UPFRONT

Pushing the Limits

Peter K. Kaiser, MD

Many of us do not realize that the American Academy of Ophthalmology announced a “limited” initiative to work with the American Academy of Optometry, to explore areas of mutual interest. Given the massive fights about scope of practice in the past and those sure to come, this announcement came as a complete surprise to many of us.

But is it? Given where we are going with Obamacare and the way many refractive specialists and even general ophthalmologists practice on a daily basis, sharing care with optometrists, is the idea of working together with optometrists so far off? I don’t think so.

Many of us work side-by-side with optometrists who have no desire to enter the scope of practice of retina specialists or even general ophthalmologists. My optometry colleagues at the Cole Eye Institute are experts at difficult contact lens fittings, and they are superb clinicians.

They often find problems missed by outside ophthalmologists. When I discuss scope of practice with them, none of them has any desire to broaden the scope of optometry or add the years of training and medical boards that would be required of them.

Now, of course, there are the optometrists who lead the American Optometric Association (AOA), which is aggressively and quasilegally attempting to legislate their scope of practice to include ophthalmology procedures. These are the people who get laws approved in the dead of the night, without any public comment, by heavily lobbying the state lawmakers. Their dues are almost entirely used for lobbying, which is why all of the societies contribute to the Surgical Scope Fund (as do I).

That is what makes working with an educational institution such as the American Academy of Optometry a good first step and one that I applaud. I hope this association will be fruitful and will go a long way toward healing the educational divide started by the AOA.

Only time will tell if this association was a good or bad thing, but it is a step in the right direction, and I for one hope it works.