MD ODs look to order tests, Rx all agents, remove foreign bodies

The Maryland Optometric Association (MOA) looks to expand optometry’s scope of practice in the state via cross-filed bills this session in the General Assembly. The bills would allow ODs to order any necessary diagnostic test, Rx all FDA-approved therapeutic agents, and strip away outdated restrictions related to foreign bodies.

HB 807 is scheduled for a hearing on February 21, and SB 611 is scheduled for a hearing on February 22.

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Both bills would put Maryland (MD) on par with other states in what it’s able to offer in the form of care, according to Jennifer Levy, executive director of the MOA.

“Things are now progressing fairly quickly, and will continue to do so given Maryland's 90-day legislative session,” says Levy.

Currently, MD laws governing the scope of practice of optometry are among the most restrictive throughout the U.S. and its territories, according to the MOA.

How HB 807 and SB 611 will affect ODs in MD

If the bill does pass, optometrists seek to:

• Prescribe all FDA approved therapeutic agents (drugs, vitamins, other ocular-related therapies)

• Order and perform diagnostic tests (blood work, MRI, X-ray, sonogram, other ocular related lab work)

• Remove foreign bodies (eliminate restrictions of Alger Brush and central axis restrictions)

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The MOA wishes for ODs in MD to be equivalent to those who work in the state’s federal facilities says Bryan Rogoff, OD, MBA, CPHM, MOA president.

“We have waited a long time to practice to the level of our training and education,” says Dr. Rogoff. “It makes no sense that Maryland ODs practicing at federal facilities in the state are allowed to perform these procedures-we want this to be extended to all ODs within the state of Maryland.”

The MOA says the expanded scope of practice will allow ODs to:

• Reduce unnecessary and redundant care, including duplicative visits, prescriptions, tests, and treatment

• Reduce emergency department and urgent care clinic admissions and readmissions

• Facilitate early and effective preventative care, lowering healthcare costs

• Provide care that saves patients time and money (time off work, additional copays, and unmet deductibles), increasing patient satisfaction and improving outcomes

“By expanding the scope of practice, we are able to better the care for our patients and increase access to needed eye care for all Maryland citizens,” says Dr. Rogoff. “Providing the right care at the right time in the right place is the key to improving patient satisfaction and outcomes.”

Primary sponsors of the bill are Delegate Karen Lewis Young (D-District 3A) and Vice Chair, Sen. Paul Pinsky (D-District 22), vice chair of Education, Health, and Environmental Affairs Committee. In addition, HB 807 is cosponsored by Delegate Shane Pendergrass (D-District 13), chair of Health and Government Operations Committee.

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Organized ophthalmology’s response

Not everyone is on board to extend the scope of practice for ODs in MD. The Maryland Society of Eye Physicians & Surgeons (MSEPS) doesn’t agree scope should be expanded, citing quality of care as its main concern.

In an October 2015 letter sent to members by former MSEPS President David B. Glasser, MD, the MSEPS said, “(The) proposals for the 2016 Maryland legislative session did not meet ophthalmology’s or optometry’s prime patient objective-to maintain patient access to the highest quality of eye care currently available to the residents of Maryland. Expanding scope is not in the best interest of patients”

Dr. Rogoff says the MOA was disappointed but not surprised by the response received by organized ophthalmology.

“Optometric proposals regarding prescription of controlled substance expansion and other oral medications, independent treatment of glaucoma, ordering of independent tests and testing in the office setting, removal of foreign bodies, and use of all FDA approved therapeutic agents and devices would unnecessarily and significantly lower the quality of eye care Maryland residents currently have available to them,” according to the 2015 letter from the MSEPS to the MOA.

The MSEPS did not explain how or why expanded scope would lower the quality of eye care.

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