UPDATE: Optometrists to withdraw OHIP-covered services after breakdown in government talks

Ontario optometrists are making calls, preparing patients, and cancelling upcoming appointments that can only be paid for through the Ontario Health Insurance Plan (OHIP) for the foreseeable future.

The head of the Ontario Association of Optometrists (OAO) said starting Wednesday, September 1, optometrists will call affected patients to cancel appointments and place them on waiting lists. 

Dr. Sheldon Salaba said his group's members are currently paying for around 45 per cent of those services and that the job action comes after disappointing talks on the issue with the government.

The OAO wants the government to cover the full cost of the exam. 

Dr.Salaba explains that people should still contact optometrists with emergencies for help reaching a family doctor or another health-care setting.

Ontario Minister of Health Christine Elliott said, “We were disappointed to learn this past Saturday that the association declined the opportunity to proceed with further mediation.”

Despite the province seeking mediation to aid in the communication between the two parties, there has been no progress made and no further plans for discussion.

“We had two days of mediation with the government,” said Dr. Joshua Smith, practicing optometrist in Ottawa and past president of the Ontario Association of Optometrists.

“After which the mediation was adjourned for about a week with no communication back from them until the minister tweeted an offer, basically directly to the public in the public sphere.”

Dr. Smith added that in doing so, the minister has breached confidentiality, allowing the OAO to seek an application with the Supreme Court of Justice to have them remove the tweet as well as stop any further breaches of confidentiality.

Elliott's tweet came on Monday, August 23. The tweet read:

“I want to be fully transparent with you, here is the offer we put on the table: 

• An immediate compensation increases of 8.48% at the fee code level, retroactive to April 1, 2021. This represents a “catch up” of fee increases calculated to reflect similar increases applied to physicians over the past decade.
• A one-time payment of $39 million. Like the fee increases described above, this payment would cover a retroactive period over the past decade and was calculated to reflect similar increases applied to physicians during this time.
• Future fee increases to align with increases provided to physicians under the upcoming physician services agreement, including any increases physicians receive beginning April 1, 2021. 
• A commitment to immediately establish a Working Group with the OAO that would continue to be supported by a mediator and would allows us to come to a common understanding on the overhead costs associated with the fees for the delivery of optometry services. 
• A commitment to ensure ongoing monthly discussions with the OAO through establishing an insured optometry services review committee to:  
• Develop recommendations on the implementation of the fee increases; and
• Provide a mechanism t continue to discuss health care policy and system issues affecting optometrists.”

“This $39-million sounds like a large sum of money, but it is supposed to be, according to them, ‘a retroactive payment covering the last decade,'” said Dr. Smith. “In during which time, we delivered over $34-million in OHIP services so, it works out to a buck a visit… a buck an exam.”

The Ottawa doctor also emphasised that nowhere in their negotiations with the province did the OAO demand retroactive payments, stating they’ve only been focused on viable funding going forward. The proposed fee increases at 8.48 per cent will continue to leave Ontario optometrists responsible for covering 40 per cent of the exam.

As for the working group Elliott mentioned in her tweet, Dr. Smith believes they would do little in coming up with any more lucrative information than they already have now.  

“In December 2020 the OAO asked the ministry to conduct a joint study, similar to what the Quebec government did three years ago,” he said.

However, with zero government response Dr. Smith explained that the OAO continued with the study at their own expense, hiring a third-party accounting firm with the OAO now in possession of those results.

“They want to ignore that and start all over again after ignoring us for the past eight or nine months,” said Dr. Smith. “We have no confidence this group would come up with any better information, and there’s no commitment from the ministry whatsoever about what they would do with that information.”

Even with the looming deadline the OAO remains hopeful, saying it is more than willing to jump back into negotiations, if the province shows it's willing to better understand the issues its facing.

“If they can agree, service withdrawal can end immediately and we can get down to the table and do what we know will be months of work to get a structure in place that’s going to mean a sustainable eye care system,” said Dr. Smith. “But they have to agree that whatever we get to, that we’re not going to be subsidizing care. That’s the crux of the whole thing.”

Anyone looking to voice their concerns on this issue is asked to visit saveeyecare.ca.

“People do have the voice and the power on this, and the government knows that, if any time they have to listen…it's now,” concluded the Ottawa doctor.

— with files from The Canadian Press