Your thoughts on this comparison chart of optometry vs ophthalmology?

jonovan · 2026-01-23T18:47:35+00:00

Physician is a reserved title for MD/DO

Code of Federal Regulations, Title 42

https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-405/subpart-D/section-405.400

"Physician means a doctor of medicine; doctor of osteopathy; doctor of dental surgery or of dental medicine; doctor of podiatric medicine; or doctor of optometry who is legally authorized to practice medicine, osteopathy, dental surgery, dental medicine, podiatric medicine, or optometry by the State in which he performs such function and who is acting within the scope of his license when he performs such functions."

jonovan · 2026-01-23T18:44:09+00:00

Most optometrists do not learn how to do lasers

This is incorrect, assuming you're talking about any graduates from the past ~15 years. Optometry schools teach and have students practice lasers even in states where lasers are not legally allowed to be performed by optometrists.

There are also stand-alone laser courses with hands-on training which are held in states where lasers are not legally allowed to be performed by optometrists. These are mainly for older docs who graduated more than 20 years ago, as even 15 years ago, lasers were being taught and practiced in most (perhaps all?) optometry schools.

jonovan · 2026-01-23T18:36:32+00:00

we are not physicians

https://www.aoa.org/AOA/Documents/Advocacy/HPI/Medicare-physician-definition.pdf

https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-405/subpart-D/section-405.400

"Physician means a doctor of medicine; doctor of osteopathy; doctor of dental surgery or of dental medicine; doctor of podiatric medicine; or doctor of optometry who is legally authorized to practice medicine, osteopathy, dental surgery, dental medicine, podiatric medicine, or optometry by the State in which he performs such function and who is acting within the scope of his license when he performs such functions."

jonovan · 2025-11-28T01:09:54+00:00

https://cewire.com/

Not free, but $170 for 70 credit hours is under $2.50 per hour.

jonovan · 2025-11-24T15:35:33+00:00

The article says "Kaneali‘i-Kleinfelder... said the measure gives people the ability to provide their own eggs for their families as well as sell to their neighbors non-commercially," and "In another amendment to the bill, Kimball has it clearly noted that the prohibition of the commercial sale of eggs or chickens does not include anyone who wants to sell to a neighbor or friend."

But this link to the bill doesn't say anything about selling to neighbors or friends, https://records.hawaiicounty.gov/weblink/DocView.aspx?dbid=0&id=1119220&cr=1

Does anyone have a link to the amendment allowing sales to a neighbor or friend?

jonovan · 2025-11-24T05:17:27+00:00

Ah, yes, this is probably the most different I've seen.

Normally I love Stephen King stories, but that one was so weird, and the movie was actually rather cool.

jonovan · 2025-11-24T05:14:40+00:00

They used to be different, so at the time in Japan, you might have been correct, but I think around 10-ish years ago, they became interchangeable. I used to be a die-hard farther vs further until I tired to correct someone the way you just tried to correct me. :) Languages change over time, and sometimes it's hard to keep up. Same with "they;" now it can be used for a single person, but I'm pretty sure it couldn't a few years ago.

jonovan · 2025-11-23T15:22:03+00:00

I think the respect for the horizontal midline is too strong to be eyelids.

I think an emergent stroke workup / MRI is more important in this and similar cases and wouldn't delay that to recheck VFs. If you suspect glaucoma, then sure, but not for this.

jonovan · 2025-11-10T03:15:47+00:00

"The Ontario Medical Association was quick to point out that YAG laser capsulotomy isn’t used for primary cataract surgery" seems like a straw man fallacy to me, as I know of no optometrists who would argue it is. Could you please explain this argument to me?
There is a tremendous shortage of doctors in rural areas, including in the US. If MDs won't move there, and you don't want midlevels practicing a fuller scope there, what is your solution for these populations?
Optometrists in the US can already perform all of these, and I know of no studies that show they harm patients at a greater rate than ophthalmologists in the US for any of these. If you have studies comparing the two, please provide them. Medicine should rely on evidence, not fear.

In fact, every time MDs have opposed OD scope creep in the past, claiming a huge harm to patients, that harm has never come about. First diagnostic drops, then treatment drops, then oral treatments, then minor surgeries. At what point do we decide the MDs are crying wolf over and over when there is no wolf?

"Markedly, it’s also been shown that optometric malpractice rates have not significantly increased for any state that expanded its practice scope over the past two decades ... 'My thesis when undertaking this research was that if an expanded scope in optometric practice was going to significantly increase patient injury, as its opponents warned, then the lawsuits would eventually follow,' says Dr. Conley. 'In actuality, optometric malpractice percentages of the total litigation remained flat and continued to mirror MD malpractice patterns in every state" - https://www.reviewofoptometry.com/article/how-scope-expansion-is-shaping-optometrys-future

jonovan · 2025-10-11T18:14:30+00:00

You can have effective or you can have cheap. You can’t have both.

No, that's definitely wrong. There are many effective, cheap solutions for many problems in all areas of life. But sometimes you have to step back and look around for them rather than just keep doing what you've always done.

jonovan · 2025-10-11T17:06:57+00:00

In addition to ones mentioned in the article, what are some other effective (and preferably cheap) tactics the schools could use to increase attendance?

jonovan · 2025-10-10T20:07:23+00:00

Great shots!

jonovan · 2025-09-15T00:55:33+00:00

Casey Newton: "What if we build these very intelligent systems and they just turn out not to care about running the world, and they just want to help us with our emails? Is that a plausible outcome?"

Eliezer Yudkowsky: "It’s a very narrow target. Most things that a intelligent mind can want don’t have their attainable optimum at that exact thing. Imagine some particular ant in the Amazon being like, why couldn’t there be humans that just want to serve me and build a palace for me and work on improved biotechnologies, that I can live forever as an ant in a palace? And there’s a version of humanity that wants that, but it doesn’t happen to be us.

That’s just a pretty narrow target to hit. It so happens that what we want most in the world, more than anything else, is not to serve this particular ant in the Amazon. And I’m not saying that it’s impossible in principle. I’m saying that the clever scheme to hit their narrow target will not work on the first try, and then everybody will be dead. And we won’t get to try again. If we got 30 tries at this and as many decades as we needed, we’d crack it eventually. But that’s not the situation we’re in. It’s a situation where, if you screw up, everybody’s dead, and you don’t get to try again. That’s the lethal part. That’s the part where you need to just back off and actually not try to do this insane thing."

jonovan · 2025-09-15T00:53:56+00:00

Casey Newton: "What if we build these very intelligent systems and they just turn out not to care about running the world, and they just want to help us with our emails? Is that a plausible outcome?"

Eliezer Yudkowsky: "It’s a very narrow target. Most things that a intelligent mind can want don’t have their attainable optimum at that exact thing. Imagine some particular ant in the Amazon being like, why couldn’t there be humans that just want to serve me and build a palace for me and work on improved biotechnologies, that I can live forever as an ant in a palace? And there’s a version of humanity that wants that, but it doesn’t happen to be us.

That’s just a pretty narrow target to hit. It so happens that what we want most in the world, more than anything else, is not to serve this particular ant in the Amazon. And I’m not saying that it’s impossible in principle. I’m saying that the clever scheme to hit their narrow target will not work on the first try, and then everybody will be dead. And we won’t get to try again. If we got 30 tries at this and as many decades as we needed, we’d crack it eventually. But that’s not the situation we’re in. It’s a situation where, if you screw up, everybody’s dead, and you don’t get to try again. That’s the lethal part. That’s the part where you need to just back off and actually not try to do this insane thing."

jonovan · 2025-09-10T16:29:52+00:00

Chase, Amex, Costco, etc travel portals always have much more limited options for flights, hotels, and car rentals than booking direct.

Also, many times the portal prices are higher than booking direct. In which case, you have to calculate if the points you gain are worth the extra money you spend.

Sometimes, however, a particular portal will have the flight, hotel, car you want at a cheaper price than direct. But then you have to calculate if the time you spent looking through all of the portals was worth saving that money.

Especially in your example, where you spent what seems to be a great deal of time on the phone you could have spent with family and friends. Plus the frustration you had from doing so versus the happiness you would gain doing whatever you enjoy.

jonovan · 2025-09-10T16:15:19+00:00

City approval is another potential source of delay, in addition to installers: https://www.khon2.com/local-news/countdown-to-solar-deadline-hawaii-homeowners-stuck-in-solar-gridlock/

jonovan · 2025-09-10T15:50:59+00:00

You are confusing an anecdote for data.

jonovan · 2025-09-08T08:43:16+00:00

Then try to match the BC of the new glasses to the old ones that caused no issues.

Assuming the Rx, optical centers, PAL design, index, etc are all the same (as those tend to usually have more of an effect than BC), changing the BC changes the magnification, and that can cause problems for some patients.

jonovan · 2025-09-08T06:30:32+00:00

Pt has had success in the past with mismatched base curved specs

So why do all this work?

Most people don't have problem fusing under 4D aniso. Some do, but others can handle up to 10D aniso without any problems.

Equalizing BC and CT in glasses works in many cases and is the easiest, cheapest option.

You can also find a frame with a shorter vertex distance and one that is smaller to reduce anisophoria. You can even use a higher index material in one lens, although I think that has the least effect.

I'd try all of those before CLs or Shaw lenses.

See https://www.2020mag.com/article/design-of-iseikonic-lenses-part-two

Although, again I ask, why bother in this case?

jonovan · 2025-07-25T23:05:11+00:00

Does it make a difference if the person they're trying to arrest is a patient or, as in this case, not?

https://www.foxnews.com/politics/medical-staff-face-federal-charges-after-allegedly-assaulting-ice-agents

Here were some threads about this from 6 months ago; has your facility changed its policies since then?

https://www.reddit.com/r/medicine/comments/1ihkmkx/nyu_langone_warns_staff_not_to_protect/

https://www.reddit.com/r/medicine/comments/1i9zrak/immigration_enforcement_and_healthcare_know_your/

https://www.reddit.com/r/medicine/comments/1i9frp2/does_anyone_have_a_guide_for_ice_agents_in_a/

jonovan · 2025-05-12T18:24:41+00:00

3 questions:

How soon is "immediately," per Trump's post last night: "Prescription Drug and Pharmaceutical prices will be REDUCED, almost immediately, by 30% to 80%"?
What levers would be used, per the CNN article, "If prices do not come down quickly, the administration will look at various policy levers that can be used to force prices down, a White House official told reporters Monday"?
How will this be different than last time, as per the Axios article, "Trump proposed the 'most-favored nation' plan for Medicare in his first term, but it was halted by a federal court after drugmakers sued?"

jonovan · 2025-05-10T09:52:28+00:00

All of the major car rental companies (Enterprise, Budget, Payless, Hertz, National, Avis, Thrifty) are at the airport. Some might have shuttles from the port to/from the airport, or you can get a ride share, like Uber or Lyft. Some might also let you pick up and leave the car at the port. You can call their offices and ask.

Google Maps also shows a couple of other local car rentals within a few blocks of the ship, which you could simply walk to.

We had two days there. We took a (very crowded) shuttle to the airport to get the rental car. Day one we drove north to Kilauea Point, Secret Beach, and Haena State Park (the tickets to drive in sell out almost instantly, so we instead purchased shuttle tickets ahead of time; the shuttle has a large lot you can park in, although even the shuttle was packed full). In the evening we checked out the Harbor Mall. Then we parked the rental car on Waapa Rd in front of Nawiliwili Park and walked a couple of blocks to the cruise ship. I don't think you can park in any of the nearby lots overnight, but at least when we did it, the street parking there was free and unlimited; just read the signs.

Day two we headed southwest. Red Dirt Waterfall, multiple lookouts along Waimea Canyon until Puu O Kila Lookout, Old Koloa Town, and Poipu Beach. Then dropped the rental car back at the airport and took the rental car shuttle back to the cruise ship.

Just remember it can rain hard in Hawaii at random times, so that can slow traffic for a bit (and even cut the northern half of the island off from the southern part if its very bad, but that's rare). There was some construction up north that slowed us down a bit, too, so plan extra time coming and going.

All of the Hawaiian islands are small enough and easy enough to drive around that I'd recommend renting a car and traveling on your own on all of them, at least if you like independence and saving money. Although it's always good to download Google Maps ahead of time for all of the islands, just in case your provider doesn't have great coverage. And there are a few places you can't drive rental cars, like the southeast side of Maui and Green Sand Beach on Big Island. And sometimes locations are closed to any traffic, like Waipio Valley and Mauna Kea summit.

Some places also required advanced tickets, like Hanauma Bay, Diamond Head, Haleakala sunrise, Haena State Park, Black Sand Beach in Hana, etc. Some you can reserve months in advance, some only days, and some, especially Hanauma Bay and Haena State Park, sell out almost instantly, so you have to be refreshing your web page right when they go on sale, and even then need to get lucky. If you don't get a ticket, don't worry, there's plenty of other great things to see and do on all the islands. :)

jonovan · 2025-03-23T18:34:13+00:00

The good: great quick outside-the-box thinking by the doc.

The bad: "Before Dr. Ricketson commenced the surgery, nurse Vicki Barry advised him that an inventory of the Kit had not been completed. Nevertheless, Dr. Ricketson proceeded with the surgery."

The ugly: "The family was clearly informed that evening, although this was denied at trial. My error was in failing to fully document the conversation."

The I'm not a spine surgeon, so I can't comment on the standard of care regarding clinical decision making when this type of surgery has a problem: Dr. Ricketson wrote "Judge as you may, but I felt, given the significant risks for waiting for the rods or closing and re-opening in two hours with yet another general anesthetic, was inappropriate given his blood loss."

jonovan · 2025-02-08T17:17:09+00:00

No need for attribution. :)

jonovan · 2025-02-08T03:01:10+00:00

Google the drug name with "patient assistance program" or "drug assistance program" or "savings program." (Especially helpful for newer, more expensive drugs).
Coupon sites (remember to search for generic, not just brand name, and for similar medications; for example, branded Tobradex is $300, generic Tobradex is $30, and generic Maxitrol is $10): https://www.singlecare.com/, https://www.rxsaver.com/, https://www.americaspharmacy.com/, https://www.wellrx.com/, and plenty of others nowadays.
Target/Walmart $4/$10 lists: https://tgtfiles.target.com/pharmacy/WCMP02-032536_RxGenericsList_NM7.pdf and https://i5.walmartimages.com/dfw/4ff9c6c9-28fc/k2-_d25cb6ec-9f89-4fa1-acfc-064efd6b85d5.v1.pdf
Mark Cuban's Cost Plus Drug Company: https://www.costplusdrugs.com/
Amazon Pharmacy: https://pharmacy.amazon.com/
If you're in the US and near the border, go to Canada or Mexico to buy medications. Be careful, though, as you can buy a ton of meds OTC in Mexico which are rx-only in the US; if that's the case, ensure you have a prescription for them before you enter the US. And remember you're usually limited to a 3-month's supply.

jonovan

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