COS 2018 Advocacy in Action (second quarter update)

National Advocacy Initiatives

Vision Health Month 2018: See The Possibilities Campaign: To mark Vision Health Month 2018 (May), the COS developed a number of initiatives as part of the See The Possibilities public awareness campaign, including:

Cataract Awareness Month: See The Possibilities Campaign: To mark Cataract Awareness Month (June) the COS worked with Cossette Health/The Colony Project to conduct targeted media outreach to select health and health and lifestyle reporters. Media highlights included Global News and 680 CJAD Radio (Winnipeg). Special thanks to Dr. Rosa Braga-Mele and Dr. Jennifer Rahman for participating in media interviews.

For more information about the campaign, please visit |

Canadian Ophthalmological Society (COS) Council on Advocacy Updates: 

The COS Council on Advocacy held teleconferences on March 29, 2018 and June 19, 2018 to discuss common advocacy issues and develop strategies to deal with these issues.

On May 31, 2018, members of the Council on Advocacy participated in an Advocacy 101 training session held at the 2018 COS Annual Meeting and Exhibition in Toronto. The session featured a talk by government relations expert Ryan Clarke from Advocacy Solutions Inc. on how physicians can effectively communicate with governments at all levels. Mr. Clarke also led two interactive role-playing exercises designed to mimic a real-life meeting between an ophthalmologist and a government official on a relevant topic. The second half of the session featured a Media 101 Session with speakers from COS’s public relations firm Cossette Health/The Colony Project, who spoke about media relations as an effective tool in advocacy.

Canadian Ophthalmological Society (COS) and the American Academy of Ophthalmology (AAO) continue to work closely on areas of mutual interest: COS has regular calls with key physician leaders from the AAO, including Dr. David Parke, Dr. Dan Briceland and Dr. Michael Brennan to discuss issues of importance, including Advocacy. COS also appreciates the support of AAO staff members on key advocacy issues.

COS Advocacy and Public Awareness Fund: Thank you to all who have supported the COS and our efforts by contributing to the Advocacy and Public Awareness Fund. To date, we have reached 90 per cent of our target goal. The monies gathered from the Advocacy and Public Awareness Fund, along with a significant investment from the COS, will be used to support the COS to continue its strong advocacy and public awareness work at a federal level and empowering the provinces, subspecialty societies, and academic community with advocacy tools, training, and resources to help raise the profile of the profession.

It’s not too late! If you have not yet contributed to the COS Advocacy and Public Awareness Fund, you may do so by contacting Rita Afeltra at [email protected] or at: 613.729.6779 x300 for details.

Thank you to everyone who has contributed to the 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.

Sub-Specialty Advocacy Initiatives

Canadian Glaucoma Society (CGS) and the Canadian Ophthalmological Society (COS) continue to consult with the Canadian Agency for Drugs and Technologies in Health (CADTH) on micro-invasive or minimally invasive glaucoma surgery (MIGS). COS continues to support CGS on this initiative and will provide updates as this evolves. CADTH considers CGS and COS as key stakeholders and as the recognized medical and surgical experts in this space.

Provincial Advocacy Activities

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

  • British Columbia
    • Pria Sandhu from BC “Doctors of Optometry” is proposing a collaborative case sharing model with BCSEPS, which is being reviewed by BCSEPS Executive.
    • BCSEPS is going to work on a “floor” fee for cataract surgery as an insured service. This is a pilot project to see if it brings utility to membership as a bargaining tool with government. BCSEPS will be engaging John Pinto as an economic advisor if he is willing.
    • On May 11, 2018 COS Past-President Dr. Guillermo Rocha and Dr. Vikram Lekhi (Alberta) were guest speakers at the BCSEPS Provincial meeting for an inaugural advocacy session.
    • On May 17, 2018, Dr. Briar Sexton (BCSEPS) and Rosalind O’Connell (COS) participated on a call with the BC Ministry of Health regarding initial research the Ministry is undertaking for an appropriateness in surgery study (which would also include cataract surgery). As a next step, BCSEPS agreed to participate in a consultation with the BC MOH on the development of the appropriateness strategy for cataract surgery with the assertion that its intent is to improve patient care.
    • Negotiations with the BC government around the cataract fee are ongoing.
  • Alberta
    • COS and the Eye Physicians and Surgeons Association of Alberta (EPSAA) are in the process of developing a formal position paper with regard to higher level sterilization of ultrasound probes and ultrasonic pachymetry probes. The position paper is in response to recommendations put forward in the Alberta Health Services (AHS) Medical Device Reprocessing (MDR) of Semi-Critical Devices used in Ophthalmology Briefing Document, dated February 26, 2018. COS and EPSAA are still awaiting a response from AHS from their initial letter. View a copy of the letter. Special thanks to Dr. Karim Damji, Dr. Stephanie Dotchin, Dr. Michael Ashenhurst and Dr. John Huang for leading this work.
    • EPSAA is in cataract fee code negotiations with the Alberta Medical Association (AMA).
    • EPSAA is continuing to work with the COS and the Alberta College and Association of Opticians (ACAO) on the formation of a provincial Eye Health Council (EHC).
  • Manitoba
    • On June 11, 2018, Dr. Lorne Bellan, Dr. Jennifer Rahman and Dr. Mathen Mathen met with the Deputy Minister of Health (DMOH) and her staff to discuss recommendations from a 2017 provincial wait times report; including the introduction of a single queue system and an RFP system for cataract surgery. As a result of feedback provided at the meeting, the government agreed to continue to consult with ophthalmology on these ideas.
    • In response to an enquiry from Manitoba Public Health, the Eye Physicians and Surgeons of Manitoba (EPSOM) are working with the COS to develop a position statement on scleral tattooing, with the goal of having it banned in the province. Thank you to Dr. Jennifer Rahman and Dr. Tenley Bower for their work on this.
  • Ontario
    • The Eye Surgeons and Physicians of Ontario (EPSO) and Ontario Medical Association (OMA) have been negotiating with the Ministry of Health on the new proposed physician services agreement for ophthalmology. In January 2018, they reached a standstill and the OMA triggered binding arbitration. This process is slated to finish the next step, including a funding contract, by the end of 2018/ early 2019. The next step of relativity will begin in late 2019.
    • On June 7, 2018, Ontario elected a new provincial Conservative government. EPSO is planning its annual Queens Park legislature day to meet with new ministers to advocate on behalf of patients and enhanced eye care.
  • New Brunswick
    • The eye care working group for NB has been essentially disbanded since a consensus on glaucoma care could not be reached and the Minister of Health denied the New Brunswick Association of Optometry’s request for increased scope of practice. The next meeting of the NB Ophthalmologists group is in October 2018.
    • The Committee to assess fees affected by new technology has been formed but has not yet met.
    • The Atlantic Provinces Annual Meeting is June 21-22 in Nova Scotia. APOS will be reviewing the opportunity to create a “Media Relations” position for the Society. This person would be the appointed spokesperson for the Society on all media platforms, on behalf of the Executive. This would be a separate role from the President of APOS. The media relations position would be a three-year term with option to renew, to ensure time for training and continuity. A backup spokesperson will also be appointed in the case of negative media attention in the province where the spokesperson practices.
  • Nova Scotia
    • The entire fee schedule for Nova Scotia physicians will be re-written this fall and winter. The current agreement expires on March 31, 2019. There will be no ophthalmologist on the committee and despite two recent attempts, we have no representation from our Section on the Board of Directors of Doctors Nova Scotia.
    • The Doctors Nova Scotia Executive, including CEO Nancy McCready-Williams, recently met with the Dalhousie based ophthalmologists at their last quarterly staff meeting to take questions about fees. Despite having a relatively high cataract surgery fee, Nova Scotia ophthalmologists are the second lowest billers to their provincial insurer after Quebec.
    • Doctors NS was asked about the possibility of developing technical fees to cover the costs associated with the ownership and operation of expensive equipment. We were told this would be a non-starter for this government and likely any to follow. Nova Scotia and Newfoundland and Labrador are the only two provinces without technical or tray fees. It was also discouraging to hear that there was uncertain support from Doctors Nova Scotia for offices billing patients directly for these missing technical fees.
    • There are ongoing discussions on the development and extension of a Dalhousie Referral Guide to direct physicians and optometrists to the correct ophthalmologists with the necessary information. There have been allegations about barriers to access, which a province wide referral guide will hopefully address. Currently, the existing Guide is before the Council of the Nova Scotia Association of Optometry for their feedback.
    • Dr. Paul Rafuse is working on a referral guide for GPs, Optometrists and Ophthalmologists for how urgent care should be managed. Guidelines will include; referrals from Family Physicians, Pediatricians, Emergency Physicians, nurse practitioners, etc. to optometrists and ophthalmologists, guidelines for referrals from optometrists to ophthalmologists (when and how to refer, i.e. phone call, fax, letter), and guidelines for ophthalmologists on response back to Family Physicians and optometrists.
  • Prince Edward Island
    • On June 7, 2018, COS worked with Dr. Guy Boswall and Dr. Andrew Boswall to submit a letter to the Antimicrobial Stewardship Committee regarding a proposal to allow oral antibiotic prescribing by optometrists (ODs) in the province. The letter outlined key arguments against the expanded scope including: Inappropriate use of oral antibiotics has the potential to produce resistant organisms, systemic complications, or drug interactions which ODs are not trained to recognize or treat; putting patient safety at risk; and none of the conditions that ODs are allowed to independently manage require the use of oral antibiotics at the stage of disease which is outlined in the current regulations. COS is working with Dr. Guy Boswall on developing a second letter on this issue which is due to be submitted by July 31, 2018 to the Ministry of Health, as part of the consultation on this proposed OD expanded scope.

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