What's to be confused about? If an OD see's a patient covered by the provincial health plan they can bill the province for services rendered. However, if the OD is employed the employer cannot bill the province b/c that would be fee-splitting (bad).
Now, are there really any OD's out there in Canada employed by OD's? I've never come across any such employment offers anywhere.
Well, for frames, we do cost. I'm sure there's some discounts there, but just your average ones. No, we don't use the discounted cost, but on a per-frame basis, the difference is quite small. For lenses though, It's definatly not cost. I don't deal too much with the lab end, buying wise, atleast, but I know we're charging more than cost for the lenses. It's still less, even with the fee, than they'd get elsewhere.
That's my point exactly and frankly, I couldn't care less. We all know that every OD out there does this....but rarely one ever admits it. I suppose it's mostly the denial and arrogance that are most annoying as I didn't see those two courses on the curriculum for optometry.
If the OD is employed by the optician and there is an ohip billing, then the OD would make the money from that. Actually, the agreements I have heard about have always centred on the OD making the full fee for the examinations.
Is this done in Canada? Yes, everywhere. Just not in Ontario.
Not one is starving...Most I know have big homes, cottages and all of the toys to go with it and that certainly isn't generated from 20% vendor discounts.
The funny thing is I enjoy every aspect of the optical industry, except optometry with all due respect. I had the grades, but it never gave me any interest and seemed 'rather boring' as the guy on Molson's Canadian commercials indicates.
Fezz is truly the beer man on this forum.
Then that's not really true "employment" is it? Does the optician withhold taxes and CPP? Just wondering b/c when you say the OD makes the full exam fee it starts to sound like independent contractor situation where the OD is really self-employed, leasing space from an optician.
Yes. Now are you equally unhappy about not being able to hire a physician? Are you pushing your association to negotiate with the Ontario Medical Association to allow physicians to be hired in the same way as you are pushing for optometry?
As for boring, if you think any of these fields are exciting, you must be an accountant.
Let me be clear: The association rules are absurd and should be changed. MD's already work within opticals. OD's and opticians should work together. I have an optician working for me. (Someone earlier was upset about salary. Every employer has a right to offer any job for any amount. Every employee has a right to accept or reject. No animosity or hurt feelings. It's just business). I don't think opticians want to hire an optometrist, any more than they want to hire an MD. I think they want to associate. Finally professionalism is not where or how you work, but what you do.
In Ontario opticians are not allowed to have an employee place a frame on someone's face. How absurd is that? In most major retailers the optician or staff is limited to sell whatever is on the board and whatever lens is on the list. What education do you need to do that? At Costco they only use two types of progressives from Essilor. Hakim only uses poly and never uses trivex. I had a woman working for me 20 years ago who was not an optician. She had been employed for 10 years and worked for The Bay optical, mostly by herself. There was an optician there, but not on a full time basis. They asked her to fit contact lenses and she refused and then came to work for me. I hired a woman 2 years ago who regularly ran her friend's optical store by herself. These are not exceptions, but part of the industry. Opticians are creating these situations, and therefore creating these standards.
Your first quote, that i highlighted, goes against what else has been said.
If you have a regular employee putting frames on people's faces, then it hurts the professionalism of it all. The Optician should do it, because (s)he is the one who has years of training on how to adjust, position, tilt ect. These items can affect how a person can see from a pair of glasses. It is the same reason why Opticians should not be able to refract. How difficult is it to come up with a refraction?
When it comes to glasses, there are trouble spots, and the Optician should know what they are and how to solve them, just like in Optometry.
and PS - Hakim does use trivex, and CR-39, and 1.6, and 1.67.
I really don't see why any optometrist would want to be employed by an optician. It's much better from a tax perspective to be an independant contractor. I have a fairly large practice with a dispensary, and about 8 full-time staff. Lots of headaches. It would be tempting to work beside an optician, let him or her have the dispensary, and just do exams, keep 100% of my fees, and only have to hire one or two assistants. I would still want to maintain my status as a Professional Corp, however, so being an employee would be out of the question.
Even when I use to work for another OD a few years ago, I did so as an independant contractor.
I was referring to frame selection and not the final delivery/dispensing of the appliance. Dispensing of glasses and prescribing of glasses are both controlled acts because they pose a risk to the public. Refracting is a physical measurement no different than using an automated device to measure blood pressure or a PD. It is interpreting the results for what we are trained. The final decision in frame selection needs to be professionally reviewed for proper fit, appropriateness for the Rx, seg height, etc.
Ideal for who though? Depending on how many patients the OD sees, it could cost him quite a bit to split 50/50 with an Optician. I don't see any real point in an Optician hiring an OD. Working with one? Definately. I think honestly the best relationship between the two O's would be an OD in the same office, maybe splitting on the rent/bills. OD keeps all their fees, hands the scrip to the patient, and let them walk out his door. Is it pressuring the patient? A bit, I suppose, but with script in hand, they have the choice. More often than not, they'll most likely choose to go with you, for convenience sake. So, the OD gets all his fees, with less overhead, and you get more scripts. Win win.
But that's the problem with the law. An agreement like this is illegal.
Ideal for both. The 'mine' thinking wouldn't exist. An even split on all start up costs, investments, revenues and expenses and each makes the same salary. Any profits after year end are paid out as dividends to each share holder, hopefully only 2. It's simple and would work. OD's and opticians would have to check their egos and differences at the door and stop being so territorial and narrow minded. I would do it in a heartbeat.
I would like to see the eye exam split up so that a patient would go to an optometrist for an eye health screening only, for a small fee. Then with a "healthy eyeball certificate" they would come into my dispensary to have a free refraction done by my receptionist.
Of course, she would be a fully certified opticianry assistant. The OPTICIANS ASSOCIATION could offer a short course in refraction to train her for this purpose.
Then if the province would lift the free association ban, I could have the freedom to hire a receptionist/optometrist to do this job at a fair hourly wage.
Of course you would, but you have to take a step back and look at the big picture for both parties. A situation like this would have tons of advantages for an Optician, but very little for an OD. In the end, they'd probably make less money than they would if they just did their exams, and had no dispensary. The example I made earlier would be the ideal for BOTH ends. Yours would be ideal for the Optician, no doubt, but not for the OD.
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