Optometry in Puerto Rico: The Desire for Equality

As a collective group of students, we are motivated and excited about our future careers as ODs, and with great reason! The profession of Optometry grows in scope almost daily and our relationship in the United States with Ophthalmologists is harmonious. The dedicated ODs before us triumphed in their pursuits locally and Federally to give us the opportunity to practice our craft without much limitation. We are joining a workforce of distinguished and accomplished professionals who have set a precedent and have paved the road to our success. However, have you ever considered what it would be like if your chosen profession and passion weren’t so accessible? What if your relationship with Ophthalmology were chaotic and disruptive, as to where you were considered inferior? How would you feel if you were limited to refractions and could barely pay your student loans to the government that invested in your education? Lastly, imagine having to take NBEO parts 1, 2 and 3 without the permission to prescribe therapeutics and having restrictive use of diagnostic pharmaceutical agents. Ladies, gentlemen, and future ODs, whether you can or cannot imagine such a scenario, I regretfully welcome you to Optometry in Puerto Rico.

A sad fate indeed suffers our profession on the Island of Enchantment; as a matter of fact, there is nothing “enchanting” about Optometry’s scope of practice in Puerto Rico. One could comfortably assume that since it is a US Commonwealth, our influence would have “trickled down” so to speak, especially since the only Optometry school in the Caribbean has its home here. So, why are Puerto Rican ODs so limited in practice and why has this not changed? I asked the same questions two years ago when I began my education at IAUPR’s School of Optometry, and as of recently those questions were answered.

FACT: The US Commonwealth of Puerto Rico is the only location in the Caribbean and US Territories where Optometrists are not permitted use of TPA’s.

FACT: The US Armed Forces has recently enacted a law that only permits ODs with therapeutic licenses to practice in their VA hospitals. Thus, ODs with a license from Puerto Rico are ineligible to serve their country as clinicians.

FACT: The Commonwealth of Puerto Rico has over 4.5 million residents, including approximately 120 Ophthalmologists and 475 Optometrists. Patients report an average waiting time of 3 months for a visit with an OMD to treat conditions such as Glaucoma.

FACT: Ophthalmologists in Puerto Rico do not accept government funded insurance and economically disadvantaged citizens are underserved for eye care. Optometrists in Puerto Rico accept these insurance policies.

FACT: ODs in Puerto Rico have introduced a bill for TPA privileges 7 times in the last 15 years. All of the attempts have been unsuccessful.

FACT: Ophthalmologists in Puerto Rico have publicly announced (recently) that Optometrists are “…technicians, who if permitted to prescribe any type of therapeutic will kill patients due to their lack of knowledge of systemic and ocular pharmacology…”

FACT: In order to practice Optometry in Puerto Rico, candidates must pass all 3 NBEO examinations and write a law exam in Spanish.

On June 18th, 22nd, 23rd and 25th, students from IAUPR’s School of Optometry and ODs from the Colegio Optómetras de Puerto Rico protested in front of the Capitol Building in San Juan, exercising their right to assemble and petition their government. It was the 7th time that a bill for TPA’s had been introduced and it was scheduled for presentation on the Senate floor at 2:00 PM on June 25th, 2012. All preliminary meetings about the bill (P.S. 2634) were positive and ODs on the island were hopeful. The Democratic process was halted however, when the Senate President (Thomas Rivera Schatz) decided the bill should not be heard and the chamber was thus unable to vote. Disappointed indeed were the ODs in Puerto Rico, as they had labored diligently for 6 months to educate the public, campaign, gain press, and speak to Senators about their plight.

What’s next for Optometry in Puerto Rico? A new campaign has begun and with that, a new sense of unity amongst ODs on the island. There are plans to propose a new project in January, after the elections for their new Senate and House of Representatives. And so the fight will continue, as nobly as ever, to give ODs in Puerto Rico equality with their colleagues on the mainland. A victory in favor of TPA’s is not only a victory for the ODs practicing in Puerto Rico, but for their patients, the citizens of the Commonwealth, and the profession of Optometry.

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