[Congressional Record Volume 150, Number 138 (Tuesday, December 7, 2004)]
[Extensions of Remarks]
[Page E2176]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




     ON THIS DAY OF REMEMBRANCE: AMERICA'S VETERANS DESERVE BETTER

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                            HON. DAN BURTON

                               of indiana

                    in the house of representatives

                       Tuesday, December 7, 2004

  Mr. BURTON of Indiana. Mr. Speaker, on December 7, 1941, over 2,200 
brave servicemen and women sacrificed their lives protecting the 
freedoms we have come to cherish. Now, sixty-three years after the 
devastating attack on Pearl Harbor, America has over 26 million 
veterans who have selflessly dedicated themselves in service to our 
great country and sacrificed to guarantee Americans the freedoms we 
enjoy today.
  Unfortunately, rather than receiving the full respect they deserve, 
our nation's veterans are now faced with a recently released Department 
of Veterans Affairs (DVA) directive (VHA Directive 2004-045) that 
exposes them to tremendous risk. The directive grants optometrists--
non-Medical Doctors (MDs)--in the VA system privileges to perform laser 
eye procedures under the supervision of an ophthalmologist--a fully 
trained and certified MD. While I fully understand that the Directive 
mandates the procedure will be supervised, I am also aware of the fact 
that supervising a procedure is not the same as actually performing the 
procedure. As a result, allowing an operation to be performed by a non-
surgeon could potentially jeopardize patient safety, and ultimately the 
quality of care provided to our veterans.
  As eye health deteriorates with age, more and more older Americans 
are faced with the need for eye surgery. And just when our aging 
veterans need this care the most, they are now faced with the prospect 
of having their surgery performed by someone who hasn't been through 
intensive surgical education or training. This new policy blatantly 
imposes a substandard level of health care on our veterans.
  Currently, only one state--Oklahoma--permits optometrists (non-MDs) 
to perform laser eye surgery, while 35 other states have outright 
prohibited this type of procedure. In fact, 14 states, including 
Indiana, have debated and soundly rejected similar measures--seven 
states in this calendar year alone. But regardless of individual state 
restrictions, the DVA directive allows an eye care professional to 
practice anywhere in the VHA system, ``up to the limits'' of their 
license. As a result, optometrists with no formal surgical education or 
training will be able to go to Oklahoma, take a 16 hour course, pass 
the Oklahoma optometry certification exam, and then go anywhere in the 
country and practice laser eye surgery on any veteran in any VHA 
facility. Thus, in states that have prohibited this type of threat or 
rejected Oklahoma-like legislation, optometrists will be practicing 
surgery on veterans against the wishes of state lawmakers.
  As a proud veteran of the U.S. Army, I find it shocking that this 
practice has been allowed to come this far. And I'm not alone in my 
belief that medical doctors who are specifically trained to reduce 
surgery-related risks should be the only ones legally permitted to 
carry out these delicate laser eye procedures. In fact, in a national 
poll of U.S. veterans, 95 percent said it was important for a licensed 
medical doctor, specializing in eye care, to conduct eye surgery.
  Any medical operation has the potential to cause adverse affects. In 
older populations--such as those served by VHA facilities--the rate of 
adverse events tends to increase for any surgical procedure. Therefore, 
it makes no sense that this very population--those most in need of a 
medical doctor's training and education to determine the safest surgery 
for their overall health--be needlessly exposed to the very real threat 
of having a non-MD operate on them. It should be our highest priority 
as American citizens to help ensure the safety of those who have so 
proudly and bravely defended our great country. All U.S. veterans 
deserve to have quality health care performed by medical doctors with 
the proper education and training.

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