The Colorado Springs Gazette

State’s Legislature shouldn’t oversee vision

Barry Fagin is senior fellow at the independence institute in denver. His views are his alone. readers can write Fagin at barry@faginfamily.net.

“Your vision is at risk!” So Facebook told me, anyway. Intrigued, I clicked on the ad, and got sucked into the Battle of Dueling Professions to gather material for today’s column.

First, some definitions. Optometrists have a Doctor of Optometry degree from a College of Optometry, which requires four years of education beyond a bachelor’s. They can write prescriptions for eyeglasses, perform eye exams, dilate your pupils, get you contact lenses and perform other vision-related tasks depending on where they practice.

Ophthalmologists, by contrast, are medical doctors with a degree from a medical school. In addition to four years of education beyond college, they will normally have an internship year, three years or so of residency specializing in disease and treatment of the eye, and perhaps a fellowship if they want to specialize further.

Ophthalmologists are allowed to treat all eye diseases and perform all vision-related surgical procedures, including laser surgery. And therein lies the retinal rub.

Colorado House Bill 22-1233, a piece of legislation reviewed every decade or so for the continued regulation of optometry, says optometrists can perform “any service, procedure, or treatment … that is within the training and skills of optometrists based on the areas of competence tested by a standardized national examination approved by the board pursuant to” blah blah blah. It passed the House this week.

According to the Safe Surgery Coalition, this means optometrists in Colorado could conceivably perform laser surgery. And guess what? The SSC is an organization of ophthalmologists, and they are looking out for me. How nice of them to warn me, out of the pure altruistic goodness of their hearts, that my vision is at risk.

Except that’s nonsense. My best friend since high school is now a nationally known eye surgeon. When I need cataract surgery (as virtually everyone will), you’re darn right I’ll use him. What SSC means is that patients who choose to have laser surgery (I’d prefer the term laser treatment) are putting their vision at risk when they use an optometrist. And that, my friends, is an entirely different matter. Particularly since not everyone’s best friend is an eye surgeon.

It’s astonishing to me how many commenters wrote things like “I trust my eye doctor” “Why would you put your vision at risk?” and so forth.

The medical decisions other people make are, frankly, none of your business. If freedom means anything, it includes the freedom to make your own health care decisions. This absolutely includes your right to make risky decisions, or more accurately to make your own decisions about how much risk you are willing to accept. Even if I think you’re being a complete moron.

The proper role of government here is to enforce common law standards of negligence and the prohibition of fraud. Optometrists must be required to make their credentials clear, and not pretend to be medical doctors. But that’s all. The appropriate standard in a freedom-loving country should be informed consent. Not legislative permission.

Lest people think I’m some shill for optometrists, they also are guilty of using the law to their own advantage. Did you know in Europe, if you know your lens prescription, you can tell the store clerk what you want and walk out with glasses? Or that you can walk in to a drug store and get a box of contacts?

Alas, you can’t do that here in the land of the free. Ordering glasses or contacts in America requires a current prescription. Which means a current eye exam. Which means visiting, you guessed it, an optometrist. According to the Center for Responsive Politics, the American Optometric Association spent over $3 million in 2016 in lobbying and/or campaign contributions to keep this law on the books. Presumably the figure is higher now.

This is a game every profession plays. They want the right to compete with others, while demanding protection for themselves. But the fact something is done all the time doesn’t make it right.

Colorado’s Legislature should stop seeing its primary function as passing out privileges. Instead, it should perform the limited but essential functions necessary to expand the freedoms and opportunities that brought us here in the first place.

OP/ED

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2022-04-29T07:00:00.0000000Z

2022-04-29T07:00:00.0000000Z

https://daily.gazette.com/article/281921661615308

The Gazette, Colorado Springs