By Aaron Punim, OD
June 26, 2019
New optometrists have their hands full, working hard to establish themselves in the profession. As you do your best to advance your own career, it’s important to also make time to advocate on behalf of the profession. I graduated from optometry school less than five years ago, and I have made involvement with OD associations a priority.
This month, I moved from vice-president to president of the Hudson Valley Optometric Society (HVOS), a chapter of the New York State Optometric Association. Here’s why I advocate, and why you should, too.
Is It Really Worth Our Time?
Optometrists are state-licensed professionals who can perform procedures that fall within our scope of practice, as determined by our individual state boards of optometry. Many states do not allow us to practice the full scope for which we were trained. Only by getting involved with your state association will your state’s scope of practice get to the next level. Patients expect and need the full range of diagnosis and treatment from us.
We are the primary eyecare providers, particularly in rural and low-income urban areas. If left untreated, many eye conditions can result in greater healing time or permanent damage to a patient’s eyesight and health.
Advocating for the profession can enhance access of care by eliminating the need for ODs to refer patients to other providers (e.g., ophthalmologists, primary care physicians and emergency rooms) for the prescription of oral medications. This helps eliminate additional health-care system costs and patient co-pays for unnecessary second visits.
What’s at Stake?
The bills pending in each state that would affect optometry differ, but I can tell you from my experience as an advocate for the profession in New York, that the issues at stake can make a huge difference to your ability to serve patients.
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The priority for ODs legislatively in New York this year was Assembly Bill No. 1193 (Paulin) and Senate Bill No. 4035 (Bailey). Unanimously passed in the state senate, the bill died in the assembly. It would have authorized optometrists to prescribe a formulary of oral therapeutic pharmaceutical agents solely for the treatment of eye and adnexa diseases.
Optometrists have had the ability to use diagnostic topical drugs since the mid-1980s and therapeutic topical drugs since the mid-1990s. However, ODs remain unable to prescribe oral medications for the treatment of eye disease in New York State.
If the bill had passed, ODs would have been able to prescribe oral medications if they are DPA and TPA (Phase I and II) certified, along with successful completion of a 40-hour course.
Other legislation pending in New York:
• An eye drop delegation bill, which optometry and ophthalmology partnered on. This bill would allow ODs and ophthalmologists to delegate instillation of anesthetics, mydriatic and cycloplegic drops.
• The Title VIII health professions partnership bill would allow willing individuals to form partnership/co-ownership of practice by and between Title VIII, non-physician health practitioners and MDs/DOs.
• A bill prohibiting discriminatory practices in NY. This would prevent denial of services based on erroneous prejudice of OD scope of practice for procedures that are covered by insurance when performed by MDs.
These battles are not easily won and require a lot of time and effort. The hard work of the Maryland Optometric Association finally paid off, as they were able to pass their scope expansion bill. Starting March 1, 2020, optometrists in Maryland will be able to treat glaucoma independently, remove foreign bodies, order laboratory testing, prescribe all topical drugs, and certain categories of oral medications upon completion of a 10-hour education course.
Hopefully our efforts in New York will be rewarded next year.
How Much Time Does Advocacy Require?
Time engagement depends on your level of involvement. For example, HVOS presidents like myself are required to orchestrate the happenings of the society for their term. The president also is required to attend state meetings, answer to leadership and relay updates to the local society members.
However, involvement in advocacy does not always require large amounts of time. Just by contacting your local and state representatives by letter, e-mail or phone you are helping.
I have found that local representatives are eager to meet with their constituents. All you have to do is identify yourself by your local and state society and explain why you would like to set up a meeting. You should let the legislator/staff know if you are a constituent (i.e. you live and/or work directly in their district), or if you treat patients from the legislator’s district. The staff at the representative’s office are usually cordial and will help schedule a meeting.
Why Get Involved Early in Your Career?
For younger ODs, professional advocacy provides the opportunity to pick up valuable clinical pearls from older ODs, and to become more familiar with their local eyecare professional network. It can open up other opportunities like jobs, lecturing and research. You never know what career opportunities are waiting.
For both younger and older ODs, advocacy opens up the possibility of partnership opportunities or purchasing and selling practices. An older OD, who wants to cut back, and a younger OD, who wants to find their way into private practice, might meet through involvement in a local optometric association.
By showing up and meeting others in your community, you become privileged to information you may not have otherwise had access to. You can use that information to grow your own career, and to help advance the whole profession.
Are you active in your state optometric association? What opportunities has this involvement provided you with? What have you learned in the process about our profession?