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Numbers small, but hopes high as D.C. optometrists go for TPA
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WASHINGTON - The nation's capital is the only place in the country where you can still find ODs - although only about 50 total - who cannot prescribe therapeutic agents for their patients. Michael Rosenblatt, OD, however, hopes the most recent introduction of therapeutic pharmaceutical agent (TPA) legislation will get a long-awaited vote of approval from D.C.'s City Council.
Dr. Rosenblatt, in general group practice, is currently serving his second term as president of the Optometric Society of the District of Columbia. A 7-year member of the society, Dr. Rosenblatt hopes optometrists here will soon gain therapeutic privileges.
"Of course we'd like to achieve TPA privileges, and we've introduced legislation for the past 5 years (D.C. operates on a 2-year legislative cycle), but it has not passed," he said. "The proposed TPA bill is basically a change in the definition of optometry to allow optometrists to prescribe medications for therapeutic purposes."
Once that hurdle is cleared, however, Dr. Rosenblatt and his colleagues will address the regulatory side of optometry, which specifies exclusions and the therapeutics ODs may prescribe.
From DPA to TPA
The last time optometrists in the District of Columbia passed therapeutic legislation was in 1986, when they successfully gained diagnostic pharmaceutical agent (DPA) legislation. Two states also gained DPA legislation that year - Connecticut and Florida.
Dr. Rosenblatt told Primary Care Optometry News that the District of Columbia's proposed TPA bill was the subject of a public hearing in June, and the bill is now with the Consumer and Regulatory Affairs Committee pending a vote or some other action.
"The exclusions are surgery and most injectables," he said of the proposal, "and if this first part to change the definition passes, there is the regulation side that has to take place and where the exclusions as they relate to therapeutics occurs."
If the proposed TPA bill receives a favorable vote from the regulatory committee, it will be presented to the District of Columbia City Council for final vote. "Our local legislators are receptive [to TPA]," Dr. Rosenblatt said, "but we have very few optometrists who live in the district, so we're not constituents."
MDs are main opposition
The major opposition to D.C.'s proposed TPA law has come from ophthalmology, which outnumbers optometrists here 2:1, according to Dr. Rosenblatt. "We had to amend our definition at the last public hearing," he said. "Some of the ophthalmologists felt we were not specific enough in excluding certain surgeries and that our bill was too broad."
The society amended the proposed bill to limit certain types of surgery, but not all types. For example, Dr. Rosenblatt said, the bill was amended to exclude laser surgery, but not all types of lasers.
And while ODs in other states enjoy a cooperative, comanagement situation with ophthalmology, optometrists in the District of Columbia really do not, Dr. Rosenblatt said.
"There is not a lot of comanagement between optometrists and ophthalmologists here," he said. "There's referral with return of patient, you hope, but ophthalmology outnumbers optometry."
There is no timetable as to when the regulatory committee may vote or act upon D.C.'s proposed TPA bill, and Dr. Rosenblatt noted, "It's a waiting game; we just have to be patient."
For Your Information:
- Michael Rosenblatt, OD, may be contacted at Klessman and Rosenblatt, OD, PC, 1800 K Street, NW, Suite 921, Washington, DC 20006, (202) 331-7566; fax: (202) 331-8533. The Optometric Society of the District of Columbia may be contacted through executive director Virginia Martin at (301) 229-4990.