Eye-care tactic is out of focus
The Ontario Association of Optometrists is suffering from a case of myopia.
In a misguided campaign to get more funding from the province, the organization has asked its 1,700 members to direct some patients to seek treatment from a hospital emergency room or another health-care provider. It’s already costing the province about $250,000 a day.
At the bottom of this is a dispute between the association, which represents about 70 per cent of Ontario’s optometrists, and the health ministry.
In short, they don’t see eye to eye on how optometrists should be compensated for seeing patients who are covered by the Ontario Health Insurance Plan (OHIP). The optometrists may well have a point, but they’ve adopted a tactic that penalizes patients, sends people to emergency wards unnecessarily, and wastes taxpayers’ money.
According to the optometrists, they lose money on every patient who’s covered by OHIP — people who are under age 20 or over 65, or who have a special medical condition. They say it costs at least $80 to $90 to see a patient, but OHIP reimburses, on average, only $44 per visit.
So the optometrists say they are, in effect, subsidizing provincial coffers to the tune of $173 million a year, and complain that their remuneration has barely increased over the past 30 years. Any increases, they say, haven’t come close to keeping pace with inflation.
The health ministry disagrees with that assessment, saying payments for OHIP-insured optometry services have risen as the number of patients seen grows.
The optometrists’ job action began in mid-June. If a patient has floaters in her eye, for example, instead of seeing an optometrist she will be sent for treatment to a hospital emergency room at a significantly higher cost to taxpayers, or to a family doctor.
By mid-July, according to an internal message to the optometrists’ association from its president, Dr. Sheldon Salaba, 43 per cent of redirected patients were being sent to emergency wards while most of the rest were being sent to physicians. Salaba said the job action could cost $400,000 a day if all patients are redirected to ERs instead of to family doctors.
The campaign has, for good reason, come under fire for sending patients to hospitals during the pandemic, potentially exposing them to the COVID-19 virus and taxing our already crowded emergency departments. Patients with eye problems suitable for an optometrist’s care will likely wait for hours to be seen while medical staff treat patients with more urgent issues, wasting everybody’s time.
Dionne Aleman, an associate professor at the University of Toronto who specializes in pandemic planning, told the Star’s Jesse McLean that sending a patient with a minor problem to an emergency department is akin to using them as “cannon fodder” in their fight with the province.
Still, Salaba is sticking by the campaign. “I understand that it’s inconvenient for people,” he said. “I don’t like having to go to an emergency room myself … but we didn’t create this problem.” He blames “successive governments” for failing to find solutions.
But patients are facing a lot more than a minor inconvenience, especially during a pandemic when everyone is being called on to make sacrifices in a common fight.
Even the profession’s regulator, the College of Optometrists of Ontario, is concerned about patients being abandoned and, if redirected, not getting the treatment they require.
“Ultimately, if the job action escalates, it’s very likely it will be the public who will pay the price for it,” says college president Dr. Patrick Quaid.
Optometrists aren’t the only profession in Ontario with grievances about funding. They may, in fact, have a just cause.
But by putting patients’ health in jeopardy and wasting vital health-care dollars, their selfish and dangerous tactic is focused on the wrong people. This wrong-headed campaign needs to stop now.