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Started By
Message
re: Optometry: LA HB 1065/SB 568: What if your Louisiana Eye Surgeon is NOT an MD?
Posted on 5/17/14 at 12:25 am to Bmath
Posted on 5/17/14 at 12:25 am to Bmath
quote:
So why are nurse practitioners and PA's essentially taking the place of GPs? They didn't go to medical school.
At LSUHSC, PA and NPs take some courses with the med school students, but some courses such as pathology they don't go into the vast detail. Even the pharmacology classes they share they don't get tested on the same things or the amount.
NP/PAs being able to take care of 'basic' things such as well visits and common symptoms such as prescribing amoxicillin for an ear infection saves everyone time and insurance companies money.
Now when we're getting into bigger details and more life threatening/altering diseases, you better hope a well trained MD is going to be the one to treat you and not someone who has never learned what TB even looks like.
On the topic:
There's a reason why ophthalmology is one of the top residencies to get into.
As for 'similar coursework', if you've seen pharmacy school, they take similar science courses as well. Immunology, path, and pharm as well, but do you compare their knowledge of certain things to a physicians'?
Pharmacy students at xavier have to learn the top 100 prescribed drugs in their coursework. I think in 4 years they may learn somewhere around 3-400. In medical school, pharmacology courses expand somewhere around 8-900 drugs.
Pathology courses between them are night and day as well (I took the undergrad path as a senior which was the pharmacy school's path course, same test and all). Medical school's was more in depth as well. LSU and XU pharmacy school shared the same immunology book and in one semester of immunology, pharmacy finished 2/3s of the book, medical school finished the book cover to cover in a month.
Certain things I trust a physician more, my eyes are one of them. Pass the law all they want, but majority of the people will still go to the highly certified ones when it comes to things that can't be fixed if it gets jacked up, like their eyes. People's health and their bodies are very important to them.
I've gone to minute clinics if I'm in a rush and I know the problem I have isn't too bad (like my ear infection last year). If I'm dying of night sweats, chills, fever, and some random bs associating symptoms, you can believe I'd go to a MD before a PA/NP.
This post was edited on 5/17/14 at 12:35 am
1
Posted on 5/17/14 at 12:43 am to htran90
quote:
Pharmacy students at xavier have to learn the top 100 prescribed drugs in their coursework. I think in 4 years they may learn somewhere around 3-400. In medical school, pharmacology courses expand somewhere around 8-900 drugs.
Then why do pharmacists have to fix doctor's prescriptions constantly?
Honestly, I think it is a giant pissing contest, and MD's have the upper hand.
I concur that they are much better trained for handling most ailments.
I still feel that optometrists should be allowed to obtain the proper residency training to expand their role. Not to perform all procedures. Some are largely robotically automated, and optometrist routinely perform those procedures in other states.
Why not allow them to utilize those tools within the oversight of an ophthalmologist?
Posted on 5/17/14 at 12:48 am to LATigerdoc
quote:
You gotta see the whole picture to know what you know and what you don't. Trying to be a physician (comprehensive care-taker of a human's pathologic disease states) without medical school is the equivalent of European explorers before the West got mapped out.
Why can dentist care for people with tooth decay?
Studies have shown that poor dental health can lead to heart conditions.
They didn't go to medical school . How could they possibly know anything about that sort of thing?
Posted on 5/17/14 at 12:59 am to Bmath
(no message)
This post was edited on 5/17/14 at 1:02 am
Posted on 5/17/14 at 1:01 am to LATigerdoc
Caring for someone's life is not a giant pissing contest. It's an extremely serious matter that requires a tremendous level of commitment. It really is impossible to explain without living through it.
Posted on 5/17/14 at 1:03 am to LATigerdoc
Go away. Your such a douchebag
Posted on 5/17/14 at 1:10 am to oilmanNO
Dentists do care for people with tooth decay
Posted on 5/17/14 at 1:12 am to LATigerdoc
quote:
Caring for someone's life is not a giant pissing contest. It's an extremely serious matter that requires a tremendous level of commitment. /quote]
But what I keep hearing is that only your way is correct.
Furthermore, I'm not advocating that they are allowed to handle all forms of optical procedures. In fact, I even explicitly agreed that they be allowed to receive proper residency training.
[quote]It really is impossible to explain without living through it.[
As one of my doctoral committee members once told me: if you say that it is difficult to explain then you really don't understand it yourself.
Posted on 5/17/14 at 1:16 am to LATigerdoc
quote:
Dentists do care for people with tooth decay
No shite. But why can they? They don't take cardiology classes to understand the effects of bacterial infections in the mouth that lead to heart failure.
You said it yourself that optometrists can't perform eye surgeries because they didn't receive a holistic training like MD's. Why is this not the same for a DDS?
Posted on 5/17/14 at 1:17 am to Bmath
well there's level of understanding. that's why they call it practice
Posted on 5/17/14 at 1:22 am to LATigerdoc
Which is why I go back to needing to allow optometrists access to a residency.
Posted on 5/17/14 at 1:23 am to Bmath
quote:
Then why do pharmacists have to fix doctor's prescriptions constantly?
Having two pharmacists in the family and knowing a whole lot of pharmacists as well (family friends, friends, and people I went to school with), it isn't the pharmacist that always fixes it.
For every bad physician that messes up a prescription, there are 99 other MDs that know what they're doing properly. Same can be said of any profession.
As for 'fixing it constantly', fix what? dosing amount? I've seen hospital pharmacists let dosing and prescriptions that were written wrong fly right by them. There was a case some years back with a patient that was prescribed 50x the opioid dosage.
The MD said it, the nurse wrote it down, the MD signed it without checking the dosage, the PIC at the hospital scrambled to get that amount from neighboring hospitals, got the amount and handed it to the nurse who ended up administering the amount. The MD ultimately got in trouble, but there are multiple checks and people who could have fixed it.
To get through an ophthalmology residency, they are required to go through extensive training and do 'x' amount of different procedures before they are able to practice independently and finish their residency programs. Same for any specialty. Hell, even OB's have to deliver a certain amount in their residency training.
If you were pregnant (and a woman), would you go to the PA/NP that got approval to deliver a baby, but has 0 training to do it?
Even in terms of robotics, they're simply not trained to do it right now and I wouldn't feel comfortable at all being that they don't have someone overlooking their work to tell them if it is right or wrong. If you told me they would have to go through training, calculations, identification, etc on the process of cutting an eye for whatever reason, I'd feel more comfortable.
If it is within the range of them working WITH someone, I agree it is and should be fine. We have NP/PA's working with PCP's all the time. Even minute clinics like CVS' require their PA/NP's to have worked in a hospital or at a clinic a certain amount of time before they are able to be hired, not fresh out of school/program PA/NPs.
Posted on 5/17/14 at 1:30 am to htran90
quote:
If you were pregnant (and a woman), would you go to the PA/NP that got approval to deliver a baby, but has 0 training to do it?
Once again, why not give them access to it? Other states feel that they have the background to learn and perform certain procedures safely.
I am not advocating that you let them do whatever the hell they want.
Posted on 5/17/14 at 1:36 am to Bmath
quote:
Then why do pharmacists have to fix doctor's prescriptions constantly?
In my experience the majority of the time the pharmacist calls its one of 3 things
1. about some tiny side affect or interaction which the MD knows about and doesnt care because the drug is necessary to patient care
2. what is and isnt on the hospital formulary
3. dosing of high level abx which the md would rather let the pharmacist handle instead of pulling out a calculator looking up the formulas and calculating. Its not a question of which one to use, but how much.
Thats not to say they dont catch mistakes in how things are written-they do and its life saving-but the majority of time its one of the above.
Posted on 5/17/14 at 1:37 am to Bmath
quote:
Once again, why not give them access to it? Other states feel that they have the background to learn and perform certain procedures safely.
I am not advocating that you let them do whatever the hell they want.
I think its also "if you wanted to do it and learned how to do it, you would have gone that route to be able to do it"
The more you expand one's job, the more you have to pay them as well which is why you don't see PA/NPs doing everything specialized docs can. There's always little nitty gritty details that a MD learned that a NP/PA didn't learn.
Am I all for certain things like PA/NPs being able to do more to help and expanding their jobs? Yes, but to a certain extent. If they wanted to do a certain job, they should have gone into schooling to do that.
Posted on 5/17/14 at 1:41 am to Bmath
quote:
I still feel that optometrists should be allowed to obtain the proper residency training to expand their role.
Once again. They have the opportunity. Go to med school do a residency. They chose optometry which is a field which performs primary care of the eye. There is a way to do surgical procedures on the eye-get and MD and do ophthalmology. If they wanted to do that they could have and they still can. Im sure all those advanced science courses will help.
Posted on 5/17/14 at 7:30 am to LATigerdoc
I call my optometrist doctor WTF are you talking about. If you go to optometry school the teach you about eyes so that's what he can do for a living. There are too many idiots like you running around trying to line your pockets who don't want laws and regulation if he's a eye doctor then he works on eyes let him do that I don't want a doctor working on my eyes I want a EYE DOCTOR let the bill pass.
Posted on 5/17/14 at 8:08 am to Wes B
an ophthalmologist IS the "eye doctor":
4years medical school,plus an internship and then 3-5 medical and surgical training totaling 8-10 yrs in eye medicine and surgery
an optometrist goes to 4 years of optometry school after college. they mostly do contacts and refractions and basic eye exams but have no comprehensive medical training and zero surgery
An optometrists is not a medical doctor and not trained to do surgery or diagnose medical disease.
And when someone punches you in the face/eye at 2am (and I'm sure someone will) and injures your eye, the person on call to help you is an ophthalmologist.
4years medical school,plus an internship and then 3-5 medical and surgical training totaling 8-10 yrs in eye medicine and surgery
an optometrist goes to 4 years of optometry school after college. they mostly do contacts and refractions and basic eye exams but have no comprehensive medical training and zero surgery
An optometrists is not a medical doctor and not trained to do surgery or diagnose medical disease.
And when someone punches you in the face/eye at 2am (and I'm sure someone will) and injures your eye, the person on call to help you is an ophthalmologist.
Posted on 5/17/14 at 8:33 am to jamarkus
You left off the part about able to diagnose and treat conditions/diseases of the eye using any meds necessary. You also left off that they routinely remove embedded corneal foreign bodies, which by the way, is probably more invasive and dangerous than I/Ding a chalazion.
This post was edited on 5/17/14 at 8:34 am
Posted on 5/17/14 at 8:41 am to guttata
except when that "chalazion" is a sebaceous cell carcinoma. Optometrists refer chalazion all the time that end up getting MOHS procedures and a systemic cancer w/u because it was not a chalazion. Good luck with the 4 day course for that.
This post was edited on 5/17/14 at 8:44 am
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