Eye doctors argue over practice limits

Feb 28, 2012

An almost 40-year old scuffle between two kinds of eye care professionals could be coming close to an end. But, as Sascha Cordner reports, despite passage of a bill that could do so, opponents say ending the war at the cost of limiting the amount of legitimate medical malpractice claims is not the way to do it.

It’s an ongoing dispute known as the “eyeball wars” between ophthalmologists and optometrists. Both professions deal with eye care, but there’s one difference:

Ophthalmologists are medical doctors, while optometrists are not.

“Would you feel better having your prescriptions written by someone who has taken a course of 20 hours, including 10 hours of internet course, or someone who has studied the side effects for several years and has training?”

Optometrists contend that they should be able to expand the scope of their practice, like prescribing controlled substances, while ophthalmologists, like Mark Michaels, who are medical doctors and can perform surgeries, have argued they shouldn’t.

So, to put an end to an almost four-decade-year-old war, Senate President designate Don Gaetz struck a deal with the some ophthalmologists who are part of the Florida Medical Association to concede allowing optometrists to expand the scope of their practice.

In exchange, he filed a bill that could limit future medical malpractice lawsuits:

“First, aligning medical malpractice laws to the same standard of clear and convincing evidence as is used in other parts of Florida statutes dealing with liability. And, secondly, the bill in this section conforms Florida law dealing with subsequent treating physicians to the laws of a vast majority of other states that the inability of defense counsel to interview a subsequent treating physician in a malpractice case severely limits discovery and fairness. So, the bill creates equal access to a medical witness in a case with 10 days prior notice and with that physician’s own counsel present.”

But, not everyone agrees on the terms.

Mark Michaels represents the Florida Society of Ophthalmology and the American Academy of Ophthalmology. He says the groups are not part of the deal struck between the Florida Medical Association and the Optometrists and they have serious concerns with the bill:

“The bill goes much farther than most other states. It allows optometrists to own and order lab tests for all types of medical conditions, everything from bronchitis to bellyaches, without having any real experience practicing medicine. Would they be able to determine if there was a problem with the test results that they ordered? I doubt it, the answer is no.”

Keystone Heights resident Margie Stone, a medical professional herself, says she understands the aim of the bill, but she says that does not mean doctors should get a chance to escape from legitimate medical malpractice claims, like hers:

“I lost my husband a few years ago in a medical malpractice issue. It’s very tough as a widow to deal with these things. And, to increase the burden of proof, we’ve already got all these hurdles to jump. We don’t need any more hurdles. It’s already bad enough.”

And, she wasn’t the only one who felt that way.

Dole Slayton, a restaurant owner from Crawfordville, joined his wife Julie in recounting the story of what happened to their son, who died due to medical malpractice:

“My son Levi Slayton was born August 16th, 2002 and died five days later. He died after being seen by our pediatrician that same day, who failed to run tests and readmit our son, despite clear evidence that he was suffering from an infection. Our case went to trial, and even the doctor’s own expert conceded they would have treated our son differently. Levi’s life could have been spared. Please do not take the rights away from the victims and our families. Vote no on this very bad bill.”

However, the latter testimony had the bill’s sponsor Don Gaetz on the defense:

“The last thing this bill does is to water down the standard of care. Anyone who is able to show clear and convincing evidence would have access to the courts as would their clients, absolutely.”

But, Senate Democratic Leader Nan Rich wasn’t buying it:

“I believe that this language will make it much more difficult for people to get their day in court and it will close the courthouse doors to a lot of people who deserve to have their cases heard, and decision to be made on what would happen. So, I will be voting no on the bill today.”

Gaetz, however, says he feels like he has a very sound bill:

“I believe the rough edges have been sanded off. I believe that we have a good vehicle to go forward to end a 38-year war and to provide a better environment for physicians and optometrists to practice in the state of Florida and I ask your support for the bill.”

The bill passed along a party line vote with Democrats opposed. The bill is expected to go to the Senate Budget Committee.