Proposals to expand the drugs that optometrists can administer have sparked new opposition but also some support.
The Australian Medical Association (AMA) has strongly opposed plans by the Optometry Board of Australia to expand optometrist prescribing rights to include oral medicines, warning the move poses unacceptable risks to patient safety.
But the Pharmacy Guild of Australia has thrown its weight behind the change, saying it is another “positive step toward improving patient access to timely, affordable, and effective care”.
In a media release, the AMA said its submission to the board’s consultation on the proposal highlighted that optometrists lacked “the extensive medical training required to safely manage the systemic risks associated with oral medicines”.
AMA vice president Associate Professor Julian Rait said using workforce shortages to justify expanding non-medical prescribing was reckless and put patients at risk.
“Patient safety must come first and the board needs to recognise that inappropriate prescribing of these medicines can have very significant consequences for patients,” A/Prof Rait said.
“Unlike medical practitioners, optometrists simply don’t have the comprehensive training needed to provide holistic diagnoses and manage the complex systemic risks that come with prescribing oral medicines.”
The AMA said evidence cited in the board’s own consultation documents revealed concerning gaps in optometry training.
It said the Optometry Council of Australia and New Zealand report found that the reviewed optometry programs did not equip optometrists with sufficient knowledge to understand the types, causes, and risks of medicine errors.
A/Prof Rait warned the proposed changes risked fragmenting patient care and creating confusion about who was responsible for a patient’s overall medication regime.
“Expanding prescribing rights without robust evidence and safeguards undermines the integrity of Australia’s healthcare system.
“We need a clear distinction between medical and non-medical roles to ensure prescribing remains the responsibility of those with appropriate training and accountability.
“The AMA believes optometrists should not be permitted to prescribe beyond topical agents under current arrangements,” he said.
However, the Pharmacy Guild of Australia has welcomed the proposal.
National president Professor Trent Twomey said the proposal reflected a growing recognition that empowering qualified health professionals to practise to the full extent of their training delivered better outcomes for patients and communities — particularly in rural and regional Australia.
“When patients can access the right care from the right health professional at the right time, everyone benefits,” Prof Twomey said.
“This proposal aligns with the guild’s long-held view that scope of practice reforms across health professions — including community pharmacy — are essential to strengthening Australia’s primary care system.”
The guild noted the proposed changes would allow optometrists to prescribe oral medicines where clinically appropriate, reducing unnecessary delays and helping patients avoid preventable complications, such as vision loss.
Prof Twomey said this collaborative, multi-professional approach to healthcare reflected the intent of the National Medicines Policy and National Strategy for Quality Use of Medicines — both of which emphasise safe, effective, and accessible use of medicines.
“Optometrists, pharmacists, nurses, and other health professionals all play vital roles in delivering care closer to home.
“By supporting initiatives like this, governments can continue to build a more integrated and patient-centred health system. The outcome ultimately will be healthier Australian communities,” he said.
