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Optometrists could do some surgery under W.Va. bill

Organized medicine is opposing a West Virginia bill that would allow optometrists to perform surgical procedures, including laser surgery to treat glaucoma, and to order tests to diagnose and treat patients. The measure heads to the state House after receiving Senate approval in late February. A hearing before a House health committee was expected to begin in early March.

In a March 4 letter to House lawmakers, the American Medical Association expressed concern that the scope of practice changes put patients at risk because optometrists do not have the necessary medical education and training to ensure that such complex procedures are performed safely. The West Virginia State Medical Assn., West Virginia Academy of Ophthalmology, and a coalition of other medical and hospital organizations have joined in opposing the bill.

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Obesity prevalence still rising among some children

Rates of obese and overweight children seem to be leveling off nationally. But the numbers are still rising among certain groups, including those who are publicly insured or living in low-income households, says a study in the March Health Affairs.

Researchers analyzed data of children age 10 to 17 from both the 2003 and 2007 National Survey of Children's Health. The combined prevalence of obesity and overweight among this group increased slightly from 30.6% in 2003 to 31.6% in 2007 (content.healthaffairs.org/cgi/content/abstract/29/3/347/).

Rates increased more substantially among publicly insured children, rising from 39.6% in 2003 to 43.2% in 2007. A jump from 39.8% to 44.8% was found in children living in low-income households.

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Specialists often unseen even after referrals made

Only 50% of referrals to specialists are completed, says a study of 6,785 Medicare patients in the February Journal of Evaluation in Clinical Practice (www3.interscience.wiley.com/journal/123282886/abstract).

Of more than 7,000 orders for patients to consult with specialists, 71% resulted in scheduled appointments, the study said. But even then, patients didn't show up 30% of the time.

Health information technology can help ease the appointment-scheduling process, the study said. But social factors outside physicians' control -- lack of transportation, for example -- also prevent patients from keeping specialist appointments.

The print version of this content appeared in the March 22, 2010 issue of American Medical News.

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