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VA rules that only MDs may perform therapeutic laser procedures
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The Veterans Health Administration proclaimed in late December that “only ophthalmologists will be privileged to perform therapeutic laser eye procedures in Department of Veterans Affairs medical facilities,” nullifying a previous ruling in favor of optometry.
In August 2004, the VA had stated optometrists with appropriate training and licensure could perform therapeutic laser eye procedures under the supervision of an ophthalmologist. This directive, VHA-2004-045, has been rescinded. The new decision, VHA Directive 2004-070, specifies that “therapeutic laser eye procedures only be performed by ophthalmologists with the requisite training and expertise.”
Oklahoma is the only state that licenses optometrists to perform laser surgery.
The optometric community is unhappy with the VA’s decision.
"We are deeply disappointed in the VA's decision to restrict optometrists' laser privileges in the VA system, said Wesley E. Pittman, OD, president of the American Optometric Association, in a prepared statement.” This troubling action is unprecedented, and not based on any evidence of quality of care concerns. In fact, the VA's medical inspector reviewed the cases of laser therapy performed by VA optometrists and found the outcomes met VA standards of care.”
Dr. Pittman further suggested that quality of care is not necessarily the real issue. “Instead, it is about ophthalmology and organized medicine's desire to control optometry and prevent expansion in our professional responsibilities,” he said. “It is regrettable the department caved in to those self-serving motives.”
The American Academy of Ophthalmology (AAO) has credited a group called the Veterans Eye Treatment Safety (VETS) coalition with the eventual rescinding of the VA’s August directive. Members of the VETS Coalition sought to pass a bill introduced in the Senate banning optometrists from performing surgery that was similar in scope to a bill introduced in the House.
“It was the strong collaboration of this VETS Coalition as well as support by them, ophthalmic specialty and state societies and American Academy of Ophthalmology members” that forced the VA to rescind its earlier directives, H. Dunbar Hoskins, MD, executive vice president of AAO, said in an interview with PRIMARY CARE OPTOMETRY NEWS sister publication, OCULAR SURGERY NEWS.