re: Optometry: LA HB 1065/SB 568: What if your Louisiana Eye Surgeon is NOT an MD?

Of course, this is no different than NP's and PA's practicing medicine. We were against it, but got no support from our medical societies and definitely not from our specialists friends. It wasn't their problem. Now it is. Ortho's will be next. I think I should be doing knee scopes. They're easy and pay well. I do the rest of the care and work up. I end up treating most post op complications. I probably can now if I were ballsy enough. I think we'll see this expanding into others fields. Dentists, you're next.

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Which optom do you speak of- are you saying he owns multiple clinics or actual vision insurances?

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Both. He owns clinics and he owns a network of Optometrists called Vision Benefits.

I guess this means no more "let's see. We can schedule you in next November - wait - he's in Europe - how about April?"

It's always interesting to see people who generally decry excessive government regulation of business, change their tune when a govt regulation protects their monopoly.

If optometrists can't handle the procedures, presumably the market will handle with malpractice suits and unaffordable insurance.

Any ideas what could possibly be in store for the future?

Veterinarians setting broken bones on humans?
Lawyers treating hemorrhoids? (They do have a Juris Doctor)
Pharmacists ordering x-rays and MRIs?
Pharmaceutical sales reps writing prescriptions?
Cosmetic counter sales girls treating skin cancer?

There must be something else out there?

I believe the irony you speak of is a bit contrived.

Persons on the other side of the argument are quick to point out that supposed conflict of thought. That criticism is apparently based on the idea that persons who are against excessive government control must be complete anarchists who don't want any government. This idea of all or nothing mentality is laughable and the application of that idea to individuals is frankly insulting.

Intelligent people make decisions based on their principals and the presenting situation. Since we all live in a society with a certain level of governmental control and oversight, there are certain measures that we all accept. This does not mean that we should be blind to increasing or excessive change in either direction from the current stasis.

The assertion that those with altruistic concerns about incompetent and/or underprepared persons increasingly providing health care to society are only concerned due to financial reasons and a perceived "monopoly" is simply short sighted.


The "monopoly" you speak of is non existent. Medical school admission is available to every child born in this country providing they do the work to meet the admission criteria. Even a poor kid from Livingston Parish, who attended public schools in the 2nd worst rated state in the country, who was the first in his family to graduate college, and who had no connections in the health care field or any medical school can gain admission. The "monopoly" we supposedly have has no control over fee for service (and have sadly watched it steadily decrease, has limited to no control on the required and steadily increasing overhead, has no control on number of other qualified providers, has no control over the income source (patients)other than availability, and in no way can prevent others who work to be equally qualified from competing with us right across the street or even right down the hallway.

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Were you playing when we beat y'all 35-7

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I went to Belaire and we sucked.

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Nothing stopping you from opening up your own clinic, cash only, charge whatever fee you want for services provided. Surely all the Obamacare haters would be glad to pay cash for services, in of protest of the horrors of OC, and in support of their principled opposition.

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Local population limitations are certainly a limiting factor here. The uninsured that are cash pay are rarely willing to spend funds on healthcare even if they have them. Those with funds are generally insured and rarely willing to pay for cash services. Concierge practice is a possibility but requires a particular patient population to be feasible. Honestly if you want to care for the local patients you are forced to take the array of funding options in your area. Otherwise certain patient populations simply will not receive care. A perfect example is obstetrics. If you do OB you take MCD. If you don't take MCD you will not be doing OB for long. Same with pediatrics when 80% + of the local pediatric patients have MCD.

Surely some physicians have stopped taking Medicare/Particular Insurances or changed their policies so that the pt has to bill the Payor themselves after paying the physician directly. Many of these patients end up in my office because the process of billing Payors especially MCR is too complicated for many of the elderly.

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i seriously doubt the altruism of all those involved.

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I have no trouble with PAs/NPs providing most of the healthcare that i receive. Many physicians seem too busy to spend the time required, not suggesting that issue is their fault.

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Well, you are entitled to your opinion on that matter. I will tell you that NP/PA are not equivalent to a physician. They simply are not trained to the same level. I fix the problems they create on a daily basis, and by problems I mean patient morbidity and mortality. I agree the pace at which physicians are forced to move is concerning. I alluded to the reasoning in the previous post. Decreased reimbursement and increased overhead have changed medicine into a volume business. And yes in some sections of medicine and areas of the country there are shortages in physicians.

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Hey, you never worked RRMC, eh? I got a $460 bill from the ER service when the doc saw me for approx 2 minutes then ordered the nurse to give me a tetanus shot. Can you help a brutha out?

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I sure can.


Next time go to your family physician for a simple office visit at $60-100 dollars.

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Pharmacists ordering x-rays and MRIs

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They are wanting prescriptive authority.