Transcript Optics-Optometry in Spain

OPTOMETRY IN
SPAIN
Member of:
Ignacio Costa, Grad.O-O, M.Sc., PDG IESE,
THE SPANISH OPTICIAN-OPTOMETRISTS SYSTEM
• History of how has been regulated
“A Metamorphosis from Optics to Optometry”
o Parallel progress in professional organization with education
evolution
 First Education for:
 Existing Opticians
 New Optician-Optometrists
 Then legislation
• Optics-Optometry in Spain: The role of the OpticianOptometrist
o The Spanish Optician-Optometrists in primary eye care
o An opportunity to advertise our practice
• The latest political and legislative advances in spanish
optometry
History of how has been regulated: Parallel progress in professional
organization with education evolution
“A Metamorphosis from Optics to Optometry”
1918 • First Spanish Optics Association created with Bylaws, defining the profession as a
1961 •
1964 •
1974 •
1977 •
1979 •
1990
1997
•
•
•
commercial activity and scientific profession serving primary visual health.
Regulation of the profession of optics holder of diploma in optics for all establishments
National College of Optics, created by Royal Decree with Bylaws, structuring the
professional community, looking alter the quality of professional tasks, fighting against
the illegal practice of the profession.
New Law about Professional Colleges.
The new Law is complemented regarding the National College of Optics relationship
with Government through Department of Public Health.
The new Bylaws are approved and regulations of Internal Rules appear structured.
New University Degree in Optic and Optometry.
New members of the College shall be qualified opticians-optometrists.
The National College of Optics becomes the National College of OpticiansOptometrists.
NATIONAL COLLEGE OF
OPTICIANS-OPTOMETRISTS OF SPAIN
2006
2010
SPANISH GENERAL COUNCIL OF
OPTOMETRY
Parallel progress in professional organization with education evolution for:
Existing Opticians
New Opticians-Optometrists
• Trained in the daily practice, courses, seminars, conferences, and reading
publications.
1956 • Until 1956 when the Degree in Binocular Optics is created.
• The Degree demanded several practical knowledge useful, not only for being a
glasses dealer, but for the practice of Optometry.
1972 • 1972 was created the School of Optics at the Complutense University of Madrid.
• After three courses of higher education
• University degree in optics
1990 • 1990 - official university degree in Optic and Optometry.
• First University College of Optics and Optometry created in 1972.
• Nowadays, 13 University Colleges:
• 9 Public Universities
• 4 Private Universities
OPTOMETRY IN SPAIN: A UNIVERSITY DEGREE
1 LEVEL
DIPLOMA
POSTGRADUATE
DEGREE
2 LEVELS
POSTGRADUATE
For Professional Practice
MASTERS
For Professional Practice
MASTERS
PhD
For Specialization
Research
Teaching
OPTOMETRY IN SPAIN: A UNIVERSITY DEGREE
Optics-Optometry in Spain: The role of the Optician-Optometrist
oThe Spanish Optician-Optometrists in primary eye care
• Optometry only practiced by a university qualified professional in optics and
optometry:
o Official valid degree in optics and optometry.
o Registered in the National College of Opticians-Optometrists of Spain or
another Oficial Regional College if created in that territory of practice.
o Primary healthcare professional who specialises in poorly functioning visual
systems.
 Independent primary healthcare profession not depending of other
professions.
 Clinical application of ocular physiology.
 Prevention and correction of disorders of the visual system by:
 examination.
 diagnosis and treatment of visual anomalies.
 discovery of any systemic and pathological signs.
Optics-Optometry in Spain: The role of the Optician-Optometrist
oThe Spanish Optician-Optometrists in primary eye care
 Trained and legally authorized to:
 Determine the health condition and functional assessment of the components of the
visual system.
 Examine, treat and prescribe preventive and corrective devices to compensate visual
anomalies.
 Detect ocular and systemic signs of pathologies.
 Refer patients to the appropriate healthcare professional.
Because the Spanish Optician-Optometrists were legally recognized as
healthcare professionals in primary eye care we found a great
opportunity with our authorities to advertise our practice and get social
recognition of our important role in public health care.
Our opportunity with the authorities to advertise our practice and get social
recognition of our important role in public health care.
• Free and universal national health system. offered throughout primary, secondary, tertiary or
specialized care.
• Complete network of outpatients´ departments and hospitals throughout the country.
• Acceptable healthcare system but problems of overcrowding and waiting lists
• Private medical companies provide less crowded and more personalised system so many
Spaniards complement healthcare with a private insurance option spending more money.
• 63% of the Spanish population go to the optician-optometrist.
• 37% visit an ophthalmologist:
o 26% under the National Health Service
o 11% attend private ophthalmologists or those of private health insurance.
• Optician-optometrist practices are defined by law as a healthcare establishment.
• Must meet at least the following conditions:
o The permanent and ongoing presence of the Optician-Optometrist (university graduate and
practising member of the professional organisation).
o Minimum set of instruments and protocols on proceedings.
o License, prior membership of the National College of Opticians-Optometrists of Spain.
o Inspection by the regional health authorities.
BECAUSE OF:
• Increased life expectancy
• Improved quality of life
• Surgical and pharmacological advances
BECAME THE PROBLEM:
 Saturated national health ophthalmology services.
 Alarm and social dissatisfaction.
INSALUD has approached the National College of Opticians-Optometrists of Spain.
• Optometrist’s help in reducing waiting lists
• Relieve ophthalmologist of everything to do with primary visual care
We generated a system with the authorities with the following Objectives:
• “To establish the mechanisms for the prevention of visual problems, the correction and
promotion of vision, aimed at patients, referred by the different health services of the various
autonomous regions, via family doctors or general practitioners”.
• The integration of the optician-optometrist as a primary sight carer in the national health
system with common protocols and to inform and advise the public of changes in visual
capacity.
• Allows general practitioners, when seeing a patient with visual problems with no pathology, to
refer this patient to an optometrist.
Significant agreements for collaboration has been reached In seven autonomous Spanish regions.
 These agreements have entailed many political benefits for the Spanish General Council of
Optometry.
 Great opportunity to form a part of the Spanish Public Health Service.
 These agreements are the first step towards the total integration of the Spanish optometrist
into the National Health System in primary care.
 If authorities wish to offer general public quality primary visual and ocular health care at less
cost, they must consider opticians-optometrists as independent suppliers of this primary care.
GREAT OPPORTUNITY WITH OUR AUTHORITIES TO ADVERTISE
OUR PRACTICE AND GET SOCIAL RECOGNITION OF OUR
IMPORTANT ROLE IN PUBLIC HEALTH CARE.
The latest political and legislative advances :
Royal Decree On Health Care Establishments
•
To establish the general bases for the authorisation of health centres, services and Healthcare
establishments understood as:
“An organised group of technical instruments and installations where officially
qualified professionals, carry out basic health activities, the dispensing of drugs or
health products adapted to the individual”.
•
Optician’s are considered healthcare establishments, defined as:
“Healthcare establishments where, under the technical direction of a graduate in
optics and optometry, activities are undertaken involving the assessment of visual
ability using optometric techniques; the cutting, making up, adjusting, supply,
selling, checking and monitoring of the appropriate means for the prevention,
detection, protection and improvement of visual acuity; help for low vision and the
adjustment of external ocular prostheses”.
This Royal Decree came into force on 24 October 2003.
The latest political and legislative advances :
Royal Decree On Health Care Establishments
•
•
To regulate:
o Basic aspects of qualified healthcare professions, General structure of professional training, and
Professional development.
o Applicable in public or private healthcare services.
Qualified Healthcare Professions are shown as:
those whose undergraduate or specialist training is specifically and essentially directed at
equipping those undertaking it with the knowledge, skills and attitudes appropriate to
healthcare and are organised in officially recognised professional colleges.
•
Graduates in optics and optometry are shown as healthcare professionals.
“At graduate level: the professions whose practice is enabled by holding the title of Graduate
in...... Optics and Optometry....”
“University graduates in optics and optometry carry out activities for the detection of ocular
refraction defects, by their measurement using instruments, the use of re-education
prevention and visual hygiene techniques and the adjustment, verification and monitoring
of optical aids.”
The latest political and legislative advances :
The law on regulating healthcare professions
• Advertising of services must rigorously respect the scientific basis of activities and
prescriptions.
• Objective, careful and true, so as not to raise false hopes.
• Also in our professional organization we have regulated that it is forbiden to advertise
discounts in any professional service like refraction.
• Information given must be true, discreet, careful and shown in a comprehensible manner.
• Failure to comply shall result in sanctions.
• Obligation to take out the appropriate liability insurance.
• Professional colleges may adopt the necessary means to enable their members to fulfil this
obligation.
• Public registers of healthcare professionals in order to ensure that patients may
exercise their rights with regard to clinical information and documentation.
The latest political and legislative advances :
New sentences in favor
OPTICIANS-OPTOMETRISTS DO NOT INVADE THE
COMPETENCES OF OPHTHALMOLOGISTS
RULING REJECTS AN APPEAL LAUNCHED BY THE
COLLEGE OF PHYSICIANS
The Supreme Court Rules Against Ophthalmologists
• The Official College of Physicians of the Balearic Islands:
“There is a clear invasion of the professional
competences of ophthalmologist physicians,
namely the determining of the visual capacity of
the human being and the prescription of
corrective ocular prostheses which are not the
legal competence of opticians-optometrists”.
• The sentence passed by the High Court of Justice of the Balearic
Islands was completely overruled.
• The College of Physicians launched an appeal.
• The Supreme Court overruled this.
The Supreme Court Rules Against Ophthalmologists
“Opticians-optometrists are university
graduates in optics and optometry who carry
out activities to detect ocular refraction
defects, by their measurement using
instruments, the use of re-education
prevention and visual hygiene techniques and
the adjustment, verification and monitoring
of optical aids.”
“It does not appear that public health is put at
risk by the recognition of university graduates
in optics and optometry, bearing in mind their
academic training, for their professional
function”.
The Supreme Court Rules Against Ophthalmologists
“The profession of the optician-optometrist was
created, a university degree being required
for its practice involving academic training
and sufficient knowledge, precisely for
determining the condition of sight”
“This does not affect the specific competences
of ophthalmologists with regard to eye and
vision pathology.”
The Supreme Court Rules Against Ophthalmologists
The latest political and legislative advances :
New sentences in favour
• The Andalusia High Court of Justice rejected the
Medical Association’s appeal against the agreement
signed.
• Development of sight prevention and promotion
activities does not invade the area of competence of
the ophthalmologist.
The Andalusia High Court of Justice
• Does not constitute unfair competition to the
ophthalmologist.
“an instrument for the Andalusian public health
authority to improve health care by means of
rapid client service”.
When a patient visits their G.P. with a sight problem,
the doctor can refer them to any opticianoptometrists to have their sight tested.
The Andalusia High Court of Justice
“Assessing patients’ eyesight is one of the
functions of an optician-optometrists, and,
therefore, work on information to improve
sight, sight promotion, prevention and
hygiene do not constitute any invasion of the
area of activity of ophthalmologists”
The Andalusia High Court of Justice
Thank you!
Ignacio Costa, Grad.O.O., M.Sc., PDG IESE
Consejo General de Colegios de Ópticos-Optometristas
Princesa, 25, 4ª planta
Edificio Hexágono
28008 Madrid (Spain)
+ 34 91 5414403 / 4 Phone
+ 34 91 5422397 Fax
+ 34 609 085250 Cell phone
[email protected]
www.cgcoo.es