Licensing of Optometrists Gives Assurance of Knowledge, Skill and Experience

Optometry, like many other health care disciplines, is a highly regulated profession. In order to obtain one's license to practice optometry every state requires that the provider first complete a rigorous four-year post-graduate doctorate level education, and then take and pass equally demanding and independently administered national and/or state board examinations. This process provides a substantial measure of assurance to the public that licensed optometrists have obtained the requisite knowledge, skill, and experience to be able to provide quality eye care.

Board Certification of Physicians Gives Assurance of Knowledge, Skill and Experience

Unlike medicine, Optometry has not traditionally needed any form of certification beyond licensure. This is because, unlike optometry, while a physician must obtain a license to practice general medicine, medical specialists such as ophthalmologists, internists, and surgeons, are not required by any state to obtain a license or to otherwise demonstrate that they have any formal training or knowledge in their specialty. Any physician with a license in general medicine can, legally, practice any medical specialty, whether or not he or she has been specifically trained in that field. Medical board certification, on the other hand, requires that the physician complete a rigorous formal education (called a residency) and pass an equally rigorous and independently administered board examination. Thus, board certification in medicine is the only objective means of assurance that a physician has obtained the requisite knowledge, skill, and experience to be able to provide quality care in his or her medical specialty.

Within the courts and under the eyes of the law, optometric education, training, and licensure is the medico-legal equivalent to board certification of an ophthalmologist. Licensed optometrists are generally held to the same standard of care as are board certified ophthalmologists.

Maintenance of Certification Is Being Relied Upon to Assure On-going Competence

Health care reform and related movements within the health care industry, in large part led by third party payers such as insurance companies and the government (Medicare and Medicaid) looking to cut costs resulting from poor outcomes, are increasingly looking to enhance assurance of competency in health care and to increase the quality of care being provided. These third party entities are looking at board certification, and, more importantly, the processes used in maintenance of certification, as a means of ensuring that the health care provider is adequately trained and is staying current in his or her profession. They are doing this, in some cases, by creating economic incentives for health care providers to be and to remain board certified and/or economic disincentives for not being or remaining board certified.

As a result, the various medical boards are beginning to end the practice of granting life-time board certification and, in accord with the recommendations of the American Board of Medical Specialties, are starting to require their certified physicians to participate in ongoing so-called MOC (maintenance of certification) programs.

Optometry Needs a Credible Maintenance of Certification Program

Optometric certification and maintenance of certification, like their medical counterparts, is a voluntary process. Increasingly, however, it appears that in the future third party reimbursement rates and even the ability to be a participating third party provider could be tied to participation in these programs. In particular, it appears increasingly likely that full participation in third party programs could require health care providers to be able to show on-going competency through maintenance of certification or equivalent programs. If that happens, the American Board of Clinical Optometry has been established to provide optometrists, whom, because of the requirements of licensure and license renewal, traditionally did not need to be board certified, a credible and attainable means of addressing and meeting the demands that might be expected to be put upon all health care providers in the future, namely, certification and maintenance of certification in order to be eligible for full participation in third party health care programs.