COS 2018 Advocacy in Action (fourth quarter update)

National Initiatives

COS Provides Clinical Input to Health Canada on the Risk of Limbal Stem Cell Deficiency (LSCD): On September 9, 2018, the COS received a request from Health Canada to provide clinical input about the risk of LSCD in individuals using contact lenses. This request came from a recent literature review conducted by Health Canada. The literature review has suggested that the use of soft contact lenses, may put users at risk of LSCD. Special thank you to Dr. Clara Chan for leading COS’s response.

COS Works with Health Canada on New Tobacco Warning Labels for Eye Health: Health Canada is currently in the process of renewing the labels found on tobacco products, which include health warnings (HW) and health information messages (HIM). COS has been working with Health Canada to provide medical images that graphically depict the negative risks of tobacco on eye health, for the new labelling.

COS Works with Industry to Successfully Resolve Isopto Atropine 1% Discontinuation: As a result of working with a variety of stakeholders including the Canadian Association of Pediatric Ophthalmology and Strabismus (CAPOS), the Canadian Glaucoma Society (CGS), the Canadian Retina Society (CRS), the Canadian Uveitis Society (CUS), the Canadian Psychiatric Association (CPA) and the Canadian Society of Palliative Care Physicians (CSPCP), COS is pleased to share that as of September 2018, Isopto Atropine 1% is available for physicians and their patients. Special thank you to Dr. Jamie Taylor, COS Board member and COS’ Lead Physician for National Ophthalmic Drug Shortages and Drug Discontinuations for his work with Novartis and Alcon, Specialty Pharma Solutions and Bausch + Lomb to resolve this issue.

COS Works with the American Society of Cataract and Refractive Surgeons (ASCRS) to Mitigate CTV/W5 News Story on Corneal Neuropathic Pain in LASIK eye surgery: On Monday October 1, 2018, Dr. Guillermo Rocha participated in a CTV/W5 segment on LASIK treatment and the rare side-effect of corneal neuropathic pain. COS worked in partnership with the ASCRS to ensure consistent messaging for the interview, which aired on October 21, 2018 and featured patients who have experienced this rare side-effect. Dr. Rocha expertly answered challenging questions while using statistics to reinforce points around corneal neuralgia being a rare side effect of a very successful surgical procedure. You can watch the W5 segment here.

COS Position Statements on Medical Use of Cannabis: On October 17, 2018, the Cannabis Act came into effect, making cannabis legal for recreational consumption within Canada. COS worked with Dr. Yvonne Buys and Dr. Paul Rafuse to update the Medical use of Cannabis for Glaucoma position statement, which was also endorsed by the Canadian Glaucoma Society. The final statement was provided to the Canadian Medical Association, who also shared it though their national network and their Provincial and Territorial Medical Associations. The statement will also be published in the February 2019 issue of the Canadian Journal of Ophthalmology (CJO).

COS is working with Dr. Kashif Baig and the Canadian Cornea, External Disease & Refractive Surgery Society (CCEDRSS) to finalize a position statement on the Medical Use of Cannabis for Dry Eye. This statement will be shared upon completion.

COS Meets with the Canadian Agency for Drugs and Technologies in Health (CADTH): On November 19, 2018, Dr. Yvonne Buys, President of the COS, Jennifer Brunet Colvey, Executive Director and CEO of the COS, Rosalind O’Connell, Manager of Communications and Public Affairs, and Cheryl Ripley, Manager of Continuing Professional Development met with key members from CADTH to discuss the report CADTH is preparing on Minimally Invasive Glaucoma Surgery (MIGS) and to discuss areas of future consultation and collaboration in eye health. The report is scheduled to be released in January 2019.

See The Possibilities Campaign: To conclude Year 2 of the campaign, COS continued to make national and regional headlines for National Diabetes Awareness Month (November). For World Diabetes Day on November 14, Dr. Phil Hooper, Chair of the Council on Advocacy, was featured in a diabetes supplement in Macleans magazine discussing the importance regular eye exams for Canadian’s living with diabetes, reaching over 2.74M readers. The COS will also be featured on Zoomer Radio’s “The Tonic” show with Dr. Varun Chaudhary and a local patient to discuss diabetic retinopathy. This show aired in mid-December, reaching 470,000+ listeners.

On November 3, 2018, the COS Board approved the See The Possibilities Year 3 Plan for execution in 2019. Year 3 of the campaign will continue to focus on national and regional media relations, patient video testimonials and influencer engagement, but with the addition of a more grassroots approach that will help engage ophthalmologists in their own communities. New initiatives will include a Physician Toolkit, which will feature campaign materials such as waiting room posters, videos for physician waiting room televisions, advertisements which can be placed in local media outlets and more. COS will also be engaging other national stakeholders in the campaign where appropriate, including other national specialty societies and eye care professional associations, based on a stakeholder mapping session which was conducted with Cossette/Colony Project on October 4, 2018.

2019 COS Advocacy and Public Awareness Fund:
We would like to extend our sincere thanks to those members who contributed to the COS Advocacy and Public Awareness Fund in 2018. With your contribution, the COS has successfully executed Year 2 of See The Possibilities ( public awareness campaign which has increased the profile of the profession among the public, government, media and other stakeholders. Through ongoing and targeted media relations, the COS has dramatically increased the organization’s Share of Voice – how much media coverage an organization gets relative to other organizations in its field.

Despite our success in 2018, there is still more to do. If you have not yet contributed to the COS Advocacy and Public Awareness Fund, you may do so when you renew your COS membership, or by contacting Rita Afeltra at [email protected] or at: 613.729.6779 x300 for details.

Thank you to everyone who has already contributed to the 2019 COS Advocacy and Public Awareness Fund! As our way of saying thank you for your generosity and support, COS wants to publicly recognize your contribution through our Contributor Recognition Wall on the COS website.

COS Council on Advocacy Update: On October 29, 2018 during the Society Presidents’ Recognition and Awards Session held in conjunction with AAO 2018 in Chicago, COS Council on Advocacy member Dr. Ken Roberts, was recognized for completing his participation in the Academy’s Leadership Development Program XX, Class of 2018. He was among a select group of twenty participants chosen for the LDP XX, Class of 2018, from among a large group that was nominated by state, subspecialty and specialized interest societies. Recognized for his abstract on the accessibility of Canadian ophthalmologists in Canada, Dr. Roberts hopes that this information will be useful for future advocacy discussions as well as resource planning on a national and provincial level.

On November 27, 2018, the COS Council on Advocacy hosted its final teleconference for 2018. The COS Council on Advocacy comes together five times a year to discuss common advocacy issues and develop strategies to deal with these issues at a provincial level. These calls will continue in 2019.

Provincial Advocacy Activities

Please find below the latest updates from the COS and the provinces regarding advocacy and lobbying efforts.

  • British Columbia
    • The government in BC implemented a cataract fee code of $350 including artificial lens insertion. The BC Society of Eye Physicians and Surgeons are currently planning to proceed with an internal review committee appeal to the Doctors of BC. They attempted to get an injunction against the fee cut pending the outcome of the internal review committee appeal, but this was denied.
    • Dr. Brian Day was successful in getting an injunction against the NDP government preventing a crack down on physicians providing services privately rather than through MSP. The injunction will be on hold until June 1 but will be renewed if the overall court case on the constitutionality of denying access to private care is stable for the courts. Read the Dr. Brian Day article here.
  • Manitoba
    • The Manitoba provincial government has recently committed to fund 2000 more cataract cases allocated to Misericordia Health Centre (MHC) next year. EPSOM was pushing for this to help decrease cataract surgery wait times in the short term. Going forward, EPSOM will continue to push for an ongoing increase in funding for cataract surgery cases.
    • EPSOM held its first annual general meeting on November 3, 2018 and had a very interested and engaged group. At this meeting, by-laws were passed and approved, and the EPSOM Board of Directors was confirmed for the upcoming year. Discussions included EPSOM priorities, one of which was the need to increase cataract funding (which for the short term has recently been fulfilled). Members also expressed concerns about getting 100% membership of Ophthalmologists and whether this should be mandated since EPSOM’s work helps both members and non-members.
    • Provincial fee negotiations are coming up next April 2019 and EPSOM is considering strategies to deal with potential cataract fee cuts especially considering the recent increase in funding cases.
    • CORRECTION: Previous updates stated that EPSOM had been invited by the provincial government regarding Anti-VEGF injection program negotiations. The update should have read that EPSOM is working towards improved access to Anti- VEGF injections for all retina patients by advocating to remove unnecessary restrictions.
  • Ontario
    • The Eye Surgeons and Physicians of Ontario (EPSO), represented by the and Ontario Medical Association (OMA) have been in arbitration with the Ministry of Health on the new proposed physician services agreement for EPSO is also advocating against redistribution for its members with respect to relativity. The OMA is still exploring processes for addressing relativity which at one point included binding arbitration.
    • EPSO has been an active advocate working with the MOH to reduce wait lists for cataracts and create new hospital positions with surgical privileges and allotted surgical time for new graduates. Funding is now being provided to many hospitals and several new Ophthalmology jobs are being posted across the province. EPSO will continue to advocate to improve access and wait times in all areas of Ophthalmic care for the patients in Ontario.
  • Quebec
    • After the election in held on October 1, 2018, the Coalition Avenir Quebec (CAQ) now forms the majority government. Ms. Danielle McCann is the new Minister of Health and promises to collaborate with the Fédération des médecins spécialistes du Québec (FMSQ) to facilitate access of the population to medical specialists.
    • The Canadian Institute for Health Information (CIHI) will conduct a comparative study of the remuneration of Canadian medical specialists versus Quebec. Expected results in September 2019 and will determine if we earn more than other Canadian colleagues.
    • Association des medecins ophtalmologistes du Quebec (AMOQ) met with a representative of the Ministry of Health requested to speed up the evaluation of the MIGS devices by Quebec National Institute for Excellence in Health Care (INESS).
  • New Brunswick
    • A new government was elected in New Brunswick. The minority government lead by the progressive conservatives have taken power from the liberal party. They have been very adversarial with the medical society in the past and only time will tell if they have a different agenda this time around.
    • A fee analysis committee is meeting in December to discuss adjusting fees that have been affected by “new technology”. Specifically, they aim to take money from Cataract surgery, Radiology and GI scopes and redistribute it to other sections. The committee is large and has a mandate to make changes within a 2-year timeframe.
    • Billing issues dominated the November 17th section meeting – mainly the fee schedule being out of date with modern practice patterns (corneal transplants, oculoplastic, pediatrics).
  • Prince Edward Island
    • In July 2018, COS worked with PEI Ophthalmology to submit comments regarding an expanded scope of practice for Optometry in the area of prescribing rights for oral antibiotics, anti-inflammatories and anti-allergics. With the help of COS letters were sent to the provincial antibiotic stewardship committee and Health PEI. We have received a response from the Minister of Health acknowledging receipt of our letter and confirms the expansion is still under consideration and he will decide in due course. We await that final decision.
    • PEI continues to have manpower issues with long waits for consults and surgery. Our consultations with Heath PEI have failed to achieve the desired and needed recruitment and arrangements are now being made to meet with the Minister of Health.

For questions or more information

The COS Council on Advocacy looks forward to providing further updates on issues of importance to the profession in the next Advocacy in Action e-newsletter. In the meantime, for more information or questions, please contact: Rosalind O’Connell, COS Manager, Communications and Public Affairs at: [email protected]

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