The road to optometric scope of practice expansion is bound to have some obstacles along the way. One such instance occurred last week when a bill in Arkansas’s state congress was rejected by two votes from passing the state’s House Committee on Public Health, Welfare and Labor.1 The bill would have permitted optometrists to engage in minor procedures such as benign lid lesion removal, and laser procedures such as selective laser trabeculoplasty (SLT)—a procedure many clinicians now consider first-line treatment for glaucoma patients.
“We are disappointed that the outcome of our efforts was not what we had expected, most importantly because comprehensive patient access to eye health care across the state will continue to be limited in scope until the laws change,” says Belinda Starkey, OD, president of the Arkansas Optometric Association, adding, “As evidenced here, in Texas, in Wyoming and any state that has put forth these efforts, ophthalmology will use any tool possible to maintain the status quo.”
One such example includes writing op-eds in local papers. Such was the case in Arkansas, where Jacob Dickinson, MD, (who was not identified as a surgeon) contributed a letter to the editor of the Baxter Bulletin.2 The editorial read, “If the bill passes, it will allow optometrists to perform lasers and surgeries on the eye and eyelids, and they will only need to complete 32 hours of training (one weekend).”2
Dr. Starkey rejects that characterization as “spin” and adds, “This is a problem that has been recognized at the national level. Last year, the US Department of Health and Human Services issued a public report with clear recommendations to increase patient access to care and assure new health care choices for the public. This report specifically outlined that doctors of optometry can provide the same services as other physicians and emphasized that “states should consider changes to their scope of practice statutes to allow all health care providers to practice to the top of their license, utilizing their full skill set."3
Arkansas is situated between two states—Louisiana and Oklahoma—where optometrists have such privileges.
The bill, To Amend The Definition Of “Practice Of Optometry”; To Expand The Types Of Ophthalmic Surgery That May Be Performed By Optometrists; And To Modernize The Practice Of Optometry, was sponsored by Jon Eubanks (R-Paris) and was first filed on January 24th.1
Dr. Starkey believes Arkansas optometrists will have another chance at passing future legislation. “We have the utmost confidence for eventual scope expansion in the future,” she says.
1. Davis A. Optometry bill falls short in committee. Arkansas Democrat Gazette. www.arkansasonline.com/news/2019/feb/20/optometry-bill-falls-short-in-committee/?fbclid=IwAR38mzKJhs_yJRVUO6S-vvSfmxAYoTGS61qRiyQubQIS8Xqb3Nhw3AwxuiM. February 20 2019. Accessed February 28, 2019.
2. Dickinson J. Proposed legislation would allow non physicians to engage in eye surgery. Baxter Bulletin. www.baxterbulletin.com/story/opinion/2019/02/19/letter-editor/2907495002/. February 19, 2019. Accessed February 28, 2019.
3. Health and Human Services. Reforming America’s Healthcare System Through Choice and Competition. www.hhs.gov/sites/default/files/Reforming-Americas-Healthcare-System-Through-Choice-and-Competition.pdf. December 12, 2018. Accessed December 14, 2018.