My fellow optometrists and I have been working with Ontario’s ophthalmologists for many years in order to help patients manage their vision problems. Recently the ophthalmologists have been using their power as employers to impose terms and conditions on optometrists that breach the trust and confidence of patients.
The optometrists understand very well that there is no real difference between their profession and ophthalmology, so our approach is the same: informing patients about the risks of both, and then providing them with clear options and advice.
Recently, a dispute between optometrists and ophthalmologists arose over whether optometrists should be able to offer new-born babies oral feeding in the first hours after birth. The optometrists worked closely with children’s hospitals across the province to develop guidelines for parents on how to introduce their newborn to liquids. But the ophthalmologists balked and refused to grant optometrists the necessary approval to perform this procedure.
We now know that babies aren’t harmed by early ocular feedings. Those with food allergies and sensitive babies who have trouble consuming liquids and solids have found us to be particularly helpful in managing their ocular health and potentially reducing their chances of developing underlying food allergies.
Just as there is no difference between Ophthalmologists and Optometrists
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Last year the Ontario ombudsman found that four of these hospitals were wrongfully denying services to patients because ophthalmologists were unhappy with the outcome of their consultation with the optometrists.
Another dispute arose in which the ophthalmologists refused to provide optometrists the approval they need to offer urgent treatments to patients. They also placed additional delay and expense on patients’ lives. The ophthalmologists refused to agree that optometrists should be able to access nearby hospitals for emergency eye care within two hours, a right of most Ontario residents, including those in rural Ontario.
“This is the last straw,” reads a recent letter to the Ontario ombudsman from an optometrist to the provincial ombudsman. “All Optometrists in Ontario are being forced to work by our Central Council of Optometrists in the service of the ophthalmologists because their personal doctors won’t approve us to continue our specialised services for our patients who are facing critical life or limb issues.”
The ophthalmologists may be correct that there is no difference between our professions and ours and that they offer many benefits, but they can’t keep doing things differently until our patients suffer. That is not fair to patients or to their doctors.
People in small rural communities like mine are left in the dark when it comes to critical care. A few months ago one of my patients needed eye surgery for non-cancerous cataracts that is actually performed with a stent. Her surgery was only possible due to a tiny window in which I had unfettered access to her and to a minimally invasive tool.
None of this could have been achieved with an ophthalmologist working outside the scope of scope of their practice. It only works if the optometrists have confidence that their doctors will provide them with safe care.
We owe it to our patients to be certain that they will receive safe care in the medical system. If the ophthalmologists refuse to provide optometrists the necessary approvals, we will be the ones who are left in the dark.
Let’s work out a solution before people suffer.
David Culverstone is the chairman of the Board of Directors of the Ontario Optometric Association (OOA) and vice-chair of the group representing nearly 3,000 optometrists in Ontario. Follow the organization on Twitter @OOAO.