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    The OD Conundrum

    While preparing my most recent Residents Advocacy Program lecture for the University of Medicine and Dentistry of New Jersey, I once again found myself grappling with the rationale behind keeping one’s Surgical Scope Fund (SSF) contributions confidential.

    During that lecture, I always present a state legislative update and used to speak of Oklahoma and Kentucky as anomalies. Now, however, the number of states battling injections, laser, and scalpel surgery privileges is growing quickly, and optometric surgery may become the norm sooner than any of us had believed possible.

    To get a better sense of what the new generation thinks of this issue, I read the Academy’s recent survey of young ophthalmologists. It was distressing that the most common reason for not joining state societies was the potential threat to optometric referral practice development. In a similar vein, older ophthalmologists only feel comfortable contributing to the SSF anonymously, lest they lose optometric referrals. To me, this line of thinking is absurd when you consider that the 20 percent comanagement fee pads the ODs’ income so they can support the very PACs that are aggressively promoting dozens of surgical bills. It would also be interesting to see how many of the 3,300 ophthalmologist-employed optometrists are sending membership dues to their state societies, or worse—their national and state PACs. And who is signing the dues checks?

    The optometric lobby is well funded (partially by ophthalmologists hoping to continue to share in the comanagement largess), emboldened (to some extent by ophthalmology’s economic boycott paralysis), and relentless—it will not rest until optometrists across the United States achieve parity with ophthalmologists. Do we care about the next generation of ophthalmologists if this happens? And can we survive in the long term by embracing a political mentality of hiding in the closet lest we get “cut off”?

    I fear we have met the enemy and he is us.

    Ralph C. Lanciano Jr., MD 
    Pennsauken, N.J. 
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