Ophthalmology department chairs of several leading medical schools are concerned that a recent change to the Veteran’ Health Administration’s Community Care Program guidelines will put veterans’ eye care in significant jeopardy.
The VA recently removed language from the Community Care “Standardized Episode of Care: Eye Care Comprehensive” guideline, which provided that “only ophthalmologists can perform invasive procedures, including injections, lasers and eye surgery.”
Although this change is independent from the VA’s development of national standards of practice, a separate process the Academy is closely monitoring, we are concerned about potential implications the community care policy change could have for the national standards currently being developed.
In their letters, the chairs argue the language VA removed was critical in ensuring veterans received the highest standards of eye care in the community.
Mark Mannis, MD, FACS, chair in vision science research at the University of California Davis, wrote “This wording established a consistent and high-quality standard for veterans seeing community care for eye surgery upon which they have relied and benefited.”
More than 10 letters have been sent so far and have come from medical schools that have affiliations with VA health facilities, meaning they have faculty or residents providing care for veterans. According to the Association of American Medical Colleges, 70% of all U.S. physicians complete at least part of their training in VA facilities. Medical centers and the VA have been partnering to provide veterans with health care and resident physicians with training for more than 75 years.
Despite the long productive partnership between academic medical center ophthalmology departments and the VA, these recent changes “are correctly seen as significant and an immediate threat to quality surgical eye care,” said Stephen D. McLeod, MD, Academy CEO and former chair of ophthalmology at the University of California San Francisco.
“When compared to the rigorous standards of surgical training required for ophthalmology,” he said, “the scant training and experience required in states that allow optometric surgery means that veterans are immediately thrown into a highly inequitable care delivery system that becomes luck of the draw as to who will do a surgical procedure on them.”
The Academy has been actively engaged in educating medical centers about the VA’s changes to these community care guidelines and what this could mean for veterans’ eye care.
“We are encouraged by the immediate and energetic engagement of our academic medical center colleagues and see this as compelling evidence for ophthalmology's commitment to the highest quality care for our veterans,” Dr. McLeod said.