Quote Originally Posted by mike.elmes View Post
It has more to do with the Physicians scope of practice guidelines within the health professions act. Ophthalmologists are not allowed to do remote refractions is my understanding of the situation in Ontario. Secondarily, Ontario's College of Opticians has not expanded its scope of practice to include refracting, as is the case in Alberta. I'm not sure what the status is in BC.
Yes, I am aware that the authority to delegate the controlled act lies with the individual physician, however I'm wondering why the college of opticians takes no stance on members that are involved in the off-site delegation of "eye tests" but strongly objects to delegation of dispensing - even when an RO is on-site. Here's an honest question open for discussion; what carries with it a great potiential for harm, refraction and prescribing of eyewear in the absence of non-refractive data, or dispensing?

Do you know of any source outling ophthalmology's ban on remote refraction? I suppose it would be against the interests of most ophthalmologists to delegate refraction - many do own dispensaries.

From what I've seen in Ontario, opticals that offer "sight-tests" do so with the authorization of a variety of non-ophthal. MD's (ER Physician, Physcial Med &Rehab). The question that arises in my mind then is whether these physicans are adequately trained to prescibe for refractive error? Sure an ER doc sees plenty of eye trauma, and acute disorder, but do they really know what they are doing when they rubber stamp the Rx?

Also, I think there may be a question of whether the Ontario MD's that delegate refraction to independent RO's are actually authorized by their college to do so (yes I know the RHPA gives physicians access to 12 of the 13 controlled acts, but they must still abide by college regulations). For example, the terms & conditions of the MD supposedly (does anyone know if she consented to this?) used by Great Glasses says that Dr. Trotter "may practise only in the areas of medicine in which DR. TROTTER is educated and experienced." As someone specializing in Physical Medicine and Rehabilitation I'm not sure she would be "educated and experienced" in ophthalmology, but maybe the college uses the phrase lightly. Any opinions?
CPSO: Delegation of Controlled Acts
CPSO: Requirements When Changing Scope of Practice