I?ve been thinking about some of the ?threats? to the optical profession that I have witnessed over the forty + years that I?ve been a practicing optician. When the big box stores started opening, the talk amongst eye care professionals (ECPs) was that it was a huge threat to the survival of the optical industry, especially the independent optician and optometrist.
Didn?t happen. Then laser surgery and the talk was that it was the beginning of the end. Didn?t happen. And now we have a new threat to our existence. The Internet. ?Is this the ?Big One?? ECPs have been watching ?the Internet grow at a steady pace for years.
Now it is time to ask some big questions to find the answer to that big question ? is the Internet the ?Big One??
- Are you feeling the effects of the Internet?
- Are you taking action to counter the effects?
- Do you believe there is a way to enforce the current regulations without bankrupting the system?
- Which is the most effective model for the system?
We have seen what can happen when political influence can be bought and the system changes to a certain business model. In British Columbia the College of Opticians challenged Clearly Contacts in court and right up to the Supreme Court of Canada. When the government of British Columbia changed the regulations to allow the dispensing of contacts and prescription eye wear by untrained, unlicensed individuals, we may need to question the business model. They did however keep regulation and standards in force for the regulated eye care professionals such as opticians and optometrists. The BC health minister announced that the government?s role was not to tell people where to purchase their eye care but that their role was to make sure that there is a safe option available. It would then be up to the ECPs to educate the public as to the benefits of engaging a trained and licensed eye care professional. So now there is ?Buyer beware? in health care. Why is this such a big issue? Pretty straight forward if you ask me. Dispensing in BC without a licensed ECP is legal and here in Ontario, and for the rest of Canada, it is not. Aren?t Internet suppliers breaking the law sending prescription eye wear into our provinces? Or are they? At a recent meeting with the Ministry of Health I posed this question to the government official and the response I received was ?Where does the dispensing actually take place?? I’ve heard this question many times before. Internet companies say that the dispensing takes place?when the packaged eye wear is tossed into the mail box.?When ECPs and regulators get together and this question comes up it comes back to what is the definition of dispensing???The College of Opticians of Ontario considers the definition of dispensing to be ?The preparation, adaptation and delivery of eyeglasses, contact lenses or subnormal vision devices to a person.? This definition was used in the King Optical/Sandra Wadden? vs the College of Opticians of Ontario case?In this case the definition of dispensing was upheld ?in the Ontario Court of Justice, on appeal to Superior Court of Justice, and on further appeal to Court of Appeal. The College was successful at all levels. We can debate whether Internet companies are using a loophole in the law along with their vast resources, both financial and political. It is our responsibility; opticians, professional associations, and regulatory bodies to practice opticianry within the current regulations and standards of practice. It is the mandate of the regulatory bodies to enforce regulations to ensure the public receives safe delivery of their eye care? It has been accepted by government research and reports a number of times that there is a risk of harm in the dispensing of prescription glasses and all contact lenses. I’ve heard it said that we need to stop the Internet. Big task! Last I heard there were 36 companies selling eye glasses and contacts into Ontario via the Internet. I?m sure there are many more now. Let?s say we were able to stop a major Canadian based company from selling into our province, then what? We?d say ?that?s one down? (Cost: $500,000-1M). ?Bring on the next!? I still don?t understand why the regulations are not being enforced but that is a topic for another time. I believe in the value opticians bring to the providing of quality eye care to our clients through our primary education, experience, and continuous professional learning. The Internet, with its current business models are a threat to the delivery of quality dispensed eye care. This is due to the absence of an ECP to ensure the appropriate devices and options are dispensed after a thorough assessment of a client?s visual and fitting needs . The saying, ?The horse has left the barn ?, can be a good analogy in regards to the sale of eye care on the Internet. The more I learn about the Internet the more I see that it can be used as a tool for professional learning that offers the ability to share my new professional knowledge with my clients, colleagues and friends with the hope that it will stimulate discussion and new ideas. I think we have to do this in order to elevate ourselves and our profession into the 21st century. So what would a safe dispensing model look like utilizing the Internet? Safe or not, we are at a tipping point of a number of companies joining the internet dispensing eye wear business in various models of which I can?t, at this time, see how they will comply with today?s standards. How will the regulators handle this landslide? According to author Daniel Pink (2011), this is the dawning of the Conceptual Age?, ?transitioning from the Information Age. With all this information at our finger tips and our ability to communicate instantly surely we can come together and conceptualize our role in the future of eye care delivery. A great place for us to start is with our vision of a safe dispensing model for the Internet which affords the eye care purchasing public safe accessible eye care utilizing the skills and expertise of a licensed optician. So how are we going to conceptualize our future? We have to continue the dialogue we have now and expand to include as many minds as possible. A good place to start is the conceptualizing of a safe Internet model we can live and grow with. We can start this dialogue through comments to this blog and as interest builds we can expand and have this conversation on Twitter and other social media. Please find me on Twitter at: https://twitter.com/LOrneKashin . The Internet is the window to the world and a part of the evolution and continuing professionalization of our profession. In the meantime I urge you to be diligent in your reporting of adverse experiences the public is having due to internet sales. Turn conversations about the internet with your clients into educational moments for both you and them. Make your professionalism and your professional knowledge visible.