Published in Non-Clinical

Expanding Scope of Practice - Optometry and Advocacy

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7 min read
Dr. Aaron Punim discusses expanding scope of practice in optometry and why advocacy matters.
Being an advocate for your own scope of practice and for the industry at large is more important than many ODs realize. Optometrists have long fought for their seat at the medical professional table and to solidify how they are able to treat patient; the only way to ensure the continued success of the profession is to maintain that fight.
In his first position after optometry school, Dr. Punim was working alongside an ophthalmologist and was excluded from a number of medical panels that were being managed by the practice. He had to stand up and make space for himself by speaking to medical directors and legal teams.
Learning how to navigate the treacherous waters of the political side of optometry isn’t easy, but joining organizations like the AOSA or VOSH can help get you started. Working with your fellow ODs to understand the ins and outs of what is a major piece of the profession is invaluable, not only for educating yourself but also for expanding your network to include other well-informed practitioners.

Direct advocacy and political action

Advocacy through optometric groups doesn’t have to start with joining a group or end at donating to campaigns or initiatives. You can take direct action on behalf of ODs across the country by reaching out to representatives either by yourself or through your local and state organizations!
If you have a cause that you believe needs to be addressed, reach out to your local legislators. Begin a dialogue with your senators and representatives and help them to understand what ODs in your area need! Many optometric organizations will have a member that can connect your directly to the right political representatives.
Student involvement
Being so direct may not be easy, but it can help if you get started early! Optometry students can reach out to other ODs to seek mentorship and better understand how to engage directly with politicians and political action committees. You aren’t the first (and certainly not the last) OD to get involved; you have an entire profession of prospective doctors that can help support your mission!
“Someone else will handle it”
Your scope of practice will be affected dramatically by where you’re currently practicing. A private practice’s scope and the laws that apply to it will be different from a corporate practice or a heavily medical practice.
The needs of each of these businesses may feel entirely separate from one another, but “the diagnostics, the therapeutics, the things that we use during our daily exams are things that people fought for at some point.” Punim says. Complacency in the political landscape can lead to ODs possibly being excluded from emerging technologies that would otherwise benefit the industry and patients.

Challenges to scope expansion and advocacy

While there is some level of challenge to gathering support from other ODs, one of the most difficult aspects of fighting for change can be directly opposite of one of the easiest: engaging with your representatives. While taking the time to connect with them can help the cause, you may also meet with people who do not share your views.
Even in instances where your representatives do share your views, there are other factors that have an impact on their decisions while in office. Dr. Punim recalls meeting with a senator who was willing to support an optometry initiative, but they mentioned that they were supporting, in part, because another member of their political party was interested as well. “Sometimes it’s not about common sense legislation and helping your constituents. Sometimes it’s about what the party is doing…”
Are you familiar with your state’s current specific scope of practice laws? Here’s our full guide to all 50 states so you can brush up before you pay your politicians a visit.
If a new initiative doesn’t clear its first hurdle, all is not lost. The legislative process can take years of work and coordination to achieve specific goals. This can mean proposing a rejected amendment or bill in a new legislative cycle or even waiting until you have an elected official in office that is more sympathetic to your cause. Staying involved and being persistent are invaluable when considering these long-term plans.

What is the full scope of the issue?

Advocating for the ability to practice a specific medical technique is only a small part of the full story. Dr. Fulmer mentions a children’s vision bill that is currently making its legislative rounds as but one example of the plethora of things outside of direct practice that have an impact on the profession as a whole.
Another clear example, the DOC Access Bill, worked to join optometric and dental scopes of practice together in several ways; this connection may not be considered on a regular basis, but it can legally obligate practitioners to practice outside of their scope.

Where do MDs fit in?

Collaborating with fellow ODs that already agree on a new proposition or bill is much easier than reaching out of the optometric scope of practice and recruiting help. Developing relationships with MDs that can help join an optometry-related cause is essential to a thriving political process.
Dr. Punim mentions a bill that is currently circulating in the state of New York that was negotiated by optometrists in conjunction with ophthalmologists. Creating that unity in the eyecare space may not always be easy, but ophthalmologists can provide invaluable support for eyecare-driven policies.

What can students do?

Being an advocate is not as much a commitment as it may seem. You can attend meetings of groups in school or even go directly to association meetings to begin building rapport with practicing ODs.
Post-graduation
Near the tail end of your time in optometry school, Dr. Punim also recommends joining the AOA. They currently have a specific Young Advocates Committee designed to get young ODs involved in the space. Simply taking a step and calling your state association to ask “What can I do?” can make all the difference.
If being a member of the AOA and taking part in these decisions is important to you, consider speaking with your prospective employers when you’re negotiating your employment contracts about helping to cover your AOA dues or providing vacation days for legislation-related events.
Every OD has the power to make a difference, so put yourself out there and make your voice heard. Your efforts can lead directly to expanded scope and improved care for eyecare professionals for years to come.
Dyllan Thweatt
About Dyllan Thweatt

Dyllan is a UC San Diego graduate and former Associate Editor of NewGradOptometry and CovalentCareers, which is now known today as Eyes On Eyecare. In his time out of the office, he is also a full-time Dungeon Master, pet dad, and an avid tea drinker.

Dyllan Thweatt
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