
Last month, mivision ran a controversial opinion piece by optometrist Jim Pappas predicting a dire future for the profession and eye health in general, due to Federal Government policies.
Jim Pappas argued that optometry was well positioned and capable of becoming more active in the management of eye disease, but pointed out that with an ageing population, the cost to the community of undiagnosed and unmanaged eye disease would run into billions. However, says Pappas, the current state of Optometry and vis a vis Federal Government policy would make that unlikely for this to occur.
Although there were those who did not agree entirely with his premise, many others did.
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A senior optometrist from a major corporation, who asked to remain anonymous, described the article as “accurate and insightful”.
Joe Chakman, Chief Executive Officer of the Optometrists Association Australia said: “Although it was interesting to read Jim’s views, I would prefer not to comment on them.”
However, optometrist Allan Ared was more forthcoming, saying the article “definitely highlights some of the issues currently facing the profession”.
Ared says: “I believe the biggest problem with optometry is optometry itself. If you ask ten optometrists to define optometry, you will often get ten different definitions. So if we are in disunity in our beliefs of who we are and what we stand for, then the profession will be perceived as fragmented and weak. This division makes it easier for governments, big corporations and the various medical fraternities to carve us up and keep defining our future.
“A national certification process aimed at competency standards and clinical requirements should be the professions’ prime directive irrespective of what kind of optometry one wishes to practice. “A national broad based uniform program amongst all practitioners will strengthen our resolve as a professional body and enable us to combat all these external forces far more efficiently, diligently and for the benefit of optometry’s longevity.
“This will also make us more effective within the national health arena especially in any future discussions on health reform. Optometry should be dictating its value to the community, not the government telling us our worth; especially as the cost of providing adequate eye care is becoming unsustainable.
“In my opinion, the certification process must include a prerequisite in the field of medical optometry and therapeutic endorsement as this is where I believe the future of optometry will lie. A national approach will also get rid of the irregularities, inconsistencies and discrepancies between the States and Territories which have for years made us a far less effective political force.”
A senior optometrist from a major corporation, who asked to remain anonymous, described the article as “accurate and insightful”.
He said: “The industry is shifting away from being primary eye health providers to becoming more refraction orientated. I don’t like looking at conversions and pushing for sales to meet budgets, but at the end of the day, about 80 per cent of income is obtained from selling and along with big corporate/retail chains entering the market, there is not doubt there would be a landslide shift from clinical optometry to becoming refraction and selling glasses.
“I am not sure what can be done, but increasing revenue from consultation does sound like a very possible solution to direct optometrists back to becoming more clinically orientated?
“No doubt if optometry continues to sell to make revenue, this would deter good students away from the profession … that is one of the last things the Government and public wants.”
As for the Australian Medical Association (AMA), they referred mivision to two recent media releases which seem to support Pappas’ view.
In one release, the AMA said figures released by the Government showed the most significant fall in general practice bulk billing rates since 2003.
According to AMA President Dr. Rosanna Capolingua, this was because the Government had failed to index the patient’s Medicare rebate to keep up with the cost of living.
Dr. Capolingua said in the releases: “Doctors and patients are shouldering the Government’s failure to keep pace with the cost of delivering care. The Medicare bulk billing rates went up when the Government invested in patient rebates in 2004. Up until now they have been maintained.
Increases in Medicare rebates have been substantially below inflation. In the absence of appropriate Government indexation, we would expect that the bulk billing rate will continue to fall. This will mean that patients will face increased out of pocket costs when they need to see a doctor. The Government has let them down at a time when the community is feeling the squeeze from the economic crisis.
For patients who are not bulk billed, the average patient contribution or gap has actually gone down by AUD$1.55. We know that doctors’ fees have not kept pace with average weekly earnings.
“Families, pensioners, self-funded retirees, those who have chronic illness or disabilities, those who need lots of care – they will be hit the hardest. Doctors have been trying to protect patients from out of pocket costs, but the Government has not. It is vital that the Government bolster patient rebates so that access to medical care is maintained and average and lower income Australians have access to the care they need and deserve.”
Dr. Rosanna Capolingua called on the Federal Government to increase Medicare rebates for patients to reflect the real costs involved in delivering quality health care. She pointed out that Medicare patient rebates had not kept pace with inflation adding that this was unfair to patients, who were also struggling with the rising cost of living.