Most practitioners would agree that every person has a right to adequate health care regardless of their economic, social, or legal status. That said, the provision of health care is also a business. How is an optometrist to resolve the tension between the economics of practice and the desire to serve the public good? What is the responsibility of an optometrist to provide care to a disadvantaged member of the public?
Under self-regulation, optometrists are in the privileged position of having been delegated the authority to regulate their own profession. There are obligations that go along with this power. Self-regulation works because there is an understanding that professionals will apply their specialized knowledge and skill in the public interest. There is an agreement between the professions and the public they serve that in return for the privilege of self-governance, the profession has a duty to attend to the welfare of everyone, not just those who are socioeconomically advantaged.
The first principle listed on the Ethical Guide developed by the Ontario Association of Optometrists is:
Treat all patients with respect. Consider first their visual well–being and provide appropriate care for all your patients. Do
not exploit for personal advantage; nor discriminate against
Discrimination can take many forms, including the level of access an individual is given to a practitioner’s services, or whether an individual is accepted as a patient at all. An optometrist is not required to accept every person who walks through the door as a patient, but you must be sure that your reasons for not accepting a patient, or for limiting a patient’s access to your services, are not rooted in your own personal financial interest.
Optometrists must abide by the Human Rights Code which prohibits discrimination on the following grounds: race, ancestry, place of origin, colour, ethnic origin, citizenship, creed, sex, sexual orientation, age, marital status, family status, and disability. Failure to abide by the Human Rights Code may result in a proceeding before the Ontario Human Rights Tribunal. It could also result in disciplinary action by the College. Paragraph 1. (1) 53. of the Professional Misconduct Regulation states that it is professional misconduct to engage in conduct or perform an act that, having regard to all the circumstances, would reasonably be regarded by members as disgraceful, dishonourable, unprofessional or unethical.
An ethical and transparent approach to economic issues will result in fair transactions. An optometrist’s policies related to accepting patients, booking patients and fees for professional services are legitimate as long as professional ideals are upheld and just principles are followed.
An optometric practice operates as a business and if the business isn’t sound, no one benefits. A balance between social and fiscal responsibility is essential. The key is in appreciating that you can earn a good living while cultivating a good social conscience.