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Started By
Message
re: Are we sure optometrists should do eye surgery w/o going to medical school?
Posted on 5/16/14 at 11:05 am to LATigerdoc
Posted on 5/16/14 at 11:05 am to LATigerdoc
quote:I can't see that happening.
The next thing they'll legislate will be cataract surgery.
:rimshot:
0
Posted on 5/16/14 at 11:47 am to LATigerdoc
quote:What is the typical exposure to those procedures in Optometry school?
Yag capsulotomy, peripheral iridotomy, laser trabeculoplasty
Is the training experience fairly uniform?
quote:Is that done on patients without an intraocular lens in place (i.e., post-cataract surgery)?
Yag capsulotomy
I would assume patients in the postsurgical category, with a complication, would best be seen by the surgeon, then referred from that source if further expertise is required.
Posted on 5/16/14 at 1:37 pm to NC_Tigah
quote:
I'm not sure of the relevance there. Unless I'm misreading, the optometrist would be referring those cases elsewhere.
Today. But what about after this bill passes and a fraction of these are actually performing the surgeries?
That would make this...
quote:
Presumably the consulting opthamologist would complete any appropriate additional testing prior to surgery.
moot possibly?
At any rate, at the end of the day the burden is on the patient to determine how to receive treatment whether this bill passes or not.
Posted on 5/16/14 at 2:19 pm to theunknownknight
The Louisiana State Board of Medical Examiners oversees ALL surgery in Louisiana. Why would we want the optometrists exempt from this?
The people of Louisiana need to trust we have one (not two) standard of care when it comes to eye surgery. The LSMS and all it's specialties adhere to the LSBME surgical standards free of political rhetoric & if the optometrists want to do do eye surgery they should do the same.
This post was edited on 5/16/14 at 8:44 pm
Posted on 5/16/14 at 3:00 pm to onmymedicalgrind
quote:
quote:
No, the cardiologist and CT surgeon graduated medical school..
Well yeah, I was just trying to illustrate the point that you could know alot about organ pathology without being qualified to operate on said organ.
Cardiology is more interested doing their own interventions and eliminating the need for surgery than doing the surgery. Poor analogy.
Posted on 5/16/14 at 3:00 pm to jamarkus
Posted on 5/16/14 at 3:52 pm to LATigerdoc
quote:
The next thing they'll legislate will be cataract surgery.
Reminds me of an incident in the legislature several years ago. Diana Bajoie (the DeeDee Slaughter of her day) introduced a bill allowing anyone who had served in the legislature for eight years to practice law. Peppi Bruneau countered with an amendment providing that they would also be licensed to practice brain surgery. The bill died quietly.
Posted on 5/16/14 at 3:53 pm to Layabout
Posted on 5/16/14 at 4:07 pm to LATigerdoc
This is all about Senator David Heitmeier, an optometrist, being head of the La Senate Health & Welfare committee as well as head of the Senate. This is not about patients
This post was edited on 5/16/14 at 4:09 pm
Posted on 5/16/14 at 5:55 pm to jamarkus
quote:
Yag capsulotomy, peripheral iridotomy, laser trabeculoplasty
quote:
To suggest these simplistic procedures are out of my scope is simply ludicrous and insulting. Believe it or not, I did not spend 4 years of optometry school and 1 year of residency learning how to refract. Hell, I can teach an ophthalmologist to refract in about 10 minutes. I hate to be the voice of reason here
quote:That's what I was afraid of.
A couple of days ago I was referred a misdiagnosed patient urgently from a local optometrists specifically for a peripheral iridotomy laser to "relieve the pressure for angle closure glaucoma" (This is one of the lasers passed in HB1065) The gentleman in fact had a neovascular glaucoma bleed stemming from an ischemic event and the laser would have been contraindicated & would have caused further bleeding and further increase in his pressure. Also, the glaucoma drops he was prescribed by the optometrist are also contraindicated with his congested heart failure & lung disease. He was on supplemental oxygen. HB 1065 would have allowed the optometrists to do a laser that would have worsened the situation & further delayed treatment. Performing this laser and prescribing Beta-blocker to someone on oxygen for congestive heart failure could easily be viewed as malpractice. He is now set up to see a Retina specialist to clear the blood & Glaucoma surgery next week to try to save the eye.
The judgement to suggest a laser in this situation scares me.
Posted on 5/16/14 at 5:59 pm to jamarkus
No, it's about physicians trying to maintain rents.
Let people decide, not the government.
Let people decide, not the government.
Posted on 5/16/14 at 6:01 pm to Tigah in the ATL
quote:Actually, no.
No, it's about physicians trying to maintain rents.
quote:
ophthalmologist who needs to be in our surgery center doing cataract surgery and blepharoplasties instead of doing a YAG or chalazion removal
Posted on 5/16/14 at 6:06 pm to jamarkus
quote:
prescribing Beta-blocker to someone on oxygen for congestive heart failure could easily be viewed as malpractice
Not entirely true. Cardioselective betablockers (and carvedilol) are mainstays of CHF treatment. Carvedilol and metoprolol succinate are specfically indicated and recommended per the 2013 AHA guidelines for heart failure.
This post was edited on 5/16/14 at 6:08 pm
Posted on 5/16/14 at 6:24 pm to Tiguar
quote:Agree 100%.
Not entirely true. Cardioselective betablockers (and carvedilol) are mainstays of CHF treatment. Carvedilol and metoprolol succinate are specfically indicated and recommended per the 2013 AHA guidelines for heart failure.
I'd suppose the BB in question was Timoptic or something similarly nonselective though.
Packaging likely contraindicates use in circumstances as described.
Posted on 5/16/14 at 6:29 pm to big70
quote:
Cardiology is more interested doing their own interventions and eliminating the need for surgery than doing the surgery. Poor analogy.
No its not. Cardiologists know alot about the heart. Yet they aren't trained to do open heart surgery, analogous to optometrists and ophthos. Interventional cards =/= CT surg.
Posted on 5/16/14 at 6:32 pm to jamarkus
quote:
prescribing Beta-blocker to someone on oxygen for congestive heart failure could easily be viewed as malpractice.
This doesn't really make sense, maybe I am missing something?
Other than that, good post
ETA: Tiguar and NC beat me to it
This post was edited on 5/16/14 at 6:33 pm
Posted on 5/16/14 at 6:43 pm to onmymedicalgrind
quote:Depends, doesn't it.
This doesn't really make sense, maybe I am missing something?
i.e., O2 dep COPD on qid albuterol, and currently therapeutic from cards stance on Beta-1 Selective blockers. Addition of Timoptic would not be good.
This post was edited on 5/16/14 at 6:46 pm
Posted on 5/16/14 at 6:48 pm to NC_Tigah
Sure, but good thing theres Coreg
Posted on 5/16/14 at 7:40 pm to onmymedicalgrind
CT surgeons, cardiologists, interventional cardiologists, and ophthalmologists...
...all go to medical school (MD school where you become a physician)
...all go to medical school (MD school where you become a physician)
Posted on 5/16/14 at 9:10 pm to onmymedicalgrind
quote:
No its not. Cardiologists know alot about the heart. Yet they aren't trained to do open heart surgery, analogous to optometrists and ophthos. Interventional cards =/= CT surg.
Cardiology prevents need for ct surgery and is doing stuff that ct surgery doesn't do ....optometrist are not preventing anything and just taking part of the pie from optho
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