State delegates prepare for board certification vote at AOA Congress

Issue: June 2000

LAS VEGAS – As the 103^rd American Optometric Association (AOA) Congress nears, optometrists across the country eagerly await the outcome of the House of Delegates reaffirmation vote on the American Board of Optometric Practice (ABOP) board certification program.

On June 23 in Las Vegas, the ABOP Board of Trustees will present the complete program, after which the vote will take place. In preparation, state optometric associations have made efforts to inform their membership and gather feedback to help guide their delegates’ decisions.

Primary Care Optometry News spoke with leaders of two state associations that plan to vote differently. According to Marjorie Knotts, OD, president of the Indiana Optometric Association, her state’s House of Delegates unanimously approved a resolution to vote against the ABOP board certification program. Laurie L. Sorrenson, OD, immediate past president of the Texas Optometric Association, said her state’s House of Delegates unanimously approved a resolution to vote in favor of it.

Grass roots feedback

Dr. Knotts noted that it is important for the states to “reach out to their members to understand what they’re saying. The program needs to either be accepted or opposed by the grass roots members,” she said. “It’s important to the association to make sure that it’s well understood and people realize what the implications are.”

“The board certification process will help us within and outside our own profession to prove that we’re educated and knowledgeable,” said Dr. Sorrenson. “Every time our profession has changed there has always been controversy, and there have always been people who thought we were going in the wrong direction. Fortunately, the nay-sayers did not prevent our profession from moving forward.”

Dr. Sorrenson added that the board certification classes and tests will be markedly different from other existing continuing education courses. “The information will not based on the lecturer’s experience or on anecdotal information,” she said. “It must be based on fact and science. All information must be referenced.”

Part of evolution

“I think people are afraid of taking a test,” Dr. Sorrenson continued. “But optometrists have proven themselves over and over again with therapeutics, where we’ve been tested and have come out way ahead. Optometry has worked for 25 years to be in the mainstream of health care, and becoming board certified is just part of that process. Optometry needs to continue to evolve to be an integral part of the health care system. This is part of that evolution.”

Dr. Knotts said Indiana voted against the board certification program when the concept was presented at last year’s AOA Congress, “but we wanted to make sure we were in sync with what we thought our membership wanted,” she said.

So the local societies were asked to hold a special meeting dedicated to discussing board certification. “All 12 societies did that, and when they came to the state convention in April a resolution was presented asking us to vote against board certification,” Dr. Knotts said. “It was voted through our House of Delegates unanimously. We were surprised by the fervor of the opposition. The members don’t feel there needs to be a new certification process duplicating what our state board does, and there is no documented need for a new kind of certification that might lead to confusion among professionals, third-party payers and, most importantly, our patients.”

Managed care, hospital privileges

Dr. Sorrenson said that many ODs in Texas – including herself — have experienced problems getting on managed care panels. “I’m not on a single managed care panel,” she said. “I have been turned down over and over again.”

She believes achieving “board certification” status could help. “Third-party insurers fall into the medical model,” she said, “and we as optometrists have always tried to say we’re different. In reality, we need to recognize that there is a medical model, and we need to be a part of the system instead of standing outside of it and trying to prove to every insurer that we’re worthwhile.”

According to Dr. Knotts, there is an overwhelming consensus among Indiana ODs that board certification would not make a difference to managed care panels. “We felt it was more a matter of whether they felt optometry was a good match with their panel rather than the fact that we were not board certified,” she said. “Additionally, one of the major insurance companies in Indiana just informed us that board certification is not necessary for participation in any of their programs.”

Both states have task forces investigating hospital privileges for optometrists, and this situation appears to be different in the two states as well. “We have optometrists with hospital privileges in Texas,” said Dr. Sorrenson, “but it has not been an easy task for any of them to get it. Optometrists have had to almost work outside the system, really getting to know the hospital board members to be sure they understand what optometry can do.”

“We’ve had very few problems getting hospital privileges in Indiana,” said Dr. Knotts, “although there are not too many optometrists that have really found a need to be on hospital staffs in our state.”

Prescribing climate

Optometrists in both states have a broad range of prescribing privileges. According to Dr. Knotts, Indiana ODs can prescribe all topicals and most oral medications except for controlled substances. Dr. Sorrenson said that last year’s amplification to the Texas legislation added topical antivirals and glaucoma medications as well as most oral medications, including controlled substances.

Dissemination of information

Both Dr. Sorrenson and Dr. Knotts said optometrists in their states have received an abundant amount of information on the ABOP board certification program. In addition to published articles, members received information from ABOP and the AOA, and the state associations also compiled and disseminated their own packets of information to their members. Texas ODs also had the benefit of a personal presentation of the program by an ABOP Board of Trustees member at the state meeting in February. Indiana ODs heard a presentation from state task force members at the Indiana state meeting in April.

For Your Information:

Marjorie Knotts, OD, can be reached at 6326 Rucker Rd., Suite C, Indianapolis, IN 46220; (317) 259-4234; fax: (317) 259-1538.

Laurie L. Sorrenson, OD, can be reached at Lakeline Vision PC, 12233 620N, Suite 103, Austin, TX 78750, (512) 918-3937; (512) 918-3260.