Ophthalmology and medical groups in several states—including Florida, Connecticut and Texas—are pushing legislation that would prohibit health professionals from advertising or referring to themselves as “physicians” in medical settings if the term is not defined in their respective practice acts. Furthest along is Florida’s bill, SB 230, which passed the state Senate yesterday morning with a unanimous vote of 37-0 and would go into effect this July if it becomes law. Currently, the legislation awaits a hearing in the state’s House of Representatives.

Yesterday, Florida state senators Gayle Harrell, Tina Scott Polsky and Jim Boyd each rose to support proposed legislation that would strip optometrists of the right to use the word “physician” as part of their professional title.

During the session, SB 230 sponsor Senator Gayle Harrell argued that the bill is intended to promote greater transparency between doctors and patients by requiring all healthcare practitioners to use only the language included in their profession’s practice act to define their titles and licensure. Given that the practice act for optometrists in Florida does not describe these doctors as physicians, the bill will make it so that ODs in the state will not be able to use the title “optometric physician” to identify themselves or advertise the services they provide. Yet, dentists, chiropractors and podiatrists—all of whom have a four-year post-graduate degree, similar to optometrists—would not be required to exclude “physician” from their title under the bill, due to the inclusion of the term within the practice acts for those professions.

“SB 230 contains discriminatory language that clearly disparages the profession of optometry in the state of Florida,” the Florida Optometric Association (FOA) said in a statement after the hearing. “It is especially disturbing to note that these other allied health professionals are now permitted to use the terms and titles of ‘doctor and physician’ in identifying themselves and their education and training, while optometrists would be prohibited from doing so.”

Florida Senator Tina Scott Polsky brought this point to the attention of the committee and posed the question to Senator Harrell of why the bill does not accept optometrists in particular as physicians. Senator Harrell responded by stating, “The term physician is used [to describe optometrists] in federal legislation for payment through Medicare and Medicaid. However, their practice act does not define them as physicians; it defines them as doctors of optometry.” Because of this, she explained, under the current language of the bill, optometrists “may call themselves doctors, but they cannot refer to themselves as physicians. They would have to change their practice act in order to do that.”

The bill also outlines the possible penalties for using language to describe one’s medical licensure that is not explicitly written in their profession’s practice act. An example of this scenario under SB 230 would be if an optometrist in Florida introduced themselves to their patients as an optometric physician. Senator Harrell explained during the hearing that the penalty for a violation “depends on the level of egregiousness of what the individual is doing,” and can range from a simple motion to cease and desist to a misdemeanor or even felony charge in more extreme circumstances. Senator Harrell provided an example of the latter case, noting that “if an individual is not a physician and is practicing medicine illegally, at that point there would be a recommendation to go the criminal route.”

The FOA expressed its concern about the harshness of these penalties and its attack on optometrists in its statement. “This harmful legislation imposes a felony-level penalty of ‘practicing medicine without a license’ against an optometrist for the use of these descriptive terms, which is an egregious and abusive overreach of governmental enforcement for a civil offense,” the association argued. “To no surprise, the Florida Society of Ophthalmology stood up in support of passing this bill,” the FOA noted in its statement. “However, many letters from Florida ophthalmologists around the state have been written on behalf of Florida optometrists in opposition to SB 230. It is of great significance that many MDs and DOs have responded on our behalf and voiced their opinion to the Florida legislature to oppose the potentially offensive treatment of optometrists put forth by SB 230.” 

During a brief debate portion of the hearing prior to the final vote, Senator Jim Boyd spoke up about the discrimination of the bill against optometrists in the state, despite his decision to vote in its favor. “I’ve been calling my optometrist doctor for my whole life; most everybody in the community does,” he said, adding that he has talked to a fair number of ODs whose degrees even state the specific term “optometric physician,” which the bill would prohibit Florida optometrists from calling themselves. He continued, “I understand the components related to the practice act need to be reopened, and that must be addressed. I hope that this body will be willing to reopen this discussion next year and talk about the practice act that would allow [optometrists] to be called what everybody in our community is calling them already, and that's doctor.”

Following yesterday’s disappointing Florida Senate verdict, Ronald L. Benner, OD, president of the American Optometric Association, commented in a press release that “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 is also able to defeat any bill that does not clearly recognize optometry’s status as the nation’s primary eyecare doctors,” said Dr. Benner.

The FOA and its legislative team are also mobilizing to push back against SB 230. “Volunteers and members of the FOA board of trustees have been crossing the state, meeting with all practicing optometrists and students to relay the message and galvanize support, and our colleagues have heeded the call to action with an impressive phone and email campaign voicing their strong opposition to legislators throughout the state,” the FOA noted in its statement on the bill. “Make no mistake, the FOA will remain vigilant in protecting the honorable profession of optometry and our doctor-patient relationship with Floridians,” assured the association.