When you rush a bill and deny a bill due process, you get undesirable results that go beyond the obvious risks to patient safety. This law sets the ground work for a paralegal to practice law or a chiropractor to perform knee surgery.
If a politician is willing to sacrifice your vision, do you want them representing you in any capacity?
On your behalf, your legislators who voted "yes" likely assume the following:
1. They assume that you will not drive 30 minutes to find a skilled eye surgeon. You'd drive 30 minutes for a great meal, wouldn't you? Chances are good that the Law will actually scare skilled physicians away from our state and create a greater "access" problem than already exists today.
2. They assume that they'll be saving you a trip to the ophthalmologist and an insurance co-payment if the optometrist can do it all. So what happens when the optometrists have complications and need the ophthalmology referral anyway? August 2016 issue of JAMA shows that patients will likely travel to the optometrist more frequently for the same glaucoma laser on the same eye!
3. They assume they are saving the system money. What happens when folks feel pressure to over-diagnose problems to generate revenue from their new expensive lasers and surgical tools? Do you think an additional 300 lasers in Kentucky would cut costs? August 2016 issue of JAMA shows optometrists 189% more likely to reoperate on the same eye, more than ophthalmologists.
4. They assume that there is equivalency between the skill and understanding of an optometrist and ophthalmologist. See the home page. An optometrist has one-half of the post-graduate years in training. What happens when people suffer because this bill lacks the minimum safety measures? In fact by the very nature of its language, if it's not excluded in the KY law, it's fair game. The sky is truly the limit.
5. They assume that optometrists will find the right training. Who is going to train them? The ophthalmologists? One dares to think that an ophthalmologist is careless enough to try to teach surgery to someone in a weekend or two or any time frame less than 3 years.
Outtakes...When dealing with health care law and legislators, often times some funny things happen:
The Bill took only about 12 business days from filing to Governor's desk.
When informed that there was a factual error in the text of the SB110 that clearly shows a misunderstanding of the anatomy of the eye, Legislators were so anxious to pass this that no one would second or pass a motion to entertain the fix. Representative Keene said the fix wasn't necessary, when it clearly was. He said that injections into the "back of the eye" were already forbidden...to bad it is not. The error allows an optometrist to inject medicine into the jelly of your eye.
When a Senator in committee asked for the Bill to be further reviewed to get additional testimony from the public and the surgeons, or even a study on the economic impact in KY, no-one would second the motion. What's the hurry?
When an amendment was offered requiring an optometrist to show the same proficiency as an ophthalmology resident, regarding the procedures in this Bill, Representative Keene from Campbell Co. said that would add 36 months to their training...which was an outright falsehood. He said that forcing equivalent proficiency defeats the intent of the bill to increase access. (Irrelevant) He said that it somehow keeps an ophthalmology monopoly alive. (Also irrelevant). In response to another amendment, Rep. Keene even suggested that a "good many" optometrists have been in residency for surgery--which was extremely misleading. There is a large difference between a "surgical course" and a surgical residency, and wouldn't a State have to ALLOW optometric surgery to have a residency that teaches it?
Representative Keene said something to stop every common sense amendment that was written to protect you. He encouraged a "no" vote on an amendment that would force an Optometrist to do physical exam as part of an encounter leading to surgery. Wouldn't you want a physicial exam before you had a procedure that could cause bleeding? Representative Keene advised the House to vote against medical oversight, against allowing a rescue procedure which would save your vision in the event of a complication, against standards in training, and against stopping optometrists from practicing if they've had 2 DUI's. He went so far as to state that surgery by non-physicians was "critical legislation."
The Gavel had to be struck to quiet the House chamber when those against the Bill were speaking. There was even an outbreak of laughter when representatives joked about their "Yea" vote making hard to find an ophthalmologist to take care of them.
Rep. Leslie Combs closed the vote in the House by begging optometrists to "do good". That does not show confidence.
Rep Danny Ford thought surgery by a non-surgeon was a great idea and stood up to express his satisfaction on the Floor.
One of the few heros in this battle, Susan Westrom from Fayette received phone call(s) REMINDING her of optometry's political contributions, as she headed to the Floor for a vote. Audacity!
The Bill originated in a licensing committee instead of Health and Welfare. Doesn't take a scientist to see that the greater impact here is on the Health and Welfare of KY. Perhaps the wheels of the Licensing committee were better greased?
When polled, most optometrists don't want to perform surgery. In fact, most would say that if they wanted to operate, they would have become a medical doctor, an ophthalmologist. Many optometrists are challenging their Board to allow them to "opt out". So where is this bill coming from? The extremists? Too bad for those not interested in the Bill -- their relationship with ophthalmology is now stressed.
The optometrists will tell you that 250,000 "minor" procedures have been performed without complaints to the Medical Board in Oklahoma. It's funny that the Medical Board does not have oversight over optometrists. They control M.D. doctors.
Kentucky is getting a reputation for having a legislature that can be easily coerced. We have made national news for this. Great political cartoons too. These are YOUR Representatives. It should make your stomach upset.
In the State of Kentucky, optometrists are not allowed to simply call themselves "doctor" but they are performing surgery under this Law.
And the number one most concerning outake is:
when Governor Beshear signed the Bill into Law!
The Governor cited three reasons for signing the bill:
1. Access to care. Would anyone NOT drive 30 minutes to find a skilled surgeon? The Governor just created an access problem by making the state hostile to the medical profession. Oklahoma data suggests that you'll be driving twice as much for the same procedure.
2. Overwhelming Bipartisan support. Just because the body of the Legislature does it does not make it correct. Was money involved? Representatives, on the record, have said that the Bill was "bought and paid for." Articles in the major papers seem to concur. Ryan Alesi proved in a phone poll that 79-85 percent of Kentuckians don't want non-MD's operating on their eyes!
3. Little financial impact. No financial impact study was performed in the House despite a request by Representatives! Do you think that putting 300 more lasers in the state in the hands of optometrists who have half of the number of years of training and only a 32-hour course will save money? Oklahoma data suggests that this is simply a cost burden.