Another major scope-of-practice fight went to court in California Tuesday when two large physician groups filed suit to prevent optometrists from treating glaucoma.
The California Medical Association and the California Academy of Eye Physicians and Surgeons say they object to new rules that took effect Jan. 8 that allow optometrists to complete their certification process "without having to treat a single patient with glaucoma."
Previous to the new rule, optometrists were required to treat 50 glaucoma patients over a two-year period, and do so under the supervision of a board-certified ophthalmologist.
"These new regulations are not up to snuff and in fact jeopardize the quality of eye care Californians deserve," said CMA president James Hinsdale, MD. "Failing to require certification that includes treating actual glaucoma patients is the equivalent of handing out driver's licenses to people who have read a driving manual and attended a class but have never driven a car."
The plaintiffs point to a widely publicized case involving the U.S. Department of Veterans Affairs in Palo Alto and allegations that several patients experienced significant vision loss while under the care of optometrists. The VA was said to have informed two of the patients who became blind that improper care was responsible. Another 87 patients at risk of harm were reassigned to ophthalmologists.
"At least seven veterans suffering from glaucoma were reported to have gone blind (and over 100 other veterans suffered either 'progressive visual loss" or ere identified as being at high risk for losing their sight) as the potential result of having received substandard healthcare from the Optometry Department of a Veterans' Affairs facility located in Palo Alto," the physicians said.
The California Optometric Association could not be reached last night for comment. However, that organization's website (http://www.coavision.org/) says the COA applauds an administrative law judge's decision to approve the Board of Optometry's new regulations. The association said it would address shortages of primary eye care doctors in rural and underserved areas, "a problem that is only expected to worsen with the recent passage of healthcare reform."
In the lawsuit filed in San Francisco Superior Court against the California Board of Optometry, the two physicians' groups said that the more lenient new rules were decided under a faulty process because a consultant hired to advise a key committee was not certified to treat glaucoma.
The new rule allows post-April 2008 graduates of accredited optometry schools to treat and manage glaucoma patients without additional post-graduate training was made under the presumption that a review of certain certification training would take place. But it never occurred, according to the doctors' complaint.
Optometrists are not medical doctors and don't attend medical school, "and generally have significantly less and narrower training than ophthalmologists. Instead, they "undergo four years of optometry school and (relevant to the issues herein) rarely undergo a one-year residency thereafter."