Hawaii's World
By A.A. Smyser
Tuesday, April 2, 1996
The rationale has been solid: Prescription drugs in the wrong hands or improperly used can have serious consequences. They are strong stuff.
In part because of the drive for greater medical efficiency, there is a nationwide movement to allow other highly trained people to prescribe a limited few drugs and save two-stop shopping for some kinds of help.
Hawaii has been behind the nation on this, well behind.
Only last year did we enact a law to allow advanced practice nurses who have at least six years of training (often more) to prescribe certain medications in cooperation with physicians. The law still hasn't been implemented because rules have not yet been approved by the Board of Medical Examiners.
This year it is the turn of optometrists to fight for limited rights - which 47 other states already have granted with varying degrees of strictness. Optometrists are the people who check our eyes, write prescriptions for glasses, and sound early warnings of glaucoma. They have less training than ophthalmologists, who do surgery and now are the main prescribers of eye medications. Ophthalmologists match the training of other physicians.
But optometrists must have at least four years of college plus four years of post graduate work. They are not exactly babes in the medical woods. They aren't asking to be allowed to prescribe medications by mouth, inject drugs or do surgery.
But they do ask authorization to prescribe eye drops and notionsfor pink eye and chronic eye conditions and to treat glaucoma. This will increase their business. It will also save the customer the cost and delay of going next to a medical doctor for these basic prescriptions. This problem is lessened where optometrists and ophthalmologists practice together, but quite a few optometrists are on their own.
Since Hawaii has no optometry school, our optometrists already come from the same mainland training courses as optometrists in the 47 other states that qualify them to issue limited prescriptions.
A bill to extend the prescription privilege has passed the state House and gone to the Senate, where Milton Holt's Consumer Affairs Committee will decide its fate. The House version would be the most restrictive in the nation aside from Pennsylvania and Massachusetts, the other two nonprescription states. It matches a Virginia version that even Virginia has since relaxed. It would put optometrists under a medical board rather than an optometric board as 47 states now do.
SENATOR Holt is being urged to approve a less restrictive version to pass the Senate and go back to the House. There is at least hope that he will.
The University of Hawaii's dean of nursing, Roseanne Harrigan, was a strong advocate of our 1995 law to ease restrictions on advanced practice nurses. She is an equally strong proponent of more freedom for optometrists.
She says it is "absolutely ridiculous" that optometry patients have to pay an extra $50 to go to a physician to get a simple prescription recommended by the optometrist. They are fully qualified, she says.