Florida Senator Wants to Allow Non-Doctors to Perform Eye Surgery

A lot of skills can be learned over a long weekend in a Holiday Inn ballroom. Meditation techniques. Speed reading. The basics of budgeting.

But a new bill moving through the Florida Legislature wants to add something a bit more technical to the list: eye surgery.

If you're a Floridian with eyeballs, you should probably pay attention to this one. State Sen. Jack Latvala, a Clearwater Republican, has introduced a bill that would allow non-doctors to perform eye surgery after sitting through a 30-hour training course. The companion bill, from Rep. Manny Diaz of Hialeah, passed the House Health Quality Subcommittee by a narrow 8-7 vote earlier this month.

First, a basic primer on eye docs: Not all of them are actually medical doctors. Optometrists, who go to a special four-year optometry school, are the folks at a place like Target who fit you with glasses, prescribe contact lenses, and diagnose and treat some eye problems. Ophthalmologists, on the other hand, are specialists who have graduated from medical school and are licensed to perform surgery. Currently, if you're looking to have laser eye surgery or something of the sorts, ophthalmologists are the only people legally qualified to perform the procedure in Florida.

Proponents of the new bill say extending the scope of what an optometrist can do would give rural residents greater access to eye procedures. But doctors who oppose the bill say that there's no such shortage of docs and that the crisis is manufactured by lobbyists pushing the bill.

"To say that we don’t have access, so we need optometrists to perform these procedure, is like saying we don’t have enough airline pilots, so we need the flight attendants to fly the plane," Dr. Jason Goldman, governor of the Florida Medical Association, told the House subcommittee last week.

To illustrate how out-of-whack the idea of a 30-hour surgical training session is, consider that most ophthalmologists have tens of thousands of hours of training before they practice on their own. Dr. Adam Katz, president of the Florida Society of Ophthalmology and a retina specialist in Vero Beach, says he slugged his way through 11 years of postundergraduate studies, including four years of medical school, one year at an internal medicine internship, three years of an ophthalmology residency, one year of a medical retina fellowship, and two years of a surgical retina fellowship.

"Several of the optometry schools don't even require that you graduate from college," Katz says. "People like to make this like a turf battle between optometrists and ophthalmologists, but they're not even on the same playing field."

Most states don't allow optometrists to perform eye surgery. In Oklahoma, where it is permitted, a study found that those who went to an optometrist instead of an ophthalmologist had far more likelihood of needing to go back for a second procedure. On the West Coast, eight military veterans at a Northern California VA were blinded by optometrists practicing beyond their scope.

Though it seems like most patients would choose a medical doctor when looking for someone to cut into their eyeballs, Katz says optometrists often advertise as "optometric physicians," which he believes is purposefully misleading.

"It's nothing more than taking advantage of people's ignorance," he says.

Nevertheless, optometrists have been heavily lobbying for the passage of the bills in Florida. Groups such as the Florida Optometric Association have already given at least $2.1 million in political contributions to make the idea a reality. It's worth noting that Michael Corcoran, one of a dozen lobbyists paid to advance the bills, is the brother of House Speaker Richard Corcoran, a relationship he apparently has no shame in advertising on his firm's website.

Katz stresses that most optometrists are good, hardworking professionals who do an excellent job for the vast majority of patients they see. But he says eye surgery is far too risky to be performed by people with just a few hours of study under their belts.

"We respect optometrists, but it would be unethical for me to watch this take place and not get involved," he says. "We're taught 'First, do no harm,' and to let someone with a 30-hour course do what I do is really dangerous."