Medical establishment opposed prescription rights ‘every step of way,’ optometrist recalls

By National Psychologist Editor
May 1, 1999



It took optometry 25 years to win prescription privileges in 50 states, even after optometrists had overwhelmingly agreed it was a good idea, says a Madison, Wis. optometrist who was involved in the state-by-state effort.

Victor Connors, O.D., said the first states to extend prescribing privileges to optometrists for therapeutic interventions were West Virginia and Rhode Island in 1972. Most recently, Oklahoma even extended optometrists’ scope of practice to include minor surgery involving laser technology. That’s a long way to have come for a profession once thought able at best to administer eye examinations and sell glasses.

“And we were opposed every step of the way by the medical establishment,” Connors adds.

For years, the conflict between optometry and ophthalmology was not unlike that experienced by psychology and psychiatry. Psychologists in several states have been unsuccessful in their legislative efforts to gain prescribing privileges. Opposition not only from psychiatry, but from within its own ranks has stymied any serious effort to extend the right to prescribe drugs to psychologists.

Only in Guam have psychologists been granted the right to prescribe drugs, but it’s not at all clear if the experience on the small Pacific territory can be duplicated in the United States.

Connors sees parallels between optometry’s struggle and the uphill battle psychology faces to gain prescribing privileges.

“One of our early realizations when we started was that not all optometrists agreed this was a good idea,” Connors said. “Some had no interest in gaining prescribing privileges, content to continue their practices as they always had.”

However, there doesn’t appear to have been unrelenting opposition from within optometrists’ ranks as there is in psychology, where a small, but articulate and vocal handful of academics have convinced state legislatures that granting prescribing privileges to psychologists is a bad idea.

What psychology does share with optometry, however, is the uncompromising opposition from the medical establishments, foremost the American Psychiatric Association and, secondarily, the American Medical Assn.

“There is no more reason psychologists should be denied the right to prescribe than there was reason to continue to deny this right to optometrists,” Connors said.

“It is still a political battle. The medical establishment refuses to look at the merits of the case. Instead, they exert political pressure. It’s all about politics and turf. It has nothing to do with the quality of care patients receive.”

Connors said quality of care is assured since all states have competency tests that optometrists have to pass to ensure they are thoroughly trained to use drugs for diagnostic as well as therapeutic purposes.

He said universities offer transcript-quality education that insures optometrist receive the appropriate training in the administration of drugs.

Optometrists number just over 40,000 in the United States. Optometry school requires four years.

Connors noted that the quality of care issue is particularly important to residents living in rural areas where access to an ophthalmologists would probably be limited.

“Rural residents need assurance that the care they are receiving is of the highest quality. That’s the purpose of the competency examinations required of optometrists, he said.

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