African Americans are the most medically underserved population at high risk for serious eye diseases such as glaucoma. African American adults are also twice as likely to have diabetes as White adults. If we don’t subscribe to new ideas, these situations will worsen.
Optometrists are able to diagnose and treat diseases such as glaucoma, prescribe medications, remove foreign objects that injure the eye and we work closely with medical doctor counterparts while patients recover from surgery.
California is facing a serious doctor shortage. One third of our medical doctors have reached the age of 55, a quarter of them are over 65, and young graduates are gearing their practices toward more upscale socio-economic communities. Meanwhile, the Affordable Care Act is promising access to quality healthcare to millions of Californians who previously did not have healthcare.
Policymakers recognize that we need an answer to this crisis of lacking providers for those citizens who need healthcare. The proposed solution is Senate Bill 622, an expansion to the scope of practice for optometrists. This bill is not without precedent. This is the third time in 15 years the legislature has revisited the authority of California’s highly qualified and educated doctors of optometry.
In California, only 16 of our 58 counties have a sufficient number of primary care doctors. In contrast, 57 counties have access to an optometrist. Optometrists already provide 81 percent of eye care to Medi-Cal beneficiaries. Sen. Ed Hernandez, a Democrat from a largely minority community in Los Angeles, is working alongside legislators from both parties to present a sensible solution.
SB 622 has passed through hearings and the floor of the Senate with a combined vote of 48-4. Both Republicans and Democrats are being supportive of the careful construction of the bill.
Specifically, this bill advances care and will allow optometrists to treat minor bumps, immunize patients over the age of 18 against influenza, pneumonia and shingles, and provide simple laser therapy for specific diseases optometrists are already allowed to treat.
These advances are not allowed without extensive training and education. Many optometric students will practice optometry in states that more broadly define the optometric scope of practice. As such, California optometric schools already teach students how to provide advanced care.
Optometrists in California, however, will only be allowed to practice these new procedures after a post-graduate certificate has been earned.
Unlike other states and other professions that can expand scope with weekend seminars and classes, California doctors of optometry must exceed such training and complete an additional 70 hours of courses, including work on animal eyes, rubber and plastic models, computerization and at least 56 live patients.
Opposition to this legislation has been largely absent in committee hearings at the state’s Capitol. Concerns about the capability of optometrists managing these new responsibilities have been answered. Optometrists accept that to treat more patients under the Affordable Care Act, they must strive to become the most highly trained optometrists in America.
Optometrists are not replacing ophthalmologists. Few physicians have expressed concern that their personal scope of practice will somehow be compromised. These fears are unfounded. SB 622 will allow optometrists to practice to the full extent of their training so that ophthalmologists can focus care toward patients that need specialized services only they can provide.
We are in crisis and one key to the solution is the cooperation of all healthcare professionals. Together we have the power to meet the needs of all Californians and ensure that everyone has access to quality health care. Hawthorne, D.D., is a glaucoma-certified California optometrist.
