I Tommy Tucker 64713. Before seven talking about a bill in legislature's and I think. Got out of committee by one vote that would allow optometrists are reformed. Some of the same procedures as ophthalmologist. Money comes to. Your -- and and the outcome measures say it's about helping people in rural areas in the ophthalmologist say now owns about. A lot of training that's involved in the surgical procedures and given everybody the best of care and I am full disclaimer I get shots and my guy every. Six weeks like doctor shell and I don't know that I would want anybody else doing it besides trained surgeon. Doctor Brad black present the Louisiana ophthalmologist -- Asian joins us right now and before we welcome you doctor black I should make it clear. That the law would not cover that procedure for optometrists or would it. That'll -- winds first off -- -- -- tell -- that demanding that your client loved. The the -- on. Is but -- has some conflicting programs in it but. Those are probably hurt the bill probably would not cover that procedure. There's actually another terror in the and the bills that would allow. It injection of any medication by in the -- and so. Are are feeling on that is that that would injections into the but then there's another aircraft that excludes that. My question there -- -- yeah so there are some conflicting. Paragraph in the bill and the content in the build such that it would procedures that are being. -- being a publicly. The the bill was written so that certain procedures are excluded. But there are actually 276. Different. A pelvic surgery procedures that are listed in. In the coaching manual for surgery and you can you may exclude Warren that there may be others that are similar that are technically excluded by this -- so. So they're more than just a few laser procedures and if you live procedures that could be done. Tommy -- the biggest concerns are of Louisiana out Ramallah G association. And I guess is that the training is the difference in training to me and optometrists and an ophthalmologist. I think first that you're hearing. Optometry described this as a few. Simple noninvasive. Uncomplicated procedures. And I think that any time someone uses those terms to describe surgery. That it betrays the lack of understanding of the surgery and the events that happened before and after the surgery. Inserted by definition is in -- What are -- -- laser projection or with a scalpel. And and so complications occur with any type of operation there's not any perfect surgery. And so we have to also consider -- a person skilled and trained to address the complications that doesn't care. The training is. Disorder where ophthalmologist do go to medical school receive the doctor of medicine degrees so that's. Four years in medical school and then a fit here you know surgical or medical internship so for five years. They helped -- -- has had medical training before anyone has ever led touch and I. There's then a three year residency and pour. Many ophthalmologist one or two years of fellowship after that sort of all registered trade. I have medical education -- between eight and ten years. So and optometrists who what I have to do to become an optometrists. -- goes to optometry school with a four year school after. After college. And about 20% up -- our troops will do another one year residency. We -- does not have a school optometry. Do via property -- in Louisiana mostly have a gun to school in Memphis since the Southern College of Optometry. In Houston at the University of Houston -- -- tortured and also an Alabama. In those optometrists have said that they have been trained to do surgery at those schools. The fact is that the curriculum in the schools does not include surgery because. It is against the law in those three states -- overtures to do the surgery that's described in this bill. Let me ask you this doctor -- -- before a -- that time of the concerns I have as a patient as you may have heard -- gets injections into his eyeball. Is that eventually. And you mentioned that the vagaries in the law where maybe you can maybe you can't appear in optometry is that eventually the insurance companies will say you know what. We're not gonna pay the ophthalmologist to do this area who we're we're just -- union optometrists to do this costs a lot less and then you'll have to make up the difference and in essence it would rather then expand choices for people or at least area would limit it. Yeah it's it's initially thought currently but along. CM has that would be Medicare and Medicaid. See him as Medicare Medicaid paid the same amount for the same procedure to promote and -- that there's no cost savings. As it stands. Right now for the common procedures that both of you perform. So that the user examinations in the office. The and that's mostly what it amounts to it's it's mostly that the codes that applied to various examination type procedures that are -- In the opposite nonsurgical procedure. Has that come up at all seized during this legislation that Natalie in terms of access that the optometrists are -- for rural areas but that. Eventually they could charge lower fees and the yummy did to do quality care is not even. That's not the part of the conversation it's a very important. Ingredient in this mix and I'm just wondering if that's what it would be an end game here. It has not been discussed very much and I think it's probably. Not likely just because of the policies of commercial players and the law. With C amounts. Do you think the access issues is. It's an important one to address. Louisiana ranks fifteenth in the nation in the number of ophthalmologist per 100000 population we -- lucky to have. Three residency programs that that graduated eighteen present -- a year and. So we actually have ophthalmologist distributed through the state quite well. 86% of power in Louisiana practice in the same town where there's at least -- ophthalmologist. And the furthest. That. It's. And in the other 14% were up portraits or a practice in town with no -- ophthalmologist. The -- ophthalmologist is an average fifteen miles away not to go to Lou we're at a time anything quickly human and with. Quote -- I think it's dangerous in any profession and legislation replaces education. When you go into medical facilities should have reasonable expectation that the person doing the procedure as the training and experience to do it. I think the people of Louisiana distress deserve nothing. Thank you -- we talked again doctor -- black president Louisiana ophthalmologist OCH.