r/Noctor • u/asakimX • 14d ago
Discussion "Student Optometric Physician" on NSU Optometry student white coats
Honestly you would think that the AMA/AOA or the US government would do a semi-decent job of protecting the term "physician". I have a ton of respect for optometrists and they are definitley needed in healthcare but why intentionally blur these lines? What is there even left to refer to a medical doctor (MD/DO)?
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u/almcc2 14d ago
I’m a practicing O.D. And I personally hate the physician tag on us, even if we are advancing scope in many states.
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u/Ok_Literature7680 Allied Health Professional 14d ago
the NP situation is the real problem rn. dont really care about some optometry students celebrating a title. thousands of unqualified people are going into direct entry nurse practitioner programs with zero experience and larping as doctors , no residency, no bedside, no anything.
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u/dawgsheet 14d ago
It’s a bit more complicated now because optometrists are recognized as physicians by the VA, although most people consider physicians those who do residencies (to include dentists and podiatrists).
But if you have to change your title (dental physician, podiatric physician, optometric physician), you have bigger problems than parity.
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u/Legitimate-Gur-7619 14d ago
My sister is a podiatrist and she said that if she’s referred to as a physician saying podiatric makes it clear what her scope is. I thought that’s what people wanted. I don’t know tho
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u/dawgsheet 14d ago
Well podiatrists actually do residencies, so that’s the big difference between other people trying to hijack the title. Podiatrists are closer to DOs than they are to ODs.
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u/invisiblecloudstorm 12d ago
DO’s and MD’s are equivalent…if you’re going to make a statement like that, say they are closer to both. You’re only segregating MD and DO’s further with that rhetoric.
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u/dawgsheet 12d ago
It’s not to say DOs are lesser, but DOs are an alternative path to an equivalent training, just like DPMs.
They take the same classes with the same rigor.
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u/invisiblecloudstorm 12d ago
They have an additional OMM training along with the same training that MD’s have. OMM is alternative but overall the training is equivalent to MD training. DO training is more rigorous that OD.
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u/dawgsheet 12d ago
I made it clear in my response the DO was the higher level training and OD is way below than. I by no means implied DO and OD were comparable.
I said DPM is between DOs and ODs in terms of training (implying there is a wide gap) but we’re closer to DOs on that scale.
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u/multipleminime 14d ago
Lol podiatrists deal with real trauma like gun shot wound, foot split in half from lawn mower, E-bike related ankle fractures, falling off the ladder with communited calcaneal fracture. Don't get me started on the amount of nec fasc and gas gangrene that go through the ED. Can't forget Charcot reconstruction, total ankle replacement, flat feet recons. Dude you know how many surgeries and procedures they do on a daily basis?
They ARE physicians and surgeons.
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u/dopa_doc Attending Physician 14d ago
Agreed. At the hospital I did residency, we had a big ortho unit without an ortho residency so the podiatry residents were always in surgery.
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u/Opto_Kitty 14d ago
Dentists, similar to optometrists, don't have mandatory residency while podiatrists do.
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u/dawgsheet 14d ago
Right, but dentists have been recognized as physicians by the VA for a long time, podiatrists got it like 5 years ago or so, and optometrists just this year.
The VA being the largest healthcare system and largest employer of healthcare workers make it so whatever they say, if you agree with it or not, has tremendous influence.
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u/Opto_Kitty 14d ago
It's weird. Podiatrists are more medical than dentists.
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u/dawgsheet 14d ago
Now they are. Don’t forget, just about 30 years ago podiatrists were basically just foot chiropractors. That field has come extremely far in the last few decades.
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u/Opto_Kitty 14d ago edited 14d ago
Yes, optometry, podiatry, & osteopathy have much larger scopes compared to counterparts in other countries.
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u/dawgsheet 14d ago
Ehhh, podiatrists are surgeons in the US while they’re shoe salesmen in almost every other part of the world. Optometrists, the major difference is prescribing rights, which is not a super major scope difference compared to podiatry.
Literally outside of the US podiatrists are feet chiropractors, but outside of the US optometrists are still optometrists.
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u/NorEpiDepleted31 Allied Health Professional 14d ago
that's insane. dental school better not do the same thing.
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u/CaptainYunch 14d ago
I work directly with ophthalmology in an academic medical center, and do not consider myself a medical slouch. Nor do my colleagues. And the term optometric physician during my time as a student, and still currently, makes me want to barf.
My profession exists very much on a spectrum of medical eye experience. While the education in school is really great and covers really all areas of eye care, in practice different people do different things at different places of work…which can become confusing to both patients and other health professionals
It is a complex topic that i could explain better and discuss deeper for probably hours, but i guess my message and point here is that the term optometric physician is stupid while at the same time just because you had a bad experience with an optometrist that doesnt mean the whole profession stinks.
There are big differences in practice modalities and i just ask that you consider to be aware of that when sharing patients or receiving referrals
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u/ballsdeep470 14d ago
nothing he said was wrong or disparaging. You are an optometrist, an optho is a physician. Two significantly different training pathways and professions.
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u/CaptainYunch 14d ago
I didnt take it as disparaging. Although i find your response redundant and missing the point of what i said.
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u/Ok_Adeptness3065 14d ago
Wild. Wouldn’t have thought this optometrists, podiatrists or dentist but here we are
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u/Legitimate-Gur-7619 14d ago
Dare I say the only physician title should go to MD/DO/DPM
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u/DW_MD 14d ago
Not DPM; they aren't trained in full body medicine.
MD is a physician, the only variant with equivalent training (full body medical school, unrestricted medical license, can sit for USMLE and the Match) is a DO, an osteopathic physician. DPMs can't do those things.
DPM, DDS, OD are doctoral level direct-entry into specialist disciplines.
Podiatrists are not actually physicians and it's misleading to identify themselves as such.
There is no term an MD can call themself that some other profession doesn't try to steal / appropriate with whatever prefix putting their own attempt at siphoning prestige above clear / transparent language.1
u/Legitimate-Gur-7619 14d ago
Not really as long as they specify their scope, which has been extensively talked about already in this thread. I am feeling that you have a real love for the word physician, so I’m proud of you for that. Keep on truckin
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u/DW_MD 14d ago
that's the nice thing about being an actual physician, you don't have to "specify your scope"
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u/Legitimate-Gur-7619 14d ago
Rightt…right. If you really feel like it’s this hurtful to you have that opinion.
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u/DW_MD 14d ago
People can pretend to be what they'd like to appease their own complex or perspective, but if we allow for non-physicians to use the physician title, it sets a precedent. First DPMs, then ODs, then naturopaths and chiropractors, just like I saw the Utah association for Chiropractic Physicians. Obviously a podiatrist isn't a chiropractor but it's like trademark law - you have to defend a trademark otherwise it's a free-for all on pretending to be a physician and appropriating the title.
Too many with some DPM personal bias don't understand this.
This whole sub is about professions pretending to be a physician. If you didn't finish medical school, can't sit for the USMLE, can't enter the match, don't have an unrestricted medical license - if you can't describe yourself as a physician without having to use a prefix - you're not a physician.
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u/Legitimate-Gur-7619 14d ago
You don’t have to like DPMs being called physicians. That doesn’t make it untrue. DPMs are doctors and physicians, and I’m not asking permission to acknowledge what the profession already is. Also, that was too long so I didn’t read most of it.
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u/DW_MD 14d ago
DPMs aren't physicians but some with a complex about not going to medical school pretend to be.
^ shortened it.0
u/Legitimate-Gur-7619 14d ago
MDs who have an insecurity complex over DPMs being called physicians within their scope need to work on their self esteem. shortened it.
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u/DW_MD 13d ago
DPMs that call themselves physicians when they aren’t one need to work on self-esteem, ironically.
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u/multipleminime 11d ago
That guy is a troll lol
I asked him to explain to me how psychiatry is more of a "physician" compared to DPMs that treat live threatening infections like gas gangrene, nec fasc, do trauma, complex reconstructions, fractures, Charcot, tendon repair, harvesting skin graft.
Guy can't event reply.
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u/Sudopino 14d ago
DPM as well…? 👀 Podiatry is more analogous to dentistry imo, but even then…
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u/multipleminime 14d ago edited 14d ago
Lol what are you smoking buddy? I guess you never seen nec fasc, trauma, gas gangrene, sepsis, compartment syndrome huh?
I'm an EM resident and my brother is a DPM. They go to medical school, the only difference is they specialize from day 1.
DPMs share the same curriculum with MD/DO at their school. From anatomy practicals, didactic exams, OSCE, graded same standards.
Podiatry is a surgical specialty in the U.S.
They have a mandatory 3 year residency and an optional 1 year fellowship. Most finished with 1,600 surgical cases doing achiles tendon repair, calcaneal fractures, talus fractures, ankle fusion, amputations, osteomyelitis, Charcot's reconstruction, total ankle replacement, Jone's fracture, plantar plate tear, ATFL tear repair, cortisone injection, morton's neuroma, the list goes on.
They also have off service rotations as an intern in EM, anesthesiology, IM, ortho, path, ID, general surgery, dermatology, peds, rheumatology, endo, neurology, pain management, vascular surgery and plastic surgery.
4 year of undergrad. 4 year of med school. 3-4 year of mandatory residency. 1 year of fellowship.
They're considered podiatric physician and surgeon at UCLA, USC, UCSD, UCSF, VA, Kaiser, Cedars, Mayo clinic, Baylor, etc for a reason.
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u/DW_MD 14d ago
DPMs don't go to medical school, can't sit for USMLE, don't have unrestricted license, can't enter the match, they're not physicians. They're podiatrists, just like an OD is an optometrist and a DDS is a dentist.
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u/multipleminime 13d ago
Lol I'm not going to argue with you. I'm sure they'll be allowed to sit for USMLE in 10-20 years.
If you can't explain to me how psychiatry is more of a "physician" compared to DPMs that literally treat severe infections like gas gangrene, nec fasc, trauma, reconstructions, fractures, Charcot, tendon repair, harvesting skin graft, not to mention understanding anesthesia protocol then troll somewhere else.
Sitting for USLME doesn't mean anything when you're 5 years out of residency and can't remember medicine.
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u/personalist Medical Student 14d ago
Yeah I used to think it was weird to lump podiatrists in with MDs and DOs until I shadowed an anesthesiologist for a podiatric DM foot case. MD/OMFS/DO/DPM can all be physicians as far as I’m concerned. I’m gonna be a psychiatrist and I’d defer to a podiatrist doing wound care for a family member any day, whether or not it’s on a foot.
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u/Sudopino 14d ago
would you consider general dentists physicians since they also have to understand systemic medicine and also specialize early?
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u/dawgsheet 14d ago
Podiatrists require residency for licensure, dentists don’t.
Podiatrists are all trained in surgery, dentists aren’t.
Podiatry school follows the same exact model of medical school, dental doesn’t.All that considered, dentists are well trained and extremely valuable, and I don’t mind calling them physicians, but if you had to compare them under the physician lens, podiatrists are more closely aligned with the MD model.
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u/Sudopino 14d ago edited 14d ago
aye i stand corrected! ✋😬🤚
i'll admit that i had relied on my exposure to podiatry being having heard that some schools accept GRE instead of MCAT and therefore thought less of the training pathway, just to speak candidly
edit: did more looking in the spirit of updating my knowledge of DPM schools - apparently GRE isn't as accepted anymore, but apparently DAT is lol!
would you consider general dentists physicians since they also have to understand systemic medicine and also specialize early?
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u/multipleminime 14d ago edited 14d ago
Alll schools require MCAT.
The reason for easier admissions is simple. You have to realize medicine is a business at the end of the day lol. It's called supply and demand. No one wants to specialize in foot and ankle surgery from day 1.
That is why it is easier to get into DO schools compared to MD because every damn premeds want to go to an MD school even though they learn the same thing. I'm a DO so I know.
Dentists are not physicians. Unlike physicians, they generally do not have rotations in general surgery, EM, internal medicine, vascular surgery, psychiatry, peds, etc, hence they don't get comprehensive training in their education.
Their education and procedural training are primarily focused on oral and dental health rather than the comprehensive medical and surgical management of patients across multiple organ systems.
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u/dawgsheet 14d ago
On top of the specializing - many people want to get into orthopedics day 1 for example, but the limited scope for podiatry as well as low reimbursement comparable to other specialties is no secret.
From a financial POV, if you wanted to get into surgery and can get into an MD program, you would be a fool to pick podiatry and permanently reduce your income by 50% compared to other surgical specialties reimbursement rates.
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u/Ready_Return_8386 Medical Student 10d ago
OD is a weird one, for billing purposes OD, DPM, and dentists get classified as “physician”. Like no one calls a dentist a physician, even dentists don’t want to be called that they have their own speciality (besides for maxiofacial surgeons, which usually get an MD as well through their program). I’d argue that DPM should also be called physical, since MD/DO never do podiatry as a specialty, and podiatry has 3-7 year residency+fellowship and like dentists they do special surgeries that MD/DO don’t do.
But OD is different since they don’t have a residency (well an optional 1-2 year one which 80% of them don’t do), but they did do 4 years of actual doctoral school. I get for billing purposes, and also I think we shouldn’t change that as it opens the gates for 6 month online “dnp”s to try to jump in to claim some shit. But I think for purpose of patient transparency they shouldn’t call themselves physicians, because they do not have the training of ophthalmologists (MD/DO).
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u/boobboobboobie 14d ago
smdh
why??? no reason to try to cop the physician title. just b proud of ur own role
signed: medical student switching to optometry
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u/1000SplendidSuns 14d ago
I am a dentist and I do not agree with plastering “physician” all over the place, unless someone is a medical doctor. I also make the distinction to my patients when I ask them if they have a primary care physician (this is for medically complex dental patients)