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Maryland plans to introduce legislation to expand prescribing privileges in 2000

Issue: March 1999

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BALTIMORE – Maryland has had therapeutic pharmaceutical agent (TPA) prescribing privileges since May 1995 for a limited number of drugs but is now looking to expand the list early next year, said Maryland Optometric Association immediate past president Edward Wasloski, OD. “Our game plan is that we will be introducing legislation in January 2000,” said Dr. Wasloski. “We are in the planning process.”

While hesitant to discuss details of the legislation until drafted later this spring, Dr. Wasloski said that limited orals – Maryland ODs can prescribe oral tetracycline and its derivatives for blepharitis – as well as the lack of Drug Enforcement Administration (DEA) numbers sparked the quest to expand prescribing privileges.

Optometrists in Maryland can prescribe all categories of topical drugs except antivirals and steroids. In addition, foreign body removal and glaucoma treatment – with comanaging requirements – are also permitted. Dr. Wasloski said these initial privileges were important because “it gave us a very broad-based start in all of the arenas.”

Positive OD-MD relations

According to Dr. Wasloski, the overall relationship between optometrists and ophthalmologists is a positive one, although there is always room for improvement. “You have the militant ophthalmologists who still believe ODs should do nothing and will never change their practices,” he said. “That group is not going to change. But those types of doctors are gradually going to fade away into the sunset.”

Dr. Wasloski said that of the approximately 350 practicing ODs in the state, the majority of progressive-thinking practitioners are utilizing their prescribing privileges. “I think the bulk of them – those who aren’t taking the same route that some ophthalmologists are taking — prescribe,” he said. “In Maryland, new ODs cannot get a license unless they’re TPA-certified. So by attrition, I think it’s just going to happen. I would venture to say that 90% to 95% of optometrists are TPA-certified. It’s going to go to 100% soon.”

Hospital access: future aspirations

While not aware of any ODs that currently have hospital access, Dr. Wasloski said that issue will most likely take shape further down the road after prescribing privileges have been expanded. He said that the need for optometrists to gain hospital access simply has not been great enough to cause them to seek it. “Being a fairly urban state, with the bulk of our patients in the Interstate 95 corridor running from Delaware/Philadelphia down to Washington, there are plenty of hospitals,” he noted. “There are probably more MDs than ODs in the state. There hasn’t been a big push from the hospitals asking for doctors to cover the emergency room for eye consults. There just has not been that need.”

For Your Information:

• Edward Wasloski, OD, immediate past president of the Maryland Optometric Association, can be reached at 7008 Security Blvd., Suite 100, Baltimore, MD 21244; (410) 281-2656; (410) 281-9388; e-mail: oesbalt@erols.com.