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Maryland becomes 50th state to gain steroid privileges
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After several years of struggle, the dedication of optometrists in Maryland has finally paid off, as ODs in the state recently became the last in the country to acquire steroid prescribing privileges.
"Maryland optometry is thrilled with this, because steroids are an integral part of day-to-day clinical practice," said Robert Stutman, OD, FAAO, secretary and legislative chair of the Maryland Optometric Association. "They are a key component of primary care optometry."
A one-point bill
House Bill 719, which was signed into law by Gov. Robert Ehrlich on May 10, states that "a therapeutically trained optometrist may administer or prescribe topical steroids in accordance with a practice protocol established by the board."
Dr. Stutman said the MOA has been attempting to pass a practice scope expansion bill for the past 4 years; however, the bill that was introduced 4 years ago was much broader.
"We cut it down and cut it down, and this year, at the request of our chief sponsor, who has been very supportive, we put in a bill that we affectionately refer to as the ‘49 states bill,’" he told Primary Care Optometry News. "Basically, we were trying to get the things that every other state has, which include no restrictions on foreign body removal, the use of the Alger brush, topical steroids and topical antivirals."
However, the MOA was met with opposition from the Maryland Society of Eye Physicians and Surgeons, which expressed unwillingness to compromise on the bill. Nevertheless, the MOA was able to obtain one of its three objectives: the prescription of topical steroids.
"We had a stronger grassroots effort this year than we had in the past several years, so we were really able to put political pressure on the legislators," Dr. Stutman said. "Without that, we wouldn’t have even been able to sit down at the table."
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Influence of national issues
Another force at work in the MOA's struggle was the unusual scope of political power wielded by the opposition, Dr. Stutman said.
"The Eye Society is very politically active here in Maryland," he said. "One of the prominent members of the Eye Society, Dr. Allan Jensen, is past-president of the American Academy of Ophthalmology. So this whole thing was going on while a Maryland ophthalmologist was president of the AAO, and that is when they started banning optometrists from annual meetings," he said.
Maryland is also one of the few states with a higher concentration of ophthalmologists relative to optometrists, Dr. Stutman added.
"They kept telling us that there was no room for compromise among the Eye Society," Dr. Stutman said. "Their thinking was that if they compromised on even topical steroids, next we would come back and want to do intraocular surgery and cataract surgery. They were concerned that all the states would try to do what Oklahoma has done."
Access to quality care
Despite the obstacles, the bill prevailed, and the MOA is very pleased with the outcome.
Although it was signed into law, a protocol now needs to be established by the state board of optometry by the end of November, Dr. Stutman said.
Dr. Stutman said the MOA feels that this new legislation will improve the quality and accessibility of eye care in the state. "The primary argument we used for this bill was access to quality eye care," Dr. Stutman said. "It decreases cost, because it is not mandating a referral for something we are trained to do. It's increasing access and providing better care, because we're not delaying treatment unnecessarily."
For Your Information:
- Robert Stutman, OD, FAAO, is secretary and legislative chair of the Maryland Optometric Association. He can be reached at 190 Village Square, Baltimore, MD 21210; (410) 435-8881; fax: (410) 435-8886.