I Only Play an Ophthalmologist at the Office

Rand Paul, who rushed from the operating room Tuesday to give a talk while still in his surgical duds, seems to advocate free-market doctor certification:

Rand Paul’s reputation for marching to his own drummer may extend to his medical career. The GOP Senate candidate is the founder and president of a certifying board for eye doctors, which he appears to have set up as a rival to the existing certification board. But his organization has left little public record, and the legitimacy with which it’s viewed remains unclear at best.

In 1999, Paul created a new non-profit organization, the National Board of Ophthalmology (NBO), headquartered at his home in Bowling Green, Kentucky, in order to “provide information to the public concerning physicians with exemplary qualifications in the medical specialty of ophthalmology,” according to the organization’s founding document, filed online with the Kentucky Secretary of State’s office. Page One, a Kentucky politics blog, first noted the group’s existence last month.

“It was a certifying board,” Beth Ann Slembarski, the administrator of the major existing ophthalmology certifying board, the American Board of Ophthalmology (ABO), told TPMmuckraker.

Apparently — this is very confusing — Randy’s NBO was created to get around new ABO recertification rules. Imagine needing to take a new driver’s test every ten years, then learning you could get a license from an alternative agency that was good for life. Something like that.

ABO certifies 96 percent of American ophthalmologists, while eight ophthalmologists nationwide claim dual ABO/NBO certification. Randy himself let his ABO cert lapse in 1995.

We really don’t know what it all means, if anything. Then again, we really don’t want to encounter that kind of confusion when choosing an eye doctor.

Rand Paul’s Upstart Ophthalmology Group Leaves Little Mark [TPM]

So, let me get this straight. I can choose a doctor who’s opted out of recurrent training, or go for one who’s into recurrent training. Recurrent training among pilots has resulted in a massive reduction in accidents and problems. Why would it be any different for opthalmologists? Why, it probably isn’t! In fact, I’d wager that there are new procedures popping up from time to time, which recurrent training might actually introduce a new technique to a doctor. What a crazy notion!

More importantly, does this mean he’s engaged in Medicare and Medicaid fraud? Would they reimburse non-(officially)-board certified docs?

/seriously considering spending evening reviewing Medicaid regs

Rand Paul= the angry Man from one of the last really funny Simpsons episodes:

Wiggum: All right, you scrawny beanpoles: becoming a cop is _not_
something that happens overnight. It takes one solid weekend of
training to get that badge.
Man: Forget about the badge! When do we get the freakin’ guns?!
Wiggum: Hey, I told you, you don’t get your gun until you tell me your
Man: I’ve had it up to here with your “rules”!

I said some time in the last few weeks that someone should ask him whether doctors should be regulated, with all these Government rules that require education and training and a license, or whether anyone should be allowed to hang out a shingle and claim to be an opthalmologist, and let the free market sort it out.

I was joking, but now we know, he is just than insane. And corrupt.

The Indian Health Service seems to get a lot of D.O.s, Doctors of Osteopathic Medicine, for their rural tribal clincs.

@redmanlaw: Oh, osteopaths, in many states they cannot write prescriptions unless under the supervision of an MD. But you know, I only learned when I was like 30, that my childhood doctor, my “family doctor” all the time I was growing up, was a DO. He is also a well-known horror writer, writes horror novels, one was made into a movie, The Keep, his name is F. Paul Wilson.

@redmanlaw: Some of the best “doctors” I have seen lately are nurse practitioners. I am convinced that there are many nurses and physicians assistants out there who have absorbed all the knowledge the MDs have, and more, and are better at doctoring, and they don’t have that sense of entitlement and papal infallibility that doctors have.

@redmanlaw: @Promnight: I dig DOs, NPs and PAs. If I were to go have gone to med school, I would have become an osteopath. I’ve worked with MDs who see someone with leg trauma, x-ray, cast, etc. and send them on their way, while I’ve seen a DO be like – so how dig you break your leg? Did you slip? Were you dizzy? Do you need new glasses? Shit like that. They’re more into finding out why someone broke their leg than MDs, IMHO. Treat the whole person and not merely the symptom(s).

OK. I’ve gone over the edge. Those who know what that means can fast-forward to avoid the ugliness. I send you kisses and bunny-hugs. I do.


We in the US niggle and whine (myself included) about shit and stuff. In Uganda they plan to kill those who are most vulnerable: aka; the gays.

Imagine your daily life like this.

@Benedick: Fuck to the A.

@JNOV: NPs are the best. A friend of mine’s husband is going back for pre-med and medical school at the age of 39 after realizing he hates his management consultant life. I’m jealous of the chutzpah to do that. Maybe after I pay off law school debt I’ll look into a NP program. I could totally see me and Mr. SFL living in some developing foreign country where I’m birthing babies and fixing broken arms while he’s making sure their homes survive a tsunami or earthquake.

@Promnight: The Market will decide which doctors are competent caregivers, and which are quacks. Everybody knows that.

@Benedick: Fuck this lovey dovey shit. Arm the Gays! I’ll gladly send a money order to someone who will put a machate, Glock or AK in the hands of a gay man or woman so they can live another day.

@Promnight: I love my doctor. She was a nurse before she became an MD. This would be a better world if all doctors started out as nurses.

@lynnlightfoot: @SanFranLefty: @JNOV:
i love nurses, also PA’s. there was a time i wanted to be a midwife, and know the grueling education they receive. i joked that i am the only person in history that has anatomy and physiology listed as an elective.
i recall RML also took that course. hardest undergrad course you can take. and when it comes to drugs, trust your pharmacist. they all know more than docs about meds.

@Benedick: @lynnlightfoot:
2 days in a row i have to wake up to this shit. yes, jesus is spinning like a top… from the crusades and tammy faye baker alone.
i’m still waiting for jesus to come back and say,
That’s NOT What I Meant !!!

i remember having a conversation with an IDF cutie, and when i told him about DADT, he thought i was kidding. he couldn’t believe it.

@baked: IDF cuties, you say?

I was talking with someone last weekend who quit a nursing program because of A&P. It was not that hard. I’m looking for a wilderness first responder class now, which is like an EMT basic for the outdoors. Santa Fe County is looking for volunteer EMTs, so I’ve been giving it some thought.

well, you are smarter than me then…..i’m STILL pissed i got a C.

breaking hard….i may have a puppy in THREE HOURS.
heart be still.
a cane corso (or italian mastif)
my friend breeds them…going to see the 6 week old pups.
i don’t predict i’ll leave her house without one. my heart is racing.
been dogless for almost 6 months–can’t take it.
i researched the breed. very attached to their family, but will rip the throat from an intruder–sounds good!!!!! wish me luck!!!!!

@baked: Oh wonderful!! I’ve found mastiffs to be very sweet but intimidating dogs. English mastiffs and bull mastiffs, you can’t even raise you voice to a sharp “no” without them being devastated. But just the sight of them sends any would-be intruder fleeing.

@Mistress Cynica:
exactly! it touched me so when i read they can pout for hours if you raise your voice to them. this MUST happen!!!

@baked: Just don’t bring back the entire litter…don’t you have to wait until they’re 8 weeks to wean them?

@JNOV: Fuckin’ DOs – how do they work?

i thought the same, these are 6 weeks and she said they’re ready to go.
i’m not arguing! leaving NOW……..hallelujah!!!!

@SanFranLefty: Okay — that would be beyond awesome!

@baked: I seriously owe you a phone call — I’ll get on Skype in a few.

@redmanlaw: Haha! It all depends on their training. Just like some MDs go to The Backwater College of Medicine, some DOs don’t have great training. I vibe with the philosophy behind being a DO, but they don’t get much respect — they’re seen as losers who were unable to get into MD programs, and that might be true for some. BUT having worked with DOs and MDs, I’ve found that the DOs are a different type of animal if they buy into practicing holistic medicine (not the woo woo stuff).

@redmanlaw: @JNOV:

question: what do you call the person who graduates last in med school?
answer: doctor

I HAVE A DOG. whoop! whoop! whoop! whoop!

@baked: PUPPEH!!!! PUPPEH!!! Start posting photos on the Book of Faces!

@baked: Yeeha! It’s a Memorial Day miracle!


Does “D” stand for “Done with Degree” in Med School?

Congrats on the newest addition to your family.

@redmanlaw: @baked: A&P, organic chem, bio for majors…I was on track to be golfing on Wednesdays until I discovered Owsley blotter. I probably would have turned out to be Gregory House, anyway.

Found out a coupla days ago that they’re gonna give us a “tune up” on our tactical med course; I put in a word for learning how to put in an IV, if nothing else to help folks through their hangovers (name-checked ya, JNOV!).

ADD: Nobody else recognized the Residents?

The comment that “Oh, osteopaths, in many states they cannot write prescriptions unless under the supervision of an MD,” is incorrect. DO’s have unlimited practice rights (to include all schedules of prescription drugs) in all 50 states identical to that granted all licensed MD’s. In no state or even county are DO’s reguired to obtain an MD’s approval for any prescription of any type. If in doubt visit the AMA’s website home page and type in “Osteopathic Physician” under search.

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