Buried way down on page 20, line 412, of a 70-page telehealth bill, optometrists in Massachusetts scored a big win. The bill mandates payment of some telehealth services and establishes some parities for primary care and chronic care services.
It’s been 18 years in the making, but the commonwealth’s ODs became the last ones in the country to gain expanded scope for glaucoma and class III, IV, V and VI pharmaceuticals, says Valarie Ricciardi, OD, of Vision Source of Worcester, who became president of the Massachusetts Society of Optometrists (MSO) just days before the governor signed the bill, S.2984, on Jan. 1, 2021.
Perhaps it was because the ODs in Massachusetts were the only ones left in the country who did not have this scope of practice, all lobbying efforts to keep the scope from expanding have been focused here, Dr. Ricciardi says. Then about four years ago, the MSO began to broaden their appeal to be less optometry-centric and more patient-centric. “We began to emphasize the patient perspectives: cost savings and access and convenience of not having to go through duplicative and multiple visits,” she says. When the pandemic came, the ground shifted even more as optometrists became recognized as essential providers. “We provide primary care,” she says.
For years, advocates in the state had tried to file the bill where optometry’s expanded scope could fit in. As a standalone bill, chances of passage were virtually nil. But the telehealth and patient access bill presented an opportunity to reinforce how inconvenient, costly and – in a pandemic- unsafe it is for patients to have to go from one provider to another. “The end point was really about the runaround that this creates for the patient,” she says.
A CHANGED FUTURE
Dr. Ricciardi has been active with the MSO for 25 years, serving in various roles in the local and state level. “For 18 of the 32 years I’ve been in practice, I’ve been talking about this bill,” she says. When her husband, Brian Thamel, OD, was president of the society, it was his focus too. Their daughter, Lauren Thamel, is now in her final year at New England College of Optometry. She’s entering a new stage of optometry in Massachusetts, but the fight isn’t new to her. “When she was in second grade, she would come with us to advocacy days and hold signs for legislators,” Dr. Ricciardi says. “In fact, my daughter held signs for a state representative who eventually became a senator and senate president, so it shows how small steps and grass root efforts are so important”.
Massachusetts, small but densely populated, is home to two optometry schools, and it has been discouraging for these graduates to have to choose whether to practice to their full scope elsewhere or stay in Massachusetts. For ODs who have been looking to sell their practices, this expanded scope opens new doors. “Many older ODs were having a hard time finding someone who wants to buy a practice here with limited scope,” she says.
It’s a shot in the arm for the MSO, too. “It’s been frustrating not to be able to get this done,” she says. “Maybe this will help us engage even more practitioners who see that our efforts have paid off. But it’s a legislated profession, and we need every OD to help promote the message.”
Now that Massachusetts ODs have a foot in the door, there’s more that they can aim for in scope and parity. But for now, the administration and implementation of the bill is front and center. The bill takes effect 90 days after it was signed, and the MSO, the state board and the optometry schools are working diligently to line up the process.
She’s also hoping for a bit of a celebration when it is safe. Leadership transfers are just some of the many things have changed with COVID. “When my husband was president 15 years ago, he was wined and dined and celebrated. I became president in my kitchen on a Zoom call,” she says, laughing.