Support Senate Bill 110 -- Better Eyecare
Posted in the Morehead Forum
#1 Feb 8, 2011
Kentucky residents, please take a look at this link, and if you support it, call your legislators at 1-800-372-7181 to let them know that you support Senate Bill 110, known as The Better Access to Quality Eye Care Bill.
You can also visit this link and click "Email your legislators.”
Among other things, this bill will amend KRS 320.210 to "modify the definition of the practice of optometry to include types of diagnoses and treatment of diseases, disorders, or conditions of the eye and its appendages by a licensed optometrist; permit prescribing and adapting visual aids and Schedule III or lower drugs or employing vision therapy or orthoptics, low vision rehabilitation, and certain laser surgery procedures."
#2 Feb 8, 2011
Sorry for the typo
#3 Feb 8, 2011
The public needs to realize that this is not a an access to care bill, but a bill that compromises patient safety under the guise of improved access. It is simply aimed to increased the scope of optometry. Optometrists are not Ophthalmologists (eye M.D.'s). The removal of eye "lumps and bumps" and procedures involving "lasers" increases the scope of optometry to include surgery. Optometrists did not go to medical school nor do they have formal surgical training or training in internal medicine (for years) like an ophthalmologist has. Eye "doctors" do not all have the same background. A unique training background is what makes an ophthalmologist unique. Removing lumps and bumps requires the injection of anesthesia and carries with it a risk for potentially blinding bleeds and adverse reactions to the injection. Only a medical doctor has the training to manage these things. Someday cataract surgery may be performed with a laser too. Do you want your optometrist taking you to the operating room? If you want someone without a medical degree performing surgery, then call your legislators. I think this is a careless bill and it compromises patient safety. It plays on the public's general misunderstanding of the differences between eye doctors. Bills like this have been introduced and defeated in nearly every state because they are dangerous. I like my optometrist, but I wouldn't want him operating on me.
#4 Feb 8, 2011
Optometrists,when they finish getting their Bachelors
degree start medical school the same as Ophthalmologists but their training farther into medical school has more to do with making people see better which they have more training in this field than the Ophthalmologists.They also have extensive training in diagnosing and treating eye disease.Optometrists have been licensed for several years to prescribe drugs related to eye care.Most all Optometrists have at least one Ophthalmologists
that they are associated with and send their patients to if needed.
#5 Feb 8, 2011
Optometrists do not go to medical school as this posts suggests. If they did, they would have an M.D. after their name. Simple fact. They don't take medical boards, get a medical license, and then get board certified in ophthalmology after another series of 3 board exams for a total of 7-8 years. Optometrists take optometry boards. No doubt that they have an equivalent amount of time learning to diagnose eye disorders, and one could argue that they might be better at prescribing glasses and contacts because more time is spent here in training. An ophthalmologist's time is spent performing and learning more surgical techniques, which is exactly my point in my other post. Do you want a non-surgeon, a non-medical doctor performing surgery or getting loose permission to provide laser surgery? Cataract surgery may someday be performed with laser, do you want a non medical doctor to be the captain of the ship when you "code blue" or try to die in the operating room? Or incise your whole eyelid if you bleed into your eyesocket during a lump and bump excision--which might save your sight? Or respond to a life-threatening reaction to injected anesthesia? I don't think an optometrist would honestly say that he/she feels prepared for this or the techniques or drugs that this Bill would require. If you blur the line between these professions too, the optometrist won't have an ophthalmologist to send his patients too. They'll all move to states where legislators respect that there is a difference and a difference for a reason. The professions exist because of the difference in training, you cannot simply say you can do these things and then expect equivalency. Patients suffer with this Bill. Plain and simple.
#6 Feb 9, 2011
I know everyone wants better, more affordable health care but this bill is crazy. What next, are we going to allow our General Practitioner the ability to do knee surgery? There is no way I'm letting an Optometrist near my eyes with a laser.
#7 Feb 9, 2011
The medical profession has been using these "not a real doctor" scare tactics about an optometrist's range of practice for the past 35 years. Each time the optometrists get the ability to treat more things, it works out just fine. Dentists are not MDs either, but they do injections, surgery, prescribe any drug they want, etc. A pharmacy technician can give injections without any degree at all.
And by the way, your family doctor IS licensed to do knee surgery, brain surgery, or even eye surgery. He has 30 days of training in eye care, while the optometrist has 4 years (after college, just like a dentist, podiatrist, medical doctor, etc.)
Think these negative posters are Ophthalmologists
not wanting others getting in on their money.The bill is a good bill.
#8 Feb 9, 2011
I have had cataract surgeries on both eyes, 7 different lazer treatments to remove scar tissue, cornea tranplants in both eyes, and multiple procedures to correct problems that occur with tranplants. No one is going near me with a laser that has not received enough training. All the above procedures were done by the same "specialist" in this field, I should have bben blind 12 years ago but luckily I found one of the best eye specialist is the country. I would not want a chiropractor doig surgery on my neck, let them diagnosis and then send you to a specialists who has been trained! If you have ver had one eye surgery let alone the 17 I have had then you will understand the need to have someone that know what the heck they are doing.
#9 Feb 9, 2011
The scare tactics never end. It was the same with diagnostic and therapeutic drugs, and there has not been any negative consequences to optometrists prescribing these in Kentucky. These same minor surgical procedures have been done by optometrists in Oklahoma for over ten years and there have been no adverse complications reported. NONE! Not one malpractice suit. No increase in malpractice rates for the optometrists there relative to optometrists in Kentucky.
A few points are being missed in the discussion though. One - no one is being grandfathered into this. Any optometrist wanting to do these in office procedures will have to obtain the required training prior to being able to do them. Two - most ophthalmologists didn't learn most of their current surgical techniques in med school. Any new procedure, such as LASIK in the 1990's, required them to go back for additional training prior to performing them. Three - not all ophthalmologists are M.D.'s. I know several who are D.O.'s (osteopaths), but I don't hear any problems with that. Four - optometry is the only doctoral level profession in the state of Kentucky who's licensing board does not have the authority to decide the scope of their practice and to set the requirements for their doctors to increase their scope of practice. Dentistry, medicine, and podiatry all have this priviledge. Why is optometry not treated the same?
#10 Feb 10, 2011
Dentists don't go to medical school and aren't "doctors" under your criteria, but are allowed to perform minor surgeries and administer anesthesia... MD's just don't have a monetary interest in dentistry because it doesn't infringe on their income. You don't hear anyone complaining as long as they're trained and certified competent like optometrists are currently and will be for every scope change.
#11 Feb 11, 2011
So what is it? Greed or patient care driven? I have yet to hear anyone say they couldn't find a true ophthalmologist when they needed one for an excision, laser or injection. These things just aren't needed as often as simple general care. The dentistry analogy falls on its face too when you understand that throughout dental school a student is observed FOR YEARS performing minor surgical procedures. Observed and certified by their instructors FOR YEARS for the things they are trained to do. It wasn't a weekend warrior certification for a dentist. In ophthalmology school, if you don't have steady hands or good vision you'll likely be weeded out by your supervisors or unable to complete the hundreds of surgeries required for graduation. Optometrists that want these priviledges were never evaluated, admitted, and supervised (or will they be)like the dentist or the ophthalmologist. An ophthalmologist's acceptance to residency, I'm sure, depends on steady hands and good vision. Even your primary care doctor would never be able to perform surgery if he didn't get training and approval that meets a hospital's stringent requirements with years of supervision and peer approval. And did I hear someone say a D.O. is not a doctor? What? That's medical school if I ever saw one. It is simply obsurd for optometrists, who have a fundamentally different school experience and 3 years less medical training, to perform surgery after some kind of self-governed certification process. Why don't we just let paralegals practice law after a certification process? Or chiropractors perform knee surgery after a weekend training camp? Then, we'll let them start their own policing agency the determines their scope of practice-- what they should or shouldn't do. I say if an optometrist wants to function like an ophthalmologist, then they should all go back to medical school and do an ophthalmology residency. I have no problem with that. It's the educational experience that makes the doctor, and I don't see equals here.
#12 Feb 11, 2011
The bottom line in this discussion is not about the quality or safety of eye care,it's about money.The
ophthalmologist don't want the optometrist to have these privileges as they would loose the money received from doing them.In today's law suits for malpractice do you think the optometrist would perform task they weren't properly trained for and confident they wouldn't make mistakes.The 'The Better Access to Quality Eye Care Bill' is a good bill for all of us except the ophthalmologist who would loose some business.My optometrist discovered a problem that need surgery and worked with the ophthalmologist and took care of me during healing and recovery.
#13 Feb 12, 2011
After reading more about this bill in the newspapers this week, I'm all too worried that it is about the money--the SEVERAL HUNDREDS OF THOUSANDS OF DOLLARS optometrists have given to political campaigns over the past years. I want the best quality and access to eye care for myself and all people in Kentucky, but I want it from doctors who are trained to do what they do, not because they paid politicians to make it legal for them to use a scalpel or laser and put me or my family members at risk to go blind.
I have both an optometrist and an ophthalmologist that I see, and I asked them both about this bill this week. I had no idea of the extent of the difference in training between optometry and ophthalmology before this. There is NO surgical or laser training in optometry school. Ophthalmologists complete medical school, a year of general medical training, and then 3 years of surgical training. This bill and even the Kentucky Optometric Association website is very misleading to me and other patients because the website states "Curricula and continuing education are constantly updated to keep up with all new technologies, including lasers and other medical treatments related to eye disorders," as though they were trained to do laser procedures. What I found out this week is that this means they read about the procedures only, they are NOT trained to do these procedures. I don't want my optometrist reading about how to do my surgery for the first time as he cuts on my eye or shoots a laser into my mom or dad's eye.
We really need to be careful here in Kentucky to tell our lawmakers to make sure laws are good for us and don't put us at risk. Any good bill is worth taking the time to debate. Instead this bill is being rushed through before the average person like you or me is even aware that it would allow optometrists to do surgery, which they are not trained to do during their schooling. I value the care I've received from both my optometrist and my ophthalmologist, but I only want my ophthalmologist, a surgeon who trained for years to do surgery, to operate on me.
#14 Feb 12, 2011
Tattoo artists pierce the eye lids and have gone to high school. They do more "surgery" on the eye than an 8 year trained OD. All Optometrists want is to remove some irritating skin tags and use a laser to remove a very thin skim behind an intra-ocular lens. The Optometrists who do these will in all likely-hood work for a large MD group who can afford the laser in the first place anyway. Have you ever priced a laser? Optometrists will have to do an Optometry residency in the VA centers or some eye hospital before they are allowed anyway. No one who hasn't passed the 2011 requirements will be allowed. This is such a non issue.
#15 Feb 12, 2011
I just read the bill online--it doesn't specify what surgical procedures optometrists want to do like tattoos suggests. That's a problem--a big problem. This bill is being advertised as performing "simple procedures" but it doesn't state what these procedures are. The state legislators only know that optometrists contribute a heck of a lot of dough to their campaigns--almost $400,000 last year!--but the fact is they do not receive training for scalpel or laser procedures in optometry school. Putting vague language in a bill like this is dangerous and puts people in Kentucky at risk to have things done to them by optometrists who are not trained to do surgery.
#16 Feb 12, 2011
I would think that the Kentucky Board of Optometry answers to the people of Kentucky and reports to the Governor and Legislature. Isn't it their job to safeguard the citizens just as the Kentucky Medical Board, Dental Board, etc does? I read the law too and it has specific procedures not allowed.
The following procedures are excluded from the scope of practice of optometry, except for the pre-operative and post-operative care of these procedures:
1. Retina laser procedures, LASIK, and PRK;
2. Nonlaser surgery related to removal of the eye from a living human being;
3. Nonlaser surgery requiring full thickness incision or excision of the cornea or sclera other than paracentesis in an emergency situation requiring immediate reduction of the pressure inside the eye;
4. Penetrating keratoplasty (corneal transplant), or lamellar keratoplasty;
5. Nonlaser surgery requiring incision of the iris and ciliary body, including iris diathermy or cryotherapy;
6. Nonlaser surgery requiring incision of the vitreous;
7. Nonlaser surgery requiring incision of the retina;
8. Nonlaser surgical extraction of the crystalline lens;
9. Nonlaser surgical intraocular implants;
10. Incisional or excisional nonlaser surgery of the extraocular muscles;
11. Nonlaser surgery of the eyelid for eyelid malignancies or for incisional cosmetic or mechanical repair of blepharochalasis, ptosis, and tarsorrhaphy;
12. Nonlaser surgery of the bony orbit, including orbital implants;
13. Incisional or excisional nonlaser surgery of the lacrimal system other than lacrimal probing or related procedures;
14. Nonlaser surgery requiring full thickness conjunctivoplasty with graft or flap;
15. Any nonlaser surgical procedure that does not provide for the correction and relief of ocular abnormalities;
16. Laser or nonlaser injection into the posterior chamber of the eye to treat any macular or retinal disease; and
17. The administration of general anesthesia;
#17 Feb 13, 2011
Unfortunately, most people don't realize that the bill also allows for creation of a board of optometry which wouldn't have to answer to anyone and optometrists could be doing all kinds of cutting and lasering they are not trained to do. From the bill:
"(7) The board shall have the sole authority to determine what constitutes the practice of optometry and sole jurisdiction to exercise any other powers and duties under this chapter."
Personally, I don't want a board of people who were not trained to do surgery to decide that sure, their members can start doing even more cutting on eyes or shooting lasers into my family members' eyeballs anytime they want.
That's why eye surgeons (ophthalmologists) go to medical school for 4 years, train in general medicine for a year, and then complete 3 years of surgical residency training, with some even completing 1- or 2-year surgical fellowships after this. It's not only important to know how to do the procedure but also on whom it should be done and why.
Perhaps what's even more disturbing in all of the posts in this and other message boards on here and the Louisville Courier Journal and Lexington Herald Leader websites is the way this bill is being "sold" to the public as improving access to care and a way to reduce health care costs. Yet, not one of the people who writes in support of this bill, including Joe Ellis who is apparently the head of the US optometry association, will deny that optometrists in Kentucky have spent almost $400,000.00 dollars in the last year to get this bill pushed through the state Congress so fast that you and I may not have even been aware of it. Not only do we need to step back and take some time to think about who we let cut on and zap lasers into our eyes, but we also need to realize that spending $400,000.00 on politicians and almost half of this on advertising for this bill is not exactly what one would call working to reduce costs.
I like my optometrist and I'm a friend of her family, but I've just learned too much of the circumstances of the substance of this bill and how it has progressed with so little review through our legislature not to be concerned for the safety of my family and people in Kentucky. I wouldn't let my chiropractor operate on my neck even though I know they've studied what bones and ligaments are in there. It's the same with my eyes--optometrists are good at what they do, prescribing eyeglasses and diagnosing some eye diseases, but they are not trained to do surgery or any lasers.
I want an ophthalmologist, a medical doctor who is trained to operate on eyes for years to be the one holding the knife or aiming the laser next to me or someone I love.
#18 Feb 14, 2011
Some folks have postulated that opposition to this bill by Ophthalmologists (MDs) is predicated on the assumption that permitting these procedures by Optometrists (ODs) would somehow take away from MDs' surgical income. Frankly, I think that's bogus. There's enough work to go around.
But let's take this one step further. For those who are supporting this bill on the basis of "increased access", I can only suggest that you be very careful what you wish for. What you will get is exactly what you've already read - the lack of training, supervision, & experience in surgical techniques. How many sane people would entrust their eyes to any except the most highly-trained doctors?
#19 Feb 15, 2011
A nurse who wants to perform at the next level must go BACK to school to obtain a degree and training to become a nurse practitioner. Why would an optometrist be any different? If the profession wants to perform the next level of service, go to medical school and residency training to be an ophthalmologist.
Call or email you state representative!! This topic is in committee scheduled for Wednesday.
Amazing what a $400,000 donation will do for the Optometry profession....
#20 Feb 16, 2011
So what,if the bill passes we still have the right to chose for ourselves who to go to for care.This is part of an article from the Lexington news yesterday.
'Reynolds is a Richmond optometrist who says the bill will provide better access to vision care. "In Oklahoma where this law has already been enacted since 1998, there's been over 250,000 of these procedures done. 250,000. There's not been one single complaint to the optometry board. There's not been one single complaint to the medical board."
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