EyeNet Magazine

If Politics Were a Ball Game, State Politics Would Be Big League

By Michael W. Brennan, MD
Chairman of the Veterans Eye Treatment Safety Coalition


Opening Day of the baseball season prompts me to look at the scoreboard. One might have thought that last December’s “Surgery by Surgeons” decision at the Veterans Administration was a conclusive victory. Surprise! We have merely finished the second inning. 

The first inning featured publication of the 1997 Optometric Eye Care Guide, which included VA optometric privileging for all laser surgery—subsequently rescinded.  In the top of the second, an Oklahoma-licensed OD in Wichita, Kan., scored with laser privileges in the VA only to be refuted by outgoing VA Secretary Principi. Your Academy-led VETS Coalition generated serious support from Congress and veterans’ service organizations. Unfortunately, the onslaught of nonphysicians who would prefer to achieve surgical privileges through legislation and regulation rather than through education continues unabated, inning after inning. It’s time for Eye M.D.s to put on their game face.

It has been said, “All politics are local.” When a state legislative committee discusses scope of practice, its decision can swing on votes from Ada, Okla., as much as Oklahoma City. Personal, face-to-face contact with your state legislators is the most elementary form of positive professional relations. From Hawaii to Puerto Rico, we’ll face at least a dozen challenges this year over state scope statutes involving injections, invasive procedures and laser surgery. Beyond the patient care concerns these dangerous bills present, the ripple effect of ill-advised rulings could prejudice neighboring states and potentially collapse the VA’s recent decision. 

Meanwhile, several state medical boards have relinquished partial or complete oversight of invasive procedures to nonphysician groups. The North Carolina Medical Board and the North Carolina Optometric Board continue to spar in court over injection privileges, costing both groups thousands of dollars annually. Politics are not only local, they are expensive, too.

We have many teammates to thank for the runs scored thus far. The AMA, the American College of Surgeons, the American Academy of Family Physicians and the American Osteopathic Association recognize that “Surgery by Surgeons” is not a partisan Eye M.D. chant. Our colleagues in ophthalmology specialty societies, led by the American Society of Cataract and Refractive Surgeons, the Association of Veterans Administration Ophthalmologists and the American University Professors of Ophthalmology, to name just a few, promote a consistent advocacy message.

Our own family has grown closer. Through the Surgical Scope Fund, Eye M.D.s have found an effective and equitable way to band together in the name of quality eye care. This is not a PAC, and contributions are confidential and nondeductible. You can join the team and be sure funds will be used only to support quality surgical care. Help your state societies face the onslaught of optometric scope expansion.

Late last season, it was the voice of military veterans themselves who scored the winning run. The resounding sentiment of the patient prevailed in the VA policy reversal. As a veteran myself I ask you to go to bat for your patients and your profession by contributing to the Surgical Scope Fund (www.aao.org/ssf).

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