Legislature(2017 - 2018)BARNES 124
03/27/2017 03:15 PM House LABOR & COMMERCE
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| Audio | Topic |
|---|---|
| Start | |
| Confirmation Hearings | |
| HB170 | |
| HB103 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
| + | HB 103 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| += | HB 170 | TELECONFERENCED | |
HB 103-OPTOMETRY & OPTOMETRISTS
[Contains mention of SB 36]
3:56:34 PM
CHAIR KITO announced that the final order of business would be
HOUSE BILL NO. 103, "An Act relating to the practice of
optometry." [Before the committee was CSHB 103(HSS).]
3:57:01 PM
REPRESENTATIVE IVY SPOHNHOLZ, Alaska State Legislature, as prime
sponsor, presented HB 103. She explained that the proposed bill
would give authority to the Board of Examiners in Optometry to
regulate the practice of optometry; it would ensure that the
board has the opportunity to update current, continuing
education which is more expansive than those in policy, the
scope of best practices, and would allow the board to use the
regulatory process to manage itself. Representative Spohnholz
would allow a transparent regulatory process ensuring the
vetting of any new board regulations with public and the
Department of Law. The proposed bill would not allow
optometrists to provide services outside of their scope of
practice. Representative Spohnholz stated, "My hope is this
will get the legislature out of the business of managing
optometry."
3:58:39 PM
BERNICE NISBETT, Staff, Representative Ivy Spohnholz, Alaska
State Legislature, presented a sectional analysis for CSHB
103(HSS), on behalf of Representative Spohnholz, prime sponsor.
She drew attention to the beginning of the sectional analysis,
which read as follows [original punctuation provided, with some
formatting changes]:
Section one AS.08.72.050 (4)(6) updates very old
statutes to indicate that regulations shall be adopted
to govern the current prescription and use of
Pharmaceutical agents; and develop uniform standards
for the practice of optometry.
MS. NISBETT added that the most significant change in Section 1
is that the language regarding ophthalmic surgery and non-
invasive procedures has been removed [from the original bill
version]. She continued to Section 2, described in the
sectional analysis, as follows [original punctuation provided,
with some formatting changes]:
Section two AS.08.72.060 (c)(4) the board shall
publish advisory opinions regarding standards for the
practice of optometry.
MS. NISBETT included that the sponsor of the bill would like to
add an amendment to tighten up the language and would introduce
the amendment at a later date. She pointed to page 1, line 13,
and explained that "sec.11, ch.25, SLA" refers to the Medicaid
Reform Bill that was passed in 2016. She noted that "AS
17.30.200(o)" also refers to the Medicaid Reform Bill.
MS. NISBETT highlighted the remaining portion of the sectional
analysis, which read as follows [original punctuation provided,
with some formatting changes]:
Section three AS 08.72.181(d) moves the continuing
education (CE) requirements back into regulation, as
desired by the Department of Commerce, Community &
Economic Development. Continuing education is still
required by current statute, but the hours and
subjects will be determined by the board.
Section four AS 08.72.272(a) clarifies the current
statute for the board to regulate pharmaceutical agent
prescription including standards and limitations on
practice determined by the board.
Section five AS 08.72.278 Limitation on practice adds
a new section that sets limitations on services,
ensuring that the board may not authorize any
procedure beyond the scope of the licensee's education
and experience.
Section six AS 08.72.300(3) updates the optometry
definition to reflect current practice.
Section seven Effective date for Section 2. This is
because (3) of Section two was added to statute in
2016 via Senate Bill 74, the Medicaid Reform bill, and
it had the effective date of July 2017, so (4) is
written to comply with that date as well. (per
Legislative Drafting)
4:01:58 PM
REPRESENTATIVE WOOL requested the information on the omitted
procedures in Section 1.
MS. NISBETT stated that the language in the original bill
version that was removed under the CS pertained to ophthalmic
surgery.
4:02:44 PM
REPRESENTATIVE SPOHNHOLZ emphasized that to define ophthalmic
surgery in a way that made a clear statute is challenging; this
resulted in the language being taken out in the bill. She said
that the word "surgery" has a very specific meaning to the
average person but is a broadly used term in the medical field.
She shared that she had had a small foreign body removed from
her left eye and how that meets the definition of ophthalmic
surgery. She said she doesn't want to "split hairs" in the
statute but instead leave the authority to the board to develop
uniform standards of practice for optometry. Representative
Spohnholz stated this won't give the board the authority to
allow for surgeries that are outside of [a licensee's] scope of
practice. She stated that [the board] needs to find language
that will be relevant after a few years. She gave an example of
the language that isn't durable on page 2, section 3, which is a
whole section describing a timeframe for continuing education
that is not as aggressive as the board's regulations for
continuing education. Representative Spohnholz encouraged
allowing the board to regulate itself as regularly as it would
like, without having to bring requests for minor changes to the
legislature.
4:05:02 PM
REPRESENTATIVE JOSEPHSON asked who determines the background
requirements for optometry practices regarding education and
training.
REPRESENTATIVE SPOHNHOLZ responded both the Board of Examiners
in Optometry and the Department of Law.
4:05:46 PM
MS. NESBITT, in response to a question from Representative
Knopp, explained that the sponsor intends to change the language
on page 2, line 6, of CSHB 103(HSS), which read as follows:
(4) publish advisory opinions regarding standards for
the practice seven of optometry as provided under this
chapter.
MS. NESBITT said [the bill sponsor] would like to change that
language to read as in the statute for the Alaska Board of
Nursing, AS 08.68.100(a)(9), which read as follows:
(9) publish advisory opinions regarding whether
nursing practice procedures or policies comply with
acceptable standards of nursing practice as defined
under this chapter;
MS. NESBITT noted that "optometric" would replace "nursing".
REPRESENTATIVE KNOPP expressed his approval of the bill. He
said Ms. Nesbitt, in presenting the sectional analysis, had
addressed any concerns he had regarding optometrists operating
"within the limits of their training."
4:08:29 PM
HARRIET MILKS, Assistant Attorney General, Commercial and Fair
Business Section, Civil Division, Juneau, Department of Law
(DOL), said that she represented professional licensing boards.
4:08:42 PM
REPRESENTATIVE JOSEPHSON related that Ms. Nesbitt had told him
that [the bill sponsor's] office would not "intervene on policy
or comment on how the board regulates itself." He asked if the
Department of Law has the authority to determine whether
optometrists have the necessary training to "do 'X'."
MS. MILKS responded, "Absolutely, that is our role, and the way
we do that is we look very carefully at the scope of the
statutory authority that you would give the board, and that's
our starting point." She explained that at that point the
Department of Law would advise the board if a proposed
regulation goes beyond the scope of the statutory authority.
REPRESENTATIVE JOSEPHSON shared his understanding that
ophthalmologists have concerns that under the proposed bill,
optometrists would be able to define what treatment means. He
asked whether the department has any authority over the board's
decisions regarding treatment being within the scope of field of
optometry.
4:10:57 PM
MS. MILKS responded that it "can be a delicate balance." She
said the Department of Law doesn't make judgements or substitute
its vision of what the policy should be; it looks at the
language of the statute.
4:12:15 PM
REPRESENTATIVE BIRCH asked how the Good Samaritan Law would be
affected by CSHB 103 (HSS). He related that in rural areas of
the state, dentists, veterinarians, and physicians often help
outside their field of practice. Representative Birch offered a
hypothetical example of an individual getting a fish hook stuck
in his/her eye, and the only person in town that could help is
an optometrist.
MS. MILKS responded she would have to research the Good
Samaritan Law and get back to the committee. She added that
optometrists have authority to remove fish hooks.
REPRESENTATIVE BIRCH stated many rural areas in Alaska have
incidences that would be affected by the proposal legislation,
and he stated that he is interested in the topic.
4:14:38 PM
REPRESENTATIVE SULLIVAN-LEONARD asked Ms. Milks if she was aware
of a court case where there had been a challenge regarding the
prescribed duties of optometrists versus ophthalmologists.
MS. MILKS replied that she was not familiar with any.
4:15:23 PM
REPRESENTATIVE WOOL referred to Representative Spohnholz's
example that having a small foreign body taken out of her eye
would constitute surgery. He implied that the definition "would
make a lot of layman surgeons." He questioned if the definition
for surgery would need to be in statute, how the Department of
Law defined the terms, and if the Department of Law needed
direction through statute over words like surgery.
MS. MILKS stated the Department of Law refers to sources, such
as statute and the board, and the board seeks public comment.
She said, "What we don't do is make it up."
4:17:08 PM
REPRESENTATIVE KNOPP asked for Ms. Milks' thoughts on whether an
optometrist is equally qualified to do what an ophthalmologist
does.
MS. MILKS stated she did not have an opinion on that question.
4:17:47 PM
REPRESENTATIVE SPOHNHOLZ cited current statute, AS 08.72.273,
which reads as follows:
Removal of foreign bodies. A licensee may remove
superficial foreign bodies from the eye and its
appendages. This section is not intended to permit a
licensee to perform invasive surgery.
She explained that she had read this statutory language to avoid
[the committee discussion] "going down the rabbit hole."
4:18:48 PM
REPRESENTATIVE JOSEPHSON expressed his concern regarding the
ongoing dispute between the two professions, and he stated his
presumption that the debate will shift to the board.
4:20:02 PM
MS. MILKS answered that the Department of Law provides legal
advice at every public meeting if the board requests an
attorney. She stated that she can't predict what would happen
between the two professions.
REPRESENTATIVE JOSEPHSON stated the previous version of the bill
that suggested an interest in optometrists performing surgery.
He opined that there would have to be "a day of reckoning where
some surgeries will be allowed, and some won't." He asked if
the proposed bill would resolve this or if it would be resolved
at a different date.
MS. MILKS deferred to the bill sponsor.
4:21:48 PM
CHAIR KITO opened public testimony on HB 103.
4:22:08 PM
PAUL BARNEY, MD, Chair, Board of Examiners on Optometry,
Division of Corporations, Business, and Professional Licensing,
Department of Commerce, Community & Economic Development
(DCCED), testified in support of HB 103. He noted that he is an
optometrist and past president of the Alaska Optometric
Association, who has practiced for the last 17 years as the
center director of the Pacific Cataract and Laser Institute
(PCLI), which is a referral center limited to medical and
surgical eye care. He continued as follows:
I practice with an ophthalmologist and a certified
registered nurse anesthetist. Our approach to eye
care is to approach it as a team and optimize each
practitioner's education and skills. I bring up my
mode of practice with other eye care professionals,
because by practicing to our fullest potential, we're
able to provide quality, more affordable, surgical eye
care for Alaskans. In fact, we are largest provider
of cataract care in the state of Alaska.
I support HB 103, because it'll allow the Board of
[Examiners on] Optometry to regulate the details of
the practice of optometry. This is how advance
practice nurses, dentists, and medical doctors are
regulated in Alaska. With that said, this legislation
will not set a new [precedent] in healthcare ... and
will not be a risk to Alaskans since this is already
the way other health care providers are regulated in
Alaska. HB 103 will give optometrists better
opportunity to practice at the highest level of their
education by allowing the Board of [Examiners on]
Optometry to write regulations that are commensurate
with educational advances that occur with new
technology. The current optometry statute was written
over 40 years ago and requires optometry to pursue a
statute change whenever there are advances in
education and technology. As you know, statute
changes are costly and time consuming.
Like other professional regulatory boards, the Board
of [Examiners on] Optometry cannot promulgate
regulations for practices or procedures that are
beyond the education of optometrists. The Board of
[Examiners on] Optometry is overseen by the Department
of Law, just like other healthcare boards, and the
Alaska Department of Law would ensure that the Board
of [Examiners on] Optometry's regulations were within
the scope of optometric education.
Other safeguards are our medical legal system and
insurance system. Any healthcare provider who
provides care outside of their education is subject to
disciplinary action by their respective board, as well
as serious medical legal ramifications. Additionally,
insurance carriers do not pay providers for care that
they provide outside their scope of education. As a
result, there's no incentive for any healthcare
provider to provide care outside of their education,
and there are very serious consequences, both
financially and to their licensure, to practitioners
that do provide care outside of their education.
As chair of the Alaska Board of [Examiners on]
Optometry, I can assure you that the primary concern
of the board is the safety of the public. In the six
years that I've served on the board, we've had no
complaints from the public that were serious enough
that they even considered disciplinary action.
Optometrists, in general, are conservative and
cautious practitioners, and the passage of HB 103
would not change their conservative nature.
HB 103 would be good for the state of Alaska. The
bill puts the regulatory details regarding the
practice of optometry in the authority of the Board of
[Examiners on] Optometry. These changes are important
to allow the profession and practice of optometry to
incorporate new technologies and advances in eyecare
as they occur. Optometry provides approximately 70
percent of the eye care in the U.S., and in rural
areas, especially in Alaska, they often are the only
eye care provider in the community. The citizens of
Alaska deserve to be served by a profession that is
allowed to stay current with advances in education and
new technology.
DR. BARNEY concluded his testimony by urging the committee to
support HB 103.
4:26:31 PM
REPRESENTATIVE BIRCH asked how optometrists and ophthalmologists
"do a hand-off" with their patients.
MR. BARNEY answered that optometrists and ophthalmologists work
well together. He stated that the two professions understand
each other's potential and know what statutory authority is in
each profession.
4:27:56 PM
JILL GEERING MATHESON, OD, Alaskan Vision Center Optometry,
testified in support of HB 103. She related that she was a
former chair of the Board of Examiners in Optometry. She
continued, as follows:
Over 25 years, I have testified numerous times before
this committee and many other legislative committees
in support of changes to the Alaska Optometry
statutes, and these have been successful over the
years. This is due to the level of trust that the ...
legislators have given optometrists in spite of
rhetoric saying that we were going to harm people.
Now I come before you not to argue safety or get the
efficacy of treatment options that need to be in
statute but to ask for your support for HB 103, which
gives the Board [of Examiners in Optometry] the
authority to regulate optometrists. Just as the
people of Alaska elect all of you to represent them
honestly, safely, and responsibly, the members of the
state boards and commissions are appointed and
confirmed by the legislature to do the same under
their various areas of expertise. The days of the
medical board's being the holy grail of overseeing
every health profession are long gone.
Alaska chose to set up separate boards for each
profession because each profession is unique, and
Alaska saw that the oversite for those professions
needed to be handled by those members. So, the people
of Alaska - through the legislature - have approved
statutes that are very broad to many of the other
health boards, and these boards are now able to
autonomously manage their respected profession in an
honest, safe, and responsible manner. The optometry
statute, on the other hand, is currently too
complicated and restrictive. All HB 103 does is allow
the state Board of Examiners in Optometry to have the
same autonomy.
DR. GEERING MATHESON said HB 103 is not about "eye surgery,"
which she said is a buzz term used by the opposition as a scare
tactic. She said she was licensed 25 years ago, and Doctors of
Optometry are trained to do minor surgeries that are within
their scope of practice. She said she would no more conduct an
eye surgery she was not qualified to do than would a dentist
perform jaw reconstruction, a nurse perform spinal surgery, or a
physician perform neural surgery. She stated her belief that
the world must evolve and that professions change. She stated,
"There is no way to predict what tools or treatment options a
Doctor of Optometry will need twenty years from now to protect
or cure the eyes and vision of a patient." She explained this
is why HB 103 is written with such broad language - "to allow
for updates as things advance" and encompass "unforeseeable
changes in technology." She said she trusts members of the
Board of Examiners of Optometry to make and oversee those
changes.
4:31:22 PM
REPRESENTATIVE SULLIVAN-LEONARD asked for examples of continuing
education units (CEUs) that would broaden the scope of practice
[within the field of optometry].
DR. MATHESON answered that CEUs are unforeseen. She gave an
example from other states of minor surgical procedures that
Alaska doesn't do, like laser procedures.
4:32:22 PM
REPRESENTATIVE KNOPP said the state and board mandates are for
the timeline for completion of CEUs for an optometrist.
DR. MATHESON answered that under regulation, optometrists are
required to complete 18 hours every year. She said the
licensing period is two years, so the total requirement is 36
hours during each licensing period. The 36-hour requirement
under regulation is more than the current statutory requirement,
which is eight hours.
REPRESENTATIVE KNOPP asked what credentials optometrists need to
get and how many years it takes them to get certified.
DR. MATHESON answered four years undergraduate, four years
optometry school, and then optional residencies.
REPRESENTATIVE KNOPP mentioned that some ophthalmologists are
certified in laser procedures while others are not, and he asked
if there have been recent changes with that issue.
DR. MATHESON indicated she did not know.
4:34:17 PM
REPRESENTATIVE WOOL referenced feedback his office received that
highlights a difference of opinion between ophthalmologists and
optometrists as to what optometrist are qualified to do. He
then asked if continuing education counts as "basic training."
4:36:01 PM
DR. MATHESON answered that if the board allowed a new procedure,
then there would be required training that would go along with
that new procedure. She gave an example of what has been done
in the past with new procedures and the number of hours
optometrists have had to complete before they were allowed to
perform that procedure.
4:37:06 PM
REPRESENTATIVE WOOL gave an example of dental hygienists in
other states administering Novocain injections, which 20 years
ago may not have happened. He asked what the process would be
for the board to allow changes.
DR. MATHESON answered that all medical professionals must meet a
standard of care and all are held to high standards through
their education.
4:38:41 PM
SCOTT LIMSTROM, MD, President, Alaska Society of Eye Physicians
and Surgeons (ASEPS), stated that HB 103 and its companion bill
SB 36 are opposed by the Alaska Society of Eye Physicians and
Surgeons, the State of Alaska Board of Medical Examiners, the
Alaska State Medical Association, and the American Academy of
Ophthalmology. He stated that the controversy with the proposed
legislation is that it would allow non-medical professionals
unrestricted ability to prescribe all scheduled drugs. He said,
as an ophthalmologist, he rarely prescribes narcotics for pain
control. He spoke of the epidemic in Alaska resulting in deaths
from overdoses of narcotics.
4:40:38 PM
DR. LIMSTROM opined that HB 103 and SB 36, as written, are the
most expansive scope of practice bills in the nation. He stated
that the proposed legislation would give the board full
authority to determine which invasive, diagnostic, and surgical
procedures ophthalmologists may perform on patient's eyes. He
noted that there are no doctors or surgeons on the board. In
response to a previous remark by the bill sponsor that the
attorney general would be scrutinizing the regulations of the
board, he questioned what the attorney general's qualifications
are on eye surgery. He referenced the State of Washington as
having very clear law defining eye surgery. In the law
optometrists are prohibited from performing surgery. Dr.
Limstrom said ASEPS requests clear definition of eye surgery.
He opined that for the safety of [Alaskans], HB 103 should not
move forward.
4:41:49 PM
REPRESENTATIVE KNOPP asked if prescribing drugs will be covered
under continuing education requirements.
DR. LIMSTROM stated the bill gives unrestricted ability to
prescribe all scheduled drugs.
REPRESENTATIVE KNOPP noted that Dr. Limstrom had requested a
clear definition of eye surgery. He questioned whether Dr.
Limstrom felt description of the educational experience of
optometrists was insufficient.
DR. LIMSTROM answered no, he doesn't. He referenced that
Washington State enacted a definition many years ago. He
expressed concern that the current bill could leave the board to
define what [optometrists] can and can't do and dictate what the
education requirements are.
4:44:03 PM
REPRESENTATIVE BIRCH asked if dentists and nurses have the same
authority as ophthalmologists for prescribing narcotics.
DR. LIMSTROM stated he isn't familiar with what authority nurses
and dentists have. The requirements for becoming an
ophthalmologist, as a medical doctor, include going to medical
school, serving internships, and undergoing fellowship training.
He explained his ability subscribe all five scheduled
medications but said the strongest medication he prescribes, as
a physician, is hydrocodone and rarely his prescriptions go
beyond three to four days post operation. Dr. Limstrom stated
that the reason these medications are restricted is that the
more prescriptions are written, the more abuse will occur in the
general public. So, when the Food and Drug Administration (FDA)
and the Drug Enforcement Administration (DEA) restricted
[prescribing ability], it caused a reduction in the number of
prescriptions being written.
4:45:18 PM
REPRESENTATIVE JOSEPHSON asked what ophthalmic surgeries are
acceptable for optometrists to get trained on and perform.
DR. LIMSTROM stated that Representative Josephson would get a
different answer regarding what is acceptable and unacceptable,
depending on whom he asks. He affirmed that there are
procedures that optometrists are allowed to perform and that
there are more procedures that optometrists are capable of with
the proper training. He questioned if it is necessary or safe
for the public. He said a person who wants to perform a surgery
with general anesthesia has to go to medical school. He
asserted that as an ophthalmologist, the procedures he does are
complicated, and many require generalized anesthesia. He warned
that the danger of HB 103 is that the optometrists have not had
[the same level of] training.
4:47:31 PM
EVAN WOLF, MD, Wolf Eye Center, testified in opposition to HB
103. He said he has been in practice for 15 years. He opined
that the proposed bill is the most expansive scope of practice
bill in the country. He referenced Washington State's
legislation, which established a definition on the scope of
practice for optometry, the definition of surgery, and a list of
procedures that aren't considered surgical and, thus, can be
done by an optometrist in the clinic. He cited a Washington
State statute labeled RCW 18.53.010, Section 8, which he opined
would be a good reference for Alaska lawmakers. Dr. Wolf cited
Malcolm Gladwell's book, Outliers. The book theorizes that it
takes 10,000 hours to become an expert in anything. He
explained how this theory relates to surgical knowledge, since
it took him 26,000 hours of training to use laser and perform
cataract surgery safely. He stated that the training for an
optometrist would be about 8,000 hours. Dr. Wolf cited a 2016
Journal of America Medical Association (JAMA) study, in which
Joshua Dr. Stein, MD, MS, discovered what happens if an
optometrists and ophthalmologist perform the same procedures, in
states like Kentucky and Oklahoma where optometrists are doing
basic laser procedures. The study asked what the outcomes would
be if they compared optometrists or ophthalmologists doing the
same procedures. Dr. Wolf said the study showed that worst-case
scenario is that the procedure needs to be repeated. The study
found that procedures performed by optometrists were 2.3 times
more likely to need to be repeated compared to those performed
by ophthalmologists.
4:52:42 PM
REPRESENTATIVE WOOL asked if Dr. Wolf did 26,000 hours of
training before performing an unaccompanied surgery.
DR. WOLF answered by stating his 26,000 hours of training
included medical school and residency. Residency is a four-year
process of learning, including basic surgeries and development
of knowledge and vocabulary.
REPRESENTATIVE WOOL asked if Dr. Wolf's overall medical
education of eight years was not specifically surgery training.
DR. WOLF broke down the hours of training he obtained: 12,000
hours of medical training and 14,000 hours of ophthalmology
training.
4:53:54 PM
ERIK CHRISTIANSON, OD, testified in support of HB 103. He
stated that as the only medically based optometrist in
Ketchikan, he sees how HB 103 could benefit his community. He
already performs minor surgeries every day and refers patients
to ophthalmologists for complex surgeries. His community and
the communities around him only have access to ophthalmologists
who rotate through; it can be tough to get an ophthalmologist
because of travel restraints. Dr. Christianson said he knows of
patients performing minor procedures on themselves because of
the lack of medically trained individuals available. Dr.
Christianson is asking [the legislature] to modernize the
optometry statute so that optometrists are "able to do things
within our training."
4:57:56 PM
MATTHEW GUESS, MD, testified in opposition to HB 103. He
expressed concern that under HB 103, the Board of Examiners in
Optometry could self-regulate its scope of practice, thus
allowing invasive procedures in or around the eye, for which
optometrists have received no meaningful formal training. He
referenced earlier testimony by Dr. Matheson, in which he
indicated that part of ophthalmologists' continuing education
required seven hours of injection training for eyelid
procedures. He said he spent time in medical school,
residencies, and two extra years of training in a fellowship,
and he learned to both diagnose and treat diseases of the eye
with operative procedures and operative invasive surgeries.
During that time, he spent two years in a fellowship, worked 55
to 65 hours per week, examined tens of thousands of patients,
and performed thousands of surgeries under the guidance of
experienced mentors. He stated there is no substitute for this
training; the training allows him to provide diagnoses treatment
and perform procedures and surgeries in the safest possible
manner for patients. He stated that seven hours of training a
year sounds like a minimal amount of work to learn new
procedures or stay current on the procedures that are available.
5:00:24 PM
KELLY LORENZ, MD, testified in opposition to 103. She expressed
concern over the vague wording of HB 103 and stated the proposed
bill would support optometrists performing procedures that they
are not adequately trained to do, including: several types of
laser procedures; eyelid surgery, including eye lifts; limbal
relaxing incisions; and many other procedures. She stated her
concern that "a couple weekend courses at a local hotel by an
optometrist will not make up for years of surgical training by
an ophthalmologist." She stated that the bill would lower the
standards of surgical care in Alaska. She shared statistics
that 90 percent of people polled stated they would rather have a
medical doctor performing a surgery.
5:03:30 PM
STEVE DOBSON, OD, testified in support of HB 103. He said he
has answers for all the questions he heard from the
ophthalmologists that had testified. He said he thinks either
there is intent to mislead or, perhaps, there is a
misunderstanding of the intent of the proposed legislation. He
stated that HB 103 is not about surgery but, for some reason,
organized ophthalmology has turned it into "a surgical bill."
He said HB 103 is about board autonomy and about optometrists
practicing at the highest level for which they are trained. He
indicated that malpractice is the same in those states [that
allow optometrists] to perform minor procedures, such as minor
laser procedures, as it is in Alaska, and he emphasized that
"insurance companies understand risk." Dr. Dobson stated,
"Obviously optometrists are doing what they trained to do and
nothing more." He continued, "Optometrists are trained in very
few of the procedures that ophthalmologists do. I think we all
agree with that. And that's not what we're trying to do, and
it's actually not what this legislation is about." Dr. Dobson
stressed the importance of what ophthalmologists do, and he
reiterated that there is little crossover between the two
professions. He proffered that if dentists and nurses can
maintain their own boards, then it's time optometrists were
given the respect and consideration to regulate themselves. He
said [this issue] has been repeated before the legislature for
years, with the same arguments given by ophthalmologists, whom
he said vehemently oppose the recognition of "any of the
advances in optometric care."
5:08:25 PM
CHAIR KITO announced that HB 103 was held over.