When I began looking into optometry school I kept hearing this phrase that made me a little uneasy…”optometry is a legislated profession.” At the time I didn’t really give it too much thought because, well, I was more worried about getting into school than what I’d be able to do after I graduated. Now that I’m in school, I am beginning to truly understand what being in a “legislated profession” means and I take these words more seriously than ever. Simply put, as a legislated profession each service we can provide has to be legally given to us and can be likewise taken away from us. This is why it is so important to be active in preserving and growing the list of services we can provide. Even as a student, I’ve had the opportunity to meet with practicing optometrists from across the country and I’ve had the privilege to travel to Washington D.C. to speak directly to national lawmakers about optometry’s rights.
On a national level the profession is represented by the AOA-Political Action Committee (PAC). The AOA-PAC is constantly working to ensure that all the money and effort we put into our education isn’t wasted, and that we will have the chance to achieve our promised quality of life. On a state by state basis, optometry continues to work to remove the limitations imposed by lawmakers with better results in some states than others. This is where students and future students need to pay attention. Certain services may be outside your legal scope of practice when you graduate even though you may be able to do them at school or during a VA rotation. If you’re thinking of practicing in Massachusetts when you graduate, there are some things you may want to consider.
Currently in Massachusetts, optometrists CAN:
- Prescribe topical therapeutic pharmaceutical agents (TPAs)
- Order X-Rays and lab tests
- Performing superficial foreign body removal
- Manage visual issues by providing glasses, contact lenses, vision therapy and rehabilitation, and low vision services. In fact, these services fall under the scope of most optometrists regardless of the state in which they practice.
However, O.D.s in Massachusetts are required to co-manage patients under certain circumstances, and CANNOT:
- Perform laser assisted surgeries (currently only three states allow optometrists to do so).
- Provide injections of any kind, even to counteract anaphylaxis (though again, several states prohibit this currently).
- Prescribe oral steroids. While the majority of states currently allow optometrists to prescribe oral steroids, Massachusetts is one of several states that do not.
- Prescribe oral medications. Massachusetts and New York are the only two states in which optometrists cannot prescribe oral medications to treat any condition.
- Treat glaucoma either by oral or topical medications. Massachusetts is the only state in
the country where optometrists are unable to treat glaucoma despite decades of
safe treatment by optometrists in other states.
So, if you’re thinking of practicing in Massachusetts, you shouldn’t be discouraged as there are plenty of amazing ways in which you will be able to help your future patients and chances to earn the life you want. Really, there are only 5 areas where you will have to co-manage your patients (glaucoma, oral medications, steroids (oral), injections, and laser therapies), but these may change with time. Nonetheless, if you choose to practice in Massachusetts you should start getting involved in the AOSA, AOA, Massachusetts Society of Optometrists and in the current efforts to improve the scope of practice. If you choose not to practice in Massachusetts, I still encourage you to get involved in the AOSA, AOA, and your state association by reaching out to your AOSA trustee/elect or through the AOA COMPASS website. Optometry needs you to continue to remind lawmakers locally and nationally of our knowledge and expertise in treating medical conditions in and around the eye.
The exact wording of the law is available from mass.gov and the Massachusetts Optometric Political Action Committee (MOPAC), and click here to read two important bills that seek to expand Optometry’s scope in Massachusetts.
Consider attending AOA-PAC’s Congressional Advocacy Conference in April to have the opportunity to speak with legislators on Capitol Hill and advocate for your profession. Check out other articles in our optometry legislative series here!