• Practitioner Continued Competency Captures Attendee Attention at the 1998 Annual Meeting
• Telehealth — An Emerging Issue for State Regulators
• IAB Elects Leadership for 1998-99
• IAB Establishes It's Own Office
• Dr. Steve Eyler is Elected IAB President 1998-99
• COPE — Two More States Join
• 1998 Directory of Boards of Optometry
• Counsel's Corner
• International Report: World Council of Optometry GDM

PRACTITIONER CONTINUED COMPETENCY CAPTURES ATTENDEE ATTENTION AT THE 1998 ANNUAL MEETING

The International Association of Boards of Examiners in Optometry (IAB) hosted its 79th Annual Meeting at the Hyatt Orlando, Orlando, Florida, from Sunday, June 21 through Tuesday, June 23, 1998. The meeting, scheduled over three days, brought together 63 representatives from 39 boards of optometry, as well as other invited speakers and guests. Total attendance at the Annual Meeting was 89 individuals representing 48 various organizations.

The three-day meeting opened on Sunday, June 21 with two unique workshops. The morning session saw the repeat of the popular National Board Workshop, presented by the staff of the National Board of Examiners in Optometry. This interactive presentation allowed the delegates to gain a first hand look at the workings behind the organization that administers the primary licensing exam for optometrists in the U.S. The NB Workshop gave attendees a chance to question NB staff on the 'mechanics' of exam construction and testing techniques while also engaging in a Patient Management Problem (PMP's) test item writing session that many described as a "real learning experience." Executive Director Norman E. Wallis, Ph.D., O.D., and NB Director of Psychometrics and Research Leon J. Gross, Ph.D., represented the National Board at this workshop.

The afternoon session began with an update report on the continuing development of the Federal anti-fraud and abuse initiative called the Health Care Integrity and Protection Data Bank (HIP-DB). Special guest speaker Ms. Jacqueline Rodrigue, a policy analyst with DHHS, Division of Quality Assurance, gave attendees a status report on the progress of HIP-DB, and answered questions on state board involvement in the databank. Robert Sorrell, O.D., Chair of the IAB's Information & Data Services Committee, facilitated the session and fielded attendee questions on compliance with HIP-DB reporting requirements, and the role of IAB in disciplinary data collection efforts.

Ms. Rodrigue notified attendees of the existence of an Internet site that provided updated information on the continuing developments of HIP-DB. The site can be accessed at www.hrsa.dhhs.gov/bhpr/dqa.

Dr. Sorrell concluded the first afternoon session by reviewing the progress of the National Optometric Data Bank (NODB), and discussed with workshop attendees the benefits of sharing licensee data with the IAB. Dr. Sorrell enumerated the benefits of a databank that pooled licensee information, both demographic and disciplinary in nature.

The second afternoon workshop was hosted by the newly formed IAB State Board Executive Directors/Administrators Committee and focused on issues unique to state board staff. This first-of-its-kind workshop, facilitated by committee chair Ms. Lois Ewald (Texas), was intended to provide a forum for state board staff to share common issues and experiences, and by all accounts, it was a great success. Attendees heard a panel discussion regarding the handling of complaints, investigations, and enforcement as conducted by optometry boards with varying organizational structures, from those boards that are completely autonomous, to umbrella boards, to those that share components of both. The role of staff (and the difference between those boards that had staff and those that didn't) in the process of administrating complaints was also keenly debated, as the panel discussion evolved into an open forum drawing strong attendee participation over common issues related to the role of enforcement. The afternoon session concluded with a presentation and handout on 'Violence in the Workplace.' It covered such topics as recognizing and dealing with hostility and anger of complainants and licensees, through hostage situations and bomb threats. Committee chair Ms. Lois Ewald also facilitated this session.

The IAB House of Delegates convened on Monday, June 22, and began two days of discussions and presentations that addressed the issues that currently impact licensing jurisdictions, and the laws and regulations that govern the scope of optometric practice. In addition to the business of the association, the House of Delegates considered or reviewed the following key issues: progress on the work of the Council on Optometric Practitioner Education (COPE); a Bylaws amendment; an update presentation on Telehealth; and reports from several allied organizations, including the Association for Schools and Colleges of Optometry (ASCO); the American Optometric Association (AOA) State Government Legislation Office; the AOA's Licensure & Regulation Committee; and the American Optometric Student Association (AOSA).

Continued competency and telehealth played big roles at this year's Annual Meeting. In a follow-up presentation to last year's telehealth panel discussion, the IAB Telehealth Sub-committee presented an analysis of ongoing developments in the field. The Telehealth Sub-committee notified attendees of recently enacted Alabama State Bill SB567 which authorizes a special purpose license for telehealth practice for optometrists, and presented further evidence of the expansion of telehealth opportunities available to practitioners. Presenting the committee report was Dr. Carolyn Carman-Merrifield, who reported on the analysis of the committee of several possible scenarios that licensing boards could face when addressing telehealth. Dr. Carman-Merrifield indicated that IAB would be working on refining a recommendation of a course of action for member boards by the 1999 Annual Meeting, and presented two IAB-endorsed resources that were available to assist boards when addressing telehealth (see related article this issue).

"Telehealth has the potential to initiate the greatest fundamental change in how we interact with our patients since the advent of DPA legislation," said Dr. Carman-Merrifield. "Telehealth is already occurring in many areas of the country, and we find it is increasingly being supported by both federal and state government. We need to provide our member boards with the advice and resources they need to take the proactive regulatory stance that is necessary to ensure patient protection. The possible impact of telehealth on the mechanisms of professional regulation itself cannot be overestimated."

The Continued Competency Forum was the centerpiece presentation at the Annual Meeting and prompted the participation of all attendees at the Annual Meeting. In a break from the traditional lecture or panel discussion format, the Contemporary Issues in Optometry Committee, which organized the Forum, enrolled all attendees in breakout sessions. Continued competency had arisen as a key topic at this year's meeting following the success of the Continued Competency Summit sponsored by the Interprofessional Workgroup on Health Professions Regulation (IWHPR), that was held in Chicago, IL, on July 25-26, 1997. IWHPR is a multi-disciplinary group of 18 organizations representing some 4 million health care practitioners. Over 200 attendees from a board spectrum of health care disciplines attended the Summit - just to talk about professional continued competency. The IAB also felt it was time to raise the issue for discussion amongst our member boards, and devoted a significant amount of program time at the Annual Meeting for that purpose.

The keynote speaker, Dr. Jennifer Bosma, Executive Director, National Council of State Boards of Nursing, was heavily involved in the planning and creation of the Continued Competency Summit, and challenged state board staff, "not to ignore this critical issue." Guest speakers included Dr. Arol Augsburger, President, NBEO; Ms. Sherry Cooper, AOA Staff; and Dr. Jerald Strickland, President, ASCO. Dr. Ron Detwiler, chair of the Contemporary Issues in Optometry Committee, introduced the topic and moderated the discussion and summary sessions.

Each breakout session lasted approximately an hour and addressed one of four areas: Assessment of Practitioner Competence; Continuing Education; Philosophical Questions Related to Continued Competence; and The Public and Managed Care. Summary analysis of each breakout session was produced and they will be released shortly, together with the results of an on-site attendee survey that was designed to identify for IAB in which direction our member boards wished us to proceed on the issue.

Dr. Eyler, Board liaison to the committee, noted the success of the Forum. "This is an important issue for our member boards. Our board members know it, state board staff know it, and much of the profession knows it. Sometimes, however, it takes a concentrated effort to draw the necessary attention to an issue and we saw this Forum as the way to achieve that. There are a plethora of issues before state regulators; we feel that this should be close to the top of the list."

The House of Delegates chose this occasion to recognize IAB President Ronald E. Serfoss, O.D., who passed the gavel to incoming President, Steven H. Eyler, O.D. Dr. Serfoss, who was retiring from the IAB Board after four years of service, was presented with a handsome wall plaque recognizing his contributions to the IAB and commemorating his service as President. Frank L. Salimeno, O.D., and James W. Hartzell, O.D., were appointed as Vice-President and Secretary-Treasurer respectively for the 1998-99 term (see related article this issue).

The House of Delegates also passed two resolutions (summaries follow below) which the Judicial Council is currently reviewing. The full text of both resolutions will be reproduced in the next issue of the Greensheet:

1. Recognizes the work of Dr. Ronald Serfoss upon retirement from the IAB Board of Directors, and his contributions to IAB member boards and to the profession;
2. Approved the list of accredited schools/colleges of optometry as submitted to the House of Delegates by COE.

TELEHEALTH — AN EMERGING ISSUE FOR STATE REGULATORS

To read this article in its entirety, click here.

IAB ELECTS LEADERSHIP FOR 1998-99

At the IAB's 79th Annual Meeting in Orlando, Florida, in June, Steven H. Eyler, O.D., was elected President of the IAB for the 1998-99 term, and a new Board member, Dr. Russell Jones was elected (see separate interview with Dr. Eyler in this issue).

Dr. Eyler was elected to the IAB Board of Directors in 1995 and previously served on the North Carolina State Board of Examiners in Optometry. New IAB officers are: Frank L. Salimeno, O.D., of Ogden, Utah, as Vice-President, and James W. Hartzell, O.D., of Des Moines, Iowa, as Secretary-Treasurer. Dr. Salimeno previously served on the Utah Optometrist Licensing Board, and Dr. Hartzell has served on the Iowa Board of Optometry Examiners.

The IAB welcomes a new director to the Board: Dr. Russell W. Jones. Dr. Russ Jones is a serving member of the Arizona State Board of Optometry (Secretary; also past President in 1995), and is a graduate of Pacific University College of Optometry (Summa cum Laude - 1976). He is a member of the AOA, the Arizona Optometric Association (President 1985-86), and Beta Sigma Kappa, and was recognized as Arizona Optometrist of the Year in 1992. He is also a serving member of the Board of the Mountain West Council of Optometrists, and is a past Chair of the AOA State Licensure & Regulation Committee, upon which he served for eight years. Dr. Jones has been in private practice in Flagstaff, AZ, since 1976 and is married to Daphne (a second grade teacher and past president of the AFVA), and has two children, Ean and Chian, both students at Northern Arizona Univ. Dr. Jones keeps involved in the local community with service with the Flagstaff Route 66 Rotary Club, and with Big Brothers of Flagstaff.

In summing up his view of service with the IAB, Dr. Jones said, "I have always been determined to participate in the continuing development of the practice of optometry, rather than just let things happen. Since we practice at the whim of the state legislature, it is important that state boards be diligent in protecting the residents of their state to fulfill the obligation given by the legislature. Although the practice of optometry varies in detail from state to state, we all have the same goal: Do the best job we can to take of our patients. By utilizing the resources of the IAB as a clearinghouse for new ideas, techniques and problems, we can all serve as state board members more effectively."

Dr. Jones is joining fellow Board members: Howard F. Flippin, O.D., of Searcy, Arkansas, serving as Immediate Past President, and Board Directors: Donovan L. Crouch, O.D., of Storm Lake, Iowa; Linda M. Dejmek, O.D., of Appleton, Wisconsin; Mary L. Freitag, O.D., of Greeley, Colorado; D.R. Gordon, O.D., of Clinton, Illinois; and Robert L. Sorrell, O.D., of Middletown, Ohio.

Outgoing IAB President Ronald E. Serfoss, O.D., who retired from the IAB Board of Directors after four years of service, was recognized by meeting attendees at the complete of his tenure as President. Dr. Serfoss was presented with a handsome wall plaque recognizing his contributions to the IAB and to the profession, and the House of Delegates adopted a resolution recognizing him for his dedication and affirming his designation as Life Member.

IAB ESTABLISHES IT'S OWN OFFICE

In a move characterized by the IAB Board of Directors as "an opportunity to solidify IAB's mission to provide quality services to member boards," the IAB established it's own office on April 1st of this year after almost eight years with an association management company. IAB had originally contracted with PAI Management Corp. in October 1990 to provide ongoing administrative support for IAB's activities, and dissolved the relationship effective March 31, 1998. The IAB hired Mr. James S. Vrac as Executive Director and Ms. Dawn Dellinger as Programs Coordinator for the new office, both of who served in these capacities with PAI Management Corp. The news was announced to at the IAB's recent Annual Meeting held in Orlando, FL, in June, and was enthusiastically greeted by the House of Delegates.

Commenting on the rapidity of the establishment of the office, newly elected IAB President Dr. Steve Eyler said, "The Board recognized that an opportunity had presented itself to take IAB in a new direction in terms of staff support and we acted quickly to take advantage of that opportunity. We feel the decision will prove to be a judicious application of IAB's resources."

Dr. Eyler went on to emphasize the Board's belief that the recent move to an independent office is a positive change in the ability of the organization to deliver quality services to its members. "Our decision to establish an independent office with dedicated staff will have a real, meaningful impact on member services. Significantly, it also demonstrates IAB's dedication to COPE's customers and to the level of responsiveness they receive when participating in the program. Establishing our office has already registered a new depth in the quality of services at a time when IAB has realized an increase in demand for our programs. Both the Board of Directors and our members are firmly behind this new venture."

For your records, please note the IAB's new address:

DR. STEVE EYLER IS ELECTED IAB PRESIDENT 1998-99

In an interview held shortly after the IAB Annual Meeting concluded, Dr. Eyler noted the beginning of a new administrative year for the IAB and stated his goals for the coming year. The full text of the interview follows:

How did you get involved with the IAB and/or your state board?

In 1991, I was appointed by North Carolina Governor James Martin to the North Carolina State Board of Examiners in Optometry. Prior to that, I served five years as a Board selected clinical Examiner, whose responsibility it is to administer the North Carolina Clinical Practical Examination. From 1994 to 1996 I had the privilege to serve as President of the North Carolina Board. With the presidency came the opportunity to communicate and interact daily with Dr. John Robinson, the Executive Director of the North Carolina Board. Dr. Robinson, of course, well known to the IAB, served on the Board of Directors for over twenty (20) years and provided me an invaluable amount of historical background information on the IAB. My first Annual Meeting was in Montreal in 1992. I was impressed by the quality of the optometrists present and by the issues discussed during the meeting. At the Annual Meeting in Nashville in 1995, I was elected by the IAB House of Delegates to the Board of Directors.

How has the IAB changed over the years since you joined the Board?

The evolution and maturation of the COPE program has constituted one of the major changes in the IAB. With forty-three (43) member boards currently accepting COPE and over 1480 courses qualified since its inceptions, COPE is becoming the national continuing education vehicle our profession has needed. The signing of the agreement with ASCO last year immediately elevated COPE to a higher level.

Another area of growth is the development of the National Optometric Data Base (NODB). The effectiveness of the IAB Data Committee Leadership, plus the addition of new technology and hiring staff dedicated to member board follow up, is making a current accurate National Optometric Data Base, a reality.

Internationally the IAB has become more involved in the world optometric community. Our hosting of the International Optometric Regulatory Conference in San Antonio in 1998, which drew twenty-eight (28) representatives from the ten (10) countries, the most recent example of this new outreach. In our ever shrinking information linked the world we must stay involved in the World Council of Optometry.

One of the most recent and important changes is the IAB becoming more financially secure and independent. The IAB's financial position is as stable as it has been in many years. Additionally, the establishment of an independent office, staffed by Mr. Jim Vrac, our full time Executive Director and Ms. Dawn Dellinger, our full time Administrative Assistant, is a very positive development.

Finally, I believe the IAB has evaluated its' status among the other recognized organizations in optometry. By continuing to be proactive in interacting with all facets of optometry, the IAB has become a key spoke in Optometry's Rolling Wheel.

What do you see as the primary role for IAB?

The primary role of the IAB is to continue to assist member boards and to provide them with accurate information on the current "Hot Topics" that confront them. But, beyond just providing information, I would like to see the IAB offering specific suggestions and models to help member boards positively address these issues. Telehealth, Continued Competence and Practitioner Mobility (Endorsement) would rank as my top three "Hot Topics" presently.

How can IAB ensure that it stays relevant to its member boards?

Communicate, Communicate, Communicate. The IAB must continue to listen carefully to our member boards. The IAB is the forum for the member boards to share their concerns, their problems and their solutions. This can be done at the Annual Meeting or the Regional Meetings; or via electronic or newsletter communications. It is a two-way street, with the IAB holding the responsibility for gathering the information and presenting it to member boards in an organized useful manner.

What are your main goals for your year as President?

The IAB is blessed with some very talented individuals within its membership and it's Board of Directors. Stressing organization and communication, I hope to maximize our group effectiveness. I am a results oriented person, and to that end, I am looking for successful completion of individual projects, while maintaining the "big picture" goals of the optometric profession that translate to excellence in patient care. More specifically, I would like to help firmly establish COPE as a financially solvent entity, using it as the foundation to address the issues of continued competency and licensing by endorsement.

What do you think your biggest challenge will be?

Integrating and blending all the talented individuals that serve the IAB as staff members, consultants, participating board members, committee members and members of the Board of Directors, to produce positive outcomes is my biggest challenge. I want to see these outcomes advance the profession of optometry, and benefit the patients we serve and protect.

How would you like to be remembered after your term is over?

As a president who took the time to listen. After listening, a president that took the time to organize the information that the membership brought forward. Then, as a president, who with the help of IAB team members listed above, brought forth specific ideas, models and programs, that moved optometry forward.

Tell the members a little about yourself. What do you do to relax?

I enjoy all types of sports, from golf, to basketball, to softball, to racquetball. I have coached youth basketball and baseball teams for nearly twenty years. My wife, Carol and I have taught sixth grade Sunday School the last three years. I enjoy writing and photography, when I find the time. And I am most relaxed when I am in the beautiful North Carolina Mountains hiking or camping with my family and friends.

Is there anything you'd like to say to the members?

The IAB is just starting to realize it's potential in the rapidly progressing world of eye health care. As regulators with the charge of protecting the public, we must stay informed. Together we can accomplish much. Take the time to get involved, the IAB is always looking for good people to volunteer and serve.

COPE: TWO MORE STATES JOIN — Forty-three boards now accept COPE

The Council on Optometric Practitioner Education (COPE), now in operation for over three years, is pleased to announce the recent decision of two states to begin accepting COPE Approved courses. COPE received announcements from the Michigan Board of Optometry and the Rhode Island Board of Optometry stating their intent to begin accepting COPE Approved Courses. Forty-three (43) boards of optometry now accept COPE approved courses.

Robert L. Klein, O.D., Chair of the Michigan Board of Optometry, said, "in approving and adopting by reference the standards and criteria of the Council on Optometric Practitioner Education (COPE), our state board found it to be beneficial in three ways: First, to the Board itself as it decreased the amount of time spent in reviewing and approving courses for continuing education; secondly, to the sponsors of continuing education as they will not be required to submit extensive applications to the state for courses having COPE approval; and finally, we feel the big winner is the individual optometrist, as COPE approved courses can be taken anywhere with the full assurance they are approved by the State of Michigan for license renewal."

Dr. Barry Schneider, COPE Chair, noted, "We are extremely pleased to welcome the Michigan Board of Optometry, and the Rhode Island Board of Optometry as COPE participating states. The recognition by these two states that COPE's standards meet or exceeds their own lends additional credibility to our program, and adds extra value to the program with their participation."

COPE has received over 1,700 courses since it's inception on January 1, 1995; has granted the COPE Qualified Administrator designation to over 140 organizations/individuals; and approved over 500 programs.

1998 DIRECTORY OF BOARDS OF OPTOMETRY

The 1998 Directory of Boards of Optometry was recently mailed to all board members and staff; we hope you find it a useful reference tool. IAB staff would like to extend their appreciation to all board staff for helping us to keep our board rosters up to date. As ever, please feel free to contact the IAB staff at any time. Both Mr. James Vrac, Executive Director, and Ms. Dawn Dellinger, Programs Coordinator, are available to answer your questions.

COUNSEL'S CORNER
— by Dale J. Atkinson, Esq., IAB Legal Counsel

The Bare Facts

In the days of health care reform, overlapping scopes of practice legislative reform and sunset legislation, regulatory boards will be confronted with difficult issues relative to scopes of practice and professional responsibilities. It should be stressed that all board members read and understand the practice act, rules and regulations, and administrative procedures act of your particular jurisdiction. In many professions, the scope of practice may, at times, be difficult to apply to a particular technique or procedure in determining whether such a technique or procedure constitutes appropriate practice. A relatively recent case illustrates this point.

An optometrist licensed in Iowa was charged with misconduct alleged to be "unethical conduct or practice harmful or detrimental to the public," conduct prohibited under the practice act and grounds for disciplinary action. Specifically, the optometrist was requiring certain female patients to disrobe from the waist up to conduct scoliosis examinations as one indicator of determining the source of eye problems.

Unable to informally resolve the matter, the Board conducted a formal hearing. Testimony from the optometrist and an expert witness indicated that this type of examination is accepted, although rare, in the field of optometry. Testimony indicated these examinations were used on patients who complained of ocular problems, including headaches, eye fatigue and tiredness. Testimony also indicated that although these procedures were not part of an educational curriculum, medical literature indicated the potential relationship between eye problems and scoliosis.

Not only does the fact pattern of this matter take on an unusual flare, but the Board activities were also somewhat perplexing. First, the Board concluded that the optometrist "was honestly attempting to provide the best care for his patients, and did not engage in unethical conduct or practice harmful or detrimental to the public." The Board concluded that a licensed optometrist may conduct such screenings if the practitioner believes an eye condition may be related to scoliosis. Because the Board found that this optometrist held such a belief and was motivated by an intent to care for his patients, the Board determined that his actions were within the scope of professional practice and dismissed the charges.

Following the enormous publicity and criticism precipitated by this initial decision, the Assistant Attorney General who represented the Board at the initial hearing filed a petition for rehearing on behalf of the state. Based on this petition for rehearing, the Board reconvened and, although no additional evidence was received, reconsidered the matter and amended its decision. After its rehearing, the Board determined that the optometrist had not "harmed" his patients but did determine his conduct to be harmful and detrimental to the public in violation of the practice act, because it was an unreasonable intrusion upon their expectation of privacy. The Board determined that scoliosis screenings should not be used by any Iowa optometrist in relation to eye examinations. The optometrist appealed the findings and three-year probationary placement upon his license.

On appeal, the optometrist argued that the practice act was unconstitutionally vague and violated his due process rights. In rejecting these arguments, the Iowa Supreme Court identified the technical legal arguments and burdens necessary to overcome the presumption of constitutionality of a statute. It held that the practice act's proscription of practices that are harmful or detrimental to the public were sufficient to inform practitioners of inappropriate conduct. The Supreme Court stated that in "regulating certain matters a degree of indefiniteness is necessary to avoid unduly restricting the applicability of proscribing rule." The Court added "regulation of the medical profession requires flexibility" and "the limits between good and bad professional conduct can never be marked off by a definite line of cleavage." Thus, the Court held that the optometrist was informed such conduct was detrimental to the public.

The optometrist also argued his due process rights were violated in that the Board commingled its investigative and adjudicative functions through the involvement of the Assistant Attorney General who prosecuted the initial matter yet requested the rehearing. Coupled with this issue, the optometrist argued that the second hearing, held in closed session with no additional evidence taken, created a strong likelihood of prejudgment on the part of the Board. In rejecting these arguments, the Supreme Court stressed the presumption of honesty and integrity in the Board and cited the fact that an independent investigator was appointed. In its analysis, the Supreme Court stated that the optometrist "simply failed to satisfy the high burden placed on those challenging agency action."

Finally, the Supreme Court rejected the arguments of the optometrist that extensive media coverage and criticism influenced the Board's decision. The Court stated that the rights of the licensee were protected on the basis of his preservation of appeals.

Boards of optometry are encouraged to carefully delineate between investigations, prosecutions and adjudications. Although the Supreme Court upheld this particular decision, caution dictates a striking separation between these various functions of the disciplinary process. This case also illustrates the authority of a board to rehear a matter. Again, boards of optometry are cautioned to limit the basis of modifying any previous decision on the conclusions of fact and law determined. [Fisher v. Iowa Board of Optometry Examiners, 510 N.W.2d 873 (Iowa, 1994)].

INTERNATIONAL REPORT: WORLD COUNCIL OF OPTOMETRY GDM
— by Tom Lawless, O.D., Chair, International Committee

The World Council of Optometry (WCO) held its 1998 General Delegates Meeting May 10-14 in Jerusalem, Israel. This meeting has an extensive agenda to consider, with reports from officers, directors, country members and committees. The purpose of this article will be to highlight some of the items more pertinent to IAB members.

The WCO office is now located in the Elkins Park facility of Pennsylvania College of Optometry. Dr. Tony Di Stefano serves as WCO Executive Director. IAB is an Affiliate Member (non-voting) of WCO as are AAO, ASCO, NBEO, NOA and OEP. The American Optometric Association is a voting, Associate Member and filed an extensive report on US optometry during the meeting.

The International Optometric Regulatory Conference organized and hosted by IAB and WCO in San Antonio was repeatedly discussed and reported. President Peter Stevenson recognized it as the "most widely representative meeting of Optometric Registration Authorities ever held." Mr. Stevenson's summary statements cautioned against a jurisdiction forcing their standards on others and to be sensitive to a country's present status. Further, he reminded delegates of the public interest aspects of regulatory authorities. Overall there was genuine interest in the concepts and topics of discussion of this unique and initial meeting of global optometric regulatory representatives.

Likewise, Executive Director Tony Di Stefano expressed pleasure with the positive efforts of this meeting. Rationalizing international policies, standards and protocols for regulation of optometric practice has taken a positive first step, stated Dr. Di Stefano. Developing country manpower profiles and databases incorporating information similar to IAB's Survey on Optometric Regulation (distributed at the IAB's recent Annual Meeting) was recognized as an important goal.

The WCO web site address is http://www.worldoptometry.org/. Future GDM Meetings are scheduled for Brazil in 1999 and South Africa in 2000. It is anticipated that continued participation of the international optometric regulatory community will be involved in these or similar meetings. A call for a Handbook of the Scope of Optometric Practice around the world, and practitioner profiles on eye care professionals was issued. The International Committee believes such an effort would dovetail appropriately with the IAB National Optometric Data Bank (NODB) initiated several years ago and under constant update and expansion.

The WCO's Practice Standards Committee defined a need to determine the various clinical standards (privileges) worldwide. Eventually, a World Diploma in Optometry to enable 'knowledge portability' to support licensing/registration for practitioners' relocation needs internationally would be the ultimate goal. However, extreme variances in scope of practice, education and testing make this an enormous undertaking. This is an excellent reason for IAB to pursue uniformity in states' optometric practice acts so that US jurisdictions might uniformly participate in world optometric endorsement criteria.

Contact Executive Director Tony Di Stefano at (215) 276-6118 or e-mail wco@pco.edu to request a copy of the WCO agenda for the 1998 GDM in Jerusalem.