On Thursday the Alabama Senate passed controversial legislation to allow optometrists to perform procedures currently allowed to be performed only by ophthalmologists.
Senate Bill 120 (SB120) is sponsored by State Sen. Del Marsh (R-Anniston).
“This is a bill that has been around for 10 years,” Marsh said. “Sen. [Jim] McClendon has worked tirelessly on this.
“I know the Medical Association has opposed this,” Marsh said. “The practice of training optometrists includes training for this. We are training people who are leaving the state and doing the procedure in 20 other states.”
Marsh said that this bill increases the “scope of practice of optometry.”
The Alabama Optometric Association were guests of McClendon and were in the Senate gallery during the debate.
Sen. Sam Givhan (R-Huntsville) opposed the legislation.
“I don’t think it got out of committee,” Givhan said. “That committee structure was not the best form of good government that day.
“I have got a problem with allowing the (Optometry) Board to decide what they do. This bill was not vetted, was not discussed in committee.
“Folks, three-day weeks have really been a grind. It has been problematic to keep up [with] the law that we are passing, in my opinion, without enough oversight.”
“Any expansion of practice has to be dealt with by the legislature,” Marsh said. “That is the process.
“We come in and say this is an agreed-upon bill,” Givhan said. “It wasn’t agreed upon by me.”
Givhan proposed an amendment to the bill limiting the powers of the Optometry Board to set the scope of practice for optometrists. That amendment was adopted on a 27-0 vote.
“I know they teach this in school, but the older optometrists were not trained in this,” Givhan said. “I am not suggesting an age cap per se, but it needs to be tied to the education.”
“Using a laser to punch a hole in a membrane that forms after cataract surgery,” McClendon said. “It is done in the office without anesthesia and has been successfully performed thousands of times.”
Givhan asked McClendon if he was trained in this procedure when he was in college.
“When I was in optometry school, I don’t think we had lasers at all,” McClendon said. “This is called progress. It is a great example that technology in healthcare changes over time and existing practitioners have to be certified in the new procedures.”
Givhan said, “A great many optometrists are not going to do this.”
Sen. Dan Roberts (R-Mountain Brook) said, “It is my understanding that they are not doing this in optometry school.”
Sen. Billy Beasley (D-Clayton) said, “The laser mechanism is relatively new. The optometrists go to seminars to learn how to do this. The ophthalmologists I think go to seminars as well to keep up.
“This is a new technique and I feel that optometrists have the ability to perform these procedures,” Beasley said. “We are losing optometrists to other states where they can perform the laser procedure.”
“There are demarcations that we follow where we are responsible for the lines, where I have concerns,” Roberts said. “This is nothing personal about a profession that cares for our state.”
“There are not any optometrists in this state that want to do any harm,” Beasley said.
“The entire committee meeting lasted two minutes,” State Sen. Larry Stutts said of committee passage of this bill on a voice vote.
“Ophthalmology is extremely competitive, when you look at a medical school class, they are the best of the best,” Stutts said. “If this is illegal in Alabama, how are the optometry students being allowed to be trained to do this?”
Marsh said, “Just this week, Virginia passed scope of practice.”
Marsh said that McClendon told him that medical doctors are training the optometrist students.
State Sen. Tom Butler (R-Madison) said, “It is one thing to watch as a doctor performs this procedure and another to actually perform the procedure themselves.”
State Sen. Donnie Chesteen (R-Dothan) said, “My question would be, what about the optometrists who have been in practice for 15 years who were not trained to do this?
“They would have to be trained and certified by the Board of Optometry," Marsh said. “I have a lot of trust in the Board. We have worked with the professional groups to establish the scope of practice.”
“This is not a degree-granting body,” Butler said. “This is the Senate. We do not want to substitute legislation for education.”
The Alabama Senate passed SB120 by a vote of 17-12.
The legislation as amended by the Senate now goes to the House of Representatives.
Tuesday will be Day 22 of the 2022 Alabama Regular Legislative Session.
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