Ontario’s optometrists take a stand against underfunding

The Ontario Association of Optometrists (OAO) is encouraging its members to take direct action against underfunding by refusing to see patients outside of regular check-ups, redirecting any optical emergencies to hospitals and family doctors instead.

OAO president Dr Sheldon Salaba said the association had no choice but to begin the action, claiming decades of underfunding from the province had resulted in optometrists covering services ‘out of pocket’ and putting some practices at risk of closure.

According to Dr. Salaba, 43% of redirected patients were being sent to emergency wards, while most of the rest were being sent to physicians. As a result, the action has raised issues of potentially exposing patients to the COVID-19 virus, forcing those with eye problems to wait for hours to be seen while medical staff treat patients with more urgent issues.

The dispute, between the body of optometrists and the province’s health ministry, stems from a disagreement on how optometrists should be compensated for seeing patients who are covered by the Ontario Health Insurance Plan (OHIP). According to the optometrists, they lose money on every patient covered by OHIP, i.e. people who are under the age of 20, over 65, or who have a special medical condition.

The association defends that it costs at least CA$80 to see a patient, whereas OHIP reimburses, on average, only CA$44 per visit. Following this logic, optometrists have been subsidising the province to the tune of CA$173 million a year, and complain that their remuneration has barely increased over the past 30 years. The health ministry disagrees, arguing that payments for OHIP-insured optometry services have risen as the number of patients grows.