In the editorial, The Marriage of Education and Ethics, (Editors Page, May 2004) I think Editor-in-Chief Amy Black missed an important point. Ophthalmologists and AAO members rarely adhere to the political positions put forth by the American Academy of Ophthalmology. Its unfortunate that the members of the AAO Board of Directors take a position that challenges optome-trists to respond.
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Dr. Arthur Epsteins quote from Optometric Physician, to see the wedge between the two professions grow, is another misconception. The majority of O.D.s will not see a wedge grow between them and the M.D.s. The ophthalmologists and O.D.s who believe that excluding optometrists from the AAO educational meetings is misdirected should not respond with a knee-jerk reaction. The optometric media need to temper remarks so media ethics are used in conjunction with some thought about the consequences of agitation before communications can proceed calmly and intelligently between the two professions. Howard Levenson, O.D., San Rafael, Calif., howard326@comcast.net.
The Role of the Modern Optometrist
In a previous issue, Samuel J. Simon, O.D., expressed his concern about the direction of optometric training and the professions emphasis on developing diagnostic doctors, (Letters & E-mail, June 2004). While his observations regarding the history, evolution and current state of optometry are enlightening, I believe that his views reveal a misunderstanding of the reality of modern optometry.
Why must there be a division between vision care and medical care? Some O.D.s believe learning about medical eye care means turning our back on vision care. Why must the two be mutually exclusive? Medical eye care is a necessary and logical extension of vision care. We practice both ... and why not?
Dr. Simon said, Diagnosing eye pathology is certainly a part of our calling, but it is a small part of what the public wants from us. I disagree. Our calling is to serve patients to the best of our ability. Depending on your patient base, that may mean a practice limited to vision care, but for others it may require practicing everything short of surgery. The latter simply manage a wider range of patient types. Modern O.D.s can be true primary care physicians, treating a variety of challenging and interesting cases.
An argument can be made that O.D.s are over-trained for the traditional job of optometry, but we must consider that optometry is still evolving. Students should be taught to the highest level of optometric practice in the U.S. Anything less would shortchange those who aspire to practice in states with advanced scope of practice laws.
Dr. Simon also admonishes our professional publications for falling into the therapeutic trap and suggests that we cannot survive by focusing on pathology. In reality, the reverse is more likely. Over the last two decades, the cost of ophthalmic products for the public has decreased significantly, competition is greater and profit margins are thinner. Those who place all their apples in one basket may survive, but they may find it quite difficult.
In order for optometry to survive and flourish, we must offer a range of services to our patients and deliver those services with the highest level of skill and professionalism. That means including medical eyecare. The domain of optometry should be optical, visual and medical. Why? Because we have the ability to encompass all three. As long as we educate our students and ourselves with expertise and compassion, we will have more stimulating and rewarding practices. Cliff Courtenay, O.D., Valdosta, Ga., drcourtenay@completeicare.com.
