Optometrists/Opticians

[Chief Hoult]

Debate over the household table/at work sparked some interesting conversations.

First some background:

In ONTARIO, all eye exams are covered by OHIP. Under 18/65+ are covered annually, 19-64 are covered every other year.

For each eye exam that an Optometrist performs, they are paid $39.15. This has been the case for a number of years. Typical eye exam takes between 20-45 minutes, depending on the experience of the OD.

Remember, while that adds up to potentially $120/hour, that is without expenses, paying for your staff, rent, etc. Ontario is currently the only province that covers those between 19 and 64. Most OD's outside Ontario charge anywhere from $70-$115/exam (Although I see the occassional $60).

Recentley, the College of Optometrists protested, albeit unsuccessfully....They went to Queen's park, and weren't seen by anyone. They were going to be on the news, but a puppy fell down a well....and they were somewhere in the back of the paper. Reason being that the number of Optometrists is so small (60 English speaking/year) that really, who cares if they protest? Not like they're a rowdy bunch.

So firstly, what is your opinion overall? Is it right that the OD's want to have coverage eliminated for those betwen 19 and 65? Is it just greed? Should the government up the amount they are paid? Is it right that they are treated because of how insignificant their numbers are? Would YOU pay $75 every year/other year if you weren't covered?

That's the Ontario portion...

The other part of this arguement is somewhat separate, and related to the Province of BC.

Optometrists were recentley authorized to be able to prescribe TPA's (thereputic eye drops). This is because what normally happened is someone would go to their GP, who would refer them to the OD, who would tell them what condition they had, and then send them back to their GP for medication. However, when the Health Minister sent his e-mail to the College, he also said that because they were allowing Optometrists to do this, they were expanding the regulations for Opticians to include refraction (Giving you a prescription for your eyes).

This is a sore point for many OD's, because a SIGHT test is much different from a Visual Examination. Although refracting is part of it, a Visual Examination also checks the health of your eye, and the OD can detect many conditions before they begin to affect site. Many times, but the time a patient recognizes that they have a visual problem, it's at the stage where it is untreatable.

The OD's arguement is that by giving Opticians the right to refract, and do Sight Tests (many will do it for free, with the purchase of eyewear), the public will stop coming to OD's, because they don't realize how much more a Visual Exam is, and won't pay the money to take care of their eyes....many people don't relalize that a Visual Examination does much more than just see if you need glasses. They believe that giving them the right to prescribe TPA's is of benefit to the public, not them, where it is of benefit to the Opticians to be able to refract.

Again, is it greed on the part of the OD's? Or is it a valid point that the public will begin to neglect the health of their eyes?

[Cheryl Tucker]

Can you possibly recap the problem by saying just what the people are doing without all the fancy numbers and extra info. I just found it a bit hard to follow.

Thanks.

[Wood]

I'm on the eye doctors side for the Ontario one. I think its wrong for the government to say "the only way we'll allow you to work in this province is if you work for significantly less than everyone else doing the same job in other provinces." I think there should be some sort of independant mediator who should be able to determine what a fair price for the service is, keeping in mind these factors:


What's fair market value?
What price will keep the best eye doctors from moving to other provinces or the US.
What price will not be over burdenous on the tax payer.

[Chief Hoult]

Can you possibly recap the problem by saying just what the people are doing without all the fancy numbers and extra info. I just found it a bit hard to follow.

Thanks.

The numbers are all relevent (How much they get paid, how long it's been since a raise...)

And the informtaion is relevent to the discussion (At least I think it could be...most people don't know the background behind Optometrists, or what their situation is, because they are so small)

But just some abreviations that might make it easier:

OD = Doctor of Optometry
OHIP = Ontario Health Insurance Plan (Like BC Care....it's the thing that makes you not have to pay for Doctors services)
TPA = Thereputic something or other.....eye drops.
College = Regulating Body (You've heard of the College of Physicians and Surgeon's, etc). They hand out licenses for someone to practice Optometry, take complaints, protect the public, etc.
Refract = That's like the number prescription you get....like when you're sitting there in a chair with the feropter (sp?) over your eyes and they go, "Better or worse?.....Better or worse?.....".

Hope that helps!

[Cheryl Tucker]

The numbers are all relevent (How much they get paid, how long it's been since a raise...)

And the informtaion is relevent to the discussion (At least I think it could be...most people don't know the background behind Optometrists, or what their situation is, because they are so small)

But just some abreviations that might make it easier:

OD = Doctor of Optometry
OHIP = Ontario Health Insurance Plan (Like BC Care....it's the thing that makes you not have to pay for Doctors services)
TPA = Thereputic something or other.....eye drops.
College = Regulating Body (You've heard of the College of Physicians and Surgeon's, etc). They hand out licenses for someone to practice Optometry, take complaints, protect the public, etc.
Refract = That's like the number prescription you get....like when you're sitting there in a chair with the feropter (sp?) over your eyes and they go, "Better or worse?.....Better or worse?.....".

Hope that helps!
Yes, That helps a lot actually. Thanks.

[sailrox]

I am NOT on the side of Onatrio doctors for this one, sorry.

First of all, I wear glasses. I can't afford that much to see an eye doc. Plain and simple.

Secondly- how is this different from the whole Canada socialised medicine, US not thing?
When snowbirds go to down to Florida for teh winter, and get sick, the Canadian government will ONLY pay for FAIR MARKET VALUE of their treatment. What does this mean?
It means that while they charge Americans hugely inflated prices for drugs and medical treatment, insirance or no, the Canadian government will only pay "fair market value"- what those drugs SHOULD cost.

Now, for some reason (I don't know the details) the remainder of the costs are not passed onto the patient- the Americans must provide treatment at the reasonable, agreed cost. That's why most Amercian doctors and dentists aren't thrilled about socilaized medicine, they see it eating into their profits.

Ontario optomitrists are hardly starving to death. They are QUITE comfortable. Why should low income ANYBODYs have to pay double the amount for necessary treatment? On that note, why should ANYBODY have to pay what is potentially an inflated price?

[Wood]

But why should someone who works in Alberta make half of what someone in Ontario make? The Ontario government has decided it will pay for this service, that means that it will be free for those who use it, not that they should have to cut their prices in half.

[sailrox]

Reverse the question:
Why should somebody in Alberta have to pay twice what it's worth? "worth"

[Chief Hoult]

Provincially, I believe Ontario has the poorest optometrists.....reason being that they can't mark up their frames, etc.....there is a fram here that is $85.....we sell the EXACT same frame BC for $295.

Most Optometrists, especially in Ontario, make very little money off of seeing patients. To be realistic, it probably costs them more to see patients than they bring in.....the money that makes their living 'comfortable' is in dispensing (when you buy glasses, contacts, etc). I know very few Optometrists who do not dispense, simply ebcause it's near impossible to run a profitable practice off of just seeinf patients alone...

We'll say an experienced Optometrist sees 3 patients/hour, so that's approx $120/hour.

Secretary gets paid $15/hour, assuming you have a really good, dedicated one. That brings you down to $105/hour. Then account for rent, equipment, and of course, debts aquired whetehr it be through school, or whatever else....then of course we're talking about living, period. House, food, etc. If an Optometrist doesn't dispense, most of the time they lose money. Just some food for thought ;) If you dispense, you need someone to dispense, which is another employee at $15/hour. The Optometrist COULD dispense themselves, but then they aren't seeing patients, so maybe they are now only making $80/hour, or sometimes less.

Should the government up OHIP coverage to $70/appt, and keep everyone covered? Would that be financially feasible? If not, is it right that they've gone so long without a raise?

CH

[sailrox]

I'm not seeing too many optometrists otu on teh street, Colin. Tehy're doing JUST fine.

And WHY, pray tell, should I pay 300 bucks for a pair of frames, when they're obviously being made, exactly the same quality, at a third of the price?

[Chief Hoult]

I'm not seeing too many optometrists otu on teh street, Colin. Tehy're doing JUST fine.

And WHY, pray tell, should I pay 300 bucks for a pair of frames, when they're obviously being made, exactly the same quality, at a third of the price?

Because they dispense, and most are married (at least from what I've seen) to a working spouse.

A new OD, freshly graduated, has a small hope of starting their own practice. It's simply too expensive to do. Add onto that, getting patients, etc, well, plus space.

Even if they aren't on the streets now, remember, these people don't have pension plans, dental plans, etc. It's an independant business.

Mark-up in frames across the country varies from the place to place. In Ontario, your frame is sold at cost (I believe). HOWEVER, there are also dispensing fees attached, depending on the type of lens you are getting (Single Vision, Bifocal, etc). These fees are not applied in BC. That being said, most people from BC aren't going to fly to Ontario to get their glasses.

Why? Well, it's still a business. I already showed how seeing patients is rarely profitable, and some OD's loose money. I heard this one OD inherited a dispensery from his father, and just worked there full time, just selling glasses, and made more than he'd ever made as an Optometrist. OD's don't make too much money, depending on what they do, and who they work for.

CH

[sailrox]

Okay.

My frames right now?

Lenscrafters 120$
Costco 69$

There IS such thing as mark-up.

And with MOST buisnesses, you can't just walk out onto the street and start one up. It's really, really uphill work. So why should Optomitrists be any different?

In addition, Ontario Optomitrists know what they're getting ito when they sign into that career. Likeevery other career out there, you have to do soemthing to survive. If it means working in an already established practice for a couple years, why not?

[Insane Power Pilot]

Under the Ontario system, why wouldn't an OD try to fit in more patients, spending 10 minutes per patient, or even 5? Then they'd be sitting pretty sweet at the going rate per patient! The easy answer...privatize the service, deregulate it, and let them charge whatever the heck they want. Let them get competitive. For example, the last time I went to an eye doctor it cost me 53 bucks, but I was in the exam room for a whole 5 minutes, 7 tops. So I won't be going back, even if that means I'll have to pay a little more the next time around...do you see what I'm saying? Now, you might be saying "But then the service is only available to rich people..." Well, if you can't save up 75 bucks twice a year, then I don't know what. And who knows...maybe you're lucky enough to work for a company that has all this covered under its health insurance plan. Meanwhile, the government's laughing because they're saving $39.15 everytime somebody goes in for an eye exam, taxes get lowered, and everyone's happy because they love extra money in their pockets.

Awaiting flames from the fans of socialist health care... :eek:

[Chief Hoult]

Okay.

My frames right now?

Lenscrafters 120$
Costco 69$

There IS such thing as mark-up.


Those aren't Optometrists (Yes, it does make a difference). In Ontario, a Lisenced Optician CANNOT work with a Lisenced Optometrist. If you look at Lenscrafters, the OD is right nextdoor, often with a door, and a ssign that look much alike...but the OD is 'affiliated', not part of that dispensery.

And they know what they're getting into? If you go into a job, you'd expect advancement. Usually in the form of a raise, health/dental plans, pensions, more vacation times, etc. It's a fairly safe expetation that one would think would be reasonable. Think about how much different prices are in the past years, I remember getting a can of AUTHENTIC coke for 50 cents, now it's a dollar a can (Yes, I know it's only coke, but you see the point). So why should OD's be any different?

Insane Power Pilot -- I think it's something like 80% of people have health plans that would cover themselves and their families. Adults are suggested to come once every other year, so $75 we'll say, every 2 years.

[sailrox]

If you're opening up your own buisness, like anybody else, you make your own advancement. And if you haven't researched the work conditions going into this new career, then you're starting from behind anyways.

[Wood]

If you're opening up your own buisness, like anybody else, you make your own advancement. And if you haven't researched the work conditions going into this new career, then you're starting from behind anyways.


So that basically means that a intelligent person should not be in this perfession.

While I wouldn't support outrageous prices I don't support a person going through university education, opening up his own business and then because of government interferance working for almost free. That's NOT fair market price.

The other solutions work faster, do a crappy job and hope you'll be able to get through more customers. But as already mentioned, this would actually decrease the amount of customers as they would move on to a better doctor.

If we're talking about fair market value then there's no way that its so far below the rest of the nation.

And as for them not living on the street, what does that mean? That people can only enjoy fair pay as long as they aren't in poverty. These are hardworking educated people, who unlike many work to help people rather than to destroy them like many large businesses. Inadequate funding causes these people to go off and work where they can best support their family, hense decreasing the healthcare system in Ontario.

[Chief Hoult]

If you're opening up your own buisness, like anybody else, you make your own advancement. And if you haven't researched the work conditions going into this new career, then you're starting from behind anyways.

If you're starting up your own business, you can also charge pretty much whatever you want, within reason, and it's competitive. One would expect that regardless of career (McDonalds --> Medicine --> Military, etc) that the pay would inflate with the rest of the world. Even in cadets, as a PO1 I made 68.06/day, where as the year before, CPO1 pay was around 70/day (they are now making 76 or so).

The only profit that OD's usually make is in dispensing fees, as they can't really mark anything up, unlike Opticians.