Ontario Opticians Banned from Refractometry

[Excalibur]

A letter from Dr. J. Tepper (Asst Deputy Health Minister) was sent July 15/2008 to the President of Jeff Fernandes, President of the College of Opticians of Ontario stating that the Ministry of Health of Ontario does not permit opticians to independently refract.

In the letter, it stated that "members of your College should not be performing refractometry under any circumstances" and that "we reiterate that no new direction has been issued by any Minister since 2001 that would permit opticians to perform refractometry".

If there is a way of posting this letter to Optiboard I would be happy to do so. It is in pdf format.

I understand that the College of Opticians has embarked on a refracting course for its members. Perhaps they should consider returning any tuition immediately.

[For-Life]

It has been made very clear to Ontario Opticians that refracting is not permitted. Those who are following through with the refracting courses have done so with the hope the law will change. Plus, some are working for ODs and doing their pre-refractions for them.

[Refractingoptician.com]

A letter from Dr. J. Tepper (Asst Deputy Health Minister) was sent July 15/2008 to the President of Jeff Fernandes, President of the College of Opticians of Ontario stating that the Ministry of Health of Ontario does not permit opticians to independently refract.

In the letter, it stated that "members of your College should not be performing refractometry under any circumstances" and that "we reiterate that no new direction has been issued by any Minister since 2001 that would permit opticians to perform refractometry".

If there is a way of posting this letter to Optiboard I would be happy to do so. It is in pdf format.

I understand that the College of Opticians has embarked on a refracting course for its members. Perhaps they should consider returning any tuition immediately.

Refractometry is in the public domain . That means anyone can do it .

[Excalibur]

If a Health Minister sent a letter like that , then in my humble opinion they made a huge error and need to reconsider the meaning of the word DISCRIMINATION !!!!!

In my opinion The Minister of Health does NOT control who can and who can not refract.

Refractometry is in the puiblic domain . That means anyone can do it . ANYONE ! Therefore, singly out one particular body and saying they can not refract is very simply ... DISCRIMINATION !!

The College of Opticians , in my opinion , was wrong to accept any such nonsense . They should only seek an immediate public apology from the author of that nonsense.

Opticians do not need anyone's permission, least of all permission from the Minister of Health , to refract.

Do you then suggest that opticians, and perhaps all other health professions, become unregulated?

[Refractingoptician.com]

[ .

[Oedema]

Please quote the exact law that states that opticians can not perform refractometry and post it here . Please post the source as well such as the Act page number and paragraph number and subparagraph as well .

It doesn't have to come from any specific act or legislation, like it or not the minister has the final word on all college activities...

Regulated Health Professions Act, 1991
S.O. 1991, CHAPTER 18

Powers of Minister
5. (1) The Minister may,
(a) inquire into or require a Council to inquire into the state of practice of a health profession in a locality or institution;
(b) review a Council’s activities and require the Council to provide reports and information;
(c) require a Council to make, amend or revoke a regulation under a health profession Act or the Drug and Pharmacies Regulation Act;
(d) require a Council to do anything that, in the opinion of the Minister, is necessary or advisable to carry out the intent of this Act, the health profession Acts or the Drug and Pharmacies Regulation Act.

[Excalibur]

It doesn't have to come from any specific act or legislation, like it or not the minister has the final word on all college activities...

Regulated Health Professions Act, 1991
S.O. 1991, CHAPTER 18

I trust that defiance of the Health Minister could be a foolish and dangerous proposition for the College.

[Refractingoptician.com]

[.

[Excalibur]

Even Ministers are subject to the laws of the courts .

The College is doing nothing wrong by offering refractometry courses and opticians are doing nothing wrong by studying refractometry.

There also is nothing wrong in doing refractometery .

The issue you are skirting is what happens with the results of refractometry.

You must also realize the world is changing .

Some things optometry used to do , is finally changing because they were just plain wrong .

Example The IRIS litigation .

Tempting the Ministry of Health in this manner is a fool's game. Ontario's optometrists were declined therapeutic prescribing privileges in 2001, but were successful in 2006. Had the College of Optometrists wantonly defied the Ministry of Health and told their members to defy government, it would have been unwise. Of course, prescribing is not in the public domain, however, blatantly defying the Ministry in any fashion is counterproductive and foolish. I trust you will eventually be able to review the entire letter from the Assistant Deputy Health Minister -- the Ministry's opposition to independent refraction by opticians is quite clear. Best of luck with your approach.

[Refractingoptician.com]

Tempting the Ministry of Health in this manner is a fool's game. Ontario's optometrists were declined therapeutic prescribing privileges in 2001, but were successful in 2006. Had the College of Optometrists wantonly defied the Ministry of Health and told their members to defy government, it would have been unwise. Of course, prescribing is not in the public domain, however, blatantly defying the Ministry in any fashion is counterproductive and foolish. I trust you will eventually be able to review the entire letter from the Assistant Deputy Health Minister -- the Ministry's opposition to independent refraction by opticians is quite clear. Best of luck with your approach.

It's not my approach , in fact I am not even in favor of opticians refracting .

Having said that , the danger is not in refracting nor is the danger even in opticians prescribing WITH THE CORRECT TRAINING . The danger is that the public does not know what they are not getting .

The COO model is too cumbersome and won't work . But no one has put forth a better model that will work . We must give COO credit for trying to overcome the obstacles .

There are not enough Ophthalmologists , therefore some of the slack needs to be taken up by Optometry and likewise some by Opticians . Something has to give and they all need to work together .

[eyemanflying]

Something has to give and they all need to work together .

Until the 3 O's can agree on at least something, there will be no progress or unity; that has always been the issue. The Minister is our expensive babysitter/mediator and must be busting a gut by now watching us all playfighting in the sandbox.

[optical maven]

It is true that measuring of a refractive error, just as measuring blood pressure, measuring body temperature, or measuring eye pressure are within the public domain. Diagnosing and prescribing are controlled acts and, as dispensing, are only permitted by authorized professionals. In the defining acts of the RHPA only three professions do not include the descriptive of "assessment". Opticianry is one of those.

[renee1111]

Tempting the Ministry of Health in this manner is a fool's game. Ontario's optometrists were declined therapeutic prescribing privileges in 2001, but were successful in 2006. Had the College of Optometrists wantonly defied the Ministry of Health and told their members to defy government, it would have been unwise. Of course, prescribing is not in the public domain, however, blatantly defying the Ministry in any fashion is counterproductive and foolish.

I don't understand your reasoning, first of all educating ourselves, to effectively further our understanding about refraction, isn't a ploy to defy government. We are acquiring the skills and knowledge we need in order to widen our scope of practice. We don’t expect the Minister of Health to just assign us the duties of refraction, without prior training and proven competencies. So your judgment is ignorant and, quite frankly, unappreciated. :angry:

I trust you will eventually be able to review the entire letter from the Assistant Deputy Health Minister -- the Ministry's opposition to independent refraction by opticians is quite clear. Best of luck with your approach.

I wish someone could post a link to this alleged letter, because there's no information posted on the College of Opticians website nor the Ontario Opticians Association's website. I would think if this was true then I would be alerted in some way.

[Refractingoptician.com]

It is true that measuring of a refractive error, just as measuring blood pressure, measuring body temperature, or measuring eye pressure are within the public domain. Diagnosing and prescribing are controlled acts and, as dispensing, are only permitted by authorized professionals. In the defining acts of the RHPA only three professions do not include the descriptive of "assessment". Opticianry is one of those.

And if that is true , that refracting is in the public domain , then anyone attempting to ban opticians as a group and distinctive from any other member of the public , is discriminating . And anyone accepting and passing on such a directive would be part of that . Opticians as a group, should not accept being subject to that and they should demand apologies and compensatory damages , in my humble opinion.

Prescribing is a different matter .

[Excalibur]

I don't understand your reasoning, first of all educating ourselves, to effectively further our understanding about refraction, isn't a ploy to defy government. We are acquiring the skills and knowledge we need in order to widen our scope of practice. We don’t expect the Minister of Health to just assign us the duties of refraction, without prior training and proven competencies. So your judgment is ignorant and, quite frankly, unappreciated. :angry:

I wish someone could post a link to this alleged letter, because there's no information posted on the College of Opticians website nor the Ontario Opticians Association's website. I would think if this was true then I would be alerted in some way.

If there's a way I can post to the forum, I will. Short of that, post your email address and I will send you a copy.

[Excalibur]

I don't understand your reasoning, first of all educating ourselves, to effectively further our understanding about refraction, isn't a ploy to defy government. We are acquiring the skills and knowledge we need in order to widen our scope of practice. We don’t expect the Minister of Health to just assign us the duties of refraction, without prior training and proven competencies. So your judgment is ignorant and, quite frankly, unappreciated. :angry:

I wish someone could post a link to this alleged letter, because there's no information posted on the College of Opticians website nor the Ontario Opticians Association's website. I would think if this was true then I would be alerted in some way.

Some opticians are 'prescribing' independently and that is what concerns the Ministry. As for being 'alerted', ask Mr. Fernandes about the letter from Dr. Tepper -- I am sure he will be delighted to forward you a copy and you can then vouch for its existence.

[Dave Nelson]

Not really wanting to jump into the fray about refracting one way or the other, Its the presumtion that opticians shouldn't be taking refracting courses that irritates me the most. 10 billion times health care professionals, including optometrists, had the education BEFORE the legislative change allowed them to use it. We ran into this time and time again in BC. For Life also points out that many opticians have been refracting for years under supervision or delegation, and finally, many opticians want to take the course just to gain insight and understanding into the process. I've been in the OR many times watching and assisting cataract surgery while an ophthalmologist explained the procedure right from pre-op to post-op and recovery. Doesn't mean I think opticians should seek the right to perform the bloody thing, just to gain insight and understanding first hand, up close and personal, so my knowlege of aphakia and its management with spectacles and contact lenses is enhanced, and some continuity with other allied professionals is realized.
rant over.

[optical maven]

Unfortunately opticianry has done a poor job in policing itself on the issue of both dispensing and refracting. Performing these procedures is rampant throughout the world of opticianry. That is why the government basically gave a cease and desist to order to opticianry on refracting several years ago. Now when that ban was lifted the College of Opticians took this as a green light, as though refracting was now within opticianry's scope of practice. So the government felt compelled to reiterate that refracting for the purpose of diagnosing is not within the scope of practice of opticianry. Opticians are not a persecuted bunch. They do seem however to try to manipulate the rules beyond their original intent.

[renee1111]

If there's a way I can post to the forum, I will. Short of that, post your email address and I will send you a copy.

Here's my e-mail address inspire.99@hotmail.com, I would love a copy, thanks!

[Excalibur]

Unfortunately opticianry has done a poor job in policing itself on the issue of both dispensing and refracting. Performing these procedures is rampant throughout the world of opticianry. That is why the government basically gave a cease and desist to order to opticianry on refracting several years ago. Now when that ban was lifted the College of Opticians took this as a green light, as though refracting was now within opticianry's scope of practice. So the government felt compelled to reiterate that refracting for the purpose of diagnosing is not within the scope of practice of opticianry. Opticians are not a persecuted bunch. They do seem however to try to manipulate the rules beyond their original intent.

Agreed. Do you think that the College of Opticians would have 'gone after' Bergez alone? I think the College of Optometrists had to initiate legal action unilaterally.
Do you think that if the College of Opticians ignores the Minister of Health's letter, they Ministry will abolish the College executive? Is that technically possible?

[Excalibur]

Here's my e-mail address inspire.99@hotmail.com, I would love a copy, thanks!

your email is not working:

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[Refractingoptician.com]

If there's a way I can post to the forum, I will. Short of that, post your email address and I will send you a copy.

please send a copy to gwhite@cogeco.net Thank you .

[Oedema]

Ministers Letter:

[Refractingoptician.com]

Unfortunately opticianry has done a poor job in policing itself on the issue of both dispensing and refracting. Performing these procedures is rampant throughout the world of opticianry. ... They do seem however to try to manipulate the rules beyond their original intent.

Not quite true Optical Maven . The real truth of the matter is that The Minsiter of Health has a done a poor job as has RHPA.

Colleges are supposed to be self governing , but they can't be self governing if they don't have the tools to enforce and perform the job. In my opinion , If the Ministers keeps sticking their noses in by giving directives and ultimatums they are effectively and constructively dismissing the entire concept of "self-governing". IN my opinion , Opticians are not self governing . In my opinion They are politically controlled illusions of self government.

If the Minister wants things cleaned up then why not ask the Minister why a certain case is dragging for years through the court systems !! And for that matter the College of Optometrists' lawyer , who handled the GG case , might be your best bet for an explanation of why it is so difficult to police & enforce .

Self government is a joke without funding and tools . And part of that is a Ministry and RHPA problem .


As far as things being "rampant" you are really talking about one chain in particular . The same is true for your statement of "manipulation" . An apology is in order .

[opti-refractonator]

I cannot believe the astounding level of stupidity that is being shown by the responses and range of arguements. I really thought that this was a board with intelligence and free mind to help our professions. It seems pretty clear that the directive from the ministry simply reiterates the fact that opticians cannot refract for the purpose of prescribing an rx. This doesn't mean we cannot learn to refract. This does not mean that we cannot work with other O's. Yes, refracting is in the public domain, just like diagnosing that your little brother has a cold, but you cannot write an rx for him. A similar thread about not being able to look at the soft/exterior tissue of the eye in contact lens fittings a few days earlier, was just as mind numbing. Please, my people, let your common sense be the judge. Just because the wording of something may be translated into a thousand different meanings, using common sense and experience will ultimately lead you in the right path.