State Journal
Section: Government
By Walt Williams
Charleston – Eye-care specialists are at odds over a proposed law that would give the state’s optometrists more authority to prescribe medications and perhaps perform some minor surgeries.
The proposal has pitted the West Virginia’s optometrists against nearly the rest of the state’s medical community, which has lined up in opposition to the legislation. However, optometrists said they are seeking what already is available to their counterparts in a majority of states. The legislation’s opponents are mischaracterizing the bill by claiming it would give them the authority to perform eye surgery.
“This bill is not about optometrists doing surgery,” Bill Radcliff, a Huntington optometrist, said. “It’s about changing an antiquated (law) that tries to specifically outline what medication may be provided only now but in the future.”
The proposed law is contained on two identical bills before both the state House of Delegates and Senate. Both would give optometrists more authority to prescribe medications, order clinical tests and perform other procedures to treat eye conditions provided that the state Board of Optometry drafts rules spelling out what they can and cannot do.
Optometrists are the specialists many patients see when they need to get new glasses or contact lenses. They already have the ability prescribe some medications and provide relatively minor invasive procedures. The field differs from ophthalmology, whose practitioners are physicians who treat eye diseases and are trained to perform eye surgery.
Optometrists can get their doctors’ degrees after four years of optometry school. Ophthalmologists, on the other hand, are physicians who need eight to ten years of schooling and training before they can enter the field on their own.
It is the state’s ophthalmologists who are the loudest critics of the bill, saying it would put patients’ health at risk by allowing some optometrists to perform medical procedures they might not be properly trained to do.
“At times we see patients where we have one shot – one shot to make a difference in a patient’s eyesight potentially for their health, for their lives and well-being,” Dr Edgar Gamponia, an ophthalmologist in Morgantown, said. “With training we hope we can do what’s best for the patient.”
Twelve state medical groups have joined the ophthalmologists in their opposition, including the West Virginia Hospital Association, West Virginia Board of Medicine and West Virginia Academy of Family Physicians.
But the legislation has gained support from many state lawmakers, who see it as a means of reducing health care costs. Several lawmakers have signed up as cosponsors on both the House and Senate versions of the bill, and a House Health and Human Resources subcommittee held a hearing on the House version March 16.
Opponents mainly pointed to the extensive training ophthalmologists receive as a reason why the bill should be rejected. However, they also noted a 2005 national survey that found that 95 percent of respondents said they preferred ophthalmologists to perform eye surgery – including laser surgery.
In addition, opponents said the bill would remove legislative oversight and transfer decision-making power to a board whose members are mainly optometrists.
Supporters of the bill – including a representative from the pharmaceutical company Johnson & Johnson – argued that current state law simply isn’t keeping up with advances in medicine. For example, Johnson & Johnson is now developing contact lenses that will dispense eye medication. Optometrists could not prescribe the lenses under current state law, with patients instead needing to seek out an ophthalmologist, whose services are more expensive.
Optometrist BJ Nibert of Oak Hill said his counterparts in surrounding states could perform procedures he is not allowed to do under state law, such as inject medicine around the eyes. He said he didn’t’ see the need for patients to be referred to other specialists for ailments that he and his counterparts could treat themselves, saying such referrals drive up costs.
“What is the logic to restrict a doctorate-level program from providing the level of care they are qualified to deliver?” he said.
The bills are House Bill 2978 and Senate Bill 570.