NEW YORK—The American Optometric Association (AOA) along with other state associations, organizations and OD groups are gearing up to actively fight new legislation, proposed in some states, which would block, limit or discourage doctors of optometry from being referenced as "doctors." In recent weeks, the AOA reports that such legislation has been introduced in Florida, Connecticut and Texas. The AOA notes that as many states, the U.S. Congress and an array of federal agencies have updated laws, regulations and policies to recognize optometry's essential and expanding role in health care, opposition is continuing to push its agenda. Citing attacks from some medical and ophthalmology groups in a recent update to its members, AOA says "anti-optometry language has been rooted out and is being actively opposed by affected state associations and the AOA."

Over a decade ago, an American Medical Association (AMA)-backed national effort to pass “Not a Doctor” legislation—known in Washington, D.C., as the “Sullivan Bill”—was exposed and defeated by the AOA and affiliates, its recap stated. Facing this renewed attack at the state level, the Florida Optometric Association (FOA) has been mobilizing doctors, optometry students, staff and concerned patients in fighting back with that same intensity.

"Senate Bill 230 is particularly concerning because it has the potential to directly impact the perceived role optometrists play in providing access to quality eyecare for Floridians throughout the state,” FOA president Mark Marciano, OD, told AOA. “The FOA will continue to defend our high level of doctoral education, patient skills and training, while keeping our doctor-patient relationship unencumbered from political abuses. Our efforts will primarily focus on the goal of ensuring that optometrists are recognized as honorable and valuable members of the eye health care team." 

The bill filed Feb. 9 in the Florida Senate relates to health care practitioners’ titles and abbreviations used in their advertisements, communications and personal identification. It requires health care practitioners to identify themselves in a specific manner, disclosing the type of license under which an individual practitioner is authorized to provide services and the title and abbreviations specified by the bill when treating patients and further, it states the grounds for disciplinary action and denial of licensure by practitioners’ regulatory boards. “Only physicians may include titles and abbreviations or medical specialties in their advertisements,” it reads.

The Senate bill does not specifically reference optometry, but there is concern, the AOA report said, that the restrictions on titles could later be used to attack the qualifications of doctors of optometry, in particular those who specialize in certain areas of optometry. In addition, the proposed ban on the use of the term “physician” in any capacity potentially conflicts with the recognition of physician status for optometrists under federal law.

The bills being exposed in a number of states reveal the linkage to the American Medical Association (AMA) years-old campaign to build support for the “Sullivan bill,” which was rejected in successive sessions of Congress. According to the AOA’s analysis, there are indications that the AMA also is resurfacing its public-facing “truth in advertising” campaign, which the AOA successfully challenged. As this threat has emerged, AOA legal, legislative and communications teams have been providing information and counsel with state associations.

In Texas, H.B. 2324 was introduced Feb. 14 and relates to “regulation of certain health professionals and health facilities.”

"Legislative proposals attempting to prevent doctors of optometry from using the term ‘doctor’ are harmful to patients and petty from organized medicine,” said Tommy Lucas, OD, director of advocacy for the Texas Optometric Association (TOA). “In Texas, we are currently monitoring this type of legislation that would affect the nursing profession but does not affect optometry in the bill's current form. States should remain vigilant in protecting patients from confusing public policy that would potentially delay and hinder their important eyecare.”

Similarly, doctors of optometry are omitted from a bill in Connecticut, called “An Act Concerning Truth in Advertising by Health Care Providers.”

The AOA and other optometry groups, associations and others will continue to monitor the situation. AOA advocacy leaders view the emergence of state “Not a Doctor” bills as an attempt to derail a new round of optometry-centered scope modernization and expanded patient access proposals being considered by legislatures in a dozen states. In 2021 and 2022, Wyoming, Mississippi, Virginia and Colorado all overcame opposition to enact optometric laser procedure laws, boosting to 10 the number of states where the profession’s education, skills and training for this type of contemporary care is recognized in statute.

The AOA stated it has been very active in these efforts through its Future Practice Initiative (FPI), a campaign to directly support affiliate scope modernization efforts. It was established as a 10-year, $10 million mobilization to make increased access to essential eye health and vision care a priority in state capitals across the country.

“Optometry will continue to look to the future and the needs of our patients as we advocate for our full recognition and scope modernization priorities and lock in more wins,” AOA president Ronald L. Benner, OD said.