This article is more than 5 years old. Information may no longer be current.
New VA policy allows licensed ODs to perform laser procedures under supervision
Click Here to Manage Email Alerts
WASHINGTON – A bill that would prohibit optometrists from performing laser surgery procedures on veterans within the Department of Veterans Affairs system was introduced in the Senate in late July. Five days later, the VA announced a new policy that would allow appropriately licensed optometrists to perform laser procedures under the supervision of an ophthalmologist.
The VA announced Aug. 2 that, effective immediately, all therapeutic laser eye surgeries at VA facilities will be performed under the supervision of an ophthalmologist. Optometrists who are fully trained and appropriately licensed will be granted clinical privileges by the department to perform these procedures under supervision, according to a VA press release.
Oklahoma is currently the only state that licenses optometrists to perform laser surgery. “VA will continue to evaluate and consider state and national standards of practice as it sets its own standard of care,” the release said.
AOA: apply privileges evenly
American Optometric Association President Wesley E. Pittman, OD, told Primary Care Optometry News, “While we are encouraged by the VA’s recognition of the Oklahoma laser credential, we question the requirement that optometrists are not to be privileged independently to perform laser procedures. In all of our discussions with VA officials, we have maintained that policy for credentialing and privileging licensed independent practitioners – including optometrists – should be applied evenly. We think the VA directive departs from existing VA policy in that it requires supervision without the possibility of lifting that supervision.”
According to American Medical Association Executive Vice President Michael D. Maves, MD, MBA, in a VETS Coalition press release, “This directive represents a significant step by the VA to resolve a serious patient safety issue; however, the VETS Coalition does not believe that optometrists – practitioners who do not attend medical school or fulfill surgical residencies – have the proper training and education to perform invasive eye surgery.”
The VETS Coalition comprises medical organizations that are “dedicated to high-quality health care for America’s veterans,” according to the press release.
“In light of VA’s intention to proceed with this directive’s approach despite VETS Coalition concerns, there remain several minimum level provisions that must be addressed before implementation to reduce the likelihood of a bad surgical outcome for veterans subject to optometric surgery,” said the AAO in the press release. Such provisions would address education and training standards and define “supervision.”
VETS Act introduced in Senate
According to an AAO press release, the Veterans Eye Treatment Safety (VETS) Act of 2004 was introduced in the Senate July 28. S 2743 would stipulate that only qualified medical doctors, doctors of osteopathy or licensed dentists – whose practices are limited to the specialty of oral or maxillofacial surgery – perform ocular surgery on veterans within the VA system. Senators Peter Fitzgerald (R-Ill.), Jeff Sessions (R-Ala.), Maria Cantwell (D-Wash.), Diane Feinstein (D-Calif.) and Fritz Hollings (D-S.C.) introduced the bill.
Sen. Fitzgerald was quoted in the press release: “This bill is a patient safety measure that protects our veterans. It protects the law of 49 states, preventing the will of one from becoming the law of the land.”
AAO Executive Vice President H. Dunbar Hoskins Jr., MD, said, “The VETS Act is an answer to the medical and veteran communities’ concern that optometrists do not have the medical education and surgical training necessary to perform invasive procedures on our veterans.”
The AOA believes such legislation is now unnecessary in light of the new VA policy. “The VA directive clearly eliminates the need for any congressional consideration,” Dr. Pittman said.
A similar bill, HR 3473, the Veterans Eye Treatment Safety Act of 2003, was introduced in the House of Representatives in November 2003. The Senate bill now clarifies that noninvasive procedures performed by optometrists, such as insertion of punctal plugs, punctal dilation and eyelash epilation, are not affected, according to the AAO press release.
The AAO said about 380 optometrists practice in the VA. The VA operates 158 hospitals, 132 nursing homes, 42 residential rehabilitation treatment programs and 854 outpatient clinics.
For Your Information:
- The U.S. Department of Veterans Affairs Office of Public Affairs can be reached at (202) 273-6000; Web site: www.va.gov.
- The American Optometric Association can be reached at 243 N. Lindbergh Blvd., St. Louis, MO 63141; (314) 991-4100; fax: (314) 991-4101; Web site: www.aoa.org.
- The American Academy of Ophthalmology can be reached at PO Box 7424, San Francisco, CA 94120-7424; (415) 561-8500; fax: (415) 561-8533; Web site: www.aao.org.