Managing Change:Managing Change:Learnings from OptometryLearnings from Optometry

Dr. Joe Chan, OD, MBADr. Joe Chan, OD, MBAMississauga, OntarioMississauga, Ontario

June 8th, 2013June 8th, 2013

OverviewOverview Who provides eye care in Canada?Who provides eye care in Canada? Our challenges as optometristsOur challenges as optometrists Maintaining our primary eye care Maintaining our primary eye care

rolerole Evolution in our scope of practiceEvolution in our scope of practice New horizonsNew horizons

Who Provides Eyecare in Who Provides Eyecare in Canada?Canada?

The Three “O’s”The Three “O’s” OphthalmologistsOphthalmologists OptometristsOptometrists OpticiansOpticians

Overlapping RolesOverlapping Roles With ophthalmologyWith ophthalmology

primary care done mostly by primary care done mostly by optometristsoptometrists

co-manage glaucoma, cataracts & LVCco-manage glaucoma, cataracts & LVC optometrists moving into medical optometrists moving into medical

treatmenttreatment able to prescribe TPAs in all U.S. states and able to prescribe TPAs in all U.S. states and

almost all Canadian provincesalmost all Canadian provinces

Overlapping RolesOverlapping Roles With opticianryWith opticianry

both dispense eyewear and contact both dispense eyewear and contact lenseslenses

opticians want to be able to prescribe opticians want to be able to prescribe independentlyindependently

opticianry have always felt we had an opticianry have always felt we had an unfair advantageunfair advantage

argued that we have a conflict of interestargued that we have a conflict of interest

Conflict of Interest?Conflict of Interest? Optometrists can both prescribe and Optometrists can both prescribe and

dispense eyeweardispense eyewear Risk that we might over-prescribe for Risk that we might over-prescribe for

our own financial benefitour own financial benefit Similar to other health care professionsSimilar to other health care professions Have strict regulations to protect Have strict regulations to protect

patientpatient

Finding a BalanceFinding a Balance Challenge to balance professional Challenge to balance professional

role vs. the retail element of our role vs. the retail element of our professionprofession

Differences between provincesDifferences between provinces Want public perception to be that we Want public perception to be that we

are “doctors” first and foremostare “doctors” first and foremost

Competitive MarketplaceCompetitive Marketplace Eyewear and contact lenses are Eyewear and contact lenses are

increasingly becoming a commodityincreasingly becoming a commodity Large-scale retail & Internet suppliers Large-scale retail & Internet suppliers

are providing low cost alternativesare providing low cost alternatives Must enhance service & convenience Must enhance service & convenience

to stay competitiveto stay competitive

Changes to CoverageChanges to Coverage Historically, optometry included in Historically, optometry included in

provincial health care programsprovincial health care programs With government cutbacks, optometry With government cutbacks, optometry

services to adults are generally not services to adults are generally not covered in any provincecovered in any province

Has not adversely affected our bottom Has not adversely affected our bottom lineline

Maintaining Role as Maintaining Role as Primary Eye Care ProviderPrimary Eye Care Provider

Maintain accessibilityMaintain accessibility Forge strong ties to medical Forge strong ties to medical

practitionerspractitioners Educating patient in our clinicsEducating patient in our clinics Develop marketing programs to Develop marketing programs to

create awarenesscreate awareness

National Marketing ProgramNational Marketing Program Public education was identified as a Public education was identified as a

priority to “brand” optometrypriority to “brand” optometry National program has evolved to National program has evolved to

television and print campaignstelevision and print campaigns Each Canadian optometrist Each Canadian optometrist

contributes over $800 annuallycontributes over $800 annually Total budget 2013: $2.1 millionTotal budget 2013: $2.1 million

NPEC TV Commercial

Evolving Scope of PracticeEvolving Scope of Practice Ontario has passed legislation & Ontario has passed legislation &

regulations to prescribe TPAsregulations to prescribe TPAs Builds on our ability to assess, Builds on our ability to assess,

diagnose and monitor ocular diseasediagnose and monitor ocular disease Follows the lead of other jurisdictionsFollows the lead of other jurisdictions

Getting LegislationGetting Legislation In Ontario, discussions started in 1994In Ontario, discussions started in 1994 Must educate politicians and key Must educate politicians and key

bureaucratsbureaucrats Grassroots lobbying is most effectiveGrassroots lobbying is most effective Cover all political partiesCover all political parties Underwent three HPRAC reviewsUnderwent three HPRAC reviews Wrote first Rx in 2011 -- 17 year wait!Wrote first Rx in 2011 -- 17 year wait!

Anticipate OppositionAnticipate Opposition Medical associations typically oppose Medical associations typically oppose

enhancing scopes of practice of other enhancing scopes of practice of other health care professionshealth care professions

Try to mitigate opposition by creating Try to mitigate opposition by creating dialogue with these organizationsdialogue with these organizations

Educating stakeholders is your best Educating stakeholders is your best tooltool

New HorizonsNew Horizons Adapting to new health care delivery Adapting to new health care delivery

modelsmodels formation of multi-disciplinary health formation of multi-disciplinary health

care teamscare teams role in hospitals & community care role in hospitals & community care

clinicsclinics Adopting new technology to enhance Adopting new technology to enhance

our servicesour services

Key ElementsKey Elements Small, cohesive professionSmall, cohesive profession High level of participation in High level of participation in

provincial & national associationsprovincial & national associations Learn from experience in U.S.Learn from experience in U.S. Commitment to maintaining Commitment to maintaining

professional statureprofessional stature

Closing ThoughtsClosing Thoughts Change & challenges exist in Change & challenges exist in

optometry as with all professionsoptometry as with all professions Have a clear vision of where you Have a clear vision of where you

want your profession to gowant your profession to go Must recognize opportunities and Must recognize opportunities and

seize themseize them Build consensus and work togetherBuild consensus and work together