List date(s) this work was published or aired.
1-Jul-11
Provide a brief synopsis of the story or stories, including any significant findings.
In 18 states, optometrists have been lobbying to broaden the services they offer, such as prescribing drugs, administering injections and performing laser surgery. This has exacerbated a turf war with ophthalmologists who provide the full spectrum of care and say optometrists are sidestepping necessary schooling and training. In the last three years optometrists have been successful in broadening the scope of practice in eight states, but they’ve failed to prevail in seven others. Three states were still considering legislation at press time. When polled, most Angie’s List members had reservations about seeking an optometrist for anything but basic eye care. Just 8 percent said they would turn to one for help with glaucoma, which optometrists are permitted to treat in every state but Massachusetts. When it came to injections or surgery, only 2 and 4 percent, respectively, say they would trust an optometrist. Optometrists argue they get the training needed, even on lasers, and that being able to offer these additional services reduces the need for referrals, saves money and better serves patients.
Explain types of documents, data or Internet resources used. Were FOI or public records act requests required? How did this affect the work?
We used a variety of documents, data and Internet resources to inform and strengthen the credibility of our story. We examined bills in 18 states that passed, failed or were still being considered at press time. We also reviewed information from verdictsearch.com that detailed court cases regarding eye care lawsuits. Within a few days of posting an eye care poll on angieslist.com we racked up more than 1,000 responses, and we sprinkled the stats throughout the article and in an accompanying column by Angie Hicks, founder of Angie’s List. We also downloaded and surveyed dozens of Oklahoma optometrists highly rated on Angie’s List to learn how expanding scope of practice had changed eye care in that state. In order to help consumers understand how costs differed between the two types of eye care providers, we partnered with Healthcare Blue Book to perform an exclusive analysis of more than 15,000 patient records. We also analyzed the results of a household survey by the Agency for Healthcare Research and Quality on patient spending for eye care. And finally we looked at CareerBuilder.com to compare average salaries for optometrists and ophthalmologists. FOI or public records act requests weren’t required for this story.
Explain types of human sources used.
Through our online poll and Angie’s List consumer reviews, we found member sources and interviewed them about their experiences with eye care providers. We talked to state legislators, several state optometric associations, the American Optometric Association, the American Academy of Ophthalmology, and the Association of Schools and Colleges of Optometry. We also spoke to ophthalmologists and optometrists who had received positive consumers reviews on Angie’s List, and reached out to patients who weren’t involved with Angie’s List. And as mentioned above, we surveyed dozens of highly rated optometrists in Oklahoma, which was the first state to allow them to perform laser surgeries.
Results:
Our story generated a lot of feedback, both positive and negative. We heard from ophthalmologists and optometrists who felt it was biased and maligned their professions. Several advertisers threatened to cancel and a few actually did. Most of the praise came from consumers, who echoed earlier interviews in saying they would only go to an ophthalmologist for surgery or thanked us for providing insight into a complex issue. “It is a shame that this article was not taken as … intended,” Dianne Meister wrote. “And that is to educate the public.” Leanne Garcia wrote that she thought the article was well written and informative and both sides represented. “I don’t consider this biased reporting at all,” she wrote. “Personally, I don’t trust anyone but an MD to perform surgery, especially on my eyes. Just like I wouldn’t want my chiropractor — as much as I trust him — doing surgery on my back!” After we went to press with the story, we learned that Texas, South Carolina and Nebraska had refrained from passing legislation that would have expanded the scope of practice for optometrists. However, we’ve since heard from Dr. Daniel Briceland, the secretary for state affairs with the American Academy of Ophthalmology, that Nebraska, South Carolina and Iowa have bills under consideration again this year and he expects more states to follow suit. “We fully expect this year to be equally challenging,” he says.
Follow-up (if any). Have you run a correction or clarification on the report or has anyone come forward to challenge its accuracy? If so, please explain.
We have not run any corrections or clarifications, and no one has challenged the story’s accuracy.
Advice to other journalists planning a similar story or project.
In preparing this story, we discovered that the topic we’d chosen — the debate over expanding scope of practice for optometrists — was even more controversial than previously imagined. We did our very best to interview as many sources as possible to make sure all sides were fairly presented. We strove to guide readers through the debate, present it dynamically, but then allow them to make up their own minds. It was clear to us that people feel very strongly about who they see for eye care and that certainly made digging into education, training and other credentialing worth the significant amount of time we invested. So our advice would be to keep digging until you have a full grasp of important details and then seek to go beyond the rhetoric to determine what’s really on the reader’s mind. In this case, the overarching question appeared to be, “What should I consider before I decide who to see for eye care?” While the debate could have taken us in a million directions, we tried to stay focused on simply answering that question.