From: Healthcare Access for Texas
Prior to 1970’s the American Medical Association and ophthalmologist M.D.s were locked in a bitter battle against optometrists to prevent their efforts to expand optometry’s scope of practice to include…wait for it…dilating eyes. Yes, unless M.D.s alone could administer eye drops during exams, patients would suffer the health consequences of trusting poorly trained non-M.D.s.
For years, ophthalmologist physicians deployed an army of white-coated medical experts to state capitols across the nation, offering their “scientific” warning: patients would suffer catastrophe if optometrists were allowed to dilate patients’ eyes. Their fight, they said “is for the patients whose safety must not be compromised by allowing those who lack education and medical training to treat patients beyond their competencies. What if something should go wrong?”
Put another way, they were saying, like Chicken Little, “The sky is falling!”
Ultimately, physicians lost that nationwide battle in the mid-to-late 1970’s. It was a bitter disappointment. An M.D. writing in a May 10, 2011 article in Physician, a medical journal, still groused that optometrists, “no longer face opposition from ophthalmology on these fronts.”
Then, in 1998, skies over Oklahoma apparently were still in place despite eye drops now in the hands of optometrists until they sought legislation to expand their scope of practice. That’s when “The sky is falling” mantra once again was trotted out by the medical cartels. It had been used successfully to defeat optometrist expansion efforts in 25 states for two decades.
But the Oklahoma Legislature didn’t buy the medical hype, given a shortage of qualified eye care providers and expanded Optometrists’ scope of practice to include some prescriptive authority and certain laser eye surgical procedures. And, when other states tried to pass similar laws, “the sky is falling” stories of devastating problems for poor Oklahoma eye patients began making the rounds.
“An optometrist misidentified a dangerous cancer and the patient suffered” is one such template repeatedly cited in several states as “sky is falling” testimony by allopaths as they seek to protect their monopoly over the eyes and pocketbooks of their captive patients. Sadly, that “example case” was rpeated in one form or another in Texas, Kentucky, New Mexico, Wisconsin, Maine, Massachusetts, Nebraska, and South Carolina, and still is cited today.
Meanwhile, there’s no mention of the annual hundreds of thousands of American deaths due to confirmed medical errors by M.D.s. Naturally, highlighting that fact isn’t part of the AMA legislative strategy.
In 2004, the Oklahoma legislature again authorized a greater expansion in optometrists’ scope of practice to allow additional surgeries. Are we to believe that even though Oklahoma’s optometrists were maiming patients left and right, the Legislature concluded that they needed more patients and more forms of surgery to better commit these routine acts of mayhem? Obviously, the hard evidence of harm was lacking.
Of course, that didn’t hinder the medical establishment’s chanting their version of Chicken Little’s erroneous refrain, “The sky is falling!” But, because Oklahomans apparently were onto their game, no one listened, and patient’s got another expansion of their right to choose their eye doctors. The word of optometry success in Oklahoma encouraged other states to expand access by patients to their favored providers.
By 2009, the American Medical News quoted an official of the American Academy of Ophthalmologists, Dan Briceland, M.D. as saying, “This was the worst year we’ve faced. It turned out to be seven or eight aggressive bills.” Despite their terrible year in which skies were falling all over the place, TMA and its allied M.D. specialties were able to defeat each and every attempt to give greater patient access to optometrists for eye care, despite a growing shortage of ophthalmologist M.D.s across the nation.
Then, in 2011, this time in Kentucky, the sky once again began falling according to the medical chorus. Despite the over-heated rhetoric of M.D.s, like Oklahoma, Kentucky’s legislature passed a law similar to those of Oklahoma.
Again, the primary issue which carried the day in Kentucky was a lack of sufficient ophthalmologist specialists in the rural areas of the state where there were plenty of optometrists ready to see patients. It turns out that ophthalmologists could only be found in one third of Kentucky’s 120 counties. Optometrists were available in 106 counties.
Despite the clear need for more providers in areas where no qualified M.D.s were available, a move away from unavailable physicians equals, “The sky is falling!”
Daniel Briceland, M.D. of the American Academy of Ophthalmologists again offered his piece of the falling sky argument, “It’s a very significant patient safety issue.” Another Oklahoma M.D. showed up to repeat the “botched procedures” stories. She also suggested that there were plenty of ophthalmologists to serve Kentuckians if only patients would travel as far as necessary to get quality of care from an ophthalmologist.
In the 2011 Physician article noted earlier, Ford Vox, M.D. bemoaned the advance of optometry as if it were the invasion of the Visigoths and Vandals who brought down the Roman Empire:
”Optometry waged state-by-state expansion of practice battles for four decades on its way to where the profession now stands….The American Academy of Ophthalmology and the American Medical Association have challenged optometry every step.”
How fortunate for us that through scope of practice battles in every state, they have fought at every step, the right of patients to choose our own preferred providers
Clearly, Medical Societies and Associations have and will continue to fulfill their duty to the woefully uneducated and unsuspecting public by shouting from the rooftops that optometrists are at the gates threatening the public with everything from eye drops to scalpels. No matter what, we can count on their scientific warning:
“The sky is falling.”