In accordance with the College of Optometrists’ zero tolerance approach toward sexual abuse of patients and the requirements of the legislation, the College has a Patient Relations Program that comprises measures for preventing or dealing with the sexual abuse of patients by optometrists, including:
Section 85.7 of the Health Professions Procedural Code requires that every regulated health College also have a Program of Funding for Therapy and Counselling. This funding program is administered by the Patient Relations Committee. It is intended to compensate the cost of therapy and counselling for anyone who alleges he or she was sexually abused by a member of the College, while being a patient.
The College recognizes that a proactive Patient Relations Program, developed to enhance relations between members and patients, has the potential to improve patient care and reduce confrontations. In September 2013, College Council approved a revised Partnership in Vision Care document that articulates the collaborative nature of the relationship between optometrists and their patients. This collaboration is necessary to achieve and maintain optimum vision health.
The educational requirements for members are focused on four broad areas:
The College has determined that all current members of at the College of Optometrists of Ontario, students currently in the optometry program at the University of Waterloo, and applicants for a Certificate of Registration to practise optometry in Ontario should receive education about these issues.
In the fall of 2017, all members of the College of Optometrist had to complete, as part of their annual renewal process, an e-learning module entitled “Professionalism, Ethical Decision-Making and the Prevention of Sexual Abuse of Patients.” This educational tool was aimed at helping optometrists understand what constitutes a professional boundary crossing or violation, what constitutes sexual abuse of patients and how unintentional boundary crossings could escalate. To view the public version of this module, please click here.
Patients are entitled to receive optometric care free from sexually abusive behaviours. Practitioners must endeavour to care for their patients in an environment of trust and respect. The College has published an advisory for members regarding how to behave with patients. Members are encouraged to review this advisory periodically and compare their behaviours to the guidelines set out in the advisory.
The staff of the College of Optometrists of Ontario plays an important role in facilitating communication and resolution of patient/optometrist disputes and complaints. College staff and committee members may have the opportunity to support victims of sexual abuse through the reports, complaints, and disciplinary processes of the College. The College regularly provides training to its staff, Council, and committee members to ensure that those entrusted with this role are able to provide support and facilitate communication.
During the 2009/2010 Council year, the Patient Relations Committee began expanding on existing and developing new materials to assist optometrists in meeting their patients’ needs. In addition to the creation of the Partnership in Vision Care, due to expanding cultural diversity of the population in Ontario, the Committee worked on a cultural competency component for the website. As a part of this initiative, they compiled some tips for enhancing the optometrist/patient relationship across cultures.
Individual members of the public may not be aware of what behaviours differentiate normal optometric care from sexually abusive behaviour by an optometrist. The following information, which is provided to assist optometrists, is also intended to assist members of the public in identifying questionable requests or behaviours. Implicit in the provision of this information is the patient’s right to bring any questionable behaviour by their optometrist to the attention of the College.
It is important that patients are aware that optometrists are advised that:
If a patient initiates sexually inappropriate conversation or behaviour, this should be respectfully discouraged and a record of the incident made. Having a staff member or third party in attendance throughout the examination may help prevent any misunderstanding or accusation. If the patient persists in the inappropriate behaviour, the optometrist should end the optometrist/patient relationship by dismissing the patient.
Sexual activity between an optometrist and a patient, even if perceived as consensual by those involved, is by definition considered to be sexual abuse of the patient.
The word “patient,” as it relates to the Code’s sexual abuse provisions, has been expanded; a former patient will remain a “patient” for one year from when the person would otherwise cease to be considered a patient (i.e., when the optometrist last provided care to the patient).
The Regulation under the RHPA establishes other criteria for defining a patient for such purposes. Without restricting the ordinary meaning of the word “patient,” an individual is a patient if there is a direct relationship/interaction between the individual and the optometrist and the optometrist has:
If any of the above interactions occur between an individual and an optometrist, then that individual is considered the optometrist’s patient, for the purposes of sexual abuse provisions. That individual will also continue to be considered a patient for one year after the termination of the optometrist/patient relationship. Any sexual act that occurs during that time between the optometrist and the individual would result in the optometrist being subject to mandatory revocation. Note that an individual is not a patient under these criteria when:
Because of the broad definition of sexual abuse in the RHPA, a social relationship with a current or former patient may be considered sexual abuse. There are different types of social engagements that may be considered “dating.” However, sexual abuse occurs whenever a relationship with a patient involves behaviour or remarks of a sexual nature.
The legislation requires that all regulatory health Colleges have a program in place to provide funding for therapy and counselling for individuals who are alleging sexual abuse while they were patients of a regulated health professional. The College of Optometrists has established a segregated fund for this purpose and application forms are available for individuals who wish to request funding for therapy. Applications for funding are considered by the Patient Relations Committee.
An individual is eligible for funding if:
The staff member responsible shall provide the necessary information to the Patient Relations Committee in order for the Committee to determine eligibility and to administer the fund. Payment will be made only to the therapist or counsellor chosen by the individual.
The Chair of the Patient Relations Committee informs Council of the status of the Fund on an annual basis.