California residents beware of inferior eye care!

[Schu]

Thanks Obama

[Fjd]

I don't get it....doesn't every doctor ultimately have their first patient of all time?

Shouldn't the focus be on what constitutes sufficient training? What if we were already requiring too much? The increase in mistakes was certainly part of the analysis. How many more people are getting treated that couldn't previously afford it? Shouldn't that weigh into the analysis too?

I'm not saying I'm behind the changes, but the anecdotal fear mongering is not representative of responsible citizenship. We used to be a nation known for making great compromises. Why do we now see compromise as the enemy?

Also, don't forget you are free to choose your doctors. You don't have to go with the rookie fresh out of school.

 

 

Part of my point about my attempts at humor and the flu shot analogy is that I don’t know anyone anymore that schedules an appointment with their family doctor along with incurring an office visit charge for a flu shot.  In addition, I have yet to find where one of the nurse practitioners, or anyone else I have dealt with, has not followed the proper procedures or missed my arm with the needle and hit me elsewhere.  The benefit to me is providing many more options within my time constraints, less expensive and I suspect frees up the doctor's time for issues better matched to his or her vast experience level.

 

The surgeries in question seem to be very old and established procedures and I suspect that once various doctors become qualified the process will evolve similar to the flu shots where these doctors will most likely become just as experienced or even more experienced. 

 

I suspect that one benefit would be that the shift would free up time for the “better trained” surgeons/physicians to perform the more risky and groundbreaking surgery procedures that will bring the higher dollars to them for which they currently may not have time to appropriately focus and hopefully lower the risk to us patients. 

 

In theory the result should be better overall skill development for everyone to benefit from as patients.  I know it is somewhat different; however, if I didn't carve out the sections of my work where I have developed reliable process and procedures and delegated them to the latest "rising stars" then focused my time on new issues and problems, I would soon become overworked and obsolete.

 

 

 

 

 

 

 

Please all, keep this on topic and non political.

 

Too late!  The first four words of the first sentence of the original post were political. 

 

 

Thanks Obama

 

 

Schu, please read the above posts as we have already lost 30,000 plus posts and many threads have vanished on this forum in the past month or so and a lot of associated history that many of us have contributed to along with those 30,000 plus posts have vanished.  In addition, several have quit posting completely due to people continuing to attempt to bring their political views into threads with what seems to be attempts to create chaos.

Edited June 6, 2015 by Fjd

[tube fanatic]

From a strictly financial perspective, it looks like you guys ought to profit more from fixing botched jobs.

 

Jeff, just to clarify, I'm not an ophthalmologist (wish I were!).  I repair ophthalmic medical equipment for eye docs, among sundry other things.  That's fun in its own right, but doing eye surgery looks like something I'd enjoy.  Just a bit too old to think about going to medical school so I console myself by doing "surgery" on vintage tube equipment!!!!!

 

Maynard

[oscarsear]

 

I don't get it....doesn't every doctor ultimately have their first patient of all time?

Shouldn't the focus be on what constitutes sufficient training? What if we were already requiring too much? The increase in mistakes was certainly part of the analysis. How many more people are getting treated that couldn't previously afford it? Shouldn't that weigh into the analysis too?

I'm not saying I'm behind the changes, but the anecdotal fear mongering is not representative of responsible citizenship. We used to be a nation known for making great compromises. Why do we now see compromise as the enemy?

Also, don't forget you are free to choose your doctors. You don't have to go with the rookie fresh out of school.

 

 

Part of my point about my attempts at humor and the flu shot analogy is that I don’t know anyone anymore that schedules an appointment with their family doctor along with incurring an office visit charge for a flu shot.  In addition, I have yet to find where one of the nurse practitioners, or anyone else I have dealt with, has not followed the proper procedures or missed my arm with the needle and hit me elsewhere.  The benefit to me is providing many more options within my time constraints, less expensive and I suspect frees up the doctor's time for issues better matched to his or her vast experience level.

 

The surgeries in question seem to be very old and established procedures and I suspect that once various doctors become qualified the process will evolve similar to the flu shots where these doctors will most likely become just as experienced or even more experienced. 

 

I suspect that one benefit would be that the shift would free up time for the “better trained” surgeons/physicians to perform the more risky and groundbreaking surgery procedures that will bring the higher dollars to them for which they currently may not have time to appropriately focus and hopefully lower the risk to us patients. 

 

In theory the result should be better overall skill development for everyone to benefit from as patients.  I know it is somewhat different; however, if I didn't carve out the sections of my work where I have developed reliable process and procedures and delegated them to the latest "rising stars" then focused my time on new issues and problems, I would soon become overworked and obsolete.

 

 

 

 

 

 

 

Please all, keep this on topic and non political.

 

Too late!  The first four words of the first sentence of the original post were political. 

 

 

Thanks Obama

 

 

Schu, please read the above posts as we have already lost 30,000 plus posts and many threads have vanished on this forum in the past month or so and a lot of associated history that many of us have contributed to along with those 30,000 plus posts have vanished.  In addition, several have quit posting completely due to people continuing to attempt to bring their political views into threads with what seems to be attempts to create chaos.

 

"We" did not lose anything.  Klipsch decided that these forums were not to be 'forums' of intellectual content and debate.  That is a loss for the group as a whole because this is how important current issues get discussed and how people learn.  There is a lot of brain power available here (used to be a lot more) and it is a waste to see it quashed and limited.  Where some see chaos - others find wisdom and enjoy the repartee.

[garyrc]

You are apparently way behind the times of terms of where medical care is going in the US that predates the ACA by a decade. Look up Physican's Assistant and Nurse Practitioner and get yourself up to date.

 

 

These new professions were designed to make up for a shortage of doctors that existed and was growing long before the Affordable Care Act.  The problem seems to have originated with some seriously flawed studies in the seventies and early eighties commissioned by the US Department of Health and Human Services and its Graduate Medical Education National Advisory Committee.   They predicted that there would be too many doctors by the year 1990, and that doctors had already been delivering “inflated volumes of service.”   So, medical school expansion was not supported.  Of course, they were dead wrong (pardon the macabre pun).

Edited June 6, 2015 by garyrc

[Zen Traveler]

There's no doubt that the ACA will completely alter the complexion of healthcare services in America and the results will be neither cheaper nor better nor more accessible.   The hardest pill to swallow will be for those who once could afford health reasonable insurance....

 

I am not sure what you are calling "health reasonable insurance," but having an interest in this debate since the mid 1990s can tell you that most people don't even know what they are paying for and are surprised when their lowball insurance didn't cover what they thought it did...I would've liked to see a single payer system and have the Insurance companies out but I didn't get my way...

 

That said, I was glued to the TV when Congress was debating the issue prior to the ACA passage and was amazed how many Americans didn't seem to care about the discussion and relied on talking heads to give them their opinion. No. I wasn't thrilled with the ACA, but the status quo was not manageable (our rates were going up over 10% a year) and now states that didn't accept the Medicaid expansion are going to need to figure a way to cover that loophole and if not, their premiums are going to be going higher than the states that did accept the expansion.

[Jeff Matthews]

 

You are apparently way behind the times of terms of where medical care is going in the US that predates the ACA by a decade. Look up Physican's Assistant and Nurse Practitioner and get yourself up to date.

 

 

These new professions were designed to make up for a shortage of doctors that existed and was growing long before the Affordable Care Act.  The problem seems to have originated with some seriously flawed studies in the seventies and early eighties commissioned by the US Department of Health and Human Services and its Graduate Medical Education National Advisory Committee.   They predicted that there would be too many doctors by the year 1990, and that doctors had already been delivering “inflated volumes of service.”   Of course, they were dead wrong (pardon the macabre pun).

 

 

Yep. Apparently, they did not consider technology, marketing and patent abuse (among other things) in the growth equation. Who would've figured that within just a few decades, 90% of the public would be medicated by Big Rx?

[Jeff Matthews]

No. I wasn't thrilled with the ACA, but the status quo was not manageable (our rates were going up over 10% a year)

 

Didn't I hear that right now, some major carriers (was Blue Cross/Blue Shield one of them) are seeking regulatory approval to jack rates 20%? 

[Zen Traveler]

 

Schu, please read the above posts as we have already lost 30,000 plus posts and many threads have vanished on this forum in the past month or so and a lot of associated history that many of us have contributed to along with those 30,000 plus posts have vanished.  In addition, several have quit posting completely due to people continuing to attempt to bring their political views into threads with what seems to be attempts to create chaos.

 

 

 + 1 Healthcare in this country should be a major concern for it's citizens.

[Zen Traveler]

 

No. I wasn't thrilled with the ACA, but the status quo was not manageable (our rates were going up over 10% a year)

 

Didn't I hear that right now, some major carriers (was Blue Cross/Blue Shield one of them) are seeking regulatory approval to jack rates 20%? 

 

 

I heard that as well and am curious how it will pan out...One of the things I liked about the ACA was the 15/85 and 20/80 percent rule where Insurance companies had to spend the higher number on actual care...One of those scenarios above is for group plans and the other is for individual policies.

[CECAA850]

Klipsch decided that these forums were not to be 'forums' of intellectual content and debate.

 

Nothing could be further from the truth.

Edited June 6, 2015 by CECAA850

[garyrc]

 

No. I wasn't thrilled with the ACA, but the status quo was not manageable (our rates were going up over 10% a year)

 

Didn't I hear that right now, some major carriers (was Blue Cross/Blue Shield one of them) are seeking regulatory approval to jack rates 20%? 

 

 

I think I heard that.  It should be noted that insurance companies can be discouraged from raising rates if there is a strong middle-man employee organization beating them down.  Mine is Cal-Pers of California, and they keep Blue Cross in line, at least for me and my fellow California retirees.  They are very assertive, and have very long cigars.  Unfortunately that doesn't help people who don't belong to the club.

 

I, too, would have liked a single payer health plan, you know, like people in most of the rest of the civilized world have.

[sheltie dave]

Maynard, if you would never accept care from a NP or PA, then why are you accepting care from a nurse? How about if you fall over with a heart attack, and I come wandering past you, freshly minted first responder. Should I zap you, or do you want to wait for a cardiologist?

[etc6849]

It seems more places offering these minor surgeries would be a good thing for the consumer as it should bring the cost down.

 

With regard to the other comment, I don't know about Obama being at fault, it seems any conservative should love letting the free market do more things with less regulation.

 

Optometrists probably spend years more in school studying just human eyes, where as someone like an ophthalmologist who has to go through full fledged medical school like an MD.

[Fjd]

Another downside of Obamacare is that California residents may soon subjected to inferior care by under-trained individuals. 

 

 

 

Thanks Obama

 

 

 

 

 

Please all, keep this on topic and non political.

 

Too late!  The first four words of the first sentence of the original post were political. 

 

 

Thanks Obama

 

 

Schu, please read the above posts as we have already lost 30,000 plus posts and many threads have vanished on this forum in the past month or so and a lot of associated history that many of us have contributed to along with those 30,000 plus posts have vanished.  In addition, several have quit posting completely due to people continuing to attempt to bring their political views into threads with what seems to be attempts to create chaos.

 

"We" did not lose anything.  Klipsch decided that these forums were not to be 'forums' of intellectual content and debate.  That is a loss for the group as a whole because this is how important current issues get discussed and how people learn.  There is a lot of brain power available here (used to be a lot more) and it is a waste to see it quashed and limited.  Where some see chaos - others find wisdom and enjoy the repartee.

 

 

 

 

Well let me try to rephrase my views in that post because by reading your response I do not believe that you have gotten the point I was trying to make, Carl was cautioning about and garyrc picked up on immediately. I guess that many of us (maybe excluding you?) have lost years of expressing our views, research, thoughts and opinions regarding various topics where we had posts that populated many of those threads that are now locked or long gone and can no longer be used as a point of reference.  I tend to believe in the Red Bull school of thought as they are one of the companies that really understands how to capitalize on "content" of their fans across many media platforms.  I'll always remember Red Bull more from our flugtag homemade flying machine over anything else.

 

From another perspective, I guess that if you do not feel you lost anything of value content-wise or lost anything with forum members leaving, that is completely within your right to feel that way; however, I don't share those views or feelings.  How about if there is just an automatic thread delete function where a thread older than 180 days automatically is deleted from the forum?  Would that bother you as then none of us would then need to be concerned with content and it would sure resolve the anonymous bump that seems to get under the skin of some?

 

Note that when I read a thread I try to read every post in that thread to try to understand the tone and direction.  Over the last couple of months it sure seemed to me that several posters were going to great lengths to exploit the system and revealed a weakness in the forum where an unscrupulous, really devious person could take advantage of this forum and censor the content they disagreed with, and push those members out that they wanted to censor from posting. 

 

Maybe you did not follow enough of those threads as I understand that many on the forum did not; however, it was very obvious to many of us that did follow those threads that the use of certain approaches in forum threads can result in blocking out people that an individual may determine are not wanted in certain special “cliques” and get threads locked regarding the intellectual content and debate that they did not agree with.  For example, “We don’t want that person around and we don't like what they post so let’s cause chaos in their thread and the thread will be locked.”  I happen to believe that the tactics included what seemed to be veiled slanderous-type comments, ridicule, ad hominem attacks and general obnoxiousness toward others with different views (including political views that differed from their own) that tended to make some people very uncomfortable.  I do not see where these actions of individual posters on the forum had anything to do with Klipsch other than put the company in a no-win situation that needed some type of quick resolution.

 

Since I, among others, seemed to interpret certain references as leading to more of the same crap we just dealt with for the past couple of months, please “educate” so I can learn how the references I quoted above to the POTUS (noting that you, yourself was knowledgeable enough to properly identify it as the affordable care act without making the veiled attacks on someone else's political beliefs) add to the intellectual content of the debate you are yearning for on the medical care concepts of this thread and the concept of an appropriately trained person being allowed to give a shot or perform a well-established surgical procedure.

 

 

[Travis In Austin]

Dr. Who, you are correct, everyone does have a first patient, client, project, whatever. With laser surgery it is usually the engineer who designed the machine who teaches the physician how to use it for the first time.

FJD, you are hit the nail on the head, there is disagreement among opthomologists about whether optometrists should do cataract laser surgery.

Here is a link to an opthomology site, Opthomology Review, discussing the pros and cons of optometrists doing cataract laser surgery.

http://www.reviewofophthalmology.com/content/i/1840/c/33272/

[Travis In Austin]

What's the old saying? You only have one pair of eyes?

Please all, keep this on topic and non political.

Did you bother to read the link smack dab in the middle of the originak post Carl?

In case you didn't, let me quote the first few sentences for you.

"The bill permits qualified optometrists to administer flu shots and two other vaccinations to adults and to perform some minor procedures.

In another legislative move that could help ease the physician shortage in California, lawmakers have voted overwhelmingly in favor of expanding the scope of practice for optometrists.

The California State Senate on May 22 approved a bill that would allow optometrists to perform minor eye surgeries and administer vaccinations to adults. The senate voted 34-4 to approve Senate Bill 622, which was authored by Sen. Ed Hernandez (D-West Covina)."

From that article Maynard gives us a warning that people in California are at risk of inferior eye care. He is entirely wrong about that by the way, according to the California legislature.

So, pray tell, how do you discuss the merits, or lack thereof, of a California bill, introduced by an optometrist, without politics?

If legislation isn't "politics" there are a number of current legislative matters from several states I am dying to bring up but thought inappropriate as being "political."

But if posting about legislation and putting your spin on it is considered appropriate I am cool with that. I have 5 or 6 bills ready for discussion, like "open carry" in Texas for example.

Travis

Edited June 7, 2015 by dwilawyer

[Travis In Austin]

You are apparently way behind the times of terms of where medical care is going in the US that predates the ACA by a decade. Look up Physican's Assistant and Nurse Practitioner and get yourself up to date.

These new professions were designed to make up for a shortage of doctors that existed and was growing long before the Affordable Care Act. The problem seems to have originated with some seriously flawed studies in the seventies and early eighties commissioned by the US Department of Health and Human Services and its Graduate Medical Education National Advisory Committee. They predicted that there would be too many doctors by the year 1990, and that doctors had already been delivering “inflated volumes of service.” So, medical school expansion was not supported. Of course, they were dead wrong (pardon the macabre pun).

Finally, an intelligent, reasoned and FACTUAL, response to this post.

Travis

[Travis In Austin]

You are apparently way behind the times of terms of where medical care is going in the US that predates the ACA by a decade. Look up Physican's Assistant and Nurse Practitioner and get yourself up to date.

These new professions were designed to make up for a shortage of doctors that existed and was growing long before the Affordable Care Act. The problem seems to have originated with some seriously flawed studies in the seventies and early eighties commissioned by the US Department of Health and Human Services and its Graduate Medical Education National Advisory Committee. They predicted that there would be too many doctors by the year 1990, and that doctors had already been delivering “inflated volumes of service.” So, medical school expansion was not supported. Of course, they were dead wrong (pardon the macabre pun).

LarryC would know everything there is to know about those studies, why medical schools didn't expand, etc. He was a member of that committee at various times IIRC.

[muel]

There were those who saw the problem accurately.  I remember vividly back in the 70's listening to a good friend of my Dad's while pheasant hunting.  He was a hospital administrator and spoke at length about the coming of socialized medicine and how the cost was going to continue going up and quality would go down.  Part of the solution as he saw it was to FLOOD us with doctors!   WE NEED A DOCTOR FLOOD!  What kind of nonsense is the concept of too many doctors?!   What is the worst thing that would happen?  Medical providers would spill over to poor rural areas and under-served countries?  That would be a good thing.