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ODs should have license to treat by the most effective route
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It’s that time of year – flu season. Despite our best efforts, there is really no surefire way of avoiding complete contact with these nasty little bugs. The fact is influenza viruses are often robust, virulent and ubiquitous. You simply cannot avoid them. The good news is we can mitigate the risk of infection by staying healthy, practicing good hygiene and getting a flu shot.
While it is true the flu vaccine is not 100% effective, it does confer a reasonable level of immunity, is cost effective (covered by most insurers), readily available and quite accessible. In fact, every day Americans are vaccinated by physicians, nurse practitioners, physician assistants, RNs, LPNs and pharmacists. But, interestingly enough, they are not vaccinated by optometrists.
The debate involving optometry and injection privileges is both contentious and old. It is also somewhat illogical. As a profession, optometry has always “educated and legislated” to better serve its patients’ needs and, in the early days, this often meant sacrificing the right to administer injections in the spirit of obtaining therapeutic prescribing privileges. So, for decades, we have relied on topical and oral routes of administration in caring for our patients. While this has been effective over the years, newer treatment protocols (and drugs) occasionally call for other means of delivery, including injection. Whether one is anesthetizing an eyelid or infiltrating a chalazion, clinicians occasionally need to administer an injection to ensure the highest level of care. It is true in every aspect of health care, and optometry is no different.
As someone who always sees (and appreciates) both sides of any debate, I struggle to understand why anyone would oppose this privilege. Those who feel that putting a syringe in the hands of optometrists will result in a Botox (botulinum toxin type A, Allergan) and anti-VEGF injection spree are simply out of touch with reality. Such fear-mongering is unjustified.
Optometry has long distinguished itself as a profession erring on the side of conservative treatment and one in which each practitioner prescribes to the degree with which they are most comfortable. Certainly, in the dozen or so states where optometrists have therapeutic injection privileges, not every practitioner has elected to do such. Those who have, have done so judiciously, successfully and only when in the best interest of the patient.
One thing is certain. With our country’s aging population and implementation of the Affordable Care Act, optometry will inevitably play an increasingly critical role in delivering eye care. We have demonstrated our ability to provide a wide array of services across a diverse range of conditions. We have long exercised good judgment in selecting effective treatment strategies. It is only logical that we be given the poetic license to optimize these therapeutic endeavors – be it topically, orally or via injection. It simply makes sense … especially in the eyes of our patients.
Disclosures: DePaolis has no relevant financial disclosures.