Optometry and Liability

[JZ2020]

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Without getting into the issue of whether expanding the scope of optometry is appropriate or not (that issue has been debated at length on other threads), I’m curious to find out how this issue plays out in the medical liability and malpractice world.
In years past, when optoms were almost exclusively dealing with refractions and contact lenses, I assume this wasn’t an issue at all. But now that optometrists are practicing as primary care eye doctors and prescribing drops – and as they lobby for scope expansion including prescribing oral meds, performing laser procedures, and possibly performing surgery – the issue becomes very relevant today. Are optoms considered to be at the same level of legal liability for malpractice as ophthalmologists? Or, from a legal perspective, is there less of a liability given that they are not MDs?
On the same note, are the optometrists in private practice today purchasing malpractice insurance? If so, are the premiums similar as for ophthalmologists?
I’m curious to hear what many of you - particularly the optometrists in practice - have to say about this issue.

 

[rpames]

I'm still an OD student, but I'll tell you what I know. We are just as liable medically as any practitioner if we mess something up. We just don't mess up major things that often b/c when things get really hairy, we send the patient to a specialist. Because we are not performing surgery our malpractice is a fraction of yours. If ODs do one day perform surgery, then I'm sure our malpractice will be just as high. My father is an OD in Wisconsin, where we Rx orals all the time, and he said his malpractice was something like~$500 per year (he as not exactly sure, he just knew it was almost nothing). He said is umbrella policy to cover him if someone twisted their ankle in his parking lot was more than his malpractice. One of our professors (in Chicago) said hers is $900 per year and she only practice outside the school 1 day a week.

"Or, from a legal perspective, is there less of a liability given that they are not MDs?"

I'm sure this is not the case. I would presume a GP's malpractice is less than a surgeon's. I thought it was all ranked on how likely it was that you would kill someone. I could be completely wrong though.

 

[Ben Chudner]

Without getting into the issue of whether expanding the scope of optometry is appropriate or not (that issue has been debated at length on other threads), I’m curious to find out how this issue plays out in the medical liability and malpractice world.
In years past, when optoms were almost exclusively dealing with refractions and contact lenses, I assume this wasn’t an issue at all. But now that optometrists are practicing as primary care eye doctors and prescribing drops – and as they lobby for scope expansion including prescribing oral meds, performing laser procedures, and possibly performing surgery – the issue becomes very relevant today. Are optoms considered to be at the same level of legal liability for malpractice as ophthalmologists? Or, from a legal perspective, is there less of a liability given that they are not MDs?
On the same note, are the optometrists in private practice today purchasing malpractice insurance? If so, are the premiums similar as for ophthalmologists?
I’m curious to hear what many of you - particularly the optometrists in practice - have to say about this issue.

OD's have to carry malpractice insurance. Some, if not all 3rd party payors require proof of liability insurance as do the banks that loan us money for any reason. I pay roughly $900 per year for a 2MM/4MM policy that covers one full-time and one part-time doctor. It is my understanding that the rates are calculated based on risk. Since OD's do not perform cataract surgery, trabs, vitrectomies, etc, our risk is much lower and therefore we have lower premiums. About a year ago, my malpractice carrier tried to raise my rates from $660 (only one doctor) to $2500 per year because my website discussed cataracts and LASIK. It took several phone calls and several people up the chain of command to get them to understand that I don't perform these procedures just because I have info on them on my website. History is also taken into account, and the majority of claims against OD's across the nation have not resulted in huge payouts.

 

[Sam MD]

It seems that optometry malpractice may be lower than ophthalmologists. One quote that I saw was $4000/yr for ophthalmologists who don't do surgery, $11000 if they do limited office stuff like chalazions, and $15000 if surgery is performed.

In some states, optometrist call themselves "optometric physicians". Some day, a tricky lawyer is going to burn these OD. If a case goes to trial, they'll mock the OD "who claims to be a doctor, a physician, and yet he didn't know ____". If you think it's not fair, blame a lawyer. (Lawyers are allowed to lie and distort as long as it is technically not a lie. They do it all the time. They also manufacture work for themselves so as to increase "billable hours". There is no precert or utilization review for lawyers. If there were, most of them would lose their license.)

 

[scott McGregor]

Without getting into the issue of whether expanding the scope of optometry is appropriate or not (that issue has been debated at length on other threads), I’m curious to find out how this issue plays out in the medical liability and malpractice world.
In years past, when optoms were almost exclusively dealing with refractions and contact lenses, I assume this wasn’t an issue at all. But now that optometrists are practicing as primary care eye doctors and prescribing drops – and as they lobby for scope expansion including prescribing oral meds, performing laser procedures, and possibly performing surgery – the issue becomes very relevant today. Are optoms considered to be at the same level of legal liability for malpractice as ophthalmologists? Or, from a legal perspective, is there less of a liability given that they are not MDs?
On the same note, are the optometrists in private practice today purchasing malpractice insurance? If so, are the premiums similar as for ophthalmologists?
I’m curious to hear what many of you - particularly the optometrists in practice - have to say about this issue.

My rates are identical to Ben's rates above. I too have had problems as I worked inside an OMD office for 10 years. My policy has specific exclusions for surgery. In court OD and OMD are held to identical standards.