How an eye care brawl consumed the Alabama Senate

It is common to see politicians going eye to eye. But it’s usually not that literal.

A bill that would allow optometrists to perform certain procedures now prohibited from them consumed the Alabama Senate last week. The fight, pitting a group of doctors against a group of optometrists, derailed the chamber’s agenda on Tuesday and consumed much of the day on Thursday.

The battle was a rare example of a fight within a private profession spilling over onto a legislative floor. Most professional organizations hire lobbyists to reach agreement on the wording of a bill before it is voted on. Representatives of both sides said on Friday that this reflected deep entrenchment on the opposing sides.

“It’s happening in most states where these battles are going on,” said Dr. Jamie Crockett, an optometrist who owns EyeCare Plus in Prattville.

The bill, sponsored by Senator Del Marsh, R-Anniston, would allow optometrists in Alabama to do certain injections and perform types of laser surgeries, as well as procedures to remove chalazions or cysts on the eyelids. The bill would ban optometrists from performing cataract, retinal and other surgeries. Ophthalmologists or eye surgeons would keep them.

Optometrists said they are trained in the procedures and current restrictions force them to practice below their training. Crockett said they have testimonials from UAB-trained doctors who left the state because they couldn’t perform the procedures.

Sen. Jim McClendon, R-Springville, a retired optometrist, said allowing the procedures would help in rural areas, which may not have as much access to eye doctors.

“These procedures need to be done across the country,” McClendon said in a phone interview Friday. “It’s a question of access from the patient’s point of view.

The Alabama State Medical Association (MASA), which represents physicians, opposed the bill. Optometrists do not hold medical degrees, and Mark Jackson, the executive director of MASA, said ophthalmologists receive much more extensive training in procedures than optometrists.

“Generally, there are surgeries that only doctors are qualified to do,” he said. “In this case, we’re talking about the eye and surrounding tissues.”

The bill was not on Tuesday’s agenda in the Senate. That timeline included legislation by Sen. Gerald Allen, R-Tuscaloosa, that would attempt to overturn executive orders on weapons issued by the Biden administration.

Senate Democrats had planned to filibuster due to the lack of Democratic-sponsored bills on the schedule. But McClendon launched his own filibuster, which killed the day. Republicans in the Legislative Assembly are quick to cut off Democrats from debate, but are very reluctant to cut off other Republicans.

“Last year the bill was introduced, and I didn’t use that method to lobby, and that bill was never introduced,” McClendon said.

The bill was put on the agenda on Thursday, where it ran into filibusters from senators opposed to the legislation.

“They have an eye infection or something, they’ll go to an optometrist, to their family doctor, but when it comes to operating on the eye, I guarantee you they want the most qualified person who either,” said Sen. Tom Butler, R-Madison. “It would be the ophthalmologists.”

Senators amended the bill to ban optometrists from using the word “surgeon” in their advertisements. It passed the House by a 17-12 vote, with Democrats and Republicans on both sides.

Marsh’s bill moves to the House, where the outcome, McClendon said, “remains to be seen.”

Contact Montgomery Advertiser reporter Brian Lyman at 334-240-0185 or [email protected]