Board Communication #4
NORTH CAROLINA STATE BOARD OF
EXAMINERS IN OPTOMETRY
Who would have imagined on New Year’s Eve as we welcomed in 2020, that only a few months later we would be hunkered down in our homes, our practices closed or open for only limited services. Our economy was booming and 2020 (20/20), in some way symbolized our excitement for the future. To say we are having to regroup and adjust is an understatement.
Some NC optometrists have expressed they would like additional clarification regarding the Board’s advice/directives provided during this COVID-19 pandemic and the current “Stay At Home” executive order. Other optometrists have complained that while they are following the CDC Guidelines and the Board’s directive, some of their colleagues are not, continuing to provide routine care. I am writing this fourth email to hopefully clear up any remaining confusion and to set the path for the next 30 days.
- Optometry is considered “essential.” (Governor Cooper’s Executive Order No. 121 - Stay at Home Order - “eye care centers, including those that sell glasses and contact lenses” are considered essential.)
- If you decide to keep your practice open to see urgent or emergent cases (defined below), you may do so. No one is suggesting you close your practice.
- Remember to screen patients before they are seen in your practice. (Current screening questions include: body temperature, new onset or worsening cough, GI symptoms/diarrhea/nausea or shortness of breath.)
- If a patient screens positive, the patient should be sent home and told to contact the patient’s PCP for advice and probable testing.
- If you decide to close your practice, that is totally your prerogative. However, the Board expects that you will continue to take patient calls and make arrangements for those patients to be seen by someone who has not closed unless you can address their questions/needs by phone or telemedicine. It is not OK to say “Our practice is closed, go to your emergency room or another practice” unless you have made prior arrangements with that practice to see your patients.
- The Board did not generate the terms routine, urgent, or emergent. Rather, they were terms provided to us from federal and state government and used by our national organizations. So, I will continue to use these terms but think I can explain them in a manner that hopefully clears any confusion. (Please forget any formal dictionary definitions, etc.)
- Routine – bread and butter optometry – vision care – glasses and contact lens exams – periodic rechecks for conditions that are not vision threatening – conditions that can be postponed without threat to the patient’s vision or welfare. The CDC guidelines remain in place and that means routine patient should not be seen.
- Emergent – obvious conditions that require treatment or evaluation to rule out vision threatening conditions
- Urgent – in your professional judgement, if you think a patient needs to be seen, then see that patient. If you think putting off their appointment for weeks or months could lead to issues, then see the patient.
- If a -2.00 D breaks his or her glasses and can’t drive and needs to drive, repair the glasses or order a new pair.
- If you have concern from your last visit, a glaucoma patient is not under control or concern for a diabetic patient that had retinopathy that could be progressive, then see the patient.
- Clear and simple, do what you think is in the best interest of the patient, considering risks to benefits. As doctors, we make these decisions on a daily basis, this is no different!
- President Trump (3/30/2020) and Governor Cooper (effective 3/30/2020), formally extended the “Stay at Home” and social distancing guidelines for 30 more days, essentially through the end of April. Therefore, continue following the CDC Guidelines by postponing and rescheduling routine patients, through the end of April. Following these Guidelines can help make a difference and curb the spread of this disease.
- The optometry members of the Board; Drs. Philippe, Johnson, Ellington, Haines, and Sikes as well as myself are all practicing and are going through this trying time with you. So, when I say, we are all in this together, I mean just that. Stay safe, protect yourself, your family and your patients.
- A famous Dalai Lama saying: “There is no benefit in worrying whatsoever.” Something to at least keep in mind.
William B. Rafferty, O.D., Executive Director
North Carolina Board of Optometry
PO Box 69
Wallace, NC 28466-2713
Board Communication #2
To: All North Carolina Licensed Optometrists
From: North Carolina State Board of Examiners in Optometry
Date: March 19, 2020
Subject: COVID-19 Advisory Following 3/18/2020 Announcement
The Board released its announcement regarding COVID-19 on 3/18/2020 (below). This announcement included the Centers for Disease Control and Prevention (CDC) recommendations that were released on 3/17/2020.
One of these CDC recommendations specifically states, "postpone routine dental and eye care visits". It is obvious that this recommendation is specifically directed to dentists, optometrists, and ophthalmologists.
Since the Board's announcement, the Board has received multiple questions asking if the Board is mandating that optometrists follow the CDC recommendations. Optometrists are also reporting that while they are following these recommendations, other optometrists in their communities are not.
The CDC recommendations are issued as a result of a world-wide crisis the likes (and potential ramifications) of which are unprecedented. Strong measures and a level of sacrifice clearly are called for on the part of our licensees in order for optometry to do its part in bringing this pandemic under control.
If the Board is called on to decide whether one of its licensees has acted appropriately under these circumstances, compliance with CDC guidelines and other prudent measures may well be the yardstick the Board uses in determining whether there has been a breach of the standard of care or whether unprofessional conduct has occurred.
Additionally, it is possible that those involved in any adverse event---patient, patient’s family member or caregiver, or even the optometrist’s professional staff---might well use an optometrist’s failure to comply with CDC guidelines as presumptive evidence of negligence in litigation against the optometrist.
The government is asking for all to practice social distancing, etc. for a minimum of 15 days. The Board strongly advises following the CDC recommendations.
With questions or concerns, please feel free to contact me by phone or email at the information below.
William Rafferty, O.D., Executive Director
North Carolina State Board of Examiners in Optometry
PO Box 69
Wallace, NC 28466
Fax: (910) 285-4546