The New Hampshire House Executive Departments and Administration Committee convened on January 23, 2025, to discuss House Bill 349, which proposes allowing optometrists to perform certain laser surgeries. The meeting featured extensive testimony from medical professionals, highlighting concerns about patient safety and the adequacy of optometric training for surgical procedures.

The session began with a presentation emphasizing that increasing the number of providers does not necessarily reduce costs for patients, particularly in Medicare-covered services. A key point raised was the correlation between surgical volume and complication rates, with studies indicating that lower surgical volumes lead to higher complication rates. This was underscored by a speaker who noted that surgical training is a slow, incremental process requiring extensive hands-on experience, which is not adequately provided in current optometric training programs.

Several medical professionals, including retired orthopedic surgeon Jim Murphy, voiced strong opposition to HB 349. Murphy argued that the bill poses a significant quality of care issue rather than a turf battle between optometrists and ophthalmologists. He highlighted the extensive training required for surgeons, which includes years of residency and fellowship, contrasting it with the limited training optometrists receive in surgical procedures. He asserted that allowing optometrists to perform surgeries without sufficient training could jeopardize patient safety.

Christie Morse, a pediatric ophthalmologist, echoed these concerns, detailing the potential complications arising from laser surgeries and the critical need for trained surgeons to manage these complications effectively. She pointed out that in states where optometrists are permitted to perform such surgeries, there is often no requirement to report negative outcomes, raising further concerns about patient safety.

The discussion also touched on the lack of comprehensive outcome data from optometric procedures, with some studies indicating a significantly higher risk of complications when surgeries are performed by optometrists compared to ophthalmologists. This was supported by a study showing a 189% increased hazard of requiring additional treatment when procedures were performed by optometrists.

As the meeting progressed, committee members engaged in a dialogue about the implications of the bill, questioning the adequacy of optometric training and the potential risks to patients. The consensus among many medical professionals present was that while access to care is a valid concern, it should not come at the expense of patient safety and quality of care.

The meeting concluded without a definitive resolution on the bill, but the testimonies presented underscored the critical importance of rigorous training and credentialing in surgical practices. The committee is expected to continue deliberating on the implications of HB 349 in future sessions, weighing the need for access against the necessity of maintaining high standards of patient care.