HOUSE BILL REPORT

HB 1102

BYRepresentatives Leonard, Braddock, Bumgarner, Day, Silver, Sutherland, Nealey, Fisher, C. Smith, McMullen, Amondson, Hankins, Lewis, Madsen, Brekke, Lux, B. Williams, Dellwo, Jesernig and Rayburn

Modifying provisions relating to the use of drugs in the practice of optometry.

House Committe on Health Care

Majority Report:  The substitute bill be substituted therefor and the substitute bill do pass.  (8)

      Signed by Representatives Braddock, Chair; Day, Vice Chair; Bristow, Bumgarner, Cantwell, Lewis, Lux and Vekich.

House Staff:John Welsh (786-7133)

AS REPORTED BY COMMITTEE ON HEALTH CARE MARCH 5, 1987

BACKGROUND:

The practice of optometry was licensed by the state in 1919 with a scope of practice which includes examination of the human eye for defects of the vision system and an analysis of the vision process.  In 1981, optometrists were authorized to use topically applied pharmaceutical agents for diagnostic purposes.  Current law, however, forbids the use of any drugs for therapeutic purposes.

SUMMARY:

SUBSTITUTE BILL:  Licensed optometrists, who possess a minimum of 75 hours of didactic and clinical instruction established by the Board of Optometry, are authorized to treat patients with topically applied pharmaceuticals.  The board is required to establish a formulary of drugs for diagnostic and treatment purposes limited to the practice of optometry for use by these optometrists.  An optometrist is defined as a practitioner who can legally prescribe, dispense, or administer these drugs, and pharmacists are authorized to fill their prescriptions.

SUBSTITUTE BILL COMPARED TO ORIGINAL:  A technical change is made.

Fiscal Note:      Not Requested.

House Committee ‑ Testified For:    Representative Leonard, prime sponsor; and Dr. Steven Jaffe, Washington Optometric Association.

House Committee - Testified Against:      Dr. R. Lee Harman, M.D., Washington State Academy of Opthalmology; Mike Ryherd, Washington State Academy of Opthalmology; and Dr. Franklin Chu.

House Committee - Testimony For:    The education of a doctor of optometry is four years of undergraduate biomedical education leading to a bachelors degree, and four years of professional, clinical and didactic training leading to a doctorate degree.  Under this bill, optometrists would have to take further training, both academic and clinical, before being authorized by the board to use therapeutic drugs.  Only those drugs approved by the board could be used.  Drug therapy is a growing part of the practice of medicine today, and professions must keep current with new methodologies to treat patients competently with quality care.  Thirteen states have similar therapeutic laws, some of which have been in existence for over ten years.

House Committee - Testimony Against:      Optometrists have minimal clinical pathology training which would allow them to correctly diagnose diseases of the eye.  Optometrists are not trained to diagnose and treat disease; they are trained to fit glasses and contact lenses.  The drugs they ask to use, with only 75 hours of training, are drugs that when applied to the eye, affect the whole body.  Optometrists do not have the thousands of hours training necessary to handle the side-effects of the drugs, the effects on the rest of the body nor to understand the effect of an optical drug on the human system when taken in combination with other medication.  Optometrists typically see less than 15 persons with eye disease during their training compared with over 3,000 seen in an opthalmology residency.  The State Health Coordination Committee recommended further study and negotiation of the issue, not passage of the bill.  The bill grandfathers all optometrists to be able to use drugs (if they attend the 75 hour class) regardless of whether they have a college degree.