Question: I am being told that ODs can’t perform minor procedures (papilloma, chalazion removal, etc.) at my VA despite being licensed in states that allow ODs to do these types of procedures. The argument is that the state we physically practice in does not allow it and so the VA shouldn’t either. My understanding has always been that ODs can practice to the extent of their state license at any VA, assuming it is covered in our clinical privileges. Has anyone else run into this issue or have a specific reference or guidance in regards to this?

Answers:

  • Summary of Responses:
    • You may practice at a Federal facility as long as you possess a valid license in any state. However, you must still be privileged by the facility. These are two separate actions. A facility may choose to be more restrictive in their privileging than your licensure. It is at their discretion. Over the past several years, many VA facilities have chosen to privilege only at the level of the state in which you are currently practicing – regardless of licensure.
    • If they wished to grant you those procedures and you had licensure to do that outside of the state your VA is in, it would be legal. That said, the local PSB and medical center leadership can determine whether or not they want to grant you this and even if you have the licensure it doesn’t guarantee you get the privilege. Local needs and sometimes other things determine the ability for you to obtain asked for priviliges
    • It is up to each VA to grant privileges regardless of scope of state license, and they do have the right to do that. Privileges are determined by the medical executive board (MEB) at each medical center can therefore vary from location to location. Privileges are renewed/re-applied for every 2 years. The board is typically made up of MD’s and apparently, in some locations where ophthalmology has chosen to leverage the decision, VA OD’s are still limited even in topical med prescribing, but this is rare. In similar cases privileges have been reduced when re-applied for too, but also rare. I think your state license matters in determining the maximum of what you can reasonably apply for, but not a guarantee, and it is still up to the local MEB to grant those privileges within the VA system regardless of what state you are in.
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