Clinical and Professional Practice Policies
- Confidentiality of Records
- Continuing Education
- Continuing Education and the Optical and Pharmaceutical Industry
- Hospital and Multidisciplinary Optometrists
- Interprofessional Communication
- Interprofessional Relations
- Peer Review
- Post-Graduate Courses in Public Health and Public Administration
- Relationships Between Optometrists and Optical and Pharmaceutical
- Relationships of Schools of Optometry to Health Centres
- Schools of Optometry
Confidentiality of Records
The Canadian Association of Optometrists (CAO) affirms the confidentiality of all information gathered as a result of the patient/optometrist relationship and recorded on the optometric record. The record remains the property of the optometrist, but the patient has a right to fair and easy access to the information contained thereof. The record contains a compilation of data including personal and family history, test results, diagnosis, etc., and may require interpretation by the practitioner with due consideration for the well-being of the patient.
An optometrist should strive to keep current with every modern development in the profession, to enhance both knowledge and proficiency by the adoption of current methods and scientific concepts of proven worth, and to contribute personally to the general knowledge and advancement of the profession. The Canadian Association of Optometrists (CAO) encourages optometrists and provincial associations to meet these goals.
Continuing Education and the Optical and Pharmaceutical Industry
Continuing Education (CE) organizers must not be in a position of conflict of interest by virtue of any affiliation with the sponsor(s) of the CE. While the programme for such CE may acknowledge the financial and/or other aid received from a manufacturer in the optical and pharmaceutical industry, it should not identify the sponsor’s (sponsors’) product(s). Every effort should be made to use generic names rather than trade names in the course of CE activities.
The Canadian Association of Optometrists (CAO) rejects the presentation of promotional activities as bona fide continuing education. Nor does it support the activity of peer selling wherein an optometrist specializing in particular areas conducts seminars on specific topics which have, as the main focus, the product(s) of the sponsoring manufacturer(s).
The Canadian Association of Optometrists (CAO) recommends that each optometrist adhere to a Code of Ethics established jointly by CAO and the provincial Associations of Optometrists. CAO is on record as supporting the Optometry laws in the various provinces, as well as their Codes of Ethics, with all means at its command. CAO will assist the individual provinces, wherever the same is possible, in preventing those who have no proper training and are unlicensed from attempting to care for the vision of the public in any manner. CAO requests individual optometrists to continue co-operation with ophthalmologists along ethical channels.
Code of Ethics
It shall be the ideal, the resolve, and the duty of each ordinary member of the Canadian Association of Optometrists:
- To accept as one’s primary concern and responsibility the visual welfare of all patients;
- To promote in every possible way high standards of vision care for all people;
- To render optometric services with equal diligence to all patients, regardless of race, creed, or economic status;
- To consult freely with colleagues and with members of other professions whenever such consultations are in the best interest of the patient;
- To seek continued growth of skill and knowledge so that the optometrist’s patients may receive the full benefit of advances in the art and science of vision care;
- To share one’s professional knowledge concerning one’s patients, and to use such information only for the benefit of those patients;
- To maintain at all times the dignity, honour, and integrity of the profession.
Hospital and Multidisciplinary Optometrists
Optometrists are trained to provide services to patients with signs and symptoms of eye disease, vision problems, ocular manifestations of systemic disease, and ocular emergencies. Patients would benefit from eyecare and consultation by their optometrists in a hospital setting.
The Canadian Association of Optometrists (CAO) supports the affiliation of optometrist with hospitals and in other multidisciplinary settings. CAO encourages the attainment of hospital privileges for optometrists within the scope of practice authorized by statute. CAO endorses the education of the public about the role of the optometrist in providing primary eyecare in the hospital setting.
It is the policy of the Canadian Association of Optometrists (CAO) that, when a patient, after being examined by his or her optometrist, is referred to an ophthalmologist or other health care practitioner, the optometrist will communicate to the patient’s family physician the details and circumstances leading to the referral.
(a) Interprofessional referral consultations are encouraged when the best interest of the patient indicates additional opinion. The protocol of the relationship and responsibilities between the referring and attending professionals that customarily is followed by health professionals shall prevail. Referrals between optometrist and ophthalmologists should be on a consultation basis with full reciprocal professional courtesies and privileges.
In the case of a referral of a patient to a physician or other health care provider by an optometrist, the optometrist should be provided with a confidential report which should include any information which may be co-ordinated in affording the best optometric care to the patient.
Other health care providers also have responsibility to screen and refer patients requiring other types of professional services. It is recommended that the primary point of entry for services related to the visual system be the optometrist.
(b) The Canadian Association of Optometrists (CAO) supports the position that a refraction or visual analysis cannot be performed properly by a technician because of the absence of training which would ensure the necessary professional judgement. All activities of technicians in the field of vision care must be under the direct in person supervision of an optometrist or ophthalmologist.
(c) Professional responsibility demands that the optometrist actively participate in public health activities with other health professionals to the end that every step be taken to safeguard the health and welfare of the public.
In order to assure the maintenance of quality in the projected scope of optometric care, the Canadian Association of Optometrists encourages the study and establishment of guidelines for peer review, self-assessment and, when appropriate, examinations for licence renewal.
Post-graduate Courses in the Public Health and Public Administration
The Canadian Association of Optometrist (CAO) encourages and supports qualified optometrists’ and optometric students’ entry into post-graduate programmes in public health and public administration.
Relationships Between Optometrists and Optical Pharmaceutical
Professional interactions between optometrists and the optical and pharmaceutical industry should have as their primary objective the advancement of the health of the members of society, rather than the private good of either the optometrists or of members of the industry. Furthermore, optometrists should avoid any self-interest in their prescribing practices.
The practising optometrist’s primary concern is towards the patient. Considerations involving the optical and pharmaceutical industry are appropriate only insofar as they do not affect the fiduciary nature of the optometrist/patient relationship. In any association between an optometrist not employed by the optical and pharmaceutical industry and the industry itself, the optometrist should always maintain professional autonomy, independence and commitment to the scientific method.
The acceptance of clinical evaluation packages (samples) and similar devices should be on the condition of full accountability. Distribution of samples should be solely for the purposes of allowing optometrist to evaluate the clinical performance of the articles outside the context of post-marketing surveillance studies, to initiate therapy, or for similar purposes. Any departure from this use must be justifiable in terms of otherwise applicable principles of ethical optometric practice. Distribution of samples should not involve any form of material gain for the optometrist or for the practice with which he or she is associated it is the accepting optometrist’s responsibility to ensure the age related quality of the samples that he or she accepts, as well as their security. The accepting optometrist is also responsible for the proper disposal of samples that are unused.
Optometrists should not knowingly invest in optical and pharmaceutical industry manufacturing companies or related undertakings where knowledge about the success of the company or undertaking might have an inappropriate impact on the manner of their practice or on their prescribing behaviour. Optometrists in active practice should not be affiliated with optical and pharmaceutical industry manufacturers if the nature of their affiliation may influence their optometric practice in an inappropriate fashion.
Optometrists in practice should not accept a fee or equivalent consideration from optical and pharmaceutical industry manufacturers, distributors, etc., in exchange for seeing them in a promotional or similar capacity. In principle, practising optometrists should not accept personal gifts, promotional items or other consideration from the optical and pharmaceutical industry or similar bodies. They may, however, accept patient teaching aids provided that these aids carry only the logo of the donor company and provided that they do not make reference to specific therapeutic devices.
Relationships of Schools of Optometry to Health Centres
It is highly recommended that optometric educational institutions form some type of symbiotic relationship with (1) the outpatient departments of hospitals; (2) various types of clinics (pediatric or geriatric); (3) nursing homes; and (4) other health facilities so that the optometric student sees more clinical examples of active disease and gains a wider variety of optometric experiences.
Furthermore, the Canadian Association of Optometrists (CAO) recommends that all Schools of Optometry be so constituted as to recognize community involvement in health care delivery, thereby gaining community support and attracting the type of students who will promote those interests.
Schools of Optometry
The Canadian Association of Optometrists (CAO) encourages Schools of Optometry to evaluate their curricula and clinical programmes continually to upgrade their training with emphasis on the full scope of optometric practice. Part of optometric education should include experience in interdisciplinary health centres. Schools of Optometry should encourage optical manufacturers to develop support materials, including audio-visual aids to go with new instrumentation in consultation with the Schools and clinical practitioners.