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OD Controversy: A Question of Tactics

OD Controversy: A Reply

Part of the Problem? Become the Solution

OD Controversy: A Question of Tactics
I fully understand and respect the board of trustees’ decision concerning optometrists and the educational programs at the Academy’s Meeting, but it’s causing collateral damage. In this era of surgical metaphors in war and war metaphors in health care, it might be useful to focus on the tactic, rather than just the strategic goal.

There are many within the optometry profession who have no interest in expanding the profession but might not have strong enough feelings to express resistance.

The response of the Academy, although dramatic and forceful, and perhaps effective with respect to the immediate issue at hand, will weaken the voice of opposition within optometry. It also will reinforce apathy among the apathetic and damage areas of cooperation and collaboration by stigmatizing relationships with optometry. This in turn will close channels of communication and advocacy.

For example, many of the academic leaders in the area of wavefront optics, although not necessarily optometrists, are employed by or are connected with academic optometry. Many of the leaders in low vision within ophthalmology also are respected and trusted voices within optometry. These leaders should be empowered to help win support within optometry, not disenfranchised by a sweeping action that threatens their work and stains their careers.

If the immediate issue is continuing education, I would think that could be targeted more precisely with “members-only” or “licensed MD-only” sessions. This would keep the Meeting open for interdisciplinary academic forums, without making exceptions, and for advancing interprofessional relations, which in itself could help the Academy’s trustees achieve the desired result.

Robert W. Massof, PhD

OD Controversy: A Reply
The Academy board recognizes the many valuable contributions of optometrists to patient care and education. Unfortunately, some optometrists have misrepresented the education the Academy has provided to try to inaccurately justify expanded optometric services into surgery.

These educational programs do not constitute training in surgery and are not intended as such—yet they have been so represented by some optometrists.

This problem has existed for some time and the Academy council has requested this action on previous occasions. Recent repeated misrepresentations have prompted this action.

With regard to the Academy, our colleagues in medicine and the public: All believe that surgery should be done by medically trained surgeons. Our hope would be that those optometrists who feel compelled to do surgery with its attendant risks, responsibilities and liabilities would follow the path of other surgeons through medical school.

We have been told this push into surgery is driven by a small portion of optometrists who do not represent the broad feelings of that profession. If that is the case, now is the time for optometry to speak up.

Allan D. Jensen, MD
Academy President

Part of the Problem? Become the Solution
I have received a letter from the Academy requesting that I support the Surgical Scope Fund.

My thinking is that the ones who should fund this fight are the very doctors who have helped fuel the problem: Those ophthalmologists who employ optometrists, give them kickbacks for referrals in the guise of comanagement fees and offer them free educational seminars as a means of boosting referrals.

I think the doctors who boast of such things as “my $100,000 surgical day” and “my 200 OD referral network” in the throwaway journals are the ones who should send their donations.

I do not feel very threatened by this initiative. I have, all my life, treated ODs with respect but have not pandered to them for referrals. Let those who have helped create the problem do their part to stop it.

Ralph M. Bishop, MD
Ithaca, N.Y.

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