NJ optometry: Improving equity, access costs
In January, I moved to New Jersey to be closer to my fiancé, who works for his family's business. I was planning to move more than a year earlier, but New Jersey's laws restricting optometric practice and my ability to provide the best care to my patients held me back.
Let me explain. After graduating from The Ohio State University College of Optometry, I completed a year-long residency in Kentucky where I specialized in ocular disease and full scope optometry. During my residency year and during the three and a half years I practiced there, I performed laser procedures every day and eyelid procedures every week. One of my passions and one of the reasons I completed a residency was to become proficient in full scope optometry and advocate for it nationwide.
I specifically chose Kentucky for my residency as it was the closest state (at the time) to my home state of Pennsylvania that allowed optometrists to practice to the full extent of their education, training, and certification. At the time, Kentucky was one of only five states that allowed optometrists to practice expanded scope this way. In just four years, that number has doubled, and there are many other states considering such legislation. New Jersey is one of those states.
This spring, legislation, A-5445 / S-3841, was introduced to update the scope of practice for optometrists and address and improve health equity and access to vision and medical eye care for our state's diverse communities, including our growing, aging population. This legislation will allow optometrists, also recognized as doctors of optometry, to perform in-office, non-invasive, minor laser procedures to treat glaucoma and after-cataract surgery care as well as minor eye care procedures to remove styes and skin tags. It also will expand upon existing vaccination and prescriptive authority for optometrists.
Access to affordable and convenient healthcare is a pressing concern for millions of Americans and one I see every day in my practice in southern New Jersey. Optometrists complete a 4-year post-graduate, doctoral level degree program, which includes extensive classroom, laboratory, and clinical training focused on the eye and its components. All U.S. optometry schools train students to perform the procedures included in this legislation — however New Jersey law restricts procedure authority to ophthalmologists and non-eye care advanced practice providers.
There are nearly twice as many optometrists as ophthalmologists in our state. This discrepancy often forces patients to wait weeks to months to see an ophthalmologist for a procedure that could be safely performed in-office by an optometrist. These unnecessary delays also lead to duplication of care and added healthcare costs.
Expanding the scope of practice for optometrists would help improve access to care, particularly in urban and underserved areas where patients face significant challenges in accessing specialized care. By authorizing optometrists to provide a wider range of services, we can bridge this gap and ensure that more individuals receive the eye care they need when they need it. Although I work with amazing ophthalmologists, they do not regularly practice in my location. This means my patients who need these procedures must either wait for the next available appointment or travel further south to be seen sooner, which can be a challenge, especially for patients with transportation issues.
This legislation has the potential to address these challenges. By granting optometrists the authority to perform minor, in-office laser procedures, New
Jersey can take a significant stride toward improving patient access, reducing costs and enhancing overall healthcare efficiency. The last few years have highlighted the many challenges facing healthcare professionals including workforce shortages. By expanding optometric scope of practice, optometrists can be part of the solution.
Throughout my education, training and practice, I've seen that optometrists and ophthalmologists are the ultimate eye care team, caring for the entire eye with every issue that can arise. As we move forward, it is crucial for policymakers, healthcare providers and stakeholders to come together, explore the possibilities and work toward creating a more patient-centered, efficient and cost-effective eye care system in New Jersey.
Dr. Kelley Sedlock, OD, FAAO is a practicing optometrist in New Jersey.