(Jacksonville, FL)—In an effort to protect Florida's eye patients and ensure the highest quality of ocular care available by properly trained licensed medical physicians, Rep. Jeanette M. Nunez, R-Miami, has filed a bill (HB 443) known as the Eye Patient Protection Act of 2013. Sen. Rob Bradley-R, Orange Park, is sponsoring a companion bill in the Senate. Lauded by the Florida Society of Ophthalmology (FSO) as an unprecedented measure to protect eye patients, the bill outlines five items that would protect consumers (patients) when it comes to eye care. Specifically the bill:

• Adds clarity to current law by defining "surgery" consistent with the definition from the American College of Surgeons and the American Medical Association;
• Prohibits an optometrist from using the term “physician” or "board certified" to advertise his or her practice (ensures truth in advertising);
• Requires optometrists diagnosing severe cases of glaucoma to immediately refer the patient to an ophthalmologist;
• Strengthens legal requirements concerning post-operative care to avoid economic incentive and potential unethical patient brokering;
• Requires optometrists to report their adverse incidents in the same manner required of licensed medical doctors (MDs and DOs) including the ability to allow consumers the opportunity to be informed regarding their optometrists' competency and credentials.

The need for the Eye Patient Protection Act is a result of years of efforts from optometrists (who are not licensed medical physicians) to try and expand their scope of practice. Scope of practice refers to the laws that state what a professional can or cannot do within the guidelines of the license held by the professional. In recent years, many allied health professionals have been seeking legislation to expand their scope of practice beyond what their license allows. Some of those seeking expansion have included nurse practitioners, nurse anesthetists, pharmacists and optometrists.

"Our first and foremost priority has always been to our patients and to ensure their safety and well-being," said Charles B. Slonim, MD, president of the FSO. "The FSO—as well as the Florida Medical Association—has always been steadfastly committed to preventing optometrists who have not been to medical school or completed a residency training program from expanding their scope of practice beyond what their training allows. Ensuring health professionals practice only within the confines of their designated license will enable patients to receive appropriate and safe treatment."

"As licensed medical physicians, ophthalmologists take an oath to "first do no harm," said Slonim. "We must protect patients above all else, and this bill sets reasonable standards to ensure that Florida’s eye patients get the best care when appropriate by properly trained licensed eye physicians."

Optometrists are not licensed physicians and do not go to medical school. Instead they complete a four-year course in optometry and receive a degree to practice optometry, not medicine. Optometrists are trained in the science and art of improving a patient’s vision through the prescription of glasses and/or contact lenses. Ophthalmologists – Eye MDs – are licensed medical or osteopathic doctors who specialize in eye and vision care. Ophthalmologists are specially trained to provide the full spectrum of eye care, from prescribing glasses to complex and delicate eye surgery. Ophthalmologists have extensive education and training requirements, including: four years of medical school (after graduation from college); one year of internship (usually in internal medicine or general surgery); three years of ophthalmology residency training frequently followed by one or more years of postgraduate fellowship training; extensive coursework and training in pharmacology; 15,000+ hours of patient contact; and advanced training to treat the entire body system and deal with drug interactions.

Again this year, optometrists in Florida are trying to gain privileges to prescribe oral medications through the legislative process—rather than through the same training that is required of licensed medical physicians. "This should be an immediate red flag to our legislators for a number of reasons," said Slonim. "Optometrists have little, if any, training in the proper use of oral medications and the dangerous side effects those drugs can have on patients, beyond just the eye; and particularly vulnerable are the elderly and pediatric populations."

It is important to understand that:

• Oral medications affect the patient's entire body system and should only be prescribed by a medical doctor (MD or DO); optometrists are not medical doctors.
• Side effects and risks to some oral medications can be devastating; only an MD or DO has the training to treat adverse reactions.
• Florida has a large elderly population, many of whom take multiple medications; only MDs and DOs are properly trained to deal with drug interactions.
• There are more deaths in Florida from prescription drug abuse than from illicit drug use. At a time when Florida is actively trying to decrease prescription drug abuse, it would seem counter-productive to arm optometrists with prescriptions pads when they have virtually no training in pharmacology, nor an understanding of adverse drug reactions, some of which can be fatal.

Further, there is no access to care issue in Florida. Florida has the sixth largest concentration of ophthalmologists in the nation with 6.91 ophthalmologists for every 100,000 residents. According to the American Medical Association’s geographic data, there is an ophthalmologist within 20 minutes of any Florida patient. Also, the fee schedule established by Medicare and Medicaid is the same for both optometrists and ophthalmologists, and Federal law prohibits a difference in fee structure. In other words, the cost to the patient for seeing an optometrist or ophthalmologist is the same.