que?
i'm asking about the incentives of those who get to decide what is "necessary"
quote:
So the legislation would dictate qualifications be granted after certain specific criterion were met. i.e., 15-20 procedures proctored by a residency attending.
quote:
I missed the lower cost thing. Where is that legislated?
quote:
Not at all. How would patients be helped?
these two comments are obtuse to the point of silliness. why would it need to be legislated?
it is costlier to obtain certification as an ophthalmologist, no? if a practitioner like an optometrist can do the same procedure, they would have to out-compete the ophthalmologist in price to get business, and there would be room for them to do so.
Posted on 5/15/14 at 6:03 pm to 90proofprofessional
quote:
just because it's YOUR preferred method doesn't mean it has to be the way quality is assured, nor does it mean that it is an efficient level of assurance. it could be drastic overkill.
Could be, could not be. Are you willing to put your (or a loved one's) vision on the line to find out?
Posted on 5/15/14 at 6:06 pm to onmymedicalgrind
(no message)
This post was edited on 3/18/15 at 7:34 pm
Posted on 5/15/14 at 6:06 pm to LATigerdoc
quote:
Who has said they would do the lasers for any different cost than an MD? I think they passed a law a couple years ago saying it was illegal for insurance companies to discriminate in reimbursement for an eye exam by an OD or MD..
now i'd agree that THIS is a problem.
the physician has to charge the same price as an optometrist? is that true?
then, the optometrists will be able to just undercut the ophth's until they don't provide the service at all, then the optometrists have the market on lock. same problem we began with.
Posted on 5/15/14 at 6:07 pm to Scruffy
UpToDate or Dynamed is all you need brah
Posted on 5/15/14 at 6:08 pm to jamarkus
Although I HIGHLY disagree with this legislation, if it passes, an easy fix to simply look for that little MD at the end of the guy/gals name you are looking to for surgery.
If they dont have that. Kindly give them the old thanks but no thanks and walk to a real ophthalmologist's office
If they dont have that. Kindly give them the old thanks but no thanks and walk to a real ophthalmologist's office
Posted on 5/15/14 at 6:09 pm to onmymedicalgrind
quote:
Are you willing to put your (or a loved one's) vision on the line to find out?
lots of good posters continually resorting to vague and/or emotional appeals in this thread
Posted on 5/15/14 at 6:12 pm to 90proofprofessional
quote:
lots of good posters continually resorting to vague and/or emotional appeals in this thread
Whats vague about it? Would you want someone operating on your eye who has not been adequately trained to do so? Its a simple yes/no question.
You want me to produce data that those who have their surgeries performed by optometrists have worse outcomes when compared to surgeries performed by ophthalmologists? Well theres a reason that data doesn't exist....
Posted on 5/15/14 at 6:13 pm to 90proofprofessional
This post was edited on 3/18/15 at 7:34 pm
Posted on 5/15/14 at 6:14 pm to Scruffy
quote:
Doctors may have to undergo too much training?
Obviously, man, its clearly overkill. Not like they can kill you or anything; we need to loosen things up!
Posted on 5/15/14 at 6:15 pm to onmymedicalgrind
(no message)
This post was edited on 3/18/15 at 7:34 pm
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