Managing Change: Learnings from Optometry

1. Managing Change:Learnings from Optometry Dr. Joe Chan, OD, MBA Mississauga, Ontario June 8th, 2013

2. Overview Who provides eye care in Canada? Our challenges as optometrists Maintaining our primary eye care role Evolution in our scope of practice New horizons

3. Who Provides Eyecare in Canada? The Three “O’s” Ophthalmologists Optometrists Opticians

4. Overlapping Roles With ophthalmology primary care done mostly by optometrists co-manage glaucoma, cataracts & LVC optometrists moving into medical treatment able to prescribe TPAs in all U.S. states and almost all Canadian provinces

5. Overlapping Roles With opticianry both dispense eyewear and contact lenses opticians want to be able to prescribe independently opticianry have always felt we had an unfair advantage argued that we have a conflict of interest

6. Conflict of Interest? Optometrists can both prescribe and dispense eyewear Risk that we might over-prescribe for our own financial benefit Similar to other health care professions Have strict regulations to protect patient

7. Finding a Balance Challenge to balance professional role vs. the retail element of our profession Differences between provinces Want public perception to be that we are “doctors” first and foremost

8. Competitive Marketplace Eyewear and contact lenses are increasingly becoming a commodity Large-scale retail & Internet suppliers are providing low cost alternatives Must enhance service & convenience to stay competitive

9. Changes to Coverage Historically, optometry included in provincial health care programs With government cutbacks, optometry services to adults are generally not covered in any province Has not adversely affected our bottom line

10. Maintaining Role as Primary Eye Care Provider Maintain accessibility Forge strong ties to medical practitioners Educating patient in our clinics Develop marketing programs to create awareness

11. National Marketing Program Public education was identified as a priority to “brand” optometry National program has evolved to television and print campaigns Each Canadian optometrist contributes over $800 annually Total budget 2013: $2.1 million

12. NPEC TV Commercial

13. Evolving Scope of Practice Ontario has passed legislation & regulations to prescribe TPAs Builds on our ability to assess, diagnose and monitor ocular disease Follows the lead of other jurisdictions

14. Getting Legislation In Ontario, discussions started in 1994 Must educate politicians and key bureaucrats Grassroots lobbying is most effective Cover all political parties Underwent three HPRAC reviews Wrote first Rx in 2011 -- 17 year wait!

15. Anticipate Opposition Medical associations typically oppose enhancing scopes of practice of other health care professions Try to mitigate opposition by creating dialogue with these organizations Educating stakeholders is your best tool

16. New Horizons Adapting to new health care delivery models formation of multi-disciplinary health care teams role in hospitals & community care clinics Adopting new technology to enhance our services

17. Key Elements Small, cohesive profession High level of participation in provincial & national associations Learn from experience in U.S. Commitment to maintaining professional stature

18. Closing Thoughts Change & challenges exist in optometry as with all professions Have a clear vision of where you want your profession to go Must recognize opportunities and seize them Build consensus and work together