295 55 62 481 374 158 123 454
NJ NM NV NY OH OK OR
731 426 254
JOURNAL OF THE LOUISIANA STATE MEDICAL SOCIETY
Oklahoma, 18.3miles; for Kentucky, 12.7miles; and for Louisiana, 13.1 miles. Thus, the author asserts that organized optometry has been misleading and deceitful in claiming as a factor for surgical privileges that referral to ophthalmologists decreased patient safety because of the need to travel greater distances to ophthalmologists. Most ironically, Louisiana actually has more ophthalmologists than optometrists. Drawbacks to this study include the use of the Medicare database itself; after all, many optometrists work at facilities like Wal-Mart, where they may not bill Medicare. However, it is those optometrists who bill Medicare who want surgical privileges in the first place. Other drawbacks include distance measurements being calculated between zip codes and not between specific addresses. This latter procedure is called geocoding and is beyond the scope of this communication; the use of measurements between zip codes is adequate for this analysis.
2208 1447
776 486
PA PR RI SC SD TN TX UT VA
2213 176 91
56 36
539 394
129 40 194 578 76 209 2 29 212
796 2655 347 1241
CONCLUSIONS
VI VT WA
16 309 733 898
It is true that there aremore optometrists than ophthalmologists in the US, but it is not true in Louisiana. Also it is untrue that patients are endangered by having to travel too far to see an ophthalmologist upon referral by an optometrist. Organized optometry so far has been able tomislead three state legislatures into granting them surgical privileges for which they will receive almost no training. Any untrained surgeon represents a danger to patient safety. 12-14 The author hopes that data in this communication can be used to improve patient safety.
212 76 34 9052
WI
WV WY TOTAL
856 195 41865
Table 2. Isolated Optometry Offices by State
Table 3
rural than ophthalmologists, thus requiring surgical privileges to treat patients who, upon referral, would have to travel great distances toophthalmologists. Thesegreat distances supposedly endanger patient safety, according to optometry apologists. This communication shows the opposite, especially in Louisiana, where a patient at an isolated optometry office need travel only 13.1 miles to see an ophthalmologist. In the entire US, while there are marginally more optometrists and optometry offices than ophthalmologists and ophthalmology offices, the distribution of both providers is such that a patient also does not have to travel that far to obtain ophthalmology services. It is true that there are variations by state, but the argument that optometric surgical privileges are necessary due to geographical remoteness of ophthalmologists is spurious and has been used in a deceptive fashion to fool both the public in general and legislative bodies in particular. In fact, this is the same argument that was made during optometric lobbying in previous years for prescriptive drug privileges. 9 When examining Table 3 as to the three states currently allowing optometric surgery, the average distance between the nearest ophthalmology office to isolated optometry offices is for
AVERAGE DISTANCE (MILES)
STATE
AK
56.5 17.5 13.4 14.8 6.2 14.1
AL AR AZ CA CO CT DC DE FL GA GU
3.9 4.4 0.0 5.4
0.0 10.0 12.1 17.5 25.9
HI IA ID
J La State Med Soc VOL 169 NOVEMBER/DECEMBER 2017 153
IL
8.7
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