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Friday, September 29, 2023
Sept. 29, 2023

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Local View: Improve patient care by expanding optometric services


This legislative session, lawmakers have an opportunity to improve patient access to eye care without increasing costs. In fact, if passed, care will likely become more cost-effective.

The solution lies in legislation to update the state’s scope of practice for optometrists, well-trained medical professionals who serve as primary eye care providers in Clark County and statewide.

Unfortunately, Washington’s restrictive scope-of-practice laws haven’t been updated since 2003 — before the first iPhone was introduced. To remain competitive — and serve our patients best — we optometrists ought to be providing the best care possible using the best available technology and practicing to the full extent of our education and training.

Under SB 5542, optometrists would be allowed to perform a large array of minor procedures, provide injections around the eye and prescribe certain oral medications.

Despite being trained to perform these procedures and prescribe these medications, optometrists in Washington are not allowed to do so under state law. This is particularly frustrating for someone like me, who is licensed in both Oregon and Washington – and practices in a border community like Vancouver.

Recently I saw a patient with a lump on his eyelid. We treated him to the best of our ability but ultimately, he needed minor surgery to correct the problem. In Washington, I am unable to help him with that, so I had to refer him to a specialist. He was very upset because he felt he wasted his time, only to be referred to another doctor and forced to pay another co-pay.

These scenarios play out every day in clinics all across Washington, putting patient health at risk with delays in care and driving up costs for patients who need help now.

Scope of practice

Updating Washington’s scope-of-practice laws would bring them into closer alignment with laws in other states, which have seen no increase in adverse patient outcomes from scope expansion. It feels odd that I can cross the river into Oregon and perform many of the procedures I cannot do here. We have the training and knowledge; now we just want to use it to help our community.

When optometrists are forced to refer patients to other providers for procedures they are trained to safely provide, it does not serve the patient well. Many times, care is delayed while waiting for another appointment.

Additionally, the patient may have to travel long distances and miss more work to see a new provider. In my practice, many patients are uncomfortable making the drive into a larger city that they are unfamiliar with, like Portland, to see another doctor they are unfamiliar with.

Because of the inconvenience or expense, patients may fail to follow through on the referral to a new provider. Patients who do choose to pursue additional care may also incur multiple co-pay expenses or incur expenses for multiple diagnostic tests. And the patients who can least afford additional co-pays, facility fees or travel costs may also suffer the most by delaying treatment. In eye care, some untreated conditions can lead to total loss of vision, a life-altering consequence.

This legislative session, optometrists will be asking the Legislature to consider SB 5542, updating our scope of practice and bringing us on par with other states in the Northwest. The Department of Health has already conducted an extensive review of this proposal and concluded that additional procedures can be safely added to optometry’s scope of practice.

Washingtonians deserve the highest quality eye care available. SB 5542 will ensure that patients in every corner of the state have access to that care in a safe, timely and professional manner.

Dr. Judy Chan is a Vancouver optometrist and is past president of the Optometric Physicians of Washington.