“The whole idea is to provide Ontarians easier access to healthcare and to give them more choice in their healthcare. This provides them with a better range of choices,” said Paula Garshowitz, registrar at the College of Optometrists of Ontario.
The organization has worked with the Ontario Ministry of Health and Long-Term Care to approve new professional misconduct regulations for optometrists, including modernized conflict-of-interest provisions that would allow eye care professionals of all kinds, including opticians, to work side-by-side.
Some of the changes include many regulations to keep optometrists working independently of opticians but also provide leeway for the two professionals to work collaboratively. In addition, patients will have better access to their prescriptions, Garshowitz said:
“According to the current regulations optometrists had to give the prescription, but only if the patient asked for it. Under the new regulations the optometrist is required to give the prescription, if one exists, to the patient without them having to ask. At the end of the eye exam, if the optometrist determines that there is a prescription, let’s say for eyeglasses, contact lenses, etc., the prescription is released.
“Now that the information is released, the [patient] can go to the dispenser of their choice. They can have it filled at the optometrist’s, at an optician’s shop or at another optometrist’s, or if a physician dispenses they can go there too.”
Brian McGrath, a licensed optician and owner of Elmira Eyewear, says the current rules governing optician-optometrist relationships are strict, and perhaps the new changes can lead to better service as well as an improved practice model for both professions. McGrath’s Arthur Street shop is also home to the office of optometrist Dr. Stephen Morris, but regulations ensure that the two men keep business and medical practice separate. Alternate exits and a sliding door ensure that Morris’ patients do not have to walk through McGrath’s store during their eye appointments, and neither McGrath nor any other business or corporation can hire Morris as a salaried employee.
“There’s no doubt that I think an office functions better when you have two licensed people together: an optometrist and optician, both licensed professionals working together, everything always works better for sure. But, why that never really existed, very often it’s sort of a tough call,” said McGrath this week.
Loosening the rules to provide Ontarians with greater choice is also allowing the two professions to work closer together through new regulations on how optometrists can retain independence while forming new collaborations with opticians, Garshowitz said.
“There are still some parameters around it. It has to do with the optometrists setting their own fees, the optometrist having 24-7 access to the premises of the office, the optometrist being able to say who can be a patient. They do complementary work, so it makes sense and provides better access for Ontarians.”
An optometrist is trained and licensed to examine the eyes for visual defects, diagnose impairments, and prescribe corrective lenses or treatment. Opticians are, as McGrath describes “the pharmacists of the optical world” and are licensed to fill the prescriptions.
The rules on retail apply to optometrists who own their own shops as well, Morris explained, and they also currently face strict limitations on advertising their products.
“The optometrists can’t charge retail. They have to charge what the frames cost, what the lenses cost and add a dispensing fee on top of that set by the College [of Optometrists of Ontario] and that’s the profit. The reason they want to do that is basically to make sure that the dispensing fee is pretty much the same for all types of glasses, that your advice would not be partial to which frames had the best margins. They can’t market to patients, they can’t say ‘we’ve got a sale,’ you can’t have signs in the windows, you can’t do flyers – [now], they are changing that.”
One of the key amendments come April will include ‘modernized rules for advertising and the naming of optometry practices.
As far as the new rules, optometrists still cannot be employed by opticians or optical corporations, thought there are countries where optometrists do work in-house, said McGrath.
Garshowitz said the changes to this somewhat tug-and-pull relationship between the optical professionals have been in the works for quite some time.
“With this new regulation optometrists will be able to work with opticians as independent contractors. So the optometrists will continue to be independent but they can do so inside the confines of an opticians shop if they choose to. It allows them to work together more freely.”