Perspective: Against SQ793

Over the next few days I hope to post some views in support and in opposition of different state questions that are on the ballot. Today, I have a column from both sides of SQ 793.

Posted earlier was a column from the Yes side. Now, we'll hear from the No side.

Optometry is a Rare Bright Spot in Rural Oklahoma Health Care … and It is Under Attack from Walmart

By Oklahoma Association of Optometric Physicians Executive Director Joel Robison

Oklahoma, and particularly rural Oklahoma, has major challenges when it comes to healthcare. The United Health Foundation ranks Oklahoma as the sixth least healthy state in the nation.

One of the main drivers of that poor health, cited in that UHF report, is the limited availability of doctors in our state. In fact, 64 of Oklahoma’s 77 counties are currently classified as areas with a shortage of primary care physicians. That means that many Oklahomans, especially those outside of our major metropolitan areas, are forced to drive long distances for routine checkups. Many simply choose not to, letting whatever ailments or health problems they have fester and grow worse.

None of this is breaking news; the state’s troubling lack of rural health care has been well-publicized. What many people are less familiar with, however, is the happy and glaring exception to this rule for optometry and vision health.

Hollywood may consider us “flyover country,” but the best and brightest optometric physicians have for years considered Oklahoma to be a destination state for vision care. As a result, we are home to hundreds of optometric physicians with offices in almost all of Oklahoma’s 77 counties, meaning patients rarely must travel long distances for world-class care. In Muskogee alone, there are at least 16 practicing optometrists.

Optometrists come to Oklahoma because we have the broadest scope of practice in the nation, and laws designed to put patients first. They are trained to perform procedures that are only administered by ophthalmologists in other states. Our optometrists diagnose and manage many types of eye conditions and diseases, including bacterial and viral eye infections, diabetic retinopathy, macular degeneration, glaucoma and cataract as well as refractive conditions like myopia, hyperopia and astigmatism. 

Before 1971, when Oklahoma’s modern optometry laws were put into place, optometrists had a much more limited scope of practice and many worked helping to sell frames and lenses at large retailers and jewelry stores.

A concerted effort was made to elevate the practice in two ways: first, by dramatically expanding scope of practice to emphasize medical care over sales; second, by establishing a much higher bar for quality of care, overseen by the State Board of Examiners in Optometry.

Finally, optometrists removed themselves from retail establishments like Walmart, where the pressure to assist in non-medical sales could corrupt the integrity of their medical practice and damage the doctor/patient relationship.

Today, Walmart wants to undo that progress by asking voters to pass State Question 793 in November. Not only would this initiative put optometric physicians back in the Walmarts of the world, it has also been deliberately crafted to give those corporate entities almost total control over their doctors.

For example: an independently practicing optometric physician is required by the Board of Examiners in Optometry to diagnose and manage conditions like glaucoma, which can eventually cause blindness. If SQ 793 were to pass, a Walmart optometrist in Oklahoma could be contractually obligated to discard every part of their medical training that does not lead to maximal sales of frames and lenses. While such a practice would be obviously and directly harmful to patients (whose glaucoma would now go untreated and continue to degrade their vision), the medical community would be powerless to object because SQ 793 was crafted as a constitutional amendment that overrules all other conflicting statutes.

State Question 793 is being marketed by its supporters as a free market proposition; in reality, it is a corporate takeover of a medical profession.

As a lifelong conservative, I support market competition, as do the doctors our association represents. After all, they compete for business with each other every day. However, I believe that all voters – regardless of their ideology or their immediate need for vision care – should be disturbed by this attempt to change the state’s constitution to benefit large corporations at the expense of good health care and patient safety. 

Our state and our Constitution are not for sale. Let’s remind Walmart of that on November 6 by voting no on SQ 793.