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Exclusion from MD meetings empowers optometry
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Last year’s decisions by the American Academy of Ophthalmology (AAO) and the American Society of Cataract and Refractive Surgery (ASCRS) to restrict optometrists’ attendance at the educational portions of their meetings ignited immediate contention within the eye care community.
One year later, these exclusions continue to have a divisive effect among eye care practitioners, culminating in recent legal action by the American Optometric Association (AOA). “The American Optometric Association has filed an antitrust complaint with the Federal Trade Commission on this matter and cannot comment on a pending complaint,” AOA spokesperson Susan L. Thomas told Primary Care Optometry News. Ms. Thomas was unable to elaborate on the complaint.
Yet, despite the highly politicized climate of the eye care profession, optometrists claim they have not only recovered from ophthalmology’s snubs – they have thrived as a result of them. “I think these actions on the part of ophthalmology have mobilized us to achieve the knowledge necessary for continued growth and competence through other venues,” said J. James Thimons, OD, FAAO, a Primary Care Optometry News Editorial Board member who practices in Fairfield, Conn. “In some ways, this is the best thing that’s ever happened to us.”
Professional collegiality?
The concept of political disagreement between optometry and ophthalmology is hardly a new one – the two professions have often been at odds on any number of issues. In the past, however, these political squabbles have had little to no impact on everyday working relationships. Today, things are not so simple, Dr. Thimons said.
“A lot of optometrists and ophthalmologists at a local level have had in the past – and continue to have – pretty good working relationships,” he told Primary Care Optometry News in an interview. “But when national organizations choose to make statements about the other profession’s competence via this type of action, it becomes difficult to maintain a good relationship with a colleague if, in fact, he or she supports the academy.”
Dr. Thimons said he greatly values the professional relationships he has built with ophthalmologists. He said while skill is his primary concern, he also prefers to associate with those whose beliefs are similar to his own.
“I work with people at the highest skill level, so it is not a matter of choosing merely based on politics,” he said. “I choose because of skills, but I have enough people to choose from that I can also choose those I like to work with and those with values similar to mine.”
According to Paul M. Karpecki, OD, FAAO, a Primary Care Optometry News Editorial Board member who practices in Kansas City, Mo., he does not often come into contact with ophthalmologists who supported the decisions.
“On an everyday working relationship, it hasn’t had any effect, in my opinion,” he said in an interview. “Most of the MDs who were in favor of the ban really don’t work with optometry to begin with and, therefore, did not see a change in referral patterns.”
Dr. Thimons said he has also encountered ophthalmologists who have expressed their disapproval of AAO’s and ASCRS’s decisions, calling them “ridiculous.”
“I think that both sides have been forced to deal with issues that have probably been left undiscussed before, because it was easier not to talk about things that might be political or sensitive,” he said. “So this has forced us to confront the true nature of the relationships between optometrists and ophthalmologists on a daily basis. These relationships have become much more well-defined as a result.”
Educational autonomy
One significant and extremely positive effect of the exclusionary decisions has been the formation of strong optometric subspecialty groups.
Dr. Thimons said that in its attempt to alienate optometry, ophthalmology inadvertently empowered the profession. “Ophthalmology forced us to understand where we needed to develop in the educational arena,” he said. “And one of these areas was the development of specialty programs that are solely devoted to one topic.”
He said optometric organizations such as the Optometric Glaucoma Society, the Optometric Retina Society, National Cornea and Anterior Segment Society and more have galvanized their efforts to provide the highest level of optometric education.
“We have just named the education chair for the National Glaucoma Symposium, optometry’s first and only open-attendance glaucoma meeting,” he said. “This meeting is literally designed for optometrists — the people who practice every day. This is our second year, and last year, it was hugely successful.”
Dr. Karpecki, who has lectured at ophthalmology meetings, agreed that being excluded from these meetings presented optometry with an opportunity to meet the challenge of educational autonomy. “It has necessitated the opportunity, and optometry has risen to the task with programs such as the pre-American Academy of Optometry refractive symposium sponsored by the Optometric Council on Refractive Technology as well as other educational programs during major meetings,” he said. “Optometric organizations stepped up and provided world-class education at the same or even a higher level.”
William Jones, OD, FAAO, a Primary Care Optometry News Editorial Board member and a leader of the Optometric Retina Society, said ODs have grown much more sophisticated in the area of education. “In the past 20 years, optometry has matured greatly in knowledge about ocular disease,” he said in an interview. “We now have numerous optometric speakers who provide a quality of ocular disease education equal to the MDs in any respect.”
Dr. Thimons said he believes that ophthalmology over-estimated the value of its educational programs to optometrists. “The academy grossly overrated the level of impact of their education on clinical optometry,” he said. “That was a remarkable over-statement on their part. I don’t think there has ever been a huge reliance on that meeting to educate optometry.”
Dr. Karpecki agreed that optometry has not been damaged by the ban. “The ODs who attended were a very small group who primarily worked in a practice with an ophthalmologist in a secondary or surgery setting,” he said.
Dr. Thimons said the only truly negative consequence of the optometry ban has been the lingering acrimony on both sides. “It has provoked an escalation of the confrontational styles of both sides,” he said. “I do believe they laid down the gauntlet first, but I think if you asked them, they would say that we provoked it by putting x, y and z in our therapeutics bills. But what we’ve ended up with is a lot of confrontation that has nothing to do with education.”
For Your Information:
- The American Optometric Association can be reached at 243 N. Lindberg Blvd., St. Louis, MO 63141; (800) 365-2219; (314) 991-4100; fax: (314) 991-4101; Web site: www.aoanet.org.
- J. James Thimons, OD, FAAO, is a Primary Care Optometry News Editorial Board member who practices in Fairfield, Conn. He can be reached at 75 Kings Highway Cutoff, Fairfield, CT 06430; (203) 366-8000; fax: (203) 334-2401; e-mail: jthimons@sbcglobal.net.
- Paul M. Karpecki, OD, FAAO, is a Primary Care Optometry News Editorial Board member who practices at Moyes Eye Center in Kansas City. He can be reached at 5844 NW Barry Road, Ste. 200, Kansas City, MO 64154; (816) 746-9800; fax: (913) 681-5584; e-mail: PaulK-VC@kc.rr.cin.
- William Jones, OD, FAAO, is a Primary Care Optometry News Editorial Board member located in Albuquerque. He can be reached at 1828 Conestoga, SE, Albuquerque, NM 87123; (505) 293-7347; fax: (505) 247-2153; e-mail: wjones556654@comcast.net.