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Kentucky now joins Oklahoma as the only states that explicitly allow optometrists to perform laser surgery on/around the eyes and even lumps and bumps removal.  (Read the article here.  H/T to kevinmd.  Also see a news article here.)

When people ask me what’s the difference between an ophthalmologist and an optometrist, I always like to say, “Optometrists do everything an ophthalmologist does except surgeries.”  (By the way, I don’t consider foreign body removal a surgery. Chalazion removal- yes, definitely a surgery.)  Even one of the ophthalmologists in the feature story seems to agree with that statement:

“We draw the philosophical line in the sand with surgery,” says Dr. David Parke, chief executive officer of the American Academy of Ophthalmology.

Of course, proponents of the bill think that allowing ODs to perform laser surgeries is good for people because, as Governor Beshear explains:

“I signed Senate Bill 110 to give Kentuckians greater access to necessary eye care.”

Now, I would probably refute that it gives people, particularly rural people, greater access to eye care. For a doctor to buy all the necessary equipment to perform a YAG capsulotomy, he would need to invest in a pretty expensive piece of equipment. To keep up payments, he would have to do a lot of procedures. How many YAGs does a rural optometrist usually see a month? Probably not a lot. How far away is the surgeon who did the patient’s cataract surgery in the first place? Probably not that far.

Optometrists are already trained in school to do periocular injections, but can an optometrist be trained to do YAGs? Absolutely. It’s an easily learned skill that is widely studied for potential complications and side effects. This stuff is not magic- it just needs training. But it’s also a skill that, if not done regularly, can get lost. If I had a patient tomorrow that needed a subtenon’s injection, I would have to refer them out because I haven’t had to do one since leaving optometry school. No way would I feel comfortable. I also think that it’s in the patient’s best interest to have a procedure done by someone who does that particular procedure regularly.

Anyway, I kind of like my definition of optometrist. What do you all think?

Tags: doctors, Government, law, OMD, ophthalmologist, optometrist, Organized Optometry, patients, politics

When Glenn Beck threw his big event on 8-28-2010 most on the theophobic Left and in Big Media were perplexed and mystified. It’s possible that most of the 500K+ crowd didn’t fully understand the why. His radio show itself should have been a big clue for anyone paying attention. He has been concentrating on Faith, Hope, and Charity for over a year. But why?

It stems from his reading of the scriptures, the bible and especially the Book of Mormon.

Regardless of whether you choose to believe the Book of Mormon, to understand what Glenn is up to, you must hear some of the back story. Book of Mormon events took place here in America. Repeatedly throughout the Book of Mormon, the Lord tells the people via the prophets that if they will keep the commandments, they will prosper in the land. If they don’t, they will be destroyed.

Two different civilizations discussed in the Book of Mormon went through several cycles of prosperity and destruction because of their faith in keeping the commandments or their wickedness in disobeying God.

Similar to what Moses and Jethro instituted, he Nephite form of government at the time was a hierarchy of judges and major law changes were by voice of the people. In setting up this government, the last king, Mosiah, warned

Mosiah 29:26-27
26 Now it is not common that the voice of the people desireth anything contrary to that which is right; but it is common for the lesser part of the people to desire that which is not right;…

27 And if the time comes that the voice of the people doth choose iniquity, then is the time that the judgments of God will come upon you; yea, then is the time he will visit you with great destruction even as he has hitherto visited this land.

At one low point, a prophet named Nephi, who also happened to be Chief Judge, forsook his high level government office to preach full time the gospel of Jesus Christ:

Helaman 5:1-4
1 And it came to pass that in this same year, behold, Nephi delivered up the judgment-seat to a man whose name was Cezoram.
2 For as their laws and their governments were established by the voice of the people, and they who chose evil were more numerous than they who chose good, therefore they were ripening for destruction, for the laws had become corrupted.
3 Yea, and this was not all; they were a stiffnecked people, insomuch that they could not be governed by the law nor justice, save it were to their destruction.
4 And it came to pass that Nephi had become weary because of their iniquity; and he yielded up the judgment-seat, and took it upon him to preach the word of God all the remainder of his days…

Why wouldn’t Nephi use his government office to invoke change among the people? The answer is from an earlier prophet, Alma the Younger, who saw the iniquity of the separatist, apostate Zoramites. Mormon writes in Alma 31:5

And now, as the preaching of the word had a great tendency to lead the people to do that which was just- yea, it had had more powerful effect upon the minds of the people than the sword, or anything else, which had happened unto them- therefore Alma thought it was expedient that they should try the virtue of the word of God.

And many listened, mostly the humbled poor, and returned to the fold and lived in Jershon with the Ammonites. Those Zoramites who remained hardhearted began a war with the Nephites because of that conversion, recruiting and eventually leading the Lamanites in this war.

The Book of Mormon teaches us that we, as a nation, must come unto God in order to have peace and prosperity. That is why Glenn Beck is taking the tack of Faith, Hope, and Charity.

Mormon was the chief captain of the entire Nephite army and prophet of the church, whose members were few since the wickedness of the Nephites had caused them to come to the point of extinction at the hand of the Lamanites. What message would you give in a speech at a synagogue during such a desperate time? His son, the prophet Moroni, in closing the book his father started, quoted his father’s speech which was dedicated to the concepts of Faith, Hope, and Charity (see Moroni ch. 7).

Also Moroni recorded in Ether ch. 12 the words the Savior had spoken to him:

28 Behold, I will show unto the Gentiles their weakness, and I will show unto them that faith, hope and charity bringeth unto me—the fountain of all righteousness.
29 And I, Moroni, having heard these words, was comforted, and said: O Lord, thy righteous will be done, for I know that thou workest unto the children of men according to their faith;

So if you had a national radio and t.v. show, believed the Book of Mormon is sacred scripture just like the Bible, and loved your county, and you knew that the best way to get a country to prosper is for the people to come unto God, then you would be doing the exact same thing Glenn Beck is trying to do: Inviting everyone to have Faith, Hope, and Charity.

Thank you, Glenn Beck. I’ll love you forever for what you have done and are continuing to do. We must all have faith in the God of Abraham, Isaac, and Jacob; repent; be baptized; and continue in faith, hope, and charity until the end of our days. Our own eternal salvation depends on it and so does the prosperity of our nation.

Please take Glenn Beck’s 40 Day and 40 Night Challenge.

Tags: charity, faith, Glenn Beck, hope, politics, religion

What Obama and Pelosi and Reid and the democrats are doing with the “Healthcare Bill” is not reform, it is a full speed statist takeover. It is so far removed from our U.S. Constitution that it should have gone through the constitutional amendment process instead of an “up or down vote,” let alone exploring to “deem and pass.”

We have a bunch of leftists running our country and Americans won’t tolerate the erroding of their rights any longer. Congressmen, for those of you who vote Yes on this monstrosity there will be consequences. There is cause and effect. You are free to choose, but you are not free to pick the consequence of your choices. God rewards good for good and bad for evil. You will be held accountable.

Citizens, vote out of office any congressmen who votes for the healthcare takeover. Refuse to employ any ousted congressmen who voted yes. Refuse to support any group or organization that pays those ousted congressmen to speak or write books. May their names be a hiss and a byword for generations. May God forgive you because we won’t. Anyone who seeks to take away the liberty of our entire nation deserves no respect from Americans.

America, you are beginning to wake up from a hundred year sleep. While you were sleeping, progressive thought has entrenched itself in every fabric of our government and society. Our children are being trained to be liberal-by-default in our schools, by our media, and even by ourselves-because we were trained liberal-by-default also. Today we are a world away from what the Founders implemented and what made our country the greatest in the world.

Pride cometh before the fall. Please, America. We must humble ourselves. We must retrain in correct principles. We the people must have faith, hope, and charity.

I invite everyone to read: the Declaration of Independence, The Constitution, The 5000 Year Leap, The Making of America, Liberty and Tyranny, and the Scriptures.

I invite everyone to listen to Glenn Beck, Rush Limbaugh, and other liberty-loving commentators.

Next week I am participating in a caucus to choose a candidate who will appear in the primary. Probably very few readers have ever gone to a caucus. It will be my first time also. We can no longer afford to let others choose our candidates. We the people need to seek out those that will adhere to the principles of liberty and the Constitution. I invite everyone to find out their state’s election/caucus process (Utahns click here). We can’t wait to get involved in the November elections or even during the primary elections. Now is the time!

Tags: Government, Liberty, off topic, politics

In Answers to Your Search Questions Part 1 and Part 2, I improved by search juice and answered the questions that seem to be on everyone’s mind.

Well, I’ve done it yet again. There seems to be no end to all the inquiring minds out there. Just to review, I know what IP address you have and the URL that was in your address bar just before coming to my website. A search URL contains the search term that you used.

1. “is Crizal worth the extra expense” – That depends. The original Crizal, Crizal Alize, Crizal Alize’ with ClearGuard, Crizal Avance’ with Scotchgard, or the next one that they come out with 6 months after you buy the one available now.
2. “satan’s plan” – This search term was by someone from Lagos, Nigeria, Africa. (It directed them to this post.) Lemme splain. In pre-earth life, Jesus wanted us to have the freedom to choose to follow Heavenly Father and obtain Eternal life. Those who don’t obey God’s will and never repent would be lost. Those who disobey (all of us) would need a Savior in order to be worthy enough to enter into God’s presence again. Well, the Son of the Morning didn’t like that. Satan, wanted us all to be forced to choose God and obey His commands so that none of God’s children would be lost. It’s kind of like liberals vs. conservatives when you think about it.
3. “what scanner should you use with officemate” – If you are going to scan, go big. You will not regret buying a fast document scanner like the Fujitsu 6130. I used to have a slow HP ScanJet N6010. It lasted two years and died. I wasted so much time waiting for files to scan. With my Fujitsu, waiting is a thing of the past. Let’s say you get an EOB that you want to scan into OfficeMate. You pull up the patient’s file, select the eDocuments tab, and then press scan. It will scan duplex, then you hit complete, and you’re done. Fast, fast, fast. Plus mine came with Acrobat 9 Standard.
4. “nbeo optometry review notes” – I just wanted to bring this up because I’m so glad I’m done with school and boards.
5. “how to recharge pachmate dgh55” – I’m thinking you should read the owners manual. If you don’t like keeping dead trees around, then scan it into a pdf with your Fujitsu scanner.
6. “stylish medicaid frames” – NO SUCH THING
7. “screening acute angle glaucoma with mydriasis with pen light in pcp office” – Yah, so what I think they want to know is before they dilate somebody, what’s the likelihood that they give them an angle closure pressure spike. I believe that should be in the manual for your nifty DigiScope. Someone in Maryland should just refer to their local optometrist.
8. “best way for optometrist to get FDA job” – I’m pretty sure you can get any government job you want by contributing enough money to the DNC. If you’re not a trust fund child, then I would spend loads of money to attend optometry school, study hard, work hard, graduate, and join the rest of America in the unemployment line.
9. “optometrists are stupid” – Someone in Alameda, CA was having a bad day.
10. “crack officemate” – Some web surfer in Indiana needs a crack for Officemate. Let’s see, I’m pretty sure stealing around $6000 for the initial year and ~$1400 per year after that could be considered enough to get you in trouble with the state optometry board. I don’t think it’s worth it. If you can’t afford it, do yourself a favor and try something else. Or, like I’ve said before, if you’re willing to crack expensive, niche software, then why stop there? Robbing banks and pimping can “earn” you boat loads of tax-free money.
11. “average christmas bonus for optometrist” – Let’s see. Um, try about $0.00
12. “pronounce similasan” – put the emphasis over the second “i” and then say the rest really fast. sim-IL-uhsahn. Or call their consumer information line, 1-800-240-9780, and they say it on the recorded message.
13. “Biofinity review” – This is by far the most searched term by people coming to my website from google and yahoo. Seriously, why don’t you just try it for a week or two? If you don’t like it, then try something else! These lenses could work great for you and terrible for someone else- or vice versa. It’s like asking other people if a certain brand or size of orthotic shoe insert works good.

I’m here to help.

Tags: Answers, economy, EHR, Jokes, optometrist, politics

InfantSee: Optometry’s Contribution to Socialism!
InfantSee: The AOA loves BIG GOVERNMENT!
InfantSee: Baby Steps towards Communism!

Earlier I discussed InfantSee here and here.

Now, it turns out the AOA has secured federal tax dollars for InfantSee.

I don’t mind charity, but let me choose the charities to which I desire to give of my property. Giving all my money to the government and letting them redistribute it is the opposite of freedom. I am not going to participate in InfantSee. If I were a member of the AOA, I would demand that Optometry’s Charity™ – The AOA Foundation return all tax dollars to the government.

Tags: InfantSee, Organized Optometry, politics

So the NIH sponsored a study published in Archives of Ophthalmology about myopia prevalence and severity over about 30 years. Bloomberg tries to pin it on texting and web surfing, quoting the lead author of the study for a reference. And why not blame computers since no one used them back in 1971? But it’s funny how the full text of the study doesn’t even mention texting or web surfing.

So…no one thinks that genetics could possibly be a bigger factor than near point stress? People in the 70s didn’t read or something? Isn’t the prevalence of many diseases increasing since our ability to treat them is increasing, like type 1 diabetes? Here’s what struck me from the study:

A review [of the literature] concluded that increasing levels of education combined with possible genetic susceptibility are likely to be responsible for the reported increases in the prevalence of myopia.

Possible genetic susceptibility??? Umm, let’s think about this. The study acknowledges that myopia is easy to treat. No one is being selected against because they can’t see stuff (enemy soldiers, criminals, dangerous obstacles, wild animals) since we correct those who care with glasses, contacts, and LASIK so they don’t get blindsided by those baddies. There is no law or even a social mos stopping these myopic people from hooking up with others of their kind and breeding like rabbits.

There’s no doubt that near point stress contributes to some myopia, but when two myopes marry and have six kids, which plays the more important factor in myopia prevelance from 1970 to 2004? Especially when today you could theoretically not even know your mate has contacts or LASIK until after you’re married. (The glasses they had back in the 70s acted effectively as birth control.)

Identifying modifiable risk factors for myopia could lead to the development of cost-effective interventional strategies.

If people are really out there ringing their hands because they’re so fearful of their kid getting more than 1 diopter of myopia, how come more parents aren’t willing to pay the price for Ortho-K lenses? Even still, the myopic gene is still there.

I’ll tell you what attitude needs changing: that myopia is bad. What’s wrong with it? Sure, if the global warming Stalinists get their way and we return to human populations as they existed in 3000 B.C., then myopia will become a problem for those Post-Algore-and-John-Holdren survivors trying to muck out an existence without modern conveniences like ophthalmic lenses and iPods.

I don’t need an intervention. I can marry whomever I choose and not abort any babies. You can throw away your laptop and iPhone if you want to. You can keep your kids from going to school. You can quit your job and become a prison tower guard (the only career I could think of that has to look far away all day). All I need are my Ciba Night and Day contacts, and I’m good.

Tags: myopia, politics, Research

E-mail is awesome because you can send notes, pdf’s, and other files quickly and easily- except when you are a doctor. Since any script kiddie can sniff your e-mail inbox, doctors can’t send e-mails of cornea topographies to labs, referrals to colleagues, or special testing results to patients because that would be a breech of patient confidentiality and a violation of that one unnecessary, burdensome law.

I’m sure George Q. Public doesn’t want his K-readings leaked to the press when he decides to run for President someday.

But seriously, sometimes birth dates and stuff are printed on the reports, so if doctors want to use this cool, new thing called “e-mail,” we’ve got to set-up our e-mails to have the capability to send and receive encrypted messages and attachments. What does it look like?
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So your email inbox gets a message that looks like this. You have an e-mail client plugin that you have set up. You input your password, and the message magically translates to:

Dude, isn’t this so cool that not even the government can tell what I’m writing you? Unless…you forward this message to them unencrypted, but I trust you.

You can see this in action on my practice website. To get started and do this you need a few things:

Your practice’s domain name (usually your web host will offer e-mail storage)
or
any e-mail address that you can access via the e-mail client Thunderbird. (ie POP3 or gmail)

Download the following:

• GnuPG– the free, open source engine that runs encryption. The Windows version is found at gpg4win.org.
• Thunderbird– a free, open source e-mail client.
• Enigmail– a free plugin for Thunderbird that makes it easy to make your encryption keys, share your public key, store other people’s public keys, and encrypt/decrypt e-mails. You should read the install instructions for Enigmail.

Make sure when you generate your encryption key password that it is extra long and random. You must assume that anyone could capture it and try to brute force it. If it is long and random, it would be nearly impossible to crack. I suggest keeping your random, long password in a password wallet.

Why not do it?

• You are afraid.
• You don’t get paid to e-mail patients.
• Spam? Some people think that if they share their public key on a key server, spammers will harvest their e-mail address. I’ve had mine there for a couple years and that’s not happening…to me.

Barriers to entry:

• It doesn’t do any good for you to have e-mail encryption if the person to whom you want to e-mail the top-secret K-readings doesn’t have e-mail encryption set up. They must have a public key that they share.
• I’ve just presented a free way (unless you have a paid practice URL/webhost) to do this, but it does require some tech savvy to download, install, and implement the tools. This way requires the Thunderbird e-mail client. If you use Outlook or something, there are paid solutions out there.

Why do it?

If every doctor would just get in gear with e-mail encryption keys, we could send patient referrals with high quality color photos and reports instead of low res, black and white faxes (usually with a few vertical black lines on the page). We could send the lab a topography. We could send a patient a report or copy of their Rx. We could talk about the stupid government and how we all secretly agree with Glenn Beck, Rush Limbaugh, and Ann Coulter.

Tags: communication, HIPAA, management, optometrist, patients, politics

KSL 5 Eyewitness news in SLC, UT reports that Algore visited with Mormon leaders because, “Since [releasing his movie at Sundance Film Festival in 2006], he often takes the opportunity to meet with civic, corporate and religious leaders around the country talking about the dangers of and solutions to climate change.”

Wow, I guess we Mormons should be thrilled that it took him three years to visit our leaders. And what’s laughable is that the only “solution” to “climate change” that The Left can come up with is increased taxes and higher energy costs. Nice.

Mormons as a whole consistently vote conservative. Personally, I can’t believe our leaders even granted him an audience, and further I can’t believe they turned off the lights at Temple Square for Earff Hour! We stand strong against gay marriage in Kalifornia, but then we appease with leaders of a cloaked fascist movement to take away our God-given rights? I think someone has some ‘splaning to do!!

You’ll notice that he met with our PR dept to give his schpeel. I’ll bet the PR department would meet with Lilburn Boggs if they thought it could remotely help with PR.

Algore, go home. We Mormons already know that we humans, made in God’s image, are the stewards over the Earff. No one is out there saying we should pollute rivers, lakes, and streams or cut down every tree in all the forests! God has provided this earth for our use and enjoyment to further His purposes. All this “green” stuff is a diversion to tax us into communism, and God does not approve of communism. The whole reason we are here on Earth is to exercise our free agency and have joy. The Global Warming-err,..Cooling…I-mean-Climate-Change folks seek to destroy both.

Tags: economy, politics, religion

So the Utah Dep. of Health and the Associated Press sound like they are trying to raise funding. KSL reports:

SALT LAKE CITY (AP) — The Utah Department of Health says the state’s American Indians are disproportionally affected by chronic health problems such as diabetes and asthma.

A report released Thursday shows more than 11 percent of the state’s American Indian population has diabetes. The average for all Utahns is about 6 percent.

Rates of asthma and smoking among American Indians are also above the state average.

The report says Utah’s American Indian population also has lower rates of health care coverage, prenatal care and physical activity.

American Indians make up about 1.7 percent of the state population.

(Copyright 2009 by The Associated Press. All Rights Reserved.)

The AP doesn’t seem to cite their source, but I think the original report is found here (pdf), and it includes these important bullet points:

• Partner with tribes to obtain grant funding to benefit American Indians;
• and Eliminate racial health disparities.

You would think that an AP reporter investigating this state report might be a little curious why this could be. Because the AP is liberal, the only answer acceptable to them is that we discriminate against Native Americans and that we aren’t spending enough money.

The real reason would be to look the Native American population in Utah itself. The Uintah and Ouray Reservation has a small population- just over 3000, and about half live within the reservation. In fact, most Utah tribes are small. With such a limited gene pool in each community, you are going to get a lot of people with the same health risks.

So you will have to excuse me if I don’t join the liberal’s hysterics in a made up outrage.

I would suggest that if you would like to increase the health of Native Americans, try letting them transfer their health benefits to anywhere they want to live. If a Native American wants to move and marry someone from off their home reservation, they are denied their treaty-established healthcare at any other reservation. I’ve seen patients that lived in another state come back to their home reservation for a few months to re-establish residency in order to have an expensive operation paid for by their benefit. Not everyone is in the position to do this, so healthcare is probably under utilized by the many Indians living off their home reservation; however, if all the sudden you allowed healthcare portability for Native Americans, you would need to significantly increase the Indian Health Service budget.

To a degree, I think this happens already since Native Americans are encouraged to get on Medicaid/Medicare if they qualify. The IHS budget is so low that they depend heavily on income from Medicare/Medicaid. Of course, I would argue the IHS budget is low because of the Indian Health Care Improvement Act of 1976 that allowed one government healthcare agency (IHS) to bill another (CMS).)

Anyway, I just wanted to highlight this liberal tactic promoted by the Drive-by Media that calls attention to some pretended outrage and lays the blame on discrimination and not enough government spending when the real problem is neither. The facts are that the smaller the genetic variation, the more probable that certain health conditions will occur among that population.

For fun, here is a video of my boy dancing to the beat at an indoor pow wow on the Uintah and Ouray Indian Reservation back in May 2003.

Here is another angle (he’s soo cute!):

By the way, for those of you not interested in reading the rest of my website, I lived in or next door to an American Indian reservation for over 20 years. I worked as a Public Health Service optometrist at the Blackfeet Community Hospital in Browning, MT for two years. Everybody admits that there are problems on the reservation, but throwing more tax payer dollars at it will never help. Seriously, if that were the answer, wouldn’t we have a utopia by now? LBJ started the War on Poverty in 1964, and it has been a 45 year quagmire. Let’s try conservative solutions for a change! Policy makers need to listen to the voices of conservatives, like David Yeagley, a descendant of Bad Eagle. And Rush, Sean, Glenn, and Ann.

Tags: Indian Health Service, politics

Kevin, M.D. says that

The retail clinic era is over, and … pharmacy-based clinics are doomed to fail.
Corporations are finding out what primary care doctors already know: it’s hard to make money only doing office visits.

Ophthalmologists make bank doing procedures. I guess the problem with the retail medical clinic is that the doctor is paid so much. I guess optical shops are lucky that optometrists aren’t as high up on the whole pay scale totem pole.

I have to wonder about the optometric profession, though. The student loan debt percentage delta outpaces optometrist’s pre-tax net percentage delta. How much longer will anybody want to apply for optometry school?

I guess we need Obama to bailout the optometry schools. Socialized medicine, here we come. Thanks for reading, comrades.

Tags: commercial, Income, optometrist, optometry school, politics