Therapeutic substitution, known also as drug switching and therapeutic interchange, is the practice of replacing a patient’s prescription drugs with chemically different drugs that are expected to have the same clinical effect. Many times patients switch to a different drug with no problems. However, for certain medications and conditions, therapeutic substitution could cause problems.
If you take prescription medication, there’s a good chance that someday you’ll be asked to switch from your current drug to a new one. There are many reasons, including costs to you or your insurer, changes in your insurance coverage, or new drugs coming on the market. Therapeutic substitution can offer benefits, but it can also pose risks. The key to ensuring your safety when making a switch is full transparency.
Choosing an eye care provider can be confusing! Optometrists, optometrists, opthalmalogists. It is important to understand the differences in education, training, credentials, and experience levels that distinguish one type of eye care provider from another - and what kind of services each specializes in.
Keep this in mind when selecting an eye care provider:
What services do I need my eye-care provider to perform?
You should distinguish between the need for primary care (fitting of glasses and lenses), and more advanced care (serious conditions and diseases, surgery).
State laws and regulations specify what services an eye care provider is permitted to provide. While ophthalmologists, as medical doctors, can perform eye treatments including surgeries and prescribe medications, state laws and regulations vary for optometrists, who are not medical doctors. You should be aware of which services optometrists are authorized to provide in your state, and whether an optometrist is able to provide all aspects of treatment that is needed.
Visit the Association of Regulatory Boards of Optometry for a link to state optometry boards and information on the services an optometrist can provide in your state:
What credentials and qualifications does my eye care provider have?
Check to see whether diplomas, licenses and training credentials are posted clearly in office/waiting room. If this information is not posted, ask the practitioner if he or she is an optometrist (attended optometry school) or an ophthalmologist (attended medical school).
Terms used for eye care professionals can be confusing. For example, some optometrists refer to themselves and other optometrists as “optometric physicians.” Traditionally, only medical doctors or MDs are referred to as physicians. While optometrists offer valuable services, they are not medical doctors, and you should be aware of the difference in training and education.
Does my eye care provider have sufficient training and experience to provide the care I need?
While each member of the eye health care team is a professional with extensive training, you should know whether a provider has adequate training for and experience with the specific procedure or care that you need.
Questions to pose to an eye care provider might include: Is he/she on call if I have a problem at night or on the weekends? If not, who is available to deal with potential problems you might develop? Can he/she provide treatment in a hospital should that be required?
Does my eye care provider have sufficient training and experience performing surgery or prescribing medications?
Ask providers about their surgical training and the number of similar surgeries they have performed before making decisions regarding surgery. Some questions you should ask include: Where did they learn the procedure? How many times have they performed the procedure? What is the complication rate (the chance that a problem may occur) for the procedure? What are the odds of success/failure?
Treatment of eye conditions and diseases often involves using prescription medication. The more prescriptions you receive, the greater your risk of drug interactions. Before prescribing, providers should ask you about other medications you are taking and any other medical conditions you may have. You should keep a personal medication list that includes all prescription medications, over-the-counter drugs (such as aspirin), vitamins and herbal supplements you are taking. Check this list with your provider to make sure there are no complications.
Do I have easy access to the eye care provider I need?
When considering access issues, you need to make sure that, in striving for convenience, you do not sacrifice quality. If you are seeking primary eye care, such as a vision check for glasses or contacts, the nearby optometrists could satisfy your patient care needs. If you are seeking advanced care, such as treatment for serious conditions and diseases, the extra time to access an ophthalmologist is likely worth the assurance of seeing a trained medical doctor.
Do I know how to report problems with my eye care provider to the proper regulatory authorities?
For optometrists, visit the Association of Regulatory Boards of Optometry.
For ophthalmologists, visit the Federation of State Medical Boards.
Consumers have many choices of eye care providers: opticians, optometrists, and ophthalmologists. How do you know which kind of provider is right for your needs?
If you're facing the opportunity to choose a new drug coverage plan for you and your family, you need to speak the language in order to weigh the costs and benefits.
Before you decide on a prescription drug benefit plan, get the facts you need.
When choosing a health plan, making sure the medicines you take regularly are covered is just as important as knowing that your doctor is in the network.
Many assume that the health care system in the United States is the best in the world — at least for those who are able to access it. The reality for many people is that our system often fails to deliver quality care, misses many people who need care the most, and suffers from significant inefficiencies that lead to high costs. Even according to conservative estimates, hospital errors are the nation’s eighth leading cause of death — ahead of breast cancer, AIDS and motor vehicle accidents combined.
Doctors and health care professionals are attempting to help patients make sense of the overload of health information by gathering, evaluating, and sharing well–tested, proven medical research. This process of bringing the best available evidence from scientific research to patient care is known as evidence-based medicine (EBM).