This article is more than 5 years old. Information may no longer be current.
New York ODs ready to tackle glaucoma privileges
Click Here to Manage Email Alerts
ROCHESTER, N.Y. - Two years after earning prescribing privileges, New York's 2,000 optometrists are poised to move into the second phase of their therapeutic pharmaceutical agent (TPA) legislation - prescribing topical glaucoma medications.
And it may be that phasing in what optometrists can prescribe has been an advantage in New York, said Craig Willoth, OD, who is in an optometric/ophthalmologic group practice here. Dr. Willoth also serves on the New York State Board of Optometry, which has the responsibility of facilitating TPA.
"We were hesitant, but it seems as though since we phased in TPA usage more optometrists will use the glaucoma medication because they had a chance to get used to prescribing other drugs and become comfortable with their clinical experience," Dr. Willoth said. "We have shown that we can use the drugs in phase I [of the legislation] appropriately; we'll proceed to use all of the topical glaucoma medications in phase II.
"I think if we had [full prescribing privileges] all at once, we would have had a low percentage of doctors who would do everything," he continued, "and the vast majority would probably prescribe all the phase I drugs but hesitate to treat glaucoma and perhaps never treat it."
Of the 2,000 licensed ODs in New York, Dr. Willoth said, approximately 1,500 are considered practicing and, of those, about 850 are TPA-certified. "I feel that 80% of those certified are actively involved in prescribing," he said, "and by that I mean using more than a mild antibiotic to treat a conjunctivitis."
Data collection complete
Further, Dr. Willoth said, he believes New York's two-phase TPA legislation has also helped increase the overall number of prescribers. The data collection requirement of phase I, overseen by the State University of New York, so far supports this.
Optometrists who prescribe phase I drugs in New York have been required to fill out a form each time they write a prescription. Thousands of reports have been collected and are being incorporated into a draft final report reviewing the use of phase I therapeutics.
"We have proven with more than 9,000 reports there were no untoward results from optometrists prescribing drugs," he said.
Phase I drugs include all topicals: antibiotics, nonsteroidal anti-inflammatory drugs, steroids and antihistamines. There is no oral or injectable component of New York's TPA legislation, and there are no privileges for prescribing controlled substances.
Smooth certification process
New York's TPA certification process has gone relatively smoothly, Dr. Willoth said. Optometrists are required to pass the Therapeutic Management of Ocular Disease exam and to qualify by logging 300 clinical hours of experience comanaging drug-related issues. There is no didactic component to New York's TPA law.
Once phase II of the legislation begins, certification to prescribe topical glaucoma medications will require 100 clinical hours, 25 of which must have occurred after 1993. This means that some ODs will receive credit for college hours while others will rely on comanagement situations outside of school.
Because of the good foundation of comanagement relationships prior to 1995, Dr. Willoth said, "The relationship between optometrists and ophthalmologists has not changed significantly since we received TPA."
The relationship that has changed, he said, is the one between the optometrist and the general practitioner. "There's less hesitancy to refer to an optometrist for a red eye or other problem and to let the optometrist treat or triage to a subspecialty," Dr. Willoth said. "We didn't get that before TPA legislation, but now we're seeing more referrals to optometry."
For Your Information:
- Craig Willoth, OD, may be contacted at 1338 Ridgeroad East, Rochester, NY 14621-2005; (716) 544-6680; fax: (716) 467-1445.