Opinion: Surgeons are made by medical schools, not legislation

Dr. Megan Collins, right, a pediatric ophthalmologist at Johns Hopkins Hospital, gives a vision screening to third-grader Alexander Dominguez. 

Dr. Megan Collins, right, a pediatric ophthalmologist at Johns Hopkins Hospital, gives a vision screening to third-grader Alexander Dominguez.  Kim Hairston/ Baltimore Sun/ TNS

In this photo taken Feb. 1, 2017, Ophthalmologist Dr. Shilpa Rose, left, looks over data collected on the health of the eye of Christianne Krupinsky in Washington, before Krumpinsky has a short eye surgery procedure.

In this photo taken Feb. 1, 2017, Ophthalmologist Dr. Shilpa Rose, left, looks over data collected on the health of the eye of Christianne Krupinsky in Washington, before Krumpinsky has a short eye surgery procedure. Andrew Harnik / AP

By ERIN S. FOGEL

Published: 03-22-2024 4:00 PM

Erin S. Fogel, MD is a cornea, cataract, and refractive surgeon and current president of Concord Eye Center. She has been practicing in Concord since 1994.

In our state legislature, there is pending legislation relative to who may provide care when you need to have a surgical procedure on your eye. This bill (SB 440) would change the law allowing non-surgeons to perform eye surgery without any oversight of NH’s Board of Medicine. Such a change is not in the best interests nor safe for the people of New Hampshire who need care for complex eye matters.

If you are reading this, chances are that I’ve taken care of you, your family member, or someone you know. I have been an eye surgeon in Concord for 30 years. After four years of college, I spent four years in medical school learning the complexity of human anatomy and physiology and the diseases that can plague us, and then another year of internship taking care of patients whose health had failed them such that they required hospitalization. I went on to three years of ophthalmology residency to specialize in eye diseases, learning the medical and surgical interventions to treat them. Then I elected to do an additional two years of fellowship to further expand my knowledge and surgical experience.

That equals 10 years of training to become a medical doctor and eye surgeon. But eye surgery is serious business and I wanted to be as prepared as I could be to meet the needs of my patients. The lessons I learned in those 10 years can’t be found in a book or a YouTube video or a 32-hour weekend course. Being a surgeon requires attention to detail, analytical and observational skills, judgment and experience, mentors to guide and critique, humility, grace under pressure, and always having a plan B. It requires all of those things but even that is not sufficient. It requires training. A lot of training.

SB 440 bypasses that training. It proposes to give optometrists many of the same privileges to perform surgery on New Hampshire residents that eye surgeons/ophthalmologists have traditionally performed. The roles between an optometrist and an ophthalmologist can be a confusing distinction. An optometrist is a key and valued member of any eye care team. They learn to screen for and diagnose eye problems. But they are not medical doctors, not surgeons, and are not required to go to medical school. The surgical training they receive is measured in hours rather than years. There are no opportunities for them to perform surgery on patients as nearly every optometry school is in a state that does not give them surgical privileges.

Why then would the New Hampshire Legislature vote to allow optometrists to perform lasers, injections of medicine into and around the eye, surgical excision of eyelid lesions and other unspecified surgeries of the eye? Why would they put you, the citizens of New Hampshire, at risk by allowing untrained eye care providers to perform surgery?

Our practice is expanding in Concord and other eye surgery practices in the state are also. We have the eye surgeons in this state to take care of our residents.

It doesn’t make sense to me. Does it to you? If not, then I urge you to contact your legislator and ask them to vote no on SB 440. It takes training to become a surgeon, not legislation.

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