Bill would make the change – and save state moneyIN EVERY OTHER STATE, optometrists prescribe oral antibiotics to treat ocular infections as well as treat and manage glaucoma. Massachusetts is the only state where this is not permitted. If a patient with one of these conditions presents at an optometrist’s office in the Commonwealth, the most he or she can do is make a referral to an ophthalmologist, and this often leads to a long wait and added costs for the uncomfortable patient.
There is no rationale for this since optometrists are experts on the eye and trained to provide care in these situations. Ophthalmologists are surgeons and they should be providing the most advanced care.
As dean at a school of optometry, I can testify with certainty that optometrists today have the education, training, and background to safely use the modalities included in a bill before the Massachusetts Legislature. Moreover, the Commonwealth would realize $20 million in MassHealth (Medicaid) savings by making the change, at a time when MassHealth faces a huge funding deficit.
Medical school curriculum is very rigorous and thorough, but because of the volume of material that must be covered for conditions such as heart attacks, strokes, and cancer, there is very little time devoted to many specialty areas such as the eye during the four-year medical school education. Ophthalmologists learn what they need to know about the eye after medical school graduation.
On the other hand, the four-year, post-baccalaureate optometry school curriculum is devoted almost entirely to the eye. Of course, there are optometry courses in general anatomy, pathology, general internal medicine, and pharmacology, which parallel the same courses taught in medical and dental schools. Consequently, optometrists are well educated and trained within their programs to properly examine, diagnose, and treat these eye conditions, and to consult with, and refer to, ophthalmology or other medical specialties when appropriate.
Many systemic diseases such as hypertension, diabetes, and immune mediated diseases are evident during a routine eye examination. Optometrists are also educated and trained to identify and diagnose these manifestations and then refer to the appropriate medical practitioner.
The privileges sought regarding application of oral antibiotics for ocular conditions and the treatment of glaucoma in the care of their patients is consistent with standards in all other states. The public can be assured that any optometrist awarded such privileges is appropriately educated and trained. The Massachusetts Board of Registration in Optometry will provide the correct level of oversight of optometrists through a strict credentialing process in keeping with the board’s role and responsibility for public protection and patient safety.
Some ophthalmologists in Massachusetts who actively oppose the bill appear to be out of step with reality, especially when they cite concerns for “patient safety.” They appear unaware that the education of optometrists has changed dramatically over the past 45 years. With these changes, the scope of practice has legally expanded through state legislative action in every other state.
The comprehensive four-year post baccalaureate education and clinical training at the two accredited optometry schools in the Commonwealth parallels that at the other 20 colleges of optometry nationwide.
Why are some ophthalmologists opposing the bill? Is it to protect their turf? Is it to secure their own economic interests? Or is it, as I believe, because of misconceptions or lack of knowledge about the education and training of optometrists today?
As eye care professionals, doctors of optometry enjoy close working relationships with many area ophthalmologists. They are on our campus, they teach our students and they understand how the profession of optometry has advanced. They are respectful and supportive of our program.
Broadening the scope of practice for optometrists is long overdue and will bring Massachusetts in line with every other state in the nation. It will also ensure that patients throughout the Commonwealth will have access to the eye care that they need.
Enabling optometrists to practice as they have been trained is a vision that we should all share.
Written by Morris Berman for the Common Wealth Magazine. Morris Berman is dean of the MCPHS University School of Optometry in Worcester.
We apologize for our late arrival this evening. Let's get right to the news. An Iranian cancer researcher bound for Children's is being held at Logan. A powerful state official has a warning for supporters of the Millennium tower. Tufts contract talks with its nurses are down to the wire. And Jon Chesto checks in with the state's optometrists, who see a possible end in sight to a long quest. Here's Talking Points for Tuesday, July 11. Chesto Means BusinessEyes on the prize: The state’s optometrists have one more good shot this year to broaden their authority.
The Senate leadership had again approved a measure allowing them to prescribe medication for glaucoma and eye infections, tasks normally handled by ophthalmologists. This time, the Senate included it in budget negotiations. But it was missing from the final package last week -- despite another lobbying push from the optometrists and a radio ad campaign.
Jay Gardiner, executive director of the Massachusetts Society of Optometrists, doesn’t sound depressed about this loss. The optometrists, after all, have just aligned themselves with the state’s biggest business groups that want broader health care reforms. Gardiner’s issue is just a tiny piece, but it’s still part of the pie.
Gardiner says he’s hopeful because Governor Charlie Baker included the change in a long slate of business-backed MassHealth modifications sent to the Legislature last month; Gardiner argues that it can save the state health program $20 million a year by curtailing trips to more expensive providers.
Lawmakers didn’t include Baker’s wide-ranging reforms in their budget plan. Now those groups -- folks such as the Massachusetts Taxpayers Foundation and Associated Industries of Massachusetts -- are lobbying fiercely to get the reforms taken up and passed by the month’s end. All eyes are on Baker, and how he wields his veto pen.
The state’s ophthalmologists have fought against this effort over the years, even though Massachusetts remains an outlier on this issue. It’s been a tough slog for the optometrists here. But now they have some powerful allies on their side.
Jon Chesto is a Globe reporter. Reach him at email@example.com and follow him on Twitter @jonchesto.
Executive SummaryChildren's researcher held: An Iranian cancer researcher is being detained at Logan Airport.
Dr. Mohsen Dehnavi holds a visiting work visa. He was traveling to Boston to work at Children's Hospital. The hospital said he, along with his wife and three children, could be returned to Iran on the next flight.
Dehnavi's detention comes two weeks after the Supreme Court ruled the travel ban on people from six Muslim-majority countries could be partially enforced. However, customs officials deny the researcher is being held as a result of the Trump order.
Galvin casts a shadow: Millennium Partners' proposed 775-foot Winthrop Square tower hit a snag: Secretary of State Bill Galvin.
Galvin wants lawmakers to hold off taking a vote to change laws restricting shadows falling on Boston Common and the Public Garden, saying it could cause great damage to historic buildings. He wants more impact studies done on how the building would affect light on the public spaces.
Galvin oversees the state Historical Commission, and he can halt the development. This would also be a problem for Boston, which has earmarked $153 million it anticipates from getting from the deal.
It's not easy finding green: A share of Millennium's $153 million payment goes toward park upkeep.
Think developers aren't doing enough? The city says, think again. The Globe's Tim Logan explains.
Nurses talks down to the wire: Contract talks between Tufts Medical Center and the Massachusetts Nurses Association are down to the final hours.
Without a deal, 1,200 Tufts nurses could walk out at 7 a.m. on Wednesday for one day. If they do, Tufts has promised to use replacement workers for an additional four days.
Stocks recover from Trump jolt: After a quick slide, the market rebounded from the latest reports on Russian interference in the 2016 election.
The S&P 500 Index fell 0.5 percent shortly after the release of an e-mail in which Donald Trump Jr. was told Russia wanted to help his father's campaign. While investors were kind, US Representative Seth Moulton was less forgiving. (Bloomberg)
Borrowing trouble: A Chinese umbrella-sharing startup would seem to have discovered the sharing economy’s limits. In just three months, Sharing E Umbrella lost its entire stock when people predictably kept all 300,000 umbrellas.
Surprisingly, this hasn't dampened interest in the business. The company plans to distribute 30 million umbrellas across China by year-end, and reportedly faces three competitors to boot. (The Guardian)
The Boston Globe Talking Points - July 11th