By Denis Langlois

The century-old professional organization that represents 1,600 optometrists in Ontario has a new president.

Dr. Jeffrey Guthrie, who practices optometry in Bancroft, Ont., will remain at the helm for the next two years.

Dr. Guthrie, who has been on the OAO board since 2013, says it’s an exciting time to take on his new role.

There’s been an incredible amount of work done over the past few years to bring the profession forward and ensure that Ontario optometrists are compensated in a way that reflects the true value of our services,” he said after being elected. “I look forward to building on the progress we’ve made under the leadership of Dr. Jeff Goodhew in opening a dialogue with the Ontario government and setting the stage to ensure that our members can continue to provide the best care possible to Ontario patients.”

Dr. Guthrie recently discussed with Optical Prism the challenges that lie ahead for optometrists in Ontario, how those challenges can be overcome and why now is the most important time for optometrists to join the OAO.

Q. Why did you decide to take on the role of president of the Ontario Association of Optometrists and what are your objectives for this term?

A. I decided to assume the president’s role because I see the practice of optometry in Ontario at a critical juncture in its evolution. With the rising costs of health care, problems with equity of access to care and a tight provincial healthcare budget, optometrists are well-positioned to take a larger role in the primary eyecare landscape.

Optometrists could be managing more patients with eye conditions, helping to keep unnecessary urgent eye problems out of busy and expensive emergency departments and working with the province to screen more patients with diabetes for retinopathy. However, taking on this role comes with its challenges. Optometrists can either accept the status quo or we can proactively engage with stakeholders to further integrate our profession into primary care.

Q. Please tell us about the main challenges facing optometrists today?

A. The primary challenge is that optometrists are not compensated at the true value of the services provided, which in many cases impedes the level of care we are able to provide. Our fees from the Ontario Health Insurance Plan (OHIP) have essentially remained flat since 1989. As you can imagine, there has been a lot of inflation in those last 27 years. I may have only been six years old at the time, but I do know that a dollar in 1989 only buys 60 cents worth of goods today! Ontario optometrists want to play a bigger role in Ontario’s primary eye care system, fulfilling our scope of practice to provide better and faster care for patients. However, the current insurance structure is hampering that evolution because it compels optometrists to provide OHIP-insured services at a loss. This problem will grow very quickly over the next decade; the senior population – the mostfrequent users of optometric services – is projected to grow by 44 per cent.

The Association is advocating hard to improve the remuneration outlook for optometrists, so that we can more ably provide the full scope of care for our patients. As with any advocacy work, there is strength in numbers. It’s now more important than ever for all of Ontario’s optometrists to become members of OAO, which is a voluntary association. We have found that membership rates have remained steady over the past few years, though the number of Ontario optometrists has grown significantly. Part of my challenge as president is to convey to all optometrists the importance of joining OAO. The success of our advocacy work depends on it.

Q. How can these challenges be overcome?

A. The Ontario Association of Optometrists has taken a page out of the 2016 Ontario Auditor General’s Report that recommended the Ministry of Health and Long-Term Care (MOHLTC) work with health-care professionals to ensure that OHIP funding is prioritized in the areas of greatest medical need. By re-patriating some of the existing optometry budget to areas that optometrists find most difficult to finance on their own, we can ensure that optometrists are able to provide the best care for their patients, while being compensated true to the costs of delivering the service.

On the OAO membership front we’re diligently working to expand our member benefits so that optometrists get the most value out of their membership. Our professional liability insurance program is hands-down the best for optometrists in Canada. New graduates can join the program for only $50, and it comes with built in coverage for College complaints, general liability and 24-7 legal advice on any topic. We will be making major improvements to our office liability insurance in the coming year. Our web-based therapeutic drug application, which gives optometrists quick and easy access to the list of drugs we are able to prescribe, has become so indispensable that we’ve shared it with other provincial associations. Finally, we are the only organization that represents the interests of Ontario optometrists to government. From my perspective, there is no reason not to be an OAO member.

Q. Have you noticed any upward trends regarding eye issues in Ontario patients? What are the reasons for these?

A. One issue I’ve seen is with patient’s drug benefits plans. More plans are starting to require front-line use of generic medications. First, patients have to try a less expensive drug and then move along a list of progressively more expensive (but more effective) drugs, if the desired treatment effect is not met. I’m seeing this mostly with glaucoma medications, where the duration of treatment is very long. The trouble with this is that it can really slow down a patient’s treatment plan. This type of approach at cost containment is not entirely surprising as the costs of medications continues to increase, which is a concern for insurers and for those paying the premiums. There will be challenges in managing this if more drug plans adopt the approach, as it adds a significant administrative burden to the optometrist’s workload.