Georgia aims to include all orals in their formulary

Issue: March 2001

ATLANTA — The Georgia Optometric Association (GOA) introduced a bill into the state’s House of Representatives that was successfully passed on Jan. 25, 97-73. The bill would allow optometrists here to prescribe all oral medications, in addition to the oral narcotics and nonsteroidals presently being prescribed for pain.

According to Paul Ajamian, OD, president of the GOA, 91 votes were needed to win. “Now it goes on to the Senate, where we are cautiously optimistic,” said Dr. Ajamian.

The state amplified its TPA bill in 1994, adding topical glaucoma drugs as well as Schedule III and IV controlled oral analgesics and non-narcotic oral analgesics.

Direct access still an issue

While Georgia was the first state in the country to pass the direct access and anti-discrimination bill, said Dr. Ajamian, direct access remains an issue for optometrists in the state. “The anti-discrimination bill has certainly had its positive effects in helping us get on plans. However, there are only a few plans that will allow a few optometrists on — it’s mostly ophthalmologists,” he noted. “So that’s always an issue, although we’ve done all we can do legislatively to address it. Our main focus is to finish the scope bill that we started years ago, and that’s the bill to use all topical and oral agents related to the eye.”

TPA effect on prescribing habits

Dr. Ajamian said that while optometric prescribing privileges have not affected him directly since he works in a comanagement referral center, he does not perceive other state ODs taking full advantage of their privileges.

“TPA privileges have affected the private practitioner here quite favorably,” he said. “We used to get a lot of red-eye referrals to our referral/comanagement center — those are being seen by the OD now instead of being referred to us. More and more ODs are treating glaucoma, although not as many as I’d like to see treating it. We still get referrals that, unfortunately for the patient’s sake, are unnecessary. Someone may have a stye that needs an oral antibiotic and could be very nicely treated by an optometrist — and will be, once we pass this bill.”

Fewer optometrists in the state will treat glaucoma as compared to other conditions, said Dr. Ajamian. “When it comes to glaucoma, I think ODs here are a little more conservative than when treating red eyes,” he said.

OD/MD relationship is ‘fair’

When it comes to the relationship between Georgia optometrists and ophthalmologists, Dr. Ajamian describes it as fair. “Unfortunately, there are still a number of ophthalmologists who are fighting our present legislation, and while it’s not going to affect their mode of practice or volume of practice one bit, they continue to be fairly militant toward us,” he said. “What’s new is that they’ve tried to get all of medicine involved in the fight. I think they know that without the rest of the medical profession as their ally, they can’t beat us, but when they bring in 20,000 physicians in Georgia, they can get a legislator’s attention. And that’s what they’ve done.”

For Your Information:

Paul Ajamian, OD, is president of the Georgia Optometric Association. He may be reached at 5505 Peachtree-Dunwoody Rd., #300, Atlanta, GA 30342; (404) 257-0814; fax: (404) 256-5446; e-mail: ajamian@aol.com.