Eye or Vision Concerns? See Your Optometrist First

They were fighting it out in Florida recently.

The eye surgeons (ophthalmologists) were battling the optometry lobby for patients’ rights. On the one hand, ophthalmologists are opposing new prescribing rights for optometrists stating that because they are not ‘medical’ doctors, the patients are at risk. Optometrists for their part are fighting for accessibility and requesting new rights so they can treat more patients locally. With the current regime, patients, even patients with debilitating eye disease, must drive further and pay more for care by an ophthalmologist, while optometrists have the appropriate training to prescribe, but are generally cheaper and closer to more patients.

The main argument by the medical lobby is that it’s ‘dangerous’ for optometrists to prescribe oral medications and that the medical doctors are simply trying to protect the patient. Of course, it goes without saying, that they don’t also mind locking the competition out of the private health care market. Optometrists, especially those who have graduated in the last 20 years, have a strong foundation in pharmacology and ophthalmology (diagnosis and treatment of eye disease) and are very comfortable managing prescribing medications. So, in the end, it’s a turf war, with the medical lobby putting profits before patients’ needs.

A similar situation exists in Alberta where restrictions on what optometrists are allowed to prescribe, diagnose, and treat, means that there are heavy burdens shifted onto patients. The greatest costs are borne by people in remote communities, including those of the Diamond Valley. Like in Florida, there are those in the medical lobby who are more interested in blocking cost-effective care measures based on turf interests more than patient interests. As a doctor working to serve people in isolated communities, every day I see the results of such restrictive policies.

Following a traditional model of care, patients are more likely to attend a family doctor or hospital ER for eye concerns, both of which have been shown to be much less clinically effective, and much less cost-effective than attending an optometry clinic. Ophthalmologists are specialists in surgical and medical treatment of eye disease, similar to an oncologist who is a specialist in cancer treatment. Family doctors have only minimal training in eye disease care and management, often only a few weeks. Optometrists sit somewhere in between, with specific training in the medical diagnosis and management of eye and vision disorders, involving many courses over 4 years of training.

Optometrists also provide great value to the Province. Because they operate in privately owned clinics, the Province is not on the hook for capital costs. Optometrists provide the service and bill the Province for the service only. In High River, taxpayers are on the hook for subsidizing the Charles Clark medical centre, there is a new multi-billion dollar facility in South Calgary, and a new billion dollar facility for cancer treatment has recently been announced. It cost less to build Canada’s first diamond mine in the high arctic, a community built from thin air. While we can question the real value and return from these outlandish expenses, there are NEVER billion dollar price tags associated with optometry, yet the return on the dollars that are spent on optometric care is great.

Optometry is a great value for the patient. Serious concerns are attended to quickly, and optometrists can manage most issues locally. Family and ER doctors are much more likely to refer to specialist care, multiplying the costs to healthcare. This is also an onerous burden on those who have serious eye concerns, especially the elderly in remote communities, who must find a ride into a major centre so they can wait two hours to see an ophthalmologist for 5 minutes.

Some optometrists, such as myself, are also specialists in other areas. In my case, it’s child vision development. Others look at improving vision for sport, or dealing with low vision needs of the visually impaired. These are not services available through medical specialties.

In the end, the optometry lobby won out in Florida, and the bill passed. This means more people have easier access to the care they need, and for lower cost. You can read the whole story here: http://www.news-press.com/article/20130307/HEALTH/303070027/Not-seeing-eye-eye-Optometrists-ophthalmologists-differ-bills/

The bottom line is this: If you have an eye or vision concern, save yourself time and trouble, and save the Province a bundle: See your optometrist first.

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