Optometrists and Dispensing Opticians Board expanded the scope of practice for optometrists to allow them to carry out two types of laser surgery. Photo: 123rf
- Commerce Commission labelled letter from professional body to its members (advising them to refuse to participate in training optometrists to do laser surgery) as "potentially problematic" if not "anti-competitive"
- Royal Australian and New Zealand College of Ophthalmologists claimed allowing non-doctors to do laser surgery would "undermine standard of care" for patients
- Commerce Commission has closed investigation but today issued "a compliance advice letter" to the College
In 2022, Optometrists and Dispensing Opticians Board expanded the scope of practice for optometrists to allow them to carry out two types of laser surgery, provided they had been trained by an ophthalmologist.
These surgeries are YAG laser capsulotomies (typically performed on patients who have had cataract surgery but whose eye(s) have subsequently formed a cloudy membrane behind the artificial lens inserted during the initial cataract operation) and YAG laser peripheral iridotomies (performed on patients who require a small hole to be lasered into their iris(es) to allow for proper drainage).
This move was intended to "free up" specialists for more complex operations.
However, it was strongly opposed by the Royal Australian and New Zealand College of Ophthalmologists, which complained to Parliament's Regulations Review Committee that the change was likely illegal.
Its complaint was rejected, but the College then wrote to its members advising them "against facilitating non-ophthalmic, non-medical practitioners - including optometrists - performing ophthalmic surgical laser procedures on any patient".
"To do so would be counter to RANZCO's stated position as it is against the patient's interest and so undermines the standard of care which all Fellows are expected to practice," the letter said.
The Commerce Commission subsequently launched an investigation into whether this constituted an illegal attempt to stifle competition.
General manager for Competition, Fair Trading and Credit, Vanessa Horne, said while the Commission had not reached a final view on whether the conduct amounted to a breach of the Commerce Act, the College's actions were "potentially problematic".
It had today issued "a compliance advice letter" to the College.
"In this case, we were concerned that RANZCO's letter discouraged its members from training optometrists to perform these surgical procedures, with the potential to substantially lessen competition. It also had the potential to negatively impact patients waiting for these surgeries and cause Te Whatu Ora and private insurers to pay more for them."
As a result of initial concerns raised by the Commission, RANZCO sent a "clarifying letter" to its members stating it did not intend to suggest that ophthalmologists should refuse to help train optometrists, nor that there was a potential risk of disciplinary action for member ophthalmologists who did.
Horne said the clarified position brought the Commission's investigation to a close.
"We're pleased to see RANZCO clarify its position, ensuring Kiwi patients don't miss out on the benefits of competition. As this case demonstrates it's important for trade bodies, professional associations and membership organisations to ensure they familiarise themselves with the Commerce Act to avoid falling foul of the law."
Both RANZCO and the Optometrists and Dispensing Opticians Board have been approached for comment.
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