- My Forums
- Tiger Rant
- LSU Recruiting
- SEC Rant
- Saints Talk
- Pelicans Talk
- More Sports Board
- Coaching Changes
- Fantasy Sports
- Golf Board
- Soccer Board
- O-T Lounge
- Tech Board
- Home/Garden Board
- Outdoor Board
- Health/Fitness Board
- Movie/TV Board
- Book Board
- Music Board
- Political Talk
- Money Talk
- Fark Board
- Gaming Board
- Travel Board
- Food/Drink Board
- Ticket Exchange
- TD Help Board
Customize My Forums- View All Forums
- Show Left Links
- Topic Sort Options
- Trending Topics
- Recent Topics
- Active Topics
Started By
Message
2
Posted on 5/17/14 at 9:00 am to guttata
well you forgot about the 4years of medical school, surgical internship, 4 year ophthalmic surgical residency and the cornea fellowship. Not quite the same.
Hey but knock yourself out!!! Just handle your own complications, take some trauma call and don't call me at midnight
Hey but knock yourself out!!! Just handle your own complications, take some trauma call and don't call me at midnight
This post was edited on 5/17/14 at 9:16 am
Posted on 5/17/14 at 9:24 am to Adam Banks
quote:
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.
This. MD's know MUCH more about the medicines and what they are for than the pharmacists. Most of the time they are just regurgitating shite that pops up on their computer screen. The good ones knows which interactions are petty BS and fills it. Dumbasses call on every single possible teeny tiny interaction ever attributed to the meds. They serve their purpose, but they "fix" very few prescriptions. There have been quite a few times I've had to fix their mistakes. When they put the wrong pills in the wrong bottle, it's up to me to figure out why in the hell the patient is no longer doing well. I've gotten into the habit of not only checking pt's rx bottles, but the pills in them. Especially elderly pt's on numerous meds.
I will add that my wife is a pharmacist and she will agree with all I said. She was shocked to learn how much more I knew about the meds and how in depth we went in med school. On EVERYTHING.
So...that's why optometrist shouldn't do surgery.
Posted on 5/17/14 at 9:38 am to SmackoverHawg
Quote:
SmackoverHawg
Arkansas Fan
Member since Oct 2011
12173 posts
I only support it due to the hypocrisy of the medical community. Non of the specialists have opposed mid levels basically given full practice rights in primary care despite perhaps an even greater gap in total knowledge. Now that they are infringing on their domain, it's a big damn deal. Too late. You'll get no support from the rest of us. You guys are right. The optometrist should not have their roles expanded. It's not in the best interest of anyone. But neither should NP's, PA's, and cRNA's. But this is healthcare of the future. Those that know better and can afford it will get MD's and overall superior care. Meanwhile, others will receive lesser, cheaper care from other providers.
And I employ two NP's, my brother is a cRNA, and my nephew a PA. Don't fight it. Embrace it and make it work for you. My partner refuses to and works longer, harder hours for waaaaaaay less money. You can train them to do what you need, profit from it and lesser your load of bullshite. They do my forms and paperwork. They "take the talk" out of the patients before I go in. And can handle 99% of the bullshite phone calls we get.
-----------------------------------------------------------------------------------
You sound like your in the next step of the grieving process in the decline of medicine--acceptance I'm sorry no one was there for you
--------------------------------------------------
Glad to have you back
If this passes I'm probably gonna take your advice
If nobody care about quality why not benefit from it
SmackoverHawg
Arkansas Fan
Member since Oct 2011
12173 posts
I only support it due to the hypocrisy of the medical community. Non of the specialists have opposed mid levels basically given full practice rights in primary care despite perhaps an even greater gap in total knowledge. Now that they are infringing on their domain, it's a big damn deal. Too late. You'll get no support from the rest of us. You guys are right. The optometrist should not have their roles expanded. It's not in the best interest of anyone. But neither should NP's, PA's, and cRNA's. But this is healthcare of the future. Those that know better and can afford it will get MD's and overall superior care. Meanwhile, others will receive lesser, cheaper care from other providers.
And I employ two NP's, my brother is a cRNA, and my nephew a PA. Don't fight it. Embrace it and make it work for you. My partner refuses to and works longer, harder hours for waaaaaaay less money. You can train them to do what you need, profit from it and lesser your load of bullshite. They do my forms and paperwork. They "take the talk" out of the patients before I go in. And can handle 99% of the bullshite phone calls we get.
-----------------------------------------------------------------------------------
You sound like your in the next step of the grieving process in the decline of medicine--acceptance I'm sorry no one was there for you
--------------------------------------------------
Glad to have you back
If this passes I'm probably gonna take your advice
If nobody care about quality why not benefit from it
Posted on 5/17/14 at 9:43 am to guttata
quote:
Is it the same 4 day course the older MDs took when LASIK came out? I hope the ODs get to go to Florida for it as well.
Just Stop.
Those older MD's had also been performing thousands of surgeries for decades!
One of the biggest problems with the optoms supporting this bill is that you don't know what you don't know. You think you're qualified to perform these procedures. You aren't. You think surgery is "routine" and "common"- it's not.
If you wanted to be a surgeon you should have gone to medical school.
Surgeons should be made through education, not legislation.
With that said, I am fully aware that this bill will probably pass and the only people that will benefit are the optoms.
Posted on 5/17/14 at 9:50 am to EYEDOCNO
quote:This.
Those older MD's had also been performing thousands of surgeries for decades!
quote:Damn, all of this.
One of the biggest problems with the optoms supporting this bill is that you don't know what you don't know. You think you're qualified to perform these procedures. You aren't. You think surgery is "routine" and "common"- it's not.
Surgery is never routine, and that is Scruffy drawing on his limited med school surgical interactions.
quote:100x this.
If you wanted to be a surgeon you should have gone to medical school.
quote:And this.
Surgeons should be made through education, not legislation.
quote:Yep. Scruffy isn't, nor will he ever be an ophthalmologist, and this won't affect him financially, but he fully expects quality of care to suffer.
With that said, I am fully aware that this bill will probably pass and the only people that will benefit are the optoms.
Posted on 5/17/14 at 9:55 am to jamarkus
quote:
You sound like your in the next step of the grieving process in the decline of medicine--acceptance I'm sorry no one was there for you --------------------------------------------------
Yep. I tried getting pissed and fighting it, but it only made me angry, bitter, and miserable. Then I see other physicians, albeit a minority, doing unethical shite and practicing well below normal standards of care. In those cases, a decent, ethical midlevel would be better. Our on colleagues are our worst enemies. The shitheaded outliers ruin our reputations and set the bar low for quality issues. We all get lumped in together. It got quite frustrating. I know in primary care, I get pissed to see other FP's just acting as glorified NP's and not doing the jobs they were trained to do. It's hard to fight the NP's and PA's when in fact some are better than these guys/gals. Of course the vast majority of these inadequately trained unethical physicians are foreign trained. There is a reason and purpose behind med school selection and matriculation. Even in our schools, I've seen them accept way too many unqualified students in a push to graduate more doctors. It dilutes the field and makes us all look bad. If they'd make medicine a more attractive field to pursue, and more lucrative for primary care, the quality students would easily fill those spots. As is fewer and fewer are drawn into medicine and the standards have been lowered intentionally or not. I for one do not think the overall quality of our physicians is nearly as good as it was 30 years ago. I attribute much to the watering down of primary care training. Even when I was a resident, they were moving the focus away from real medicine and toward more of a NP, social worker type role for FP's. I took the initiative to get additional training in internal med, peds, surgery, and derm to expand my skill set and knowledge base. Most do not and have allowed themselves to be replaced by midlevels. I'm not worried personally, but I am worried for the entire future of primary care.
Posted on 5/17/14 at 10:00 am to SmackoverHawg
Well you don't really have to worry about the PAs. They already fall under the medical board, so they are easily controllable. NPs and CRNAs are a whole different ballgame since they fall under their own boards.
Posted on 5/17/14 at 10:13 am to guttata
quote:
Well you don't really have to worry about the PAs. They already fall under the medical board, so they are easily controllable. NPs and CRNAs are a whole different ballgame since they fall under their own boards.
True. And we have very few PA's in AR because until just here recently we did not have a school. I have seen the few independent NP's around waaaaaay overstep their bounds. One even gave adipex to a 80yo for weight loss!!!!! Not to mention the woman was thin. My wife reported it to the board of nursing and they just said it's up to the provider. My wife, a pharmacist, said no!! there are guidelines on the proper use of this med and this violates all of them. I've found that even in instances of gross malpractice and unethical behaviors the nursing board is loath to punish these rogue NP's for fear of marring their undeserved reputation for good care. This is the Pandora's box that will be opened by passing this legislation. 90% of optometrist will practice within the scope of their skills. The majority will not change their practice. Most that do will do so under the supervision of a MD. But those few that choose to push the boundries will f$%k some people up. I've seen it hundreds of times with NP's. I can give horror story after horror story of shite they've done or missed that 99% of MD's would've diagnosed in their sleep. If this is passed, they should be required to be supervised by an MD or be regulated by the medical board. As their own board would be acting against it's and it's members best interest to sanction one of their own.
Posted on 5/17/14 at 10:34 am to SmackoverHawg
Optoms will never allow themselves to fall under the medical board. If MDs had it their way, they would try to repel all the legislation that has allowed optoms to practice to their full scope. I can just imagine where optoms would be if they had to go before the medical board and ask them for permission to expand their scope. MDs can also be pretty good at protecting their own when it comes to sanctioning.
Posted on 5/17/14 at 10:36 am to SmackoverHawg
very good perspective on this, smack...thanks for posting..
Posted on 5/17/14 at 10:57 am to Spankum
You're wrong, the 66 reps will also benefit. I'm not sure what we are doing to our healthcare system when you can win over the statehouse and become a surgeon of a type you were not the day before
Posted on 5/17/14 at 11:07 am to guttata
Quote:
Optoms will never allow themselves to fall under the medical board. If MDs had it their way, they would try to repel all the legislation that has allowed optoms to practice to their full scope. I can just imagine where optoms would be if they had to go before the medical board and ask them for permission to expand their scope. MDs can also be pretty good at protecting their own when it comes to sanctioning.
-----------------------------------------------
And therein lies the rub. The optoms want to cross the line and do eye surgery but do not want to do what it takes to be properly trained like every other surgeon AND want to self govern and expand their scope as they see fit instead of being under the LSMBE like every other surgeon has for the last 120years! 90% of lay people agree and don't want this. The only reason this has legs is because of politics specifically the OD's own the Senate.
And this has nothing to do with protecting our own. It is about patient safety. But please have your board expand to take trauma call at the hospitals while your at it! Don't just cherry pick the good stuff that pays, cause that's what this is all about! Access my arse
Optoms will never allow themselves to fall under the medical board. If MDs had it their way, they would try to repel all the legislation that has allowed optoms to practice to their full scope. I can just imagine where optoms would be if they had to go before the medical board and ask them for permission to expand their scope. MDs can also be pretty good at protecting their own when it comes to sanctioning.
-----------------------------------------------
And therein lies the rub. The optoms want to cross the line and do eye surgery but do not want to do what it takes to be properly trained like every other surgeon AND want to self govern and expand their scope as they see fit instead of being under the LSMBE like every other surgeon has for the last 120years! 90% of lay people agree and don't want this. The only reason this has legs is because of politics specifically the OD's own the Senate.
And this has nothing to do with protecting our own. It is about patient safety. But please have your board expand to take trauma call at the hospitals while your at it! Don't just cherry pick the good stuff that pays, cause that's what this is all about! Access my arse
This post was edited on 5/17/14 at 11:17 am
Posted on 5/17/14 at 11:09 am to LATigerdoc
Not gonna pass. 10 of them will see the light before Tuesday and set this straight.
Posted on 5/17/14 at 11:10 am to LATigerdoc
This is just more of the ACA style takeover remaking our system
Posted on 5/17/14 at 11:19 am to guttata
quote:
MDs can also be pretty good at protecting their own when it comes to sanctioning.
Not to the same degree as pharmacy and nursing. I've seen pharmacist get $500 penalties for shite they shoulda went to jail for. And nursing is much harder on RN's and LPN's than on NP's.
I also think it's bullshite that cRNA's get the SAME reimbursement for their services as an anesthesiologist. There is no savings there. And an NP's reimbursement is only 15% less than ours but the pt's copay is the same. They are much less efficient and take more visits and time to treat the same issues and still often times have to defer to us. I use mine basically to do the shite I used to do for free. The idea that they lead to "cheaper" healthcare is a farce. The agenda is to flood the market to drive down reimbursement, but it's obviously not working.
Posted on 5/17/14 at 11:19 am to Spankum
I dont think this bill will affect most ODs/OMDs much either way. But there's a lot of misinformation in this thread and some important points that are worth repeating...
-"surgery" is a broad term. These procedures are serious, but not as complicated as some are making it sound. They're non-invasive laser treatments that will require some additional training, but much of the skill (gonioscopy)and knowledge (post-op eval, anatomy, etc) needed to do the procedures is already known by ODs, and the anterior seg procedures have already been learned in optometry school. Many of the outspoken MDs (and general public)in this thread are obviously not familiar with what exactly these procedures are, but just hear the word "surgery" and automatically think lasik, cataracts, retina, etc. and those are clearly not the point of this bill, but are only being used as a scare tactic-"want to be a surgeon?go to med school!", etc.
-The procedures have been done by optometrists in Oklahoma for years with no problems.
-The bill will only affect a handful of ODs that have access to lasers already. For 90+% of ODs, its not cost effective to buy a $75K laser to do 5-6 YAG surgeries a year. Its for ODs who are already in multi-practice settings, seeing post-op cataracts daily, who will benefit from being able to do a capsulotomy without having to reschedule or refer a patient. Thats why you have some OMDs in favor of the bill. The anterior seg procedures will save a patient having to be referred for minor things like chalazions, etc.
-The optometry board is important for the optometry profession going forward. A medical board made of condescending MDs would fight any advancement in the optometry profession, just like they did with pharmaceuticals, foreign bodies, and now this. Its important for ODs to have their own board to oversee the advancement when new treatment options come out, and not have to go through the legislature or a medical board with ulterior motives.
-"surgery" is a broad term. These procedures are serious, but not as complicated as some are making it sound. They're non-invasive laser treatments that will require some additional training, but much of the skill (gonioscopy)and knowledge (post-op eval, anatomy, etc) needed to do the procedures is already known by ODs, and the anterior seg procedures have already been learned in optometry school. Many of the outspoken MDs (and general public)in this thread are obviously not familiar with what exactly these procedures are, but just hear the word "surgery" and automatically think lasik, cataracts, retina, etc. and those are clearly not the point of this bill, but are only being used as a scare tactic-"want to be a surgeon?go to med school!", etc.
-The procedures have been done by optometrists in Oklahoma for years with no problems.
-The bill will only affect a handful of ODs that have access to lasers already. For 90+% of ODs, its not cost effective to buy a $75K laser to do 5-6 YAG surgeries a year. Its for ODs who are already in multi-practice settings, seeing post-op cataracts daily, who will benefit from being able to do a capsulotomy without having to reschedule or refer a patient. Thats why you have some OMDs in favor of the bill. The anterior seg procedures will save a patient having to be referred for minor things like chalazions, etc.
-The optometry board is important for the optometry profession going forward. A medical board made of condescending MDs would fight any advancement in the optometry profession, just like they did with pharmaceuticals, foreign bodies, and now this. Its important for ODs to have their own board to oversee the advancement when new treatment options come out, and not have to go through the legislature or a medical board with ulterior motives.
This post was edited on 5/17/14 at 11:21 am
Posted on 5/17/14 at 11:27 am to EvrybodysAllAmerican
quote:
The optometry board is important for the optometry profession going forward. A medical board made of condescending MDs would fight any advancement in the optometry profession, just like they did with pharmaceuticals, foreign bodies, and now this. Its important for ODs to have their own board to oversee the advancement when new treatment options come out, and not have to go through the legislature or a medical board with ulterior motives.
And it's equally important for the medical board to prevent infringement into our field. Both sides are about the money. I'm kinda sick and tired of us being required to do ever more expensive and intensive training/certification etc. While less qualified students/professionals backdoor their way into the same field. If you wanna be a doctor, go to med school. It's that damn simple. Otherwise, STFU and do what you were trained to do. That's all we're saying. I mean if I could go to a cheaper, easier school and get half arse trained then come out with waaaay less debt several years sooner, why the hell would anyone go to med school. I feel the same about DO and foreign med school grads. Are there some good ones? Yes, but all in all the average quality is faaaar below our American medical schools.
Posted on 5/17/14 at 11:36 am to EvrybodysAllAmerican
quote:
condescending
What is condescending is you doing this
quote:
ODs/OMDs
its not OMD its MD. Unlike you they know more than just about the O. They are medical doctors.
Posted on 5/17/14 at 11:43 am to SmackoverHawg
Ok, so when a new technique comes out- Lets say a contact lens that dispenses glaucoma meds. You think ODs, the contact lens experts, should have to go through a biased medical board to get permission to use it?
There's a conflict of interests, Thats why ODs dont want to be under a medical board. MDs will always try to limit OD's scope of practice becasue there's so much overlap.
There's a conflict of interests, Thats why ODs dont want to be under a medical board. MDs will always try to limit OD's scope of practice becasue there's so much overlap.
Page 12 of 43
Popular
Back to top
Follow TigerDroppings for LSU Football News