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Oklahoma ODs clarify practice act to include the word ‘surgery’
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Optometrists in Oklahoma now have a clarified practice act that includes the word “surgery,” thereby re-establishing their ability to perform basic procedures such as punctal occlusion, epilation of lashes and foreign body removal.
HB 2321, which was signed by the governor on April 28, also authorizes the state Board of Examiners in Optometry to determine which surgical procedures optometrists can perform.
The legislation was initiated in response to a previous opinion by state Attorney General Drew Edmundson, according to David A. Cockrell, OD, FAAO, president of the state Board of Examiners in Optometry.
“The Oklahoma Academy of Ophthalmology had asked the attorney general whether our statute stated that we could do surgery and whether the Board of Examiners could authorize optometrists to do surgery,” Dr. Cockrell told Primary Care Optometry News. “The attorney general then issued an opinion saying we couldn’t, because the word ‘surgery’ was not in our statute.”
Dr. Cockrell said he met with Mr. Edmundson, explaining that many procedures ODs perform technically fall under surgical codes. “He pulled his opinion, but then reissued it, stating the same thing,” Dr. Cockrell said, “but adding that since there is no definition for ‘surgery’ in the Oklahoma statute, he couldn’t say what we could or could not do. That made his ruling extremely difficult to interpret and left the definition of what constituted surgery up to anyone’s opinion, including third-party payers.”
Mr. Edmundson’s office then, “recommended that we include the word ‘surgery’ in our statute so that we could continue to do the procedures we had already been doing,” Dr. Cockrell said. “That is an important point: our goal was not to expand our scope of practice, but just to maintain what we had for years.”
The statute already set educational and clinical requirements for laser surgery, but did not address other types of surgery. Dr. Cockrell said that many routine procedures ODs have been performing for years, such as epilation of lashes, punctal occlusion and foreign body removal, are classified as “surgery” in billing codes even though most people wouldn’t consider them surgery.
Dr. Cockrell said by the time the attorney general’s ruling came out, it was too late to introduce new legislation. Therefore, additional language was attached to an existing pharmaceutical bill that already dealt with optometry’s scope of practice. “Both of our authors said they would be happy to have that added to the bill,” he said.
The legislation then passed both the senate and the house with an overwhelming majority, Dr. Cockrell said. “Even the governor sent out a letter stating that he didn’t want the legislation to expand our practice scope, but that he didn’t want our scope to be restricted, either,” he said.
Dr. Cockrell also emphasized that the Board of Examiners in Optometry goes through a meticulous process in determining which surgical procedures optometrists will be permitted to perform. “The board promulgates a rule, which is given to the legislature, then to the governor,” he said.
Dr. Cockrell recognized that the legislative activity in Oklahoma may have prompted the American Academy of Ophthalmology’s decision to ban optometrists from their annual meeting. The AAO was concerned that HB 2321 was part of a trend in which participation in CE courses was being leveraged for optometric legislative gain, he said.
For Your Information:
- David A. Cockrell, OD, FAAO, can be reached at (405) 372-1715; fax: (405) 372-3350.