Politics
Optometrists, Ophthalmologists Don't See Eye to Eye
Around the State
In one of the Capitol's longest-running industry fights, a House panel Thursday approved a bill that would expand the drug-prescribing powers of optometrists --- an idea that is fiercely opposed by ophthalmologists and other medical doctors.
Dubbed the "eye war," the issue centers on whether optometrists should be able to prescribe oral medications. They now are limited to prescribing what are known as "topical" medications, such as drops or creams, and have to send patients to ophthalmologists for conditions requiring oral drugs.
The House Health Quality Subcommittee voted 10-3 to expand the optometrists' powers, giving them an initial victory in a battle that will play out during the upcoming legislative session.
Bill sponsor Matt Caldwell, R-Lehigh Acres, said optometrists are not currently allowed to practice to the full extent of their training. He also said optometrists are allowed to prescribe oral medications, to varying degrees, in 47 other states.
Opponents, however, contend that optometrists don't have the same type of training as ophthalmologists and say the bill would not do enough to protect patients such as seniors, who might be on numerous medications and could have harmful reactions if drugs are not prescribed properly.
Stephen Schwartz, a Naples ophthalmologist, said doctors in his specialty receive years of hands-on training as they go through medical school and gain experience through such things as residencies and internships.
"You cannot learn this in a classroom,'' Schwartz said.
But Kimberly Reed, an optometrist who is a faculty member at Nova Southeastern University, said optometrists are trained in the proper use of medications, including making sure patients don't have harmful side effects. She disputed that expanded prescribing powers would threaten the quality of care provided to groups such as seniors and children.
"To think that we would treat those patients any differently is, I think, an unfair assumption,'' Reed told the House panel.
Optometrists have not been able to convince lawmakers to approve similar bills in the past, but both sides appear to be preparing for a major fight during the session that starts March 5. Industry groups spent hundreds of thousands of dollars during last year's elections, and they also have hired prominent lobbyists to push their positions.
The bill (HB 239) is slated to go next to the House Health and Human Services Committee. A similar measure (SB 278) has been filed in the Senate but has not gone before a committee.
Under the House proposal, optometrists would be required to complete a course and an exam before they would be allowed to prescribe oral medications. The Florida Optometric Association and the Florida Medical Association -- two foes on the prescribing issue -- would jointly develop and administer the course and exam.
While the House panel overwhelmingly approved the measure, some lawmakers expressed interest in tinkering with it. Rep. Kevin Rader, D-Delray Beach, voted against the bill, saying he didn't think it should move forward without changes.
"I don't really know of a strong public need for this,'' Rader said.
Supporters, however, say giving the expanded powers to optometrists would expand access to care for patients. Caldwell said he would be willing to consider changes sought by the ophthalmologists, but he also noted the years of debate about the issue.
"This bill's been around nearly as long as I've been alive,'' said Caldwell, 31.


Comments (10)
I can't prescribe it here but if I drive 30 minutes north to Georgia, I can? Did I all of a sudden become more competent when I crossed that state line?
How do state lines draw competency? North of our state border, in Georgia, optometrists are prescribing orals right now! Georgia Board of Optometry Board Rule 430-10-.03 was put into effect in 2007 and describes the oral medication rights of optometrists (in GA). This year a handful of ODs will graduate and some will remain in Florida, while others will move elsewhere (like Georgia). Let's say one new graduate moves to Folkston, GA and another moves to Hilliard, FL. They both went to the same college of optometry and got the same degree, but because there is a state line between them, along the 11.5 mile stretch of road that separates them, one can prescribe orals and the other can't because he's a danger to his patient's well being... let's be serious.
Florida optometrists undergo one of the most strenuous and in depth state board certifications in the nation behind North Carolina in regards to OD state licensure. A lot of states only require that the three parts of the National Board of Optometry Examination be passed along with a state law exam. So, before an optometrist can even practice in Florida they are taking twice as many exams as most of their counterparts residing in other states.
Updating the optometry scope of practice to follow suit with most of the country (47/50) will undeniably bring expanded access of eye care to patients. It is a disservice for patients to receive limited treatment from optometrists. The idea of optometrists prescribing oral medications, like antibiotics, has been a struggle for far too long and has hindered the growth of the infrastructure of eye care in Florida. We need to come together as a medical community to give our patient's easily accessible health care and this bill provides that.
way to be progressive FL!!!
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