Scott A. Edmonds, OD, FAAO, focuses his blog on the role of the optometrist in health care reform – moving from primary eye care to primary health care. He is the chief medical officer of MARCH Vision Care, the co-director of the Low Vision/Contact Lens Service at Wills Eye Institute in Philadelphia and a member of the Primary Care Optometry News Editorial Board. 

Disclosure: Edmonds is a consultant for March Vision.

BLOG: A model for optometric scope of practice legislation

This past weekend, I had the opportunity to provide a continuing education lecture for the Louisiana Optometric Association. It was a joint lecture with my son, Ryan P. Edmonds, OD, on the “Optometrist’s role in the management of chronic systemic disease.”

The course covered optometry’s role in three specific areas: prevention, management and rehabilitation. We had target audience members in mind for each section. Prevention is a role for all optometrists, the management of systemic medical problems is for the optometrist who has a practice geared to the medical model, and the rehabilitation segment was more for low vision providers or those who provide vision therapy.

As we prepared this course and established the relative weight and time to be spent in each section, we took a hard look at the scope of practice and the new optometry law in this state. We had an opportunity to speak with some of the leadership in the months leading up to the meeting and spent the night before the talk in informal discussions with many of the leaders who had worked through the process of passing the new optometry law in Louisiana. I am always impressed with the passion of optometric leaders in the chairs of state optometric associations and in particular those who work on optometric legislation. Having been a state president in the 1980s, in the early battles of securing therapeutic legislation for each state, I know about the grass roots work required to win these battles.

The new law in Louisiana is unique and should set the standard for scope of practice legislation for all states in the future. The law is broad enough to include the management of chronic systemic disease, in particular diabetes and hypertension, because of the effect of these particular problems on the eye and vision. As such, we were able to gear much of our talk to the common medications used to manage these disease states and side effects and issues that often present in the eye care encounter. We discussed the optometrist’s role in educating patients about their medicines and the importance of using them correctly to prevent eye complications as well as other end organ damage.

As we moved through the talk, we found a very receptive audience and were asked a number of good questions on points of education about some of the newer medications that are now available. It became clear that many in the audience had not considered their role in systemic disease and yet could understand the responsibility of their new legislation and their expanded role as primary health care providers.

As it turned out, we ran a bit long and over the COPE-suggested time for the course, but it was a passion of the audience and the questions that followed that drove a deeper review of our material. We learned that chronic medical problems, diabetes in particular, are an epidemic in Louisiana, with the percentage of citizens affected well above the national average.

I want to personally thank the optometrists of Louisiana, first, for inviting Ryan and me to speak to them about this critical new role for our profession and, second, for having the foresight and passion to pass legislation that will lead to better health care for the citizens of their state. The Louisiana landmark optometry law helps to position optometry as a profession poised to fill the public health crisis of diabetes and hypertension, affirming our profession’s broad training to serve the public as primary health care providers. Once again, I find myself inspired by yet another group of leaders of our profession.