Lupine Publishers | LOJ Pharmacology & Clinical Research
Abstract
Before the industrial revolution, in Europe and The United States of America, a client could walk into a barbershop, have a shave, a haircut, a painful boil lacerated -and have some of his blood drained off to boot! Barbers were called “barber-surgeons” and men without a medical degree-in fact men without hardly a rudimentary education-were allowed to operate. In those days as well, children of the wealthy could buy commissions into the army and navy and become overnight army and navy officers-without ever having set foot in a military academy! Those were also the days when men read law books at home or apprenticed with lawyers, showed up for exams and received law degrees without ever setting foot on a college campus or attending a single lecture!
Introduction
Is history not repeating itself today?
The explosion of the internet has in turn triggered the explosion of
organizations- many unaccredited- purporting to provide a very sound education
for you within the comfort of your home! And they are getting bolder! A few
years ago when these charlatans started they knew better than to offer courses
in healthcare. Now they have become super emboldened. Optometry, radiography,
pharmacy and nursing are now offered! How on earth can qualifications in these
fields be achieved without hands on experience? I fear for the global future of
healthcare delivery. A hallmark of civilization is a clear cut division of
labour. This present tolerance for and celebration of the “Jack of All Trades”
philosophy won’t end well. Gone are the days when you knew what to expect when
you walked into a hospital.
A doctor was a doctor and a nurse was a nurse! Now between the doctor and the
nurse the physician assistant and the nurse practitioner have smugly and snugly
inserted themselves! The optometrist and orthoptist now think themselves to be
ophthalmologists and the radiographer thinks he knows everything the
radiologist knows. The physician assistant and nurse practitioner professions
arrived in 1965 and ten years later the pharmacist assistant reared its smug
head. The creation of all sorts of midlevel “practitioners” and the “upgrading”
of their certificates to diplomas, then to associate degrees, then to bachelor
degrees then to masters degrees (I hope physician assistants are reading this)
is not a healthy development [1-2]. Make no mistake about it: too many cooks do
spoil the broth! Open a regular or medical dictionary from a few decades ago
and neither “nurse practitioner” nor “physician assistant” are defined therein,
as these professions did not then exist. The mid-level professions which did
exist then such as optometrist and radiographer have VERY different definitions
from those in contemporary dictionaries. The professions have begun to overlap
with those of ophthalmologist and radiologist. Ditto the pharmacy technician’s
inroads into the clearly defined roles of dispenser and the pharmacist of old.
The “clinical pharmacist” today has started to show up in the operating theatre
and lock horns with the anaesthesiologist and his technician! The non-medical
world is not spared the confusion. What a wedge the technician and technologist
has put between the electrician and the electrical engineer. A time bomb ticks
away! These developments cannot but spell doom!
Observe how from 1920 to 2020 the Definitions of “Optometrist” and “Radiographer” have changed
Optometrist\optometry +-istle\ One who
measures the degree of visual acuity, a refractions’; referring generally to a
person without medical training who fits glasses to correct visual defects [3].
PAGE 705 Students Medical Dictionary, 1920 optometrist A practitioner who
provides primary eye and vision care, performs eye examinations to detect
vision problems, and prescribes corrective lenses to correct those problems. Some
optometrists also make and fit eyeglasses, but many leave that job to
opticians. An optometrist is a doctor of optometry (OD), not an MD. When an
optometrist detects eye disease, the patient may be referred instead to an
ophthalmologist, a physician who specializes in evaluating and treating
diseases of the eye [4]. PAGE 309, Webster’s New World Medical Dictionary, 2008
OPTOMETRY is a health care profession that involves examining the eyes and
applicable visual systems for defects or abnormalities as well as the
correction of refractive error with glasses or contact lenses and treatment of
eye diseases.
Traditionally, the field of optometry began with the primary focus of
correcting refractive error through the use of spectacles. Modern-day
optometry, however, has evolved through time so that the educational curriculum
additionally includes significant training in the diagnosis and management of
ocular disease, in most of the countries of the world, where the profession is
established and regulated. In 2020 wikipedia it is stated thus-A radiographer
uses their expertise and knowledge of patient care, physics, human anatomy,
physiology, pathology and radiology to assess patients, develop optimum
radiological techniques and evaluate the resulting radiographic media.
From Merely Taking X Rays the Radiographer has in a Hundred Years Graduated to Assessor and Evaluator!!
Is there a Doctor in the house?
Gone are the days when anyone going by the title “doctor” was either a medical doctor or an academic doctor (a PhD/DSc/ DLitt). Now everyone’s a doctor. Optometrists are DO (Doctor of Optometry), nurses are DNP (doctor of nursing practice) and hitherto easy going physiotherapists are calling themselves DPT (doctor of physical therapy). Even the barber-surgeons in the 1700s didn’t call themselves doctors! Now pharmacists, nurse practitioners, physician assistants and even psychologists (yes, psychologists NOT psychiatrists) are writing prescriptions! It’s hard to remember there was a time when only medical doctors were allowed to write prescriptions.
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