Optometrists group has lost sight of professional ethics
It has come to this in Ontario. An optometrist won’t see you in your moment of need because there’s not enough money in it for him.
You see sudden floaters or flashes — possible warning signs for your eyesight — so you turn to your trusted practitioner for help. And he (or she) turns you away.
In your panic, in mid-pandemic, he fobs you off on a crowded hospital emergency room where the risk of catching COVID-19 compounds the peril. He passes the buck, not in your best interests but his own financial interests.
In its ongoing fee battle with the government, the Ontario Association of Optometrists (OAO) has opted to fight it out to the last patient. It is a ransom ploy that uses patients as bargaining chips, and it has gone on long enough.
In an internal message revealed by the Toronto Star this week, the association exhorts its more than 1,700 optometrist members to refuse treatment for selected patients as part of a co-ordinated strategy — sending people instead to a more costly emergency room, the better to bolster their negotiating position by worsening the government’s finances. It is one of the most stunningly short-sighted and hard-hearted job actions in recent memory.
This is no ordinary pressure tactic. How many elderly, immobile, at-risk patients who are thus referred will only be deterred by long hospital lineups from getting the care they need?
“This is a leverage point to get commitment from the government to fix the funding problem,” wrote Dr. Sheldon Salaba, president of the OAO — a lobby group akin to a trade association.
Optometrists are not medical doctors, but they are trained health professionals bound by an ethical code of conduct, no less than pharmacists or nurses. They are governed by the self-regulating College of Optometrists, which is bizarrely closing its eyes to this ruse.
A supposedly respectable trade association has lost its way. And a presumably independent regulator has forgotten its oversight role.
If optometrists are “delegating or triaging to someone else, you want to follow up to make sure that patient actually got seen,” muses Dr. Patrick Quaid, president of the college, with an air of curious detachment. “If the job action escalates, it’s very likely it will be the public who will pay the price for it.”
But what will the college actually do about it, beyond hope for the best and lament the worst? Patients cannot be the only ones to suffer for the wilful blindness of the watchdog and the trade association.
If recalcitrant optometrists are not disciplined, the regulator itself must also be held to account. For like any selfgoverning body, the college’s authority is delegated by government and can be reclaimed by the authorities.
This dispute is not new. Like its Liberal predecessor, the Progressive Conservative government is resisting pay demands from optometrists on the grounds that technology has created greater efficiencies while overall revenues keep rising.
Optometrists complain that business is down in the pandemic, because protective procedures require more time while OHIP payments (for people under 20, 65 and older, or with certain medical conditions) are still not keeping pace with rising expenses. But what a time to escalate their pressure tactics — when other workers are risking their lives to help people in need, when everyone is on edge about keeping safe, when our healthcare resources are strained to the breaking point.
Not to worry, insists Salaba, the oddly myopic president of the optometrists association: “An emergency room is as safe a place to be seen, I would think right now, as our offices would be.”
If optometrists cannot feel the pain of their patients, if they cannot sense the fears of front-line nurses and physicians, if they cannot see the anxiety etched on the faces of everyone around them, then they are truly blind to today’s realities. And oblivious to their own awful optics.
If they want more money, they are not without recourse. Like other working people with grievances, they could take a day without pay to set up picket lines at Queen’s Park, taking their protests directly to the politicians in power and making their case to the public, rather than punishing patients without power.
A pandemic is not the time to profit from people in need, nor an opportunity to put private cash flow ahead of public health. If the association cannot find its way, if the College of Optometrists will not reassert its oversight role, let the government reclaim its responsibility to protect the public from unethical conduct.
Doug Ford insists he cannot countenance the greed of landlords who toss tenants out of their apartments in midpandemic, when people are at their most vulnerable. A premier cannot be any less concerned about the avarice of optometrists who turn patients away from their offices during a COVID-19 crisis, when people must protect their vision.
If recalcitrant optometrists are not disciplined, the regulator itself must also be held to account