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MS...
Posted: Sun Jul 13, 2008 2:46 pm
Guest
Something I forgot to mention, in what I wrote below about the cost of
medical insurance for your office staff.

Since you (O.D.s) are generally self-employed, therefore having no employer
to insure you, I would guess that you are paying extremely high medical
insurance premiums (individual premiums being much more expensive than the
per person cost of group premiums), to insure yourselves and your family
medically. (Not to mention if you or a family member have a "pre-existing
condition"--in which case your premium would skyrocket many times higher!)

How much are you paying monthly overall in medical insurance premiums--for
yourselves, your families, and your employees?

As I wrote, no such thing as a free lunch. If there were a national plan,
and you had no health insurance premiums to pay, you would probably be
paying more in taxes. However--I doubt that the increase in taxes, would add
up to nearly as much, as the amount you are paying now in health insurance
premiums!

"MS" <ms at (no spam) nospam.com> wrote in message
news:Assek.101065$c5.54710 at (no spam) fe101.usenetserver.com...

Quote:
How many of you provide health insurance benefits to your office staff? If
you do, I'm sure you are aware of the skyrocketing cost of health
insurance premiums, increasingly difficult for employers to afford, and
especially for small business, like your offices!

Wouldn't it be nice if the government did the insuring (as with medicare),
and employers were not expected to provide such benefits any more, taking
it off your backs?

In fact, that would be good for American business in general. One reason
that U.S. companies are finding it harder to compete with foreign
companies, is the immense amount that U.S. companies have to pay in health
insurance premiums. For instance, the U.S. auto industry--the fact that
they have to pay so much of their income in health insurance premiums,
makes it hard to compete with European and Japanese companies, who don't
have to pay a cent in health insurance premiums--since that is handled by
the government, not by employers.

I'm not saying there wouldn't be costs involved in a national health care
plan. There is no such thing as a free lunch. Of course, taxes would have
to be higher (as they are in those other countries), to pay for the plan.
However, I think the cost involved in the increased taxes, would be much
lower than what is now being paid in private health insurance premiums,
cost of emergency room care for the uninsured, etc. In general, I think
the overall financial cost to society, would be much less than with the
present system, and it would be a great relief for employers, not to have
to deal with providing health insurance for their employees any more. (As
well, of course as the humanitarian boon that everyone would be
covered--employed or not.)
...
Posted: Sun Jul 13, 2008 4:05 pm
Guest
On Jul 13, 6:10 pm, infinitec... at (no spam) hotmail.com wrote:
Quote:

Optometry training is relatively easy to get admissions to ( < 3.0 gpa
in undergrad ), and is not comprehensive as medical school and
opthalmology residency.


I can speak to your statement since I have been to both medical and
optometry schools. My comments relate to the US health care system,
and there are significant differences in the training and scope of
practice of optometrists around the world.

Optometry school is indeed much more competitive to get into than you
think. The average GPA of the entering class in the school I attended
is ~3.4. The same university's medical school statistics are
similar. The prerequisites for admission to both schools is virtually
identical.

The optometry school curriculum is very similar to medical school
courses during the first two years-- basic science courses in human
anatomy, physiology, biochemistry, pharmacology, etc. The depth,
however, is not as great in some cases as it is in med school. But
optometry students spend considerable time also studying basic optics
and physiological optics to a level that ophthalmology programs or
medical schools simply do not even attempt to match.

IMHO, graduating from a US optometry school gives a person much
greater understanding of the eye than a general ophthalmologist has.
After all, in optometry school 4 years is spent concentrating on a
single organ system. The eye. How much does a med school graduate
really know about the eye-- the answer is, very little. A three year
residency in ophthalmology essentially provides a hands-on
apprenticeship in seeing how surgeons and subspecialists treat certain
ophthalmic conditions but does little to tie it all together, or to
provide for the lack of concentrated study in ocular anatomy and
physiology that is not provided in medical school. I believe that
optometrists get better training in understanding general eye
conditions in otherwise healthy patients who need little more than
eyeglasses or contact lens correction, or treatment of routine medical
problems like infections or abrasions. Such patients constitute the
vast majority of people seeking primary eye care. In short, see
Optometrist for primary health care, go to ophthalmologists for
surgical needs or when referred for complex conditions. Optometrists
can recognize pathologies and refer off to subspecialists as well as
any general ophthalmologist. Personally I think general
ophthalmologists are of negligible value in the US health care
system.

Not to mention that the demographics illustrate that there are
insufficient numbers of Ophthalmologists to meet the primary eye care
to the US population.

I think your understanding of this topic is rudimentary and simplistic.
Dr. Leukoma...
Posted: Sun Jul 13, 2008 5:17 pm
Guest
On Jul 13, 5:10 pm, infinitec... at (no spam) hotmail.com wrote:
Quote:
On Jul 12, 4:24 pm, "Mike Tyner" <mty... at (no spam) mindspring.com> wrote:

So you're saying you should have to wait a week because optometrists aren't
"supposed to" do what they're trained to do? Optometry schools aren't
"supposed" to teach microbiology and pharmacology?

Who does fillings better, a family dentist or an oral surgeon?

Opthalmology residency is highly competitive. It requires full 4 yrs
of medical school and an acceptance to an opthalmology residency,
which is an extra several years. Many US med grads do not get accepted
to a single one of these programs.

Optometry training is relatively easy to get admissions to ( < 3.0 gpa
in undergrad ), and is not comprehensive as medical school and
opthalmology residency.

I do not work in visual sciences and can't comment first-hand but this
is something to think about.

The fillings analogy is not a good example. Both general dentists and
oral surgeons undergo the exact same 4 yrs in dental school, where
fillings tend to be the bread/butter in the restorative curriculum.

Anybody who really cares can look up the class profiles of any of the
optometry schools and see that your statements are total nonsense.
Mike Tyner...
Posted: Mon Jul 14, 2008 1:49 pm
Guest
<infinitecore at (no spam) hotmail.com> wrote

Quote:
The fillings analogy is not a good example. Both general dentists and
oral surgeons undergo the exact same 4 yrs in dental school

And after 4 years, both of them are allowed to provide medical care within
the scope of their training.

So if optometry students endure the same four years, share the same basic
sciences curriculum and get comparable specialty training, they should
likewise be allowed to provide medical care within the scope of their
training.

-MT
albi...
Posted: Mon Jul 14, 2008 9:39 pm
Guest
Hello all:

very interesting topic.

we do not have practicing optometrists (own praxis) here in Germany
(not allowed), they work in opticians shops, or hospitals, or
ophthalmology private praxis.

I did not have the time to read every comment thoroughly, but I think
I did not read the following argument, which in my opinion is VERY
important:

Optometrists do not have a general medical education with more than
good lay insight into all other medical subspecialities.
Ophthalmologists have. Bot only education, but individual working
experience.

Finishing medical school / optometric school: of course (!!)
optomentrists are far more experienced in all parts of ophthalmology.

But the final medical student choosing ophthalmology runs through
another 5+++ years of highly specialized training. 5 yrs is the
minimum in Germany, and then you are a General Ophthalmologist, NOT a
corneal, retinal, paediatric, whatever..... specialist, this requires
further training. AND you have the background of a full medical
course, including working (!!) as junior house officer in all the main
and big fields: internal medicine, surgery, paeds, etc.

I agree however that the General Ophthalmologist is probably in spite
of the 5 years less trained in refraction, and low vision device
fitting.

Concerning the eye infection:


Quote:
I have an eye infection, and went to my optometrist about it, a few days
ago. Why? I've been to him for contact lenses, and I haven't been to an
ophthalmologist, don't know any. Also, he's close, and when I called, they
said I could come in right away, for him to see me.

The optometrist seemed knowledgeable about it, but perhaps an
ophthalmologist would have been better. I don't know. He put me on
antibiotic eye drops (zymar), and of course I'm not wearing my contacts now.
I don't know what an ophthalmologist might have done differently.

1. did the optometrist do a slit lamp examination? Contact lens
wearing problems, corneal ulceration?
2. did he do microbiology (cave: keratoconjunctivitis epidemica is
highly transmissable, and would have meant a sick leave to protect
others!
3. did he do an antibiogramm to check whether these drops are
effective?
4. did he inquire about any other of your health issues?
immunologically relevant diseases?

Quote:
Although I have vision insurance, which paid part of the cost for my contact
lens fitting and lenses, I was told at the optometrist's office that my
vision insurance doesn't pay at all for an eye infection, and I had to pay
$65 on the spot, for a few minute office visit.

I donīt quite believe that..... really?

I work in the field of paediatric and neuro-ophthalmology plus low
vision. I do need my general medical knowledge and practical
experience *every day* (including the low vision part! one does have
to know about the general medical, surgical and neurological diseases
affecting the elderly to fit low vision devices correctly!), and I
have studied paediatrics, medicine of the aged patient and much
genetics on my way as well.

You never know what you do not know if you do not know.......

greetings,
Barbara

(Consultant of Paed., Neuroophth, Low Vis., university-based)
 
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