Angie’s List: Listing towards the Wrong Side
An Open Letter to Angie Hicks Founder of Angie’s List
Dear Angie,
I knew optometry was going to be in for a rough time when I read the first sentence. In a recent Angie’s List magazine article, “Can’t See Eye to Eye”[a] (written by Michael Schroeder) the very first sentence set the tone when the author used the following quote: “Even though I love my optometrist, I would never ever let him do surgery.”
Dear, dear Angie, for an organization that prides itself on solid, truthful reviews of services and products, this article does your business and your readers a major disservice. It is obvious that the author does not understand the profession or Optometry, nor the issues involved between Optometry and ophthalmology.
As the American Optometric Association notes, Doctors of Optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. We are America’s eye doctors. We serve more people in more communities than any other eye care professional. And we do this with fiscal restraint. Optometrists are the only eye care provider in more than 3,500 communities across the United States. The bottom line is that our patients receive outstanding care at a reasonable cost.
Please note that ophthalmologists are not optometrists. They do not go to optometry school. They do not receive the well rounded education a primary care optometrist receives. They are narrow in scope and practice.
Undergraduates, who wish to have a career in optometry, often participate in the same pre-med/pre-denistry/pre-optometry programs that all who wish a career in health care pursue. After completing their undergraduate study, they then apply to optometry school. Competition for these doctoral positions is stiff. At the Illinois College of Optometry, where I am a Professor of Pediatrics and Binocular Vision, the graduating class of 2011 had 144 members receiving diplomas and were chosen from a pool of 912 applicants. This graduating class was comprised of 67% women with representation from 26 states, 6 Canadian Provinces and several foreign countries.
Our students take the same anatomy, physiology, pharmacology and disease courses that MDs, DOs (Doctors of Osteopathic Medicine) and other health care providers take. In fact future MDs, DOs and ODs often take these courses side by side at many schools and colleges of Optometry. Optometrists often have more hours in pharmacology than most of those individuals studying medicine.
Clinically our students work with a wide variety of patients. These patients often have hypertension, diabetes, and other serious chronic and acute systemic and ocular diseases. They often work side by side with MDs while diagnosing and treating these patients. At the Illinois Eye Institute (IEI), the clinical arm of the Illinois College of Optometry, we see almost 100,000 patient visits a year. In the Pediatrics/Binocular Vision Service, where I spend most of my time, we see up to 14,000 patient visits per year. Our patients range in age from infants to those who even seniors would consider senior.
After examining patients at the IEI, we send our students around the world for additional experience. Our future Doctors of Optometry receive education and clinical training in China and Australia, in Dubai and all over the United States. They work alongside other health care professionals in hospitals, secondary and tertiary health care centers and even in large group practices. Optometrists and optometry students from Spain and Australia often spend several weeks at the IEI to increase their clinical skills as well.
Before graduation all students must pass vigorous state and national board written and clinical examinations. I’m proud to say that the graduates of the Illinois College of Optometry in 2010 had a NBEO Part 1 Basic Science Pass Rate of 97.16%, Part 2 Clinical Science Pass Rate of 96.5% and a Part 3 Patient Care Pass Rates of 100%! This year we also had one of our students receive the highest score on the NBEO Part 1 of all those taking the test around the country.
Although the Doctor of Optometry is a terminal degree and no additional training is required before the graduate can practice, more than 15% of the Class of 2011 went on to participate in residency programs. These programs include specialized education and clinical training in primary care, eye disease, pediatrics, binocular vision, and vision therapy, as well as, cornea and contact lens, refractive surgery, vision rehabilitation and several other areas. This advanced training is conducted at various Veterans’ Affairs Medical Centers across the country, secondary and tertiary health care centers, various schools and colleges of Optometry and other similar facilities. All of these residencies are associated with a college or school of Optometry and are accredited by one or more organizations.
Optometrists have earned the title of Doctor.
All health care professions use education to advance their scope of practice to serve patients better and to make affordable access to care possible. Optometry is not different in this regard. I do not know of a single doctor who would use any procedure, non-medical, medical or surgical, if they were not thoroughly trained in its application. Medicine does this. Optometry does this.
Now back to your article. The author uses “scare tactics” by telling stories of optometrists who perhaps did not provide the best care. How sad that the author stopped at just telling these stories about optometrists. I have very sad stories to tell you of where ophthalmology failed their patients and their patients suffered serious visual impairment because of this. I could tell you the story about the refractive surgeon who used an old microtome blade during surgery and bits of metal chipped off this worn blade and to this day are embedded in the patient’s cornea. I could tell you about another refractive surgery mishap, where with glasses the patient saw 20/20 and unfortunately after surgery the best the patient could see was 20/40 with halos and glare.
All doctors make mistakes no matter what their training. We are human after all. And there are some doctors of any variety (MD, DO, OD, PhD, DDS) who should not be in practice. You did your readers and subscribers a major disservice by using such yellow journalism. I thought your standards were higher than this.
The author takes another dig at Optometry when he states, “…post optometry school education can amount to weekend courses at the Holiday Inn to learn surgery.” Where do you think our MD colleagues receive their post-graduate education? Yes, MDs sometimes learn new surgical procedures at the Holiday Inn as well. It is not where we learn, but how well we learn it that matters. Too bad Mr. Schroeder doesn’t realize this. Most of my colleagues receive their post graduate education during the annual meetings of such prestigious organizations as the American Academy of Optometry, the American Optometric Association, and the College of Optometrists in Vision Development.
By the way, did you know that our OMD colleagues are so frightened by Optometry’s ability to successfully increase their scope of practice through education that they do not allow optometrists to attend their meetings! If ophthalmology really cared about their patients more than their pocket books, wouldn’t you think they would want any who treat patients to have the best education possible from as many sources as possible? Obviously, this is not true for organized ophthalmology.
And now…it’s time to educate Mr. Schroeder about our legislative system. His article comes across as if Optometry pulled some fast political maneuvers that involved hundreds of thousands of dollars. What Optometry did was to make it quite clear to the law makers that Doctors of Optometry provide excellent, accessible and affordable medical/surgical care to their patients. Ophthalmology could not counter this with any rationale argument. It’s a shame that Mr. Schroeder didn’t take the time to find out how many hundreds of thousands (millions?) of dollars MDs have available to ensure access to law makers throughout the states and nationally. This is just one more example of sloppy, incomplete and just plain bad reporting.
If Angie’s List magazine was called the National Enquirer, I could understand how such an article could be published. We expect more from you. You let us down.
One of the best ways Americans have available to us to show displeasure with a product or service is to not buy the product or use the service. Until you can restore my faith in what otherwise appears to be a solid organization, I am seriously considering canceling my subscription to Angie’s List. I am also recommending that all Optometrists, their families and our patients re-evaluate the benefits of subscribing to Angie’s List as well.
We all want Angie’s List to be an organization that provides information we can trust. You failed to do this by publishing this biased article.
Sincerely,
Dominick M. Maino, OD, MEd, FAAO, FCOVD-A
Professor, Pediatrics/Binocular Vision Illinois Eye Institute/Illinois College of Optometry
I just sent Angie's List an email suggesting they read this letter and respond. I'm curious what will happen next.
ReplyDeleteHello, Dr. Maino. Thank you for taking the time to provide such a thoughtful response to our article. I contacted Mr. Schroeder, the author of the piece, to respond. Here's what he had to say:
ReplyDeleteYou rightly point out that optometrists play a primary role in providing eye care for patients across the U.S. This is not in dispute. Instead, the story focuses specifically on optometrists’ efforts to expand scope of practice — to include, for example, laser surgery. Admittedly, it’s a divisive issue, and we took great pains to get feedback from all sides.
You take issue, for example, with the lede quote from an Angie’s List member who says, "Even though I love my optometrist, I would never, ever let him do surgery.” Most members responding to an Angie’s List poll shared similar sentiments, but in the story’s second paragraph we quote a member who would consider going to his optometrist for laser surgery — if only he were allowed to perform it. "I totally trust him," the member says. "He's just so knowledgeable."
You also take issue with a statement made by an ophthalmologist that post-optometry school education can amount to weekend courses at the Holiday Inn. Your assertion that doctors do this as well is reflected in the story’s next line: "Ophthalmologists may also learn new laser techniques at short seminars." The article also points out that optometrists undergo four years of post-graduate training and learn about everything from treatment of glaucoma to operating a laser.
Finally, you take issue with the inclusion of a patient who went to an optometrist for laser eye surgery and “was almost blinded.” This is understandably a lightening rod, but hardly a calculated “scare tactic,” as you suggest. On balance, we repeatedly reached out to David Cockrell of the American Optometric Association, to speak with another patient who’d undergone laser surgery by an optometrist and had a positive experience. Ultimately, we were unable to connect with a patient, but it was never our intention to imply that only optometrists make mistakes, or that ophthalmologists don’t.
Again, this a complex issue and many nuances that go into reporting don’t wind up in the final story. But please know we take your concerns very seriously, and we take pains to make sure all sides get a hearing.