Short answer: States and the political nature of optometry and optometry politics. States are independent. Optometry is regulated. So, as scope changes, new laws and rules come up due to politicking or state board rules. The result is 51 jurisdictions with 51 sets of laws/rules. Some of them are pretty good; some not so much.

Some states ask for new categories based upon perceived or real need.

Medicine runs about 20 years ‘ahead’ of optometry in CE accreditation and mobility concepts. They’ve also had problems, controversies, and politics; it’s messy. But, we see them address flexibility, mobility, compacts, and CME accreditation concepts much sooner. Some of that relates back to open scope and more favorable politics. Much of it is our optometry colleagues. I supported small increments of accredited CE: 15, 30, and 45 min. as well as hour or longer. In this way, the OD learner can get credit for researching a real world problem relating to improved pt care. You’d be amazed at the pushback from optometry. Stunned.

While ARBO and COPE take the heat (that’s life), the etiology lies in archaic state laws, new laws, state board rules, money, and fear of change. Optometry.

I certainly agree that it’s convoluted. I generally favor simplicity and flexibility. Generally. There are exceptions. Some of medicine’s CME has been criticized quite strongly. It’s all a moving target. We will see their CME evolve.

If I was COPE Czar and removed the categories, the individual ODs in each of 51 states would still have to meet 51 laws/rules.

In medicine, MDs in many jurisdictions also need to address mandatory reporting, opioids, ACLS, etc.

Things to do: One: volunteer. Be a COPE Reviewer. Take an interest in our own learning. It’s not a lot of work. Frankly, many speakers don’t take the time to place their course in the proper category. Two: Read. Raise hell with the right people. There’s nothing gained by an OD calling an ARBO staff person to rant when their state board made the rule, their state legislators made the law, and their state association got the law produced. See what I mean?

Practice mx for CE credit is difficult to defend as public protection in this century. I realize that upsets people, but think about it as a patient or legislator. However, teaching a professor how to be a better professor… that should be easy. It’s not. I had Category E (educators) designed. Now, if I can get 51-66 jurisdictions to recognize it…

…and that adds a category.

Many years ago, my ideology would have been ‘let each OD decide what they need.’ And, there’s still merit in some of that. Some. Not all. I was… wrong. F*#k.

The regulated nature (laws), being held to the medical standard of care, the immense resistance and bitterness over no-brainer standards for commercial support (how many state boards, our ODs granted the privilege (not a right) of serving as public protectors, require enforced standards for commercial support?), the fact that physicians are unable to accurately assess their own weaknesses (study after study), few residencies (ours are closer to internship rather than medical residencies), the inane social media posts re DFE, $, if in doubt, send it out, refer CHRPE, etc…. it’s not a public health crisis, but it’s not great.

I’ve had no coffee. Send more questions.

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