JOURNAL OF THE LOUISIANA STATE MEDICAL SOCIETY
Table 2
The smallest distance in each state to each isolated optometry office was taken as the closest ophthalmology office. An average of these distances by state was calculated as the average distance in that state to isolated optometry offices. These results are shown in Table 3.
UNIQUE ZIP CODES
ISOLATED OPTOMETRY OFFICES 24
STATE
AK
275 709 838 567 2653 662
AL AR AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MI
108 157 162 789 153 124
RESULTS
The Physician Compare National Downloadable file for June 26, 2014 contained 1,986,848 records, representing all the offices of all Medicare providers in the US and its territories. The zip code database contained latitude and longitude information for 41,891 active and 634 recently decommissioned zip codes. Table 1 shows that there were 18,444 ophthalmologists in the US with 36,136 offices, while there were 29,676 optometrists with 45,560 offices. For the entire US there were 62% as many ophthalmologists as optometrists, but 79% as many offices. There were state-by-state variations. Table 2 shows that, out of 41,865 US zip codes, 9052 had isolated optometry offices that did not contain an ophthalmology office. Table 3 shows the average distance between zip codes in each state for isolated optometry offices and the nearest ophthalmology office; these distances ranged from a low of 0 for Guam, the Virgin Islands, the Northern Mariana Islands, and the District of Columbia, to highs of 56.5 miles for Alaska, 53.0 miles for North Dakota, 45.3 miles for Montana, and 43.6 miles for Wyoming. The average distance for the entire US was 14.5 miles. In Louisiana there were 270 ophthalmologists with 634 offices. There were 250 optometrists with 364 offices. These results mean that ophthalmologists actually outnumber optometrists by 8% and have 74% more offices than do optometrists. There were 725 unique zip codes in Louisiana, with 102 of them having an “isolated optometry office,” an optometry office without an ophthalmology office in that zip code. Nevertheless, the average distance from these isolated optometry offices to the nearest ophthalmology office was only 13.1 miles.
438 290 98
11 24
1490 13 973 139 1063 325 1588 987 756
476 228 1 34 161 62 358 206 139 138 239 102 119 67 285 212 180 1 100 47 280 41 88 51 295
962 703 725 622
488 1170 1031 1171 3
MN MO MP MS STATE
DISCUSSION
533 UNIQUE ZIP COES
ISOLATED OPTOMETRY OFFICES
Patient safety is a concept that constantly is reinforced to physicians, as they hold hospital privileges and must adhere to strict credentialing guidelines and peer review. Optometrists, on the other hand, do not hold hospital privileges and are not subject to the same peer scrutiny. In their zeal to be independent of ophthalmological oversight, their actions violate principles of patient safety because optometrists do not have the necessary training to properly treat serious eye conditions in patients. This assertion can be seen in the injuries caused at one Veterans Affairs hospital. 11 Organized optometry has contrived to get surgical laws passed in three states (Oklahoma, Kentucky, and Louisiana) by using the argument that optometrists are more numerous and more
ND NE NH NJ NM NV NY OH OK MT NC
1090 405
407 620 284 731 426 254
55 62
2208 1447 776
481 374 158
152 J La State Med Soc VOL 169 NOVEMBER/DECEMBER 2017
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