I am writing this letter in response to the Feb. 27 article entitled, “Clear-eyed look at law-making,” written by Al Cross. In the article, Cross points out how Senate Bill 110 flew through our state legislature and was signed into law by Gov. Beshear. This law allows optometrists in this state to perform laser eye surgery and multiple other procedures in and around the eye, which they have not been allowed to do in the past. The bill was signed into law a mere 16 days after it came out of a friendly Senate committee — Licensing, not Health. This was clearly a committee that should have never handled this bill.
There was little that we as ophthalmologists could do to derail this runaway freight train of a bill. I personally made multiple phone calls and sent multiple e-mails as did my office staff and even patients that brought the issue up with me, urging our legislators not to vote for this bill. All of this was to no avail. Even if we had known that this bill was going to be brought up in this session, I do not think that we could have overcome the vast amount of money and lobbying efforts that the optometrists put forth.
But that by no means makes this bill (and now law) beneficial to the citizens of this state. I spent six years training beyond medical school; a one-year internship, a two-year research fellowship and a three-year residency. This is six more years of training than any optometrist in this state.
During my year of internship in internal medicine, I averaged 80 hours of work a week taking care of patients with multiple and complex medical problems. The three years of residency required that I perform multiple procedures under the supervision of fellowship-trained ophthalmologists who performed literally thousands of these procedures themselves.
For our legislature to pass this bill and allow optometrists to perform procedures that they do not have the knowledge or experience to perform is a travesty. One of my patients is a state legislator who voted for this bill despite my phone calls asking him not to. I know that he has received money from optometrists, and I also know that there are two optometrist offices within a half-mile of my office. I plan on asking him the next time I see him why he chose to be seen by an ophthalmologist while at the same time voting to allow optometrists to perform procedures that they should not be performing.
The bill allows optometrists to perform procedures that I would not even attempt, such as injecting medication into the eye to treat wet age-related macular degeneration. If I see this condition, I refer patients to a fellowship-trained retinal specialist, which is a specialty requiring a minimum of two years additional training beyond ophthalmology residency. Why do I refer these patients? Because, if I performed this procedure, I am not trained to deal with the complications that could occur, such as infections within the eye and retinal detachments.
In closing, I want to express my extreme disappointment with our state legislature and governor for passing a bill that will lower the standard of eye care in this state. This law will not save money for the state Medicaid fund, it will not improve access to eye care (almost all patients in this state are within 30 minutes of an ophthalmologist), and it will certainly not improve the quality of eye care.
My only wish is that the legislators who voted for this bill will realize the consequences of their vote and rescind it before we begin to see the inevitable consequences of eye procedures performed by unqualified optometrists. If they do not, I hope that they lose their seat in the next election.
I applaud Cross for pointing out how our legislators are very often influenced more by campaign contributions than the facts of a bill.
FRANK R. BURNS, M.D.
Louisville 40207
