Posts Tagged ‘optometrists’

Ophthalmologists ‘disheartened’ by House advancing bill for optometrists to practice surgery

Wednesday, March 15th, 2017

Cary Pigman, the Avon Park Republican and emergency care physician who chairs the Health Quality Subcommittee.
Optometrists enjoyed a narrow victory Wednesday in Florida’s renewed Eyeball Wars when a House committee advanced a bill to allow optometrists to perform certain types of eye surgery.
After a two-hour hearing, the House Health Quality Subcommittee approved HB 1037, sponsored by Rep. Manny Diaz and opposed by both the Florida Society of Ophthalmology and the American College of Surgeons.
Diaz, a Republican from Hialeah, argued the bill gives patients in rural areas better access to eye surgery, as well as helping lower-income patients since ophthalmologists rarely accept Medicaid.
“We have a responsibility to make sure everyone has access,” Diaz told the committee.
Dr. Ken Lawson, chair of the Florida Optometric Association, told lawmakers that the laser-based surgical procedures were non-invasive and did not involve actually cutting into the eye.
Ophthalmologists have always maintained that optometrists do not have the same medical training or qualifications to perform eye surgery.
For the past four years, optometrists and ophthalmologists have held a truce in the so-called “Eyeball Wars,” which optometrists are now actively seeking to break.
Signed into law in 2013 by Gov. Rick Scott, HB 239 had allowed optometrists to prescribe a limited number of oral medications and forbid them from prescribing Schedule I and II controlled substances. It also said optometrists must complete 20 hours of added training, pass an examination, and carry medical malpractice coverage at the same level as medical doctors. The bill also needed optometrists to report all adverse medical incidents – the same as ophthalmologists and other practitioners.
Optometrists would also have to refer patients with severe glaucoma to an ophthalmologist within 72 hours.
Dr. David Hoyt, executive director of the American College of Surgeons, sent a letter of protest Tuesday to Rep. Cary Pigman, the Avon Park Republican and

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American Surgeons warn House against latest salvo in Florida’s resurgent Eyeball Wars

Wednesday, March 15th, 2017

Tallahassee has once again found itself in the thick of a renewed Eyeball Wars between optometrists and ophthalmologists.
And no less than patient safety in Florida is on the line.
After a four-year truce, optometrists have gone back on their word, drafting legislation to allow them to perform surgery; it is a proposal that ophthalmologists, the American College of Surgeons and recent scientific research suggest would be devastating to the long-term health for thousands of Floridians.
A bill now making way through the Florida House seeks to expand optometry further into the practice of medicine and surgery, an effort fiercely opposed by ophthalmologists. HB 1037, sponsored by Republican Manny Diaz of Hialeah Gardens is scheduled Wednesday for the House Health Quality Subcommittee, chaired by Rep. Cary Pigman, an Avon Park Republican and emergency care physician.
The comparative lack of instruction for optometrists is the reason ophthalmologists — health care professionals who have completed college, a minimum of eight years of added medical instruction, and are licensed to practice medicine and surgery — have been vocal players in these resurgent Eyeball Wars.
Also joining the chorus against HB 1037 is the prestigious American College of Surgeons. In a March 13 letter to Pigman, the ACS warns this bill would pose a considerable risk to patient safety and quality of care.
Renewing the Eyeball Wars come at a time when health care professionals as a whole are implementing higher — not reduced — standards of care.
If passed, HB 1037 would allow optometrists to perform a significant number of surgical procedures and prescribe nearly all drugs, including addictive narcotics. This flies directly against a compromise reached in April 2013 with House Bill 239, which expanded the scope of practice by allowing optometrists to prescribe a limited number of oral medications and forbidding them from prescribing Schedule I and II controlled substances.

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Eyeball Wars: It’s all about knowing who takes care of your eyes

Monday, March 13th, 2017

Do you know who is taking care of your eyes?
That question is at the heart of “Joanne’s Story” a video about a Vero Beach woman who nearly lost her eyesight after an ophthalmologist caught a rare diagnosis which was missed by her optometrist.
Joanne was previously under the care of an optometrist who diagnosed her with a “small cataract.” A retinal surgeon removed the cataract, and Joanne returned to the optometrist for the remainder of her care. After several visits, Joanne was told that “everything was fine.”
But everything was not fine.
After sensing foreign matter in her eyes, Joanne turned to an ophthalmologist, who then diagnosed a rare fungus infection — a problem unrecognized by the optometrist.
“When you get a complication as serious … and as rare as mine,” Joanne says, “you have to have the most well-educated, highly qualified medically trained doctors to even begin to deal with it.”
The video was originally released in February 2013 to highlight Florida House Bill 443, which at the time sought to prevent optometrists from calling themselves “physicians,” mandating that they report any adverse incidents with patients, which is already a requirement for ophthalmologists and other medical doctors. And it required optometrists diagnosing severe cases of glaucoma to immediately refer a patient to an ophthalmologist.
Behind the bill was the idea that ophthalmologists are medical doctors who specialize in eye and vision care. As such, they possess a much higher level of training in treatment and diagnosis, more than either optometrists or opticians.
Though HB 443 ultimately died in committee, a companion bill did later pass in 2013, and was signed into law by Gov. Rick Scott.
HB 239 signified an agreement between the state’s optometrists and ophthalmologists, forging a truce in what became the so-called “Eyeball Wars,” which had been raging for decades.
Many of the changes in

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We told you so; Eyeball Wars set to begin anew

Wednesday, February 22nd, 2017

Don’t say we didn’t warn you.
Nearly four years have passed since the truce was called in the decades-long “eyeballs war” between Florida optometrists and ophthalmologists.
But with the Legislative Session approaching, that fragile peace seems all but finished.
Optometrists are seemingly going back on their word, working behind the scenes to file legislation to allow them to perform surgery, a proposal that scientific research suggests may not be a good idea.
Several signs indicate optometrists had become progressively uneasy since April 2013, when a compromise was reached after years of lobbying by the Florida Optometric Association (FOA) and Nova Southeastern University’s College of Optometry, which is one of the largest optometry schools in the nation.
House Bill 239, initially applauded by the industry, expanded the scope of practice by allowing optometrists to prescribe a limited number of oral medications and expressly prohibits optometrists from performing surgery “of any kind.,” providing a clear definition of surgery modeled after the guidelines of the American College of Surgeons.
Optometrists also cannot prescribe Schedule I and II controlled substances, and must complete 20 hours of additional training, pass an examination and carry medical malpractice coverage at the same level as medical doctors.
HB 239 also required optometrists to report all adverse medical incidents — the same as ophthalmologists and other practitioners. Optometrists are also mandated to refer patients with severe glaucoma to an ophthalmologist within 72 hours.
Over the past year, however, has noted a growing push to renew the Eyeball Wars. Representatives for optometrists have been increasingly active, especially in the last election cycle.
For example, the FOA and associated parties have given more than $2.1 million to committees and candidates statewide — and is bolstering its Tallahassee lobbying roster, specifically through Michael Corcoran, brother of current Florida House Speaker Richard Corcoran.
According to state lobbying records, Michael Corcoran will represent

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JAMA study shows research not on optometrists’ side in Eyeball Wars

Tuesday, January 24th, 2017

As Florida’s “Eyeball Wars” start up again, research in the Journal of the American Medical Association gives new insight on what is at stake in the struggle between ophthalmologists and optometrists.
In October 2016, a team of medical professionals, mostly from the University of Michigan, issued a report examining the difference in treatment outcomes between optometrists and ophthalmologists in Oklahoma. Since 1998, both types of practitioners in Oklahoma have been allowed surgical privileges to perform laser trabeculoplasty (LTP).
Laser trabeculoplasty is a procedure where doctors use lasers to treat certain types of glaucoma by burning areas of the trabecular meshwork, located near the base of the iris, to increase fluid flow.
Through a health care claim database of Medicare enrollees with glaucoma, the study examined patients undergoing the procedure from Jan. 1, 2008, through Dec. 31, 2013 — covering nearly 1,400 eyeballs.
For optometrists, the results are less than encouraging.
After accounting for potentially “confounding factors,” the report finds that eyes receiving LTP by optometrists had a 189 percent greater hazard for a follow-up procedure in the same eye, as opposed to those LTPs by an ophthalmologist.
For Florida, a state with a much higher population than Oklahoma, more than double the risk to the eye may not be a risk worth taking.
“Considerable differences exist among the proportions of patients requiring additional LTPs, comparing those who were initially treated by ophthalmologists with those initially treated by optometrists,” the report says.
In conclusion, the study offers an ominous warning: “Health policymakers should be cautious about approving laser privileges for optometrists practicing in other states until the reasons for these differences are better understood.”
In the case of the Eyeball Wars, the suggestion is far from insignificant, since the authors note that “recently, optometrists have been lobbying state legislatures for expanded privileges so they may perform LTP.”
As noted in

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Chekhov’s Gun in the Eyeball Wars? Optometrists are lobbied up for 2017

Friday, November 18th, 2016

As Anton Chekhov once said: If it’s not essential, don’t include it in the story.
What would the great Russian novelist and playwright make of recent movements in Florida’s seemingly never-neverending Eyeball Wars between ophthalmologists and optometrists?
“If you say in the first chapter that there is a rifle hanging on the wall, in the second or third chapter it absolutely must go off,” Chekhov wrote in 1911. “If it’s not going to be fired, it shouldn’t be hanging there.”
Since then, Chekhov’s Gun has emerged as a reliable trope in thousands of books, movies, theater, and television episodes. The plot device goes like this: if the viewer sees a gun early on, someone will inevitably use it later in the story.
And much like Chekhov’s Gun, the Florida Optometric Association has had a busy first act, retaining lobbyists for an as-of-yet unspecified reason in advance of the 60-day Legislative Session beginning in early March.
It’s not that optometrists have simply hired lobbyists; nearly everyone does. They are a necessary part of how things get done in Tallahassee.
What raises eyebrows is the number: 12.
Compare the list of registered lobbyists for optometrists to those currently working with the Florida Society of Ophthalmology, the other side in the Eyeball Wars. Ophthalmologists only have three.
Troop buildup is a classic military strategy, seemingly the case here. But to put it another way: Why have an obvious Chekhov’s Gun if you’re not going to use it?
For a little perspective, the even-dozen FOA lobbyists put them on par with other big legislative players, each with a clear vested interest in what could become active legislative food fights: Florida Hospital Association (22 lobbyists); Florida Medical Association (17); General Motors, Gulf Power, Florida Association of Insurance Agents, Florida League of Cities, Florida Education Association, Florida Restaurant & Lodging Association, and the Seminole Tribe of Florida

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Are optometrists going back on their word in ‘Eyeball War’ truce?

Tuesday, October 25th, 2016

For nearly two decades, Tallahassee was the front line of an epic battle — the so-called “Eyeball Wars” — between Florida’s optometrists and ophthalmologists.
On one side were optometrists — college educated to provide diagnoses and correct vision problems — fighting to perform surgery and prescribe medications beyond topical ointments and creams. Ophthalmologists, supported by the influential Florida Medical Association, argue that optometrists lacked sufficient credentials and training as medical doctors to perform such intricate procedures.
After years of legislative wrangling, a truce came in 2013 in the form of HB 239, an agreement between optometrists and ophthalmologists intended to end the Eyeball Wars. The agreement allows optometrists to prescribe and a specific, limited number of oral medications under certain conditions. They must complete additional training, pass an examination and carry the same level of medical malpractice coverage as medical doctors; and are required to report all adverse medical incidents the same way that ophthalmologists and other practitioners are required. They are also mandated to refer patients with severe glaucoma to an ophthalmologist within 72 hours.
While March’s legislative session is still a few months away, it seems the Eyeball Wars may be coming back to Tallahassee. reported in August that the Florida Optometric Association and associated organizations have geared up for battle with more than $2.1 million donated to committees and candidates statewide.
OD-EYEPAC, the political arm of the Florida Optometric Association, gave more than $1.1 million to committees and candidates through the end of July. The Florida Optometric Association gave $535,000; the Florida Optometric Eye Health Care Fund gave $260,000.
Recipients of this largesse at the time included $125,000 to the Republican Party of Florida and $10,000 to the Florida Democratic Party. Other committees received more than $1.1 million.
With that amount of money being spent on campaigns, it’s easy to see that the Optometrists

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