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Medical Forum / General / Vision / May 2005

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OD's vs Others

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Richard Lyons - 07 May 2005 07:59 GMT
I find it quite fascinating that there is such a debate between licensed
practitioners and those not licensed. This is my observation so far:

1. Licensed individuals in this forum are engaging in a vigorous defense of
their practice.

2. Non-licensed individuals are trying to convince those in practice of
findings that have sketchy, little, or no scientific backing mentioned.
(Are there any studies out there?)

3. The postings have degenerated into name calling frenzies (with the
exception of Mr. Otis Brown, who appears to actually want to conduct an
intelligent discussion with licensed parties).

I think that we can all agree that medicine is a science, and that licensed
practitioners are intelligent in scientific evaluations.

Further, I think that we can also all agree that those who may not have an
advanced degree in the field of optometry or ophthalmology *might* also be
equally intelligent in the fields of science and optometry, at least until
proven otherwise in their postings.

An engineer vs. an eye doctor? Sounds like two very educated people in
highly different fields. Perhaps the riddle of poor vision prevention and
mitigation can only be broken by these two fields working TOGETHER.

Engineers are very good at working with other specialties. The proof is in
the pudding...you have potable water to drink in your home and office, you
are able to jump on an airliner and travel the world, our military is
highly capable in defeating an enemy, you are able to drive a car or
motorcycle to work every day, and the list goes on. Certainly an engineer
is not an expert in the economics of airline transport, or techniques in
killing an enemy. But they have sure done a good job working with those
experts to give them magnificant products that accomplish just that.

The thing about engineers is that they only care about the observed facts.
You can't push on a rope, you can't climb a fence leaning toward you, you
can't kiss a girl leaning away from you, you only have 40mAh to work with -
period. The thing about doctors is that they know *everything* and nobody
else knows as much as they do. How in the world do you get these two kinds
of people to work together? Maybe it's impossible.

Here's what I see...some practitioners let their ego get in the way of true
potential progress. Remember the church vs. Galileo?

Maybe we should all take a minute to think about maximizing our expertise
to evaluate a problem vs trying to find ways to discredit the other point
of view.

So, to the doctors out there - let's put possibility on the plate for a
minute. I do this for one reason...remember the guys that said the sound
barrier could not be broken...? Or how about those who laughed at the idea
that we might actually be able to cross the Atlantic Ocean in only hours...?
Or how about the economics professor who gave the then to be future founder
of FedEx an "F" on his concept paper about the potential of a company like
FedEx...?

So here it is doctors:  If myopia could be reversed to any degree without
lenses or surgery, how would it likely happen?

Richard
Mark A - 07 May 2005 08:10 GMT
> So, to the doctors out there - let's put possibility on the plate for a
> minute. I do this for one reason...remember the guys that said the sound
[quoted text clipped - 5 lines]
> of FedEx an "F" on his concept paper about the potential of a company like
> FedEx...?

Fred Smith (founder of FedEx) did not get an F. He does not even remember
what grade he got on the paper. Here is an excerpt of an interview:

Q: Part of the lore of FedEx is that you wrote a term paper while a grad
student at Yale that first explored the idea of an overnight-delivery
service -- and that you received a C from a skeptical professor. Was that
term paper truly the genesis of FedEx?

A: The question is prescient because there wasn't a single "eureka" moment.
The original idea for FedEx came when I wrote a term paper as an
undergraduate -- not as a graduate student, because I never went to graduate
school -- about a very simple observation: As society automated, as people
began to put computers in banks to cancel checks -- rather than clerks -- or
people began to put sophisticated electronics in airplanes -- society and
the manufacturers of that automated society were going to need a completely
different logistics system.

That was becoming obvious to me both from just reading about it from an
academic standpoint, and in those days I used to fly -- I was a charter
pilot at the Tweed New Haven airport. I flew around to those airports up
there, and all those high-tech companies, including IBM (IBM ) and Xerox
(XRX ), that's what their pilots used to talk about -- what a difficult
proposition it was to keep their field-service engineers and their parts and
logistics systems operating. In fact, a lot of the corporate airplanes up
there were doing nothing more than flying [computer] parts and pieces
around...when the computer would break down.

That was the paper, and the whole issue about the C on the grade, came from
naivete on my part when I was talking to a reporter years and years ago, and
he asked what I made. I said, "I don't know, probably made my usual C."

Q: So did you, or did you not make the infamous C on the term paper?

A: I don't know. It was so long ago, even when that question was asked 20
years ago, I didn't know. I've tried to correct it many times, and usually
when a journalist like you listens to the story and realizes how complex the
story is, you realize it would take your whole profile to explain it.
Sibirer - 07 May 2005 10:13 GMT
You brought up a few good points that shouldbe addresed.

>I find it quite fascinating that there is such a debate between licensed
> practitioners and those not licensed. This is my observation so far:
>
> 1. Licensed individuals in this forum are engaging in a vigorous defense
> of
> their practice.

This is likely to be the perception for someone just stepping in within the
last few years. People who have learned the physics, psychology, and
pharmacology of the visual/ physical/ mental systems are just trying to keep
the quacks from preying on people who have problems and have not been
through that level of education in those fields.

> 2. Non-licensed individuals are trying to convince those in practice of
> findings that have sketchy, little, or no scientific backing mentioned.
> (Are there any studies out there?)

Snake oil salesmen have been around forever, and they can be very
convincing. None of them can offer a double blind study that has been
independently verified (major rule of scientific studies is that the study
must be verifiably reproduced by other parties,) that supports their claims.
Anecdotal claims are often quoted, but are totally useless because there is
no valid verification process. They are always very emotional, but not
scientifically verifiable.

> 3. The postings have degenerated into name calling frenzies (with the
> exception of Mr. Otis Brown, who appears to actually want to conduct an
> intelligent discussion with licensed parties).

I have not spoken with Otis, but from his posts, I fail to detect any
offerings of double blind tests independently verified. I only see claims
that have been circulating on the internet since DARPA released control of
the internet.

> I think that we can all agree that medicine is a science, and that
> licensed
[quoted text clipped - 4 lines]
> equally intelligent in the fields of science and optometry, at least until
> proven otherwise in their postings.

We can agree that many people without degrees are capable of scientific
thought. Some people with advanced degees are not capable of such despite
their papers.
Optometry involves science and psychology. I'm amazed that the optometric
courses are so lax on the psychology issues and are becoming ever more lax
on the optics issues. The courses are becoming more pharmocology related.

> An engineer vs. an eye doctor? Sounds like two very educated people in
> highly different fields. Perhaps the riddle of poor vision prevention and
> mitigation can only be broken by these two fields working TOGETHER.

Engineers design things. They can't deal with self designing and self
controlling systems. You just can't do the math when every constant becomes
a variable that you can't control. There are plenty of schematics for the
visual system. Heck, I have a schema of the human eye on my computer as far
as it's optical properties are concerned. I use it quite often when dealing
with the really screwball Rxs that I sometimes get. I use it for trying to
get the two eyes to work together when the math just doesn't add up. I have
to use psychology to finish the answer.

> Engineers are very good at working with other specialties. The proof is in
> the pudding...you have potable water to drink in your home and office, you
[quoted text clipped - 4 lines]
> killing an enemy. But they have sure done a good job working with those
> experts to give them magnificant products that accomplish just that.

The above cases refer to manmade physicsl structures, not living organisms
that are far more complex. Well, the military defeating all is a good
example. Yes, we have the most powerful techologically advanced force in the
world. We still can't win a peace. this is the technological failure. We're
assuming we can change anything at a whim. THis is where the snake oil
salesmen prey. They call to our emotions and offer unverified "proof" of
their scientific superiority. They can't meet the scientific standard, but
they can appeal to the emotional standard. They strike with the efficiency
of a roadside bomb, and offer the same twisted justifications as the
bombers.

> The thing about engineers is that they only care about the observed facts.
> You can't push on a rope, you can't climb a fence leaning toward you, you
[quoted text clipped - 3 lines]
> else knows as much as they do. How in the world do you get these two kinds
> of people to work together? Maybe it's impossible.

Uhm, you made the same description for both groups. You just cast your
prejudices to the everything is a metal and math problem. Yes, you can climb
a fence leaning towards you. I've done it plenty of times; not to mention a
few rock faces so oriented ( it's a rush to see your ground  above you and
the open air below you!). I wouldn't want to kiss a woman leaning away from
me.

> Here's what I see...some practitioners let their ego get in the way of
> true
> potential progress. Remember the church vs. Galileo?

Remember the caveat on trying to compare apples to oranges? THis is a very
worn out line, let the dead dog go to where ever.

> Maybe we should all take a minute to think about maximizing our expertise
> to evaluate a problem vs trying to find ways to discredit the other point
> of view.

The brightest optical and biological engineers are hard at work on the
issues at hand. So are the brightest ophthamologists, optometrists, and an
alphabet soup of other optical specialists. We could make far more money
pushing the vision therapy snake oil than we do currently. Heck, I might be
able to go farther than 10 miles on a vacation.

> So, to the doctors out there - let's put possibility on the plate for a
> minute. I do this for one reason...remember the guys that said the sound
[quoted text clipped - 8 lines]
> So here it is doctors:  If myopia could be reversed to any degree without
> lenses or surgery, how would it likely happen?

Well, let us not touch the FedEx thing. Not a reality. Everthing else you
stated are all of the questions that have brought us to this current level
of vision treatment. Yes we can see near and far. Yes, we can correct
astigmatism.. Yes ,we can get rid of the lines and image jump. Yes, we can
remove a cataract riddled lens and replace it.We are actively doing the
physically possible and learning to do more. Unfortunately, the quacks keep
bringing pipe dreams into the picture and  ridicule people who actually are
keeping track of developments in human knowledge.

Do not feed the quacks. They thrive on desperation and especially on a lack
of understanding of true scientific principles.

Carl

> Richard
Neil Brooks - 07 May 2005 15:46 GMT
Richard Lyons: In golf, they call it a whiff.

Sibirer: thumbs up.  You got it, and you explained well why Mr. Lyons
*didn't*.

It'd be nice to believe all the conspiracy theorists in this world,
too.  I probably would . . . if just *one* of them were *ever* proved
right.

What you're really hearing is bright, caring, passionate, well-meaning
eye doctors who make their living helping people with vision problems.
These people -- Mike Tyner has been a standout in the clarity with
which he presents his case -- have repeatedly offered that they would
*make more money* if theories like Otis's and Rishi's were true.
Defense of profession?  Not hardly.

Remember: the average American can't take a pi$$ by himself these
days.  He needs a counselor, a coach, a trainer, a doctor . . .
somebody to work with him step by step.  The doctors have no reason to
be threatened.

It's just that nobody's offered *any* proof that *any* of the bull$hit
they're trying to sell works at all.  Period.  End of story.

Elevating their status by comparisons to Fred Smith (whom I've had the
pleasure to meet) or Galileo is lunacy.

Further, your characterization of Otis's postings as "intelligent
discussion" has me rolling on the floor in unbridled laughter.
Literally.  I'm picking carpet fibers off right now.

An intelligent person (let alone an alleged engineer or scientist)
would set about to *prove* his hypothesis by commonly-accepted
methods.  I've offered time and again a plan by which either of our
primary offenders can partner with qualified institutions to conduct
proper experiments.  If their experiments succeed, then vision care
will be advanced dramatically.  The problem is in the risk: if (when?)
their experiments fail, these charlatans will be unmasked.  They fear
the risk.  What does that tell you?

These yahoos prefer to state and restate anecdotal--and likely
entirely fabricated--stories until they believe them themselves.  You
call that intelligence?  How do you figure?  Civil discourse?  Maybe.
Productive?  Definitely not, since they don't listen to the
well-educated, well-intended masses *begging* them to be right, and
informing them as to how they may prove that they are, so that
millions can be helped.  Destructive?  Quite possibly, since the
subtext of what they are saying is quite often "avoid these
self-serving doctors for they cannot and will not help you."
Bushmaster - 07 May 2005 10:47 GMT
>The postings have degenerated into name calling frenzies (with the
>exception of Mr. Otis Brown, who appears to actually want to conduct an
>intelligent discussion with licensed parties).

I admire Otis' dignity and professionalism when he is having
conversations, he is always kind to everyone.
Neil Brooks - 07 May 2005 15:48 GMT
>>The postings have degenerated into name calling frenzies (with the
>>exception of Mr. Otis Brown, who appears to actually want to conduct
[quoted text clipped - 3 lines]
>I admire Otis' dignity and professionalism when he is having
>conversations, he is always kind to everyone.

Agreed.  He does that exceptionally well, but there's not a hint of
substance behind what he so politely says and he fears any efforts at
validating his own assertions . . . which is somewhere between scary
and flat-out pathological, your call.

He should prove out his hypotheses or he should spout different
garbage in different forums instead.

SCIENCE.med.vision.....
Dr. Leukoma - 07 May 2005 13:47 GMT
I take offense to your assertion.  I do not defend a practice so much
as the science behind the practice.  I invite you to study the issues
yourself, and to find the evidence for or against the assertions by a
handful of individuals who claim that they have found the cure for
myopia, hyperopia, astigmatism, macular degeneration, and other
maladies...in short, snake-oil salesmen.  To do so, you will have to go
outside of this NG.

When you do, if you do, you will find that there is currently
insufficient evidence to indicate that the current practice should be
changed.  When asked to provide such evidence, Otis cites a study of
bifocal wearers published thirty years ago.  If one reads the fine
print, one will see that it was done on a minority subset of myopes who
had esophoria at near.  Most myopes do not fit into that category.
Otis will never admit this.  Only in recent days has he recognized that
there is actually a subtype of myopia, called accommodative myopia,
which may respond in some degree to bifocal treatment.

Otherwise, all studies published since then indicate a lack of efficacy
for this technique, with the exception of one, which showed a slight,
but statistically insignificant effect.  One recent study actually
indicated that witholding corrective lenses was harmful.  However, Otis
has yet to acknowledge the existence of a single scientific study other
than the single one he continually references.  In support of this, he
draws around himself the names of a few non-visual scientists who have
written decades ago in support of his theories, a single optometrist
practicing in Asia, and the odd imaginary person or two with whom he
holds an discussion about "taking control."  Meanwhile, time and
science marches on....

I and other individuals have brought other ideas about the mechanism of
myopiagenesis into this newsgroup for discussion.  All recent ideas,
backed by scientific studies, I might add.  One preventive technique is
actually 100 percent effective.  Another is 50% effective.  But, they
must be over his head, because Otis, true to form, continues to drag
down this discussion like a boat anchor.  Like a yo-yo, he keeps
returning to the junk heap of discarded ideas, and he can never cite
proof of efficacy.  When pressed, he returns to the same circular
argument about the nature of the "dynamic eye," "step input," "average
environment," "poison minus lenses," and other pseudo-scientific jargon
which he has created to cloak his thoughts.

Now, despite the seemingly polite rhetoric of Otis, lies a thinly
veiled viciously spiteful attitude toward optometrists.  This earns him
no quarter from the many optometrists who post here and help keep this
NG going.  I learned about the intellectual dishonesty of this man
first-hand when he sent me a seemingly innocuous email.  He responded
by taking certain comments of mine totally out of context and
publishing them in this NG in a way that made it seem like I totally
supported his position.  This is his modus operandi.

If you look back into the archives of this NG, you will find that
anything and everything that could be said on the subject has been
discussed.  Few of us have the interest in revisiting those same
arguments.  In so doing, we simply give Otis the credibility he does
not deserve.

DrG
Neil Brooks - 07 May 2005 15:50 GMT
[snip]

Beautifully said.

Perhaps *that* should be the weekly posting for s.m.v.
LarryDoc - 07 May 2005 17:22 GMT
Very nicely done, Dr. G.

Thanks for taking the time to so eloquently present the issue.

--LB, O.D.
William Stacy - 07 May 2005 15:22 GMT
> 3. The postings have degenerated into name calling frenzies (with the
> exception of Mr. Otis Brown, who appears to actually want to conduct an
> intelligent discussion with licensed parties).

I admit to having this happen, but Otis does the most serious name
calling of all.  He calls most O.D.s (the ones that don't buy his line)
eyeglass pushers and says we are not interested in helping people.  A
velvet lined sword, I'd say, very effective in bringing people to
defensive tactics.

w.stacy, o.d.
Charles - 07 May 2005 17:31 GMT
> An engineer vs. an eye doctor? Sounds like two very educated people in
> highly different fields. Perhaps the riddle of poor vision prevention and
> mitigation can only be broken by these two fields working TOGETHER.

I would rather depend on an eye doctor than an engineer on my vision
problems. (I read this group because of several vision problems)

As far as the very educated, even those can come up with crank ideas.
Which is my evaluation of Otis and ilk.

Signature

Charles

Wooly - 07 May 2005 17:49 GMT
>3. The postings have degenerated into name calling frenzies (with the
>exception of Mr. Otis Brown, who appears to actually want to conduct an
>intelligent discussion with licensed parties).

Otis called me quite a few names the last time I asked him to defend
his position.  When I persisted he actually trotted out the F word
(not to be confused with the F name of the company that stomped a $10k
server of mine during shipment back in 1991 and refused to pay for
it).  To Otis's credit when he discovered I'm a female he did
apologize for the language, but the fact remains that he owns the
vocabulary and is willing to use it when his pet theories are debunked
by the simple expedient of pointing out the lack of substance about
them.

+++++++++++++

Reply to the list as I do not publish an email address to USENET.
This practice has cut my spam by more than 95%.  
Of course, I did have to abandon a perfectly good email account...
otisbrown@pa.net - 07 May 2005 18:53 GMT
Dear Wooly,

You must have confused me with
some one else.  I simply
do not use the "F" word -- unless
is it used on me.

I think true-prevention is difficult
and will depend on the motivation
of the person who wishes to do it
agressively.

I think we should be very careful
with the minus lens -- and
allowing the person himself
to review the preventive option -- before
a minus lens is used.

Basic facts concerning the
dynamic behavior of the natural
eye -- should give us pause -- be
fore a minus is used.

I WOULD GLADLY PAY FOR
AN OD OR MD who would take
time to cultivate my "understanding"
if these issues.

Clearly, pilots, with considerable
PERSONAL motivation have
been able to do it.

Why not work together on this
issue.

"Name calling" simply does
not "work".

Best,

Otis
Engineer
 
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