| Greensheet – May 1999
VISTAKON SUPPORTS IAB'S WEB-SITE
Dr. Yamane further shared that, "Vistakon has become the world's largest contact lens manufacturer with the world's three leading brands, Acuvue, 1-Day Acuvue and Surevue, thanks to colleagues around the world recommending our family of products to their patients. We appreciate that. Our continued success has given us the ability to provide institutional grants that in turn help our colleagues as they endeavor to improve their skills and understanding of the eye care areas to better serve their patients." The IAB salutes Vistakon for their ongoing support of the profession and the IAB's OptometryCE web-site!
NATIONAL OPTOMETRIC CONTINUING EDUCATION CONFERENCE On April 9-11, IAB hosted an historic meeting in Oak Brook, IL, at the Oak Brook Hills Resort & Conference Center. The National Optometric Continuing Education Conference (NOCEC), hosted by the IAB's Contemporary Issues in Optometry Committee, and chaired by Dr. Charles Harrill, declared an ambitious mission: to initiate a profession-wide analysis of the current status of optometric CE and to foster an exploration of its future direction for the benefit of the public. To address this mission, representatives from the American Optometric Association (AOA); the American Academy of Optometry (AAO); the National Board of Examiners in Optometry (NBEO); deans and presidents representing the Association of Schools & Colleges of Optometry (ASCO); Continuing Education Directors from Southern Council, Mountain West, and the North Carolina State Optometric Society; and invited speakers and special guests from within the profession, came together to lend their collective talents to explore the larger issues facing CE in the profession of optometry today. IAB Member Boards were also well represented with no less than a dozen past and present state board presidents/chairs in attendance. Using breakout session formats, attendees addressed the following four major topic areas: Tied into these breakout sessions were two panel discussions. The first tackled "Competency Assurance in Optometry" with a follow-up panel on the last day of the conference that challenged participants to examine "Economic and Logistical Factors Related to Implementing Work Group Results". Dr. Richard Penna, Executive Vice-President of the American Association of Colleges of Pharmacy, and a past member of Council on Optometric Education (COE) was a guest speaker at the conference, and began his remarks by saying, "I want to congratulate the IAB for calling this conference. The kind of questions you are asking - Is continuing education the right way to go? Is requiring continuing education the right way to go? Do we need to re-evaluate this current yard-stick for measuring the quality of professional practice? - are precisely the kinds of questions that all health professions should be asking. The dialogue you create this weekend, I hope will continue." Dr. Eyler, IAB President, said "This conference has been an extraordinary accomplishment for IAB. We hope that the conclusions reached by the attendees will help lay the foundation for a new future for continuing education, and provide the stimulus needed to assure state boards of the quality of this important component in continued practitioner competency. "The IAB also wishes to extend our gratitude to CIBA Vision Corp. and Essilor Lenses, for without their generous support the conference might not have enjoyed this impressive level of success and recognition." The Contemporary Issues in Optometry Committee will present a detailed report on the findings of the conference at the Annual Meeting in San Antonio, TX, in June.
Welcome to a very special issue of the Greensheet. This issue is being sponsored by Vistakon, Inc. (a Johnson and Johnson Company) as part of our corporate partnership campaign to fund the IAB's OptometryCE web-site. A statement from Dr. Stan Yamane, Vice President of Professional Affairs at Vistakon, who was instrumental in supporting this new service, can be found above. I will return to the issue of the IAB's OptometryCE web-site later in this column. The IAB will celebrate its 80th Anniversary this June at our Annual Meeting in San Antonio, Texas. Regulatory boards of optometry have a rich, storied history of providing and administrating the mechanisms to assure that the public receives safe and effective eye care from licensed optometrists. Our history includes the organization of the IAB, the founding of the National Board of Examiners in Optometry (NBEO), active participation on the Council on Optometric Education (COE), aiding in the establishment of the principles of life long learning via continuing education, the creation and evolution of the Council on Optometric Practitioner Education (COPE) and so much more. As President of the IAB, I have had the opportunity to work first hand with the impressive individuals who make up the IAB. Be it in the area of data & technology services, telehealth, or the detailed planning of an upcoming meeting, all of IAB's volunteers combine to make an effective team. It has been my sincere privilege to be your president this past year. Over the last few years the IAB has consciously increased its involvement within the inner circles of organized optometry. Utilizing our Member Board's respective talents and strengths, we have become a more high profile organization. This year alone has witnessed board level meetings with the leadership of the American Optometric Association (AOA), the American Academy of Optometry (AAO), the Council of Optometric Education (COE), and the Association of Schools and Colleges of Optometry (ASCO). We believe this direct face-to-face dialogue will benefit both the profession of optometry and ultimately the public, which regulatory boards of optometry are charged to protect. Internationally, the IAB has recently sent representatives to the World Council of Optometry's Congress on Optometric Education in Köln, Germany, and WCO's Annual Congress held in Brasilia, Brazil. These meetings were preceded by the IAB hosting the December 1997 International Optometric Regulatory Conference in San Antonio, TX. Along these same lines, the IAB recently hosted thirty-two recognized leaders in optometry at the National Optometric Continuing Education Conference in Oak Brook, Illinois. The April 9th - 11th event boasted an attendance list that included: Dr. Richard Penna, Executive Vice-President of the American Association of Colleges of Pharmacy; several Deans and Presidents from the schools and colleges of optometry; several Continuing Education Directors from ASCO institutions; members of the AOA Board of Trustees; Continuing Education Directors from Southern Council, Mountain West, and the North Carolina State Optometric Society; and no less than a dozen past and present state board presidents/chairs represented the IAB. Discussion was at a 'high level' with CE being analyzed as it relates to competency assurance, board certification, and licensure by endorsement. A complete written report from Dr. Charles Harrill, Chair of the Contemporary Issues in Optometry, and the National Optometric Continuing Education Conference, will be forthcoming at the Annual Meeting in June. It is through proactive endeavors such as the National Optometric Continuing Education Conference that IAB Member Boards, and the profession as a whole, will continue to learn. This learning will result in a direct benefit to the profession, and therefore, to the public, who are the recipients of quality visual care. Similarly, the COPE committee recently met in Bethesda, MD, to continue their ongoing work of refining the COPE process. This commitment to improvement assures the effectiveness of COPE in meeting the needs of both IAB Member Boards and individual optometrists. Just as significantly for our Member Boards comes news from the COPE Committee that the COPE web-site is about to be overhauled to provide a more user-friendly interface, offering more ways to access and search COPE course data. The IAB's new service, OptometryCE, has also recently been revamped and provides an informative counter-balance to the COPE site. If you haven't already done so, take a moment to visit the site and become one of the 5,000 hits the site is averaging a month! Special thanks also go to Vistakon, Inc., for their generous support in our endeavors. In closing, as we approach the 80th Anniversary Meeting, let us remember and reflect upon the past in an effort to improve and guide our future. The Annual Meeting Planning Committee has put together an excellent program, overflowing with useful information for all attendees. I look forwarding to seeing you in San Antonio.
ANNUAL MEETING 1999 - SAN ANTONIO, TEXAS For more information, visit www.iabopt.org/about/annualmeeting99.shtml.
John D. Robinson, O.D., Executive Director of the North Carolina State Board of Examiners in Optometry and Secretary-Treasurer of the IAB from 1967 to 1984 (some lean years for IAB) was awarded an honorary degree at the Pennsylvania College of Optometry Commencement Ceremony on May 15. Dr. Robinson, a 1954 graduate of PCO, received the Doctor of Laws degree for his career-long commitment to organizational service and optometric advancement. He has been highly influential in expanding the responsibilities of optometrists in his home state of North Carolina. Dr. Robinson received the PCO President's Medal in 1995. IAB congratulates Dr. Robinson on his latest accomplishment!
Nominations are being solicited for TWO positions on the IAB Board of Directors. The following nominations and elections are to be made at the Annual Meeting:
THE NATIONAL OPTOMETRIC DATA CENTER The National Optometric Data Center is a project of the Information & Data Services Committee (I&DS) of the International Association of Boards of Examiners in Optometry. The Data Center was created after the June 1998 IAB Annual Meeting when a need was identified to focus the IAB's data collection efforts. The mission of the center is to continuously update and improve on the data in the National Optometric Data Bank (NODB). In addition the center is now collecting data for the IAB Continuing Education tracking project. This ambitious project is undertaking to provide a one stop resource for optometrists, boards of optometry, and CE providers, to list all available continuing education courses relevant to optometry. The IAB feels this new service is a natural extension to the services provided by the Council on Optometric Practitioner Education (COPE) in assisting Member Boards in their CE verification efforts. The Data center is organized to provide actual phone answering 1-5 p.m. Eastern Time, Monday through Friday. Data is gathered by both members of the I&DS Committee and by staff at the Data Center. The members of the 1998-1999 Information and Data Services Committee are:
Two Board liaisons assist the committee with their work: Drs. Robert Sorrell (rsorrell@ix.netcom.com) and Howard Flippin (hflippin@csw.net). The mission of the Committee is to supervise the NODB and the CE Meeting project and to assist and expedite the gathering of data for the projects. The information gathered over the last year for the National Optometric Data Base and the initial information and structure of the CE data base are found on the IAB home page www.iabopt.org. In addition, the CE database will allow direct access at OptometryCE. Information for the CE database may be forwarded to the Data Center directly using an online data entry form available at the web-site. Information from the National Optometric database available to the public shows the location and general practice information for a licensee. This includes office address and phone numbers with a YES/NO statement on if board actions exist for a licensee. The Information and Data Services Committee retains the services of a primary consultant, Mr. Ernie Patterson efpatterson@mindspring.com. Mr. Patterson is the primary technical consultant and supervises the Data Center. His personnel maintain the office at the following address:
IAB Data Center The present plan is to have the Data Center personnel update the National Optometric Database (NODB) on a semiannual basis by initiating direct contact with state board staff. I&DS committee members contact specific states to encourage submission of continuing education meetings to the OptometryCE database on an ongoing basis. The ID&S Committee wants to emphasize a continuos open line of communication to our member boards for this database. The committee is looking for information on all CE meetings available. Please feel free to contact us with any CE information at the above address.
COUNSEL'S CORNER - Subpoena Blindsides Optometrist The authority of regulatory boards, including boards of optometry, to issue subpoenas is a vital tool in policing the profession and effectively protecting the general public. In some jurisdictions, a distinction is drawn between a subpoena issued pursuant to an investigation and to a subpoena issued pursuant to a formal disciplinary charge, sometimes referred to as "discovery." The authority of boards of optometry to issue both investigative and discovery subpoenas are of equal importance in order for such boards to have the appropriate authority to carry out the statutory mandates. An additional question which may arise is whether boards of optometry can subpoena licensees who fall within the jurisdiction of another regulatory board. A recent Iowa Supreme Court case addressed this particular issue. The Iowa Board of Medical Examiners issued a subpoena duces tecum (which requests the production of documents) to an optometrist. The subpoena sought confidential records maintained by the optometrist concerning optometry patients who were also patients of the medical doctor being investigated by the board. The Board of Medical Examiners was investigating this licensed physician regarding questions concerning his care of patients who were also under the care of the optometrist who received the subpoena. The optometrist moved to quash the subpoena, asserting it improperly sought the records without authorization from the patients. The optometrist also argued that the medical board lacked the authority to subpoena the records of the optometrist. An administrative law judge rejected the optometrist's motion to quash the subpoena. On judicial review, the district court ruled that the board had the authority to issue the subpoena as part of its investigatory power. The optometrist appealed the matter to the Supreme Court of Iowa. In its analysis, the Supreme Court initially analyzed the contention of the medical board that the optometrist failed to exhaust his administrative remedies in seeking to quash the subpoena. Generally, exhausting one's administrative appeals is a fundamental and bedrock principle of administrative law. In Iowa, courts undertake review of administrative action only after full completion of any challenge available at the administrative level. Exhaustion of administrative remedies seeks to insure an intra-agency review so that the agency will have a chance to correct its own errors prior to the involvement of the courts. The Supreme Court agreed with the optometrist that he had exhausted his administrative remedies. In so ruling, the court highlighted the distinction that the optometrist was not the subject of the board's investigation. If he were the subject of the investigation, the administrative law judge's refusal to quash the subpoena would not have constituted a final agency action. But because he was not the subject of the investigation, the refusal of the administrative law judge to quash the subpoena was a final action. At this stage the optometrist could either obey the subpoena, surrender the records, and have no further proceedings with the board; or refuse to obey the subpoena whereby the district court would become implicated because boards can only enforce subpoenas by resorting to the district court. Thus, the Supreme Court ruled that the matter was ripe for judicial review. Turning to the merits of the challenge, the optometrist argued that: 1) the subpoena power does not exist until an actual disciplinary proceeding is pending; 2) the Medical Board's subpoena power does not extend to the optometrist because he is licensed by a different board; and 3) the board, in order to issue a subpoena, is required - but failed - to show the matters sought are necessary for its investigation. The Supreme Court held that although there are concededly important distinctions between a board's investigatory and disciplinary powers, there is no reason to conclude that subpoena power should not be important to both functions. Indeed, the Iowa Administrative Code specifically grants the board authority to subpoena confidential or privileged records as part of its investigation of complaints in order to determine if probable cause exists for disciplinary proceedings against a licensee. Thus, an actual disciplinary proceeding is not a prerequisite to the Medical Board issuing a subpoena. The Supreme Court also stated that the Iowa statute is broad enough to empower the medical board to reach records in possession of an individual or licensee not under investigation. The court stated that because investigatory materials are exposed only to the board during the investigation, the confidentiality of such documentation is protected from release. Thus, the court held that the Board of Medical Examiners could issue an investigative subpoena to an individual not under investigation, including the optometrist. Based upon a similar analysis cited above, as well as previous judicial opinions, the Supreme Court rejected the contention of the optometrist that his status as a licensee of another board puts him beyond the reach of the Medical Board's subpoena power. Thus, the Medical Board was able to issue a subpoena to the optometrist. Finally the Supreme Court noted that the Medical Board must establish that the records requested pursuant to the subpoena are deemed necessary as evidence in connection with a disciplinary proceeding. Because the Board did not establish its rights to the records under this particular procedure in that it did not establish that such documents were necessary, the Supreme Court reversed the district court and quashed the subpoena. Accordingly, the optometrist did not have to comply with this subpoena. However, the Medical Board was free to issue an additional subpoena and substantiate the necessity of the evidence in connection with its investigation. Boards of optometry are encouraged to develop an understanding of their investigative powers. Subpoena power can be a compelling tool in discovering important information necessary to maintaining public protection through policing of the profession. In many jurisdictions, including Iowa, subpoena power may extend to additional licensees which may provide the board with valuable information. Conversely, many boards do not maintain any subpoena power whatsoever, which severely curtails their ability to effectively carry out their statutory mandates. For those boards, obtaining subpoena power through an amendment to the applicable administrative procedures act or other statutory authority is strongly recommended. Portz v. Iowa Board of Medical Examiners, 563 N.W.2d 592 (IA 1997)
The following Council on Licensure, Enforcement and Regulation
(CLEAR) Resource Briefs for 1998 are available from the IAB
office:
Resource Briefs for previous years are available from CLEAR. A complete list can be found at www.clearhq.org/briefs.htm.
COPE welcomes volunteers to assist with the review of CE courses. Volunteers only need to donate some of their time and a little effort to help make the program work. You must be recommended by your state board, but you do not need to be a serving member (however, we welcome both serving board members and non-serving doctors as well). COPE Reviewers are sent courses to review on a rotational basis and are required to respond within 10 days of receipt of a course. If you are interested in becoming a COPE Reviewer, please contact Mr. Ryan Higgins at the COPE office at (800) 758-COPE, or write to COPE, 4401 East West Highway, Suite 205, Bethesda, MD 20814-4521. |
