Optometric Physician vs. Optometric “Other”

I lurk at Optiboard.com, and someone posted a message about how they don’t diagnose or treat glaucoma:

No, we haven’t been diagnosing and treating glaucoma in the office for the last 5 years. There are were so many changes in instrumentation that we thought we’d let the MDs pay those leases, and we refer everything suspect.

What the c—? If you say you refer “everything suspect,” then I suspect you either over refer or under refer.

Over referrals do your patients a disservice by increasing their healthcare expenditures. They have to become a new patient at some else’s office, repeat a lot of tests, and pay more since EyeMD fees on average are higher than EyeOD fees. Then they somehow get the idea that ophthalmologists must be the experts because my optometrist is too stupid to find out if I have glaucoma or not. They probably get this idea from their ophthalmologist telling them in the exam room, “I’m glad you came in to see me because optometrists are too stupid to diagnose and treat glaucoma, and you know this is true because a representative from that trade sent you over to me.”

I could also see how it would be very easy to under refer in that scenario, “well, it’s borderline, but I don’t want them to waste a lot of money seeing Dr. Expensive Ophthalmologist since they don’t have insurance, so I’m just going to decide that it’s okay. Besides, if it’s glaucoma, it could take years before they notice it.”

Obviously, neither scenario is acceptable. I wrote the following reply to that thread on the web board:

That makes me sick. For the sake of the optometric profession, practice to the fullest extent.

This is why some of us should have a special designation called “Board Certified Optometric Physician” and then the rest of you not interested in patient care can be called Optometric Lens Flippers.

Actually, I would like to add that optometry and optometrist are good names. Shame on those who disgrace them by not practicing basic eyecare.

I think the days of an ophthalmologist marketing him/herself in the yellow pages as “the glaucoma specialist in the valley” are coming to an end. All eyecare providers should be glaucoma specialists. If we don’t have certain instrumentation, we can work it out to send the patient to another office only for that particular test.

Can you imagine an optometrist saying “I don’t diagnose cataracts”? It’s the same thing with glaucoma. We diagnose and treat it, and send the patient to someone else only when necessary to do something outside the current scope of practice (ex. glaucoma or cataract surgery).