Scope of Practice for the Different States

[qwopty99]

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Hi folks

I was wondering if anyone knows, or knows where I can find a listing showing,

1. the different entry-to-practice requirements, and
2. scope of practice

for the different states?

I have to prepare a talk that involves this information. If anyone knows any good link for the history and development of optometry in the US, that would be helpful too.

Thanks.

 

[gochi]

Hi folks

I was wondering if anyone knows, or knows where I can find a listing showing,

1. the different entry-to-practice requirements, and
2. scope of practice

for the different states?

I have to prepare a talk that involves this information. If anyone knows any good link for the history and development of optometry in the US, that would be helpful too.

Thanks.

Wikipedia would be useful for history.

http://en.wikipedia.org/wiki/Optometry

 

[jefguth]

From the AOA members section...

 

[qwopty99]

Hmm... I'm a Canadian...

Any way around this?

 

[eyepoker]

jefguth:

why can't I see the world document that you put there? there doesn't seem to have any content in the file??

 

[qwopty99]

From the AOA members section...

Wow. Very helpful. Thanks Jef. I will definitely make use of that.



In my own searches, I did manage to find this:

http://www.ucop.edu/healthaffairs/REFORMATTED OPTOMETRY.pdf

which has a lot of info on the current status of Optometry, and raises a lot of good issues that challenge the profession.

 

[qwopty99]

From the AOA members section...

A few questions here from a dumb Canadian...



First of all, I see a string of islands above "Guam". What jurisdiction is this? (Puerto Rico?)


In terms of oral drugs, "Many/All" oral agents - that's literal? "All" obviously does not include glaucoma orals. So "Many/All" oral agents refers to everything BUT glaucoma orals? Do they include steroids?


Injections - I never learned how to do injections during my education. Do most US OD students learn to do this? And what "injectables" are we talking about? Just stuff around the orbit? (kenalog?) Peri-ocular and/or intraocular?


As for narcotics - does everyone get to do this, or do you need a special license to do this? And how does one acquire this?

 

[jefguth]

A few questions here from a dumb Canadian...



First of all, I see a string of islands above "Guam". What jurisdiction is this? (Puerto Rico?)

Hawaii. Strangely I don't think i see Puerto Rico on the map which is curious b/c like Guam it's not a state.

In terms of oral drugs, "Many/All" oral agents - that's literal? "All" obviously does not include glaucoma orals. So "Many/All" oral agents refers to everything BUT glaucoma orals? Do they include steroids?

Right, many/all orals except glaucoma orals. Some states do not include oral steroids, Illinois for example does not. You'd have to look the specific info up with each state. Another twist along the same line is that while (i believe) all states allow OD's to treat glaucoma, states such as California require a co-management period with an ophthalmologist before certification for independent optometric treatment. Even then there are a number of absurd protocols that must be followed.

Injections - I never learned how to do injections during my education. Do most US OD students learn to do this? And what "injectables" are we talking about? Just stuff around the orbit? (kenalog?) Peri-ocular and/or intraocular?

We learn intramuscular, subcutaneous, intravenous, subconjunctival (bulbar and palpebral, and intralesional. No true intraocular injections (intravitreal, etc).

As for narcotics - does everyone get to do this, or do you need a special license to do this? And how does one acquire this?

Again it varies state to state, and then OD's may not have access to all narcotics. In Illinois I believe all OD's will (the legislation just passed a few months ago) have Rx privileges after a review course in oral pharmaceuticals.

 

[qwopty99]

Hawaii... Haha. duh.



What is a DEA number?

 

[jefguth]

Hawaii... Haha. duh.



What is a DEA number?

Drug Enforcement Agency number...
I'm not to certain on this, but from my understanding is that you have to have one to Rx schedule controlled narcotics. Otherwise it is not really necessary. However, many pharmacies require that a DEA# be entered into their software to fill any Rx, so if you have have one it could delay the dispensing and cause everyone confusion. Also, drug companies use these to track Rx'ing patterns of doctors.

 

[cpw]

Drug Enforcement Agency number...
I'm not to certain on this, but from my understanding is that you have to have one to Rx schedule controlled narcotics. Otherwise it is not really necessary. However, many pharmacies require that a DEA# be entered into their software to fill any Rx, so if you have have one it could delay the dispensing and cause everyone confusion. Also, drug companies use these to track Rx'ing patterns of doctors.

The pharmacy DEA # thing is actually because of insurance companies. Some insurance companies require a DEA # to fill the Rx. (even if it's not controlled substance) It's BS. I write Rxs all day long and have only had two pharmacies call me for my DEA #. I told them I can't write for controlled substances so I don't need one. There's ways around it... I believe in those cases the pharmacist puts in their own #.

 

[planex]

The pharmacy DEA # thing is actually because of insurance companies. Some insurance companies require a DEA # to fill the Rx. (even if it's not controlled substance) It's BS. I write Rxs all day long and have only had two pharmacies call me for my DEA #. I told them I can't write for controlled substances so I don't need one. There's ways around it... I believe in those cases the pharmacist puts in their own #.

I finally registered for my DEA number, I got tired of calls from the pharmacy for it when I would prescribe a topical antibiotic or restasis. It cost more than five hundred dollars for the federal for three years and then one hundred twenty five dollars a year for the state, but I am glad I registered.

Now my corneal abraision patients will get a couple of days worth of "help me sleep and not feel the pain" medicine.🙂

 

[cpw]

Now my corneal abraision patients will get a couple of days worth of "help me sleep and not feel the pain" medicine.🙂

See, I can't write for those meds anyway.. so the 500 bucks would be a complete waste of money, just to make insurance companies happy.

 

[Jenkai]

We learn intramuscular, subcutaneous, intravenous, subconjunctival (bulbar and palpebral, and intralesional. No true intraocular injections (intravitreal, etc)..

Do optometrists do botox? I saw someone listed as a resident post that optometrists do, but I didn't think we did (at least not in Cali, Oregon or Illinois). Is there a state where we do?

We learned how to do injections, but it's not going to be on our boards (the class of 2010) but it will be for next years class (2011).