Seven states have introduced potential anti-optometry bills this year. State optometric associations and the AOA are working hard to prevent any of the legislation from diminishing the role of doctors of optometry. Photo: Getty Images.

For the last several months, optometrists and their advocates in Florida have been working to monitor and fend off legislation that threatens to prevent ODs from referring to themselves as doctors or physicians as well as outlines the possible legal penalties for doing so in clinical settings. The original bill, SB 230, proposed that while other medical specialists with similar four-year post-graduate degrees, such as dentists, chiropractors and podiatrists, would still be able to identify themselves using these terms, optometrists would not be allowed due to the exclusion of the terms from the state’s optometric practice act.

After a unanimous vote by the Florida Senate in favor of the bill on March 15, optometrists and advocacy groups including the Florida Optometric Association (FOA) and American Optometric Association (AOA) fought to introduce an amendment to revise the bill to state the following:

“An optometrist licensed under chapter 463 [Florida’s practice act for optometrists] may use the following titles and abbreviations as applicable to his or her license, specialty and certification: ‘doctor of optometry,’ ‘optometric physician’ and other titles or abbreviations authorized under his or her practice act.”

The Florida House passed the bill, filed as HB 583, with the amendment on May 3 with a vote of 111-3. However, in an unfortunate turn of events, the state’s Senate refused to concur in the amendment on May 4, a motion that the House reinforced later that day with a vote of 78-34. This means that the current language of the bill has been reverted to such that would deny Florida optometrists the right to call themselves doctors or optometric physicians and subject them a felony prosecution if they don't comply. However, the AOA reports that it and other members of the proposition are still consulting with legal, and the exact implications of the bill have yet to be affirmed.

In a statement from the AOA published yesterday afternoon responding to the unfortunate news in Florida, the association wrote, “The proposed legislation undermines the doctor-patient relationship that will, in turn, jeopardize patient outcomes. The AOA, in concert with the FOA, is tirelessly working to have SB 230 vetoed by Gov. Ron DeSantis.” If this does not happen, the AOA stated that it “will use all means necessary to identify and defend against unjust targeting of our FOA members and the optometric profession. If necessary, the AOA is prepared to take steps up to and including legal action against any effort to discriminate against the profession of optometry or infringe on optometry’s essential and expanding role in the Florida healthcare system.”

Mark Marciano, OD, president of the FOA, added in a recent article published on the AOA’s website, “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 healthcare team,” said Dr. Marciano to the AOA.1

Unfortunately, Florida is not the only state where anti-optometry bills are being pushed by organized medicine and ophthalmology. According to the AOA’s article, the following states have also introduced not-a-doctor bills this year:1

  • Connecticut: SB 899 (introduced January 25)
  • California: AB 765 (introduced February 13)
  • Massachusetts: HD 1314 (H.3606; introduced March 9)
  • Texas: HB 2324 (introduced March 9)
  • Wisconsin: SB 143 (introduced March 23)
  • North Carolina: HB 576 (introduced April 5)

At the time of this reporting, most of these bills do not explicitly include anti-optometry language, though legal developments are ongoing and being closely monitored by the AOA and state optometric associations. The AOA notes in its article that “The current status of the bills varies. Some have been stymied by the valiant efforts of doctors’ state optometric associations. Anti-optometry language has been rooted out or a bill’s progress stalled in committee.” However, the AOA points out that in Florida, efforts to exclude anti-optometry language are particularly threatening as reflected by recent legislative events.

California ODs Mobilize To Protect 'Doctor' Title

The legal battle against California’s not-a-doctor legislation is also heating up. “AB 765 would make it a misdemeanor for a person who does not have an MD license to use any term implying that the person is a licensed physician, including the word ‘doctor’ or ‘physician,’” explains Kristine Shultz, executive director of the California Optometric Association (COA). “According to the author, the bill was never intended to impact doctors of optometry. It was introduced to prevent a ‘nurse anesthetist’ from calling themselves a ‘nurse anesthesiologist.’”

Fortunately, the COA has secured amendments to AB 765 that would protect ODs’ right to use the term “doctor.” Mrs. Shultz adds, “The amendments also allow an optometrist to make ‘any truthful statement that they specialize in a service or field that is within their licensed scope of practice.’”

While the COA reports that the existing amendments have addressed the majority of the association’s concerns, it will continue to seek clarifying amendments that would preserve the right of California ODs to use other terms they do currently, such as “optometric pediatrician,” which would be prohibited under the bill’s current language (only ‘pediatric optometrist’ would be permitted). “The bill includes vague language, and we are concerned how it might be interpreted,” Mrs. Shultz remarks.

AB 765 will be heard next by the California Assembly Appropriations Committee. “It still has to pass the Assembly, then the Senate, and then be signed by the governor,” Mrs. Shultz reports. “We won’t know the bill’s fate until late summer.”

In light of the ongoing attacks on optometry, AOA president Ronald L. Benner, OD, states in the online article, “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. It’s clear today, however, that those who desperately want to turn back the clock on our advancement need a fresh reminder that our advocacy strength and know-how are also able to defeat any bill that does not clearly recognize optometry’s status as the nation’s primary eyecare doctors,” he states.1

American Optometric Association. AOA and state affiliates rally to decry and defeat discriminatory ‘not-a-doctor’ bills. Published May 4, 2023. Accessed May 8, 2023.