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Achieving practice parity will require our involvement
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![Michael D. DePaolis, OD, FAAO [photo]](/~/media/shared-images/michael-d-depaolis-od-faao.jpg)
As optometrists, we share many commonalities. We attend the same professional educational institutions, sit for the same national board examinations and stay abreast of recent developments by virtue of the same professional publications and continuing education courses. We share these commonalities for good reason. Whether you practice in Maine or Hawaii, there is good likelihood your patients have the same needs. Why, then, given these similarities, is the practice of optometry so diverse from state to state?
For sure, this dilemma is not a new one. When I graduated some years ago, it was common practice to obtain more than one state license. It was very likely that each of those licenses granted you a very different set of privileges.
I recall a colleague who lived and practiced in western Pennsylvania, but would schedule “red-eye” patients in his satellite office in West Virginia. Even though it was the same patient, same doctor and the same conjunctivitis diagnosis, one state permitted treatment whereas the other did not. While optometry has made significant strides toward scope of practice (and licensure) parity, disparities still remain. However, today there is good reason for optimism.
Optometric competency assured
What differentiates today’s battle for scope of practice parity from that of two decades ago is twofold. First, and foremost, is our hierarchy. We have a well-orchestrated process designed to assure optometric competency consistent with the highest level of practice. The Association of Schools and Colleges of Optometry (ASCO) serves as our foundation.
ASCO, in communicating with each state board, continually modifies optometric curriculum, thereby preparing each graduate for practice in any state. During this formal training period, the National Board of Examiners in Optometry (NBEO), via board examinations, “validates” each graduate’s knowledge base and skill set. It doesn’t stop here.
The Association of Regulatory Boards of Optometry (ARBO), in conjunction with the Council on Optometric Practitioner Education (COPE), provides practicing optometrists with a metric for assuring continuing clinical competency. In fact, the Council on Endorsed Licensure Mobility for Optometrists (CELMO) provides practitioners with a vehicle by which to aspire to the highest level of continuing education certification. Last, but certainly not least, is the American Optometric Association (AOA). The AOA has always been proactive in assisting each state optometric association’s efforts to expand scope of practice.
Effective practice implementation
In addition to this well-designed hierarchy, there is yet another factor differentiating today’s battle for scope of practice parity. It is the fact that optometry has a very impressive track record involving scope of practice implementation. This record clearly substantiates optometry’s history of employing expanded practice privileges safely and effectively.
So, why, given this impressive hierarchy and well-documented track record, don’t we have scope of practice parity in optometry? Sadly enough, it often comes back to the issue of “turf wars” and politics. And, unfortunately, politics does, on occasion, supersede rational decision-making.
It is this realization that gives rise to yet another realization. It is the realization that we can’t expect our governing bodies to do it all. Despite their impressive efforts, ASCO, NBEO, ARBO, COPE, CELMO and AOA are not enough. Achieving state-by-state scope of practice parity – like so many other battles before it – will require a grass-roots effort. This means supporting our governing bodies, providing resources for AOA’s Political Action Committee and educating legislators. Most importantly, this means getting involved – each and every one of us.