If you have a moment, Alaska\u2019s eye surgeons would like your ears.<\/p>\n
On public radio and KINY-AM, they\u2019re advertising their message. Part of it goes like this: \u201cIt is important to learn the difference between ophthalmologists and optometrists.\u201d<\/p>\n
That innocent message \u2014 you\u2019ve probably heard it several times without remembering \u2014 is the latest psalm in what some lawmakers in the Alaska Legislature call the \u201ceye wars,\u201d a decades-old rhetorical and political battle.<\/p>\n
\u201cIt\u2019s been going on for a long time,\u201d said Sen. Cathy Giessel, R-Anchorage and sponsor of Senate Bill 36, which would close the lid on the eye wars by giving more authority to the state board of optometry.<\/p>\n
A partner bill, House Bill 103, is advancing in the House with the support of Rep. Ivy Spohnholz, D-Anchorage.<\/p>\n
The two bills directly affect only the state\u2019s 150 or so optometrists and its handful of ophthalmologists, but indirectly, they will touch any Alaskan who wears eyeglasses or suffers an eye injury.<\/p>\n
The key question in the \u201ceye wars\u201d is where the boundary lies between ophthalmology and optometry, and whether \u2014 through changes in technology and improvements in medicine \u2014 that line can change.<\/p>\n
To start, think back to the radio ad. You\u2019ve probably seen an optometrist at least once in your life \u2014 it\u2019s the person who checks your eyes and prescribes your glasses.<\/p>\n
Unless you\u2019ve had an eye injury, you\u2019ve probably never seen an ophthalmologist, a medical doctor who works as an eye surgeon.<\/p>\n
\u201cI\u2019m a medical doctor, the same as a pediatrician and the same as a neurosurgeon,\u201d said Dr. David Zumbro, an ophthalmologist in Anchorage.<\/p>\n
Most optometrists also go through years of training and education, but they typically aren\u2019t medical doctors.<\/p>\n
HB 103 and SB 36 would allow the board of optometry to define the menu of services an optometrist can provide. The state already allows its dental and medical boards to take similar action, but optometrists must have the Legislature approve any changes.<\/p>\n
Zumbro and other ophthalmologists say HB 103 and SB 36 are dangerous because the board could allow optometrists to do things currently done only by them.<\/p>\n
\u201cThis issue is about patient safety. I don\u2019t look at this as a turf war. I am concerned about potential harm if a profession which is not a surgical occupation is granted the authority and latitude to decide what surgical procedures they can do,\u201d he said by email.<\/p>\n
Mike Bennett is an optometrist in Juneau and the former president of the Alaska Optometric Association.<\/p>\n
\u201cYou kind of have to take the predictions of terrible things happening with a grain of salt,\u201d he said.<\/p>\n
Bennett said dentists haven\u2019t caused problems because they\u2019re regulated by the board of dentistry, and similar concerns were raised when the state changed the regulation process for nurse practitioners.<\/p>\n
\u201cI just renewed my malpractice insurance yesterday, and I\u2019m paying $418 for this year. I think that speaks volumes for us being cautious and conservative,\u201d he said.<\/p>\n
Spohnholz said she wouldn\u2019t be supporting the bill if she did not think it could be done safely.<\/p>\n
\u201cWhat this does is get the Legislature out of the business of regulating by law something that can be done by a board,\u201d she said.<\/p>\n
Disagreements between family members can be some of the most unpleasant fights around, and the eye wars are no different.<\/p>\n
Last year, when a bill similar to HB 103 failed to pass on the last day of the regular session, the radio ads were a great deal harsher. \u201cIf optometrists want to be eye surgeons, send them to medical school \u2014 not the Legislature,\u201d one proclaimed.<\/p>\n
In Alaska, optometrists refer cases to ophthalmologists, and ophthalmologists in turn refer cases back to optometrists for follow-up care.<\/p>\n
\u201cI absolutely hate having to talk to you about this issue. I don\u2019t want to do this because it does create acrimony,\u201d Zumbro said.<\/p>\n
Jill Matheson is an optometrist in Juneau.<\/p>\n
\u201cWe refer back and forth all the time. It\u2019s very cordial and respectful, but we differ on the trust level of the optometry board. I guess that\u2019s what it comes down to,\u201d she said.<\/p>\n
One compromise suggested by the ophthalmologists would be to write a definition of eye surgery and exclude specific procedures from the optometrists. Washington state took that approach in its legislation.<\/p>\n
Matheson said optometrists might have a problem with that. If the goal is to leave things up to the board, and technology is improving all the time, it makes sense to leave things open-ended.<\/p>\n
\u201cI\u2019m hesitant to define surgery at this point in time, knowing that definition may change,\u201d she said.<\/p>\n
Jeremiah Myers has been an optometrist in Kodiak for 30 years, delivering eye exams throughout the Kodiak archipelago and as far west as Dutch Harbor.<\/p>\n
He was raised in Wrangell, but as he said by phone, \u201cyou never go back to be a doctor where you sold newspapers in the bar.\u201d<\/p>\n
Myers said he\u2019s seen huge changes in his profession.<\/p>\n
\u201cWe have increased our capabilities as time and the science of the profession has improved,\u201d he said.<\/p>\n
Those changes have meant that while he still sends patients to specialists, he can help more people than he did before. He sees no reason why a laser tool that costs $500,000 today might one day be the equivalent of \u201ca portable radio or something.\u201d<\/p>\n
\u201cThe road ahead, with technology, should be under the control of our board,\u201d he said.<\/p>\n
Where does that leave the ophthalmologists?<\/p>\n
\u201cWe\u2019re not shuffling against them. We just want to control our own quality,\u201d he said. \u201cWe\u2019re brothers.\u201d<\/p>\n
<\/p>\n
<\/p>\n
\u2022 Contact reporter James Brooks at james.k.brooks@juneauempire.com or call 419-7732.<\/b><\/p>\n
<\/p>\n
<\/p>\n","protected":false},"excerpt":{"rendered":"
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