Eye surgery: Training not a matter of politics, public opinion

With the new wave of insured patients in California, there is a growing concern about the increase of physician shortage and the anticipated increase in waiting times.

The LAC+USC medical center reports that the approximate wait time for an ophthalmologist appointment for a Medi-Cal patient is 9 months, and the LAC+USC is the only medical center in the Los Angeles area available to Medi-Cal patients nettdating erfaringer. For these Californians there is no other choice but to wait and hope their eye condition does not worsen.

The fact is that training standards should not be decided by the political process or public opinion. These should be determined by the colleges of optometry, which are accredited by the U.S. government.

The Legislature had a critical opportunity to help increase access to medical services and reduce the wait times for patients who need ocular services. SB 492 would have allowed doctors of optometry to perform limited laser and minor procedures around the eye and freed up ophthalmologists to perform the complex surgical procedures only they are trained and educated to perform.

However, the opposition’s special interests were more important than the well-being of Californians and they continue to mischaracterize SB 492 with articles like the one authored by the Executive Vice President of the California Academy of Eye Physicians and Surgeons.  (“In eye surgery, the doctor’s experience, training are key,” Capitol Weekly, Sept. 26)

In yet another effort to confuse people, the opposition points to the average number of procedures an ophthalmologist must complete in order to become a surgeon and believes that this same number should apply to Doctors of Optometry as the minimum number of procedures to advance their practice.

The fact is that training standards should not be decided by the political process or public opinion. These should be determined by the colleges of optometry, which are accredited by the U.S. government and must periodically demonstrate that they are training optometrists to safely practice independently.

However, the California Medical Association and the Academy of Eye Physicians and Surgeons were not willing to put their special interests aside and collaborate in this area.

Asking the public how many procedures a surgeon needs to perform is impractical. We do not ask for public opinion on how many bridges must be built before an engineer can independently sign off on future construction. Those decisions are made by an accredited engineering colleges and licensing boards. The same is true for optometry education. Training standards should be developed by the colleges and approved by the optometry licensing board.

Every single one of the procedures outlined in SB 492 has been safely and effectively provided for decades to tens of thousands of patients by doctors of optometry in other states without any problems or complications.

Over 40 other states are far ahead of California in recognizing the critical role other medical professionals play in supplementing the care provided by physicians and have expanded their scope.

However, the California Medical Association and the Academy of Eye Physicians and Surgeons were not willing to put their special interests aside and collaborate in this area.

For the past 20 years, these groups have opposed every single scope of practice legislation that has been put forward by optometry. They claim the legislation will blind and/or kill people. They rely on scare tactics and pass out photos of diseased eyeballs as a warning of what could happen if we allowed any competition to physicians.

They have been proven wrong every time, and they are wrong again this time.

SB 492’s training and education component would have required twice as many hours as other bills and it would have been the toughest continuing education requirement for advancement of scope in the nation.

The California Legislature missed out on a golden opportunity to ease the provider gap and increase access to care. SB 492 would have significantly reduced waiting times and assisted a large portion of California’s population in particular those in rural areas of the state.
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Ed’s Note: Dr. John Rosten is president of the California Optometric Association.