As an ophthalmologist dedicated to preserving vision, I’m increasingly concerned about the intersection of healthcare policy and medical practice. Recent legislative efforts to expand the scope of optometric practice into surgical and medical procedures traditionally performed by ophthalmologists highlight a disturbing trend. This trend threatens patient safety and could erode trust in our healthcare system, particularly among vulnerable communities.
Protecting Patients: The Ophthalmologist-Optometrist Divide
The battle between ophthalmologists and optometrists isn’t merely about professional turf protection. It’s about ensuring that those performing delicate procedures have the comprehensive training necessary to handle potential complications. Ophthalmologists undergo years of medical school, residency, and often fellowship training to master the intricate techniques required for ocular surgeries and treatments. When complications arise—whether it’s an infection after an injection, damage from a misplaced laser, or a cancerous lesion that requires complex management—we’re equipped to address them.
Consider a patient receiving an intravitreal injection for diabetic retinopathy. These medications, some derived from
chemotherapy drugs, carry risks of inflammation, infection, retinal detachment, or hemorrhage. If an ophthalmologist encounters these complications, we can manage them appropriately. The same cannot be said for someone who has taken a weekend course.
The Advocacy Gap in Medical Education
This leads to a broader issue that medical education has overlooked: advocacy training. Unlike optometrists, who learn advocacy principles early in their education, physicians typically receive little to no training in how to advocate for their patients beyond clinical care. This disparity becomes evident in legislative battles, where optometric associations often have more substantial financial resources and broader participation in advocacy efforts than medical organizations.
Consequences of Insufficient Physician Advocacy
The consequences of this advocacy gap extend far beyond professional competition. When healthcare policies are shaped without sufficient input from physicians, the results can be devastating for patient care. Consider the resurgence of previously controlled diseases due to vaccine hesitancy, or the persistence of preventable injuries from fireworks that have failed because of financial interests in legislation.
The trust deficit in medicine, particularly among communities that have historically experienced discrimination, makes this advocacy gap even more concerning. When complications arise from procedures performed by inadequately trained practitioners, it doesn’t just harm individual patients—it reinforces distrust that can persist for generations. I’ve seen patients delay necessary cataract surgery because a parent had a negative outcome decades earlier. Now imagine how much harder it becomes to rebuild that trust when we’ve authorized less qualified providers to perform complex procedures.
Prioritizing Quality Over Lowered Standards
This is not about restricting access to care. I understand the legitimate concerns about workforce shortages in healthcare. But the solution cannot be to lower standards of training and expertise. It must be to develop sustainable pathways that maintain quality while expanding capacity
Integrating Advocacy into Medical Curricula
Medical schools must incorporate advocacy training into their curricula from the earliest stages. Physicians need to understand that their responsibility extends beyond the exam room to the legislative chambers where healthcare policies are shaped. We must learn to effectively communicate complex medical concepts to legislators and the public, ensuring that decisions affecting patient care are based on evidence rather than economic or political expediency.
The healthcare landscape is changing rapidly, and physicians can no longer afford to remain silent in policy discussions. Without our informed voices, decisions will be made by those who may not fully comprehend the medical implications of their actions. By teaching advocacy alongside anatomy and pathophysiology, we equip future physicians to protect not just the patients in their care, but the integrity of the healthcare system itself.
Our patients trust us with their health. We must honor that trust by advocating for policies that prioritize their safety and well-being over political or financial interests. The future of healthcare depends on it.
