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The optometrists punished for putting patients before sales · The Morning Edition

• 0:04
  S1: If you've ever felt that you're being rushed through a
• 0:06
  S1: health care appointment, you're not alone. Now, a number of
• 0:10
  S1: optometrists have told our mastheads that they are being pressured to, yes,
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  S1: rush appointments and even skip providing clinical tests in order
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  S1: to sell, sell, sell. I'm Samantha Selinger Morris and you're
• 0:25
  S1: listening to Morning Edition from The Age and The Sydney
• 0:28
  S1: Morning Herald today, health reporter Rachel Rasker on the optometry
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  S1: chains allegedly prioritising money over patient health. It's July the 21st. Rachel,
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  S1: welcome to the podcast.
• 0:46
  S2: Thanks for having me.
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  S1: Okay. Now, you've spoken to a number of Australian optometrists,
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  S1: I guess you could call them whistleblowers. And they say
• 0:53
  S1: that numerous optometry chains are risking patients health with various
• 0:57
  S1: types of practices. So how so? What are they telling you?
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  S2: So they've told me that at big optometry chains, including
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  S2: Specsavers and Opsm kind of being the biggest chains in Australia.
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  S2: These optometrists, who are essentially registered health professionals, are being
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  S2: pressured to hit sales targets like glasses sales, as well
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  S2: as rush through clinical consultations in order to maximize profits, basically.
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  S2: And they reckon this puts public safety at risk, public
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  S2: health at risk. And in terms of pressures, by that
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  S2: I mean being threatened with pay cuts or disciplinary reviews
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  S2: if they don't hit enough KPIs in terms of sales, basically,
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  S2: in terms of what this could mean for patients, basically.
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  S2: I mean, on one hand, maybe you go to the
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  S2: optometrist and you just think, I'm here to get some
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  S2: new glasses, you know, not that big of a risk.
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  S2: But they're also trained to detect things like cancers, possible strokes.
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  S2: There's all kinds of things that can point to how
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  S2: our overall health is doing in our eyes, essentially. And
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  S2: so I reckon this can put a lot of, yeah,
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  S2: a lot of patient healthcare at risk.
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  S1: And so you have reviewed more than 80 internal reports
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  S1: and correspondence from within a variety of optometry brands. So
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  S1: did that research. I mean, what did it tell you?
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  S1: Does it correspond with what these optometrists are telling you
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  S1: or did it paint a different picture?
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  S2: Yeah, I think when I first heard all this, I
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  S2: kind of thought, oh, surely not. I mean, I didn't,
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  S2: I didn't quite believe it. And especially because a lot
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  S2: of these, um, individual outlets, they are franchises. And I
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  S2: thought maybe it's just a few franchisees who are bad apples.
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  S2: They're trying to make ends meet its cost of living crisis.
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  S2: But essentially, from what I've looked at, this is essentially
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  S2: company policy. I've seen messages from people who are in
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  S2: head office at Specsavers in group chats with optometrists, saying,
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  S2: we're going to basically cut your pay if what they
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  S2: call conversions, which is essentially same day glasses sales don't improve,
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  S2: as well as disciplinary reviews kind of being threatened to
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  S2: come into meetings. Yeah. And even training documents, which kind
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  S2: of stipulate the way that clinical consults should be done,
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  S2: which is in line with these KPIs that optometrists have
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  S2: been telling me about.
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  S1: And you spoke with one optometrist. This is Matt Trinh.
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  S1: He worked at Opsm in Sydney and Newcastle for more
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  S1: than a decade, and he warned that such practices could
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  S1: actually result in vision loss or in extreme cases, fatalities.
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  S1: So can you tell us, I guess, a bit about
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  S1: that and other sort of warning stories that other optometrists
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  S1: told you could result when they are, for instance, pressured
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  S1: to sell or pressure to reduce the number of time
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  S1: consuming clinical tests, for instance, that they book in a day.
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  S2: Yeah. I mean, Matt spoke a lot about the possible
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  S2: risks that can happen when the focus is on sales
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  S2: and not on patient health. And he also spoke about
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  S2: the industry and optometrists as being really the front line
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  S2: for eye health, kind of like a GP would be
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  S2: where they're meant to be screening for everything, looking at everything.
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  S2: And if something's a concern, then they will refer you
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  S2: on to an ophthalmologist who is that specialist that is
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  S2: much more expensive, but this is more the everyday person
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  S2: is going to an optometrist for their eye health. So
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  S2: in terms of risk, I mean, one optometrist at Bailey Nelson,
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  S2: they mentioned that at one of these um, peak sales
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  S2: periods are also called blackout periods in the industry where
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  S2: essentially optometrists are discouraged from doing too many time consuming
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  S2: clinical tests because this is the time when they can
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  S2: make a lot of glasses sales, essentially, because health fund
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  S2: benefits may be expiring. And yeah, they can, they can
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  S2: get some good profits at that time, but they essentially
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  S2: ignored this directive because they were concerned about a patient
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  S2: with some red flag symptoms. They carried out some further tests,
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  S2: and it turned out after a referral to an ophthalmologist,
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  S2: that this patient had an unruptured brain aneurysm and the
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  S2: patient had surgery on it the week after. And essentially,
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  S2: this patient would have died had that not been picked up.
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  S1: I mean, that's shocking. Were there any other instances where
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  S1: other optometrists told you that they had picked up a
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  S1: potentially bad health outcome that would have been missed had
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  S1: they not taken that time to, to give that person
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  S1: that test?
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  S2: Yeah, I think every optometrist has a story of picking
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  S2: up something like this. I don't think it's something that
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  S2: you would be doing every day in that line of work,
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  S2: but it is definitely a possibility. I know that Opsm
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  S2: on the other end of the spectrum, they're pressured to
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  S2: give extra treatment. They're called dry eye treatments, essentially, and
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  S2: a dry eye treatment is essentially red light therapy used
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  S2: to treat dry eyes. Opsm think maybe 1 in 3
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  S2: people have these dry eye problems. Whether or not that's accurate,
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  S2: it's hard to say. And optometrists told me this shouldn't
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  S2: be a KPI. This should be based on clinical judgment,
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  S2: patient to patient. But they have these pressures. And we
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  S2: know that at least one patient has received burns to
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  S2: their eyelids and eyes as a result of this dry
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  S2: eye therapy.
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  S1: And so just to confirm, so some of these optometrists
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  S1: have said they're being pressured not to conduct clinical tests,
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  S1: in particular during these so-called blackout periods, because they should
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  S1: be using that time to just focus on selling instead.
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  S1: Is that it?
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  S2: Yeah. So it's kind of a bit of both. So
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  S2: at some points in time, it's or some chains, they're
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  S2: being told don't do these tests. They take too long.
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  S2: We're trying to get more patients in and out of
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  S2: the door to sell glasses and other places. They're either
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  S2: trying to build the patient or Medicare at higher rates
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  S2: to get a bit more bang for their buck each
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  S2: each appointment, and do extra tests that may or may
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  S2: not be necessary, or treatments just to get that extra
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  S2: bit of profit.
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  S1: After the break.
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  S2: So an optometrist that I spoke to, who worked at
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  S2: both Opsm and Specsavers, and she actually quit at the
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  S2: recommendation of her psychologist because she was so stressed, she
• 6:28
  S2: got this really bad reflux and she she couldn't eat normally.
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  S1: Okay. And so as you've pointed out just a bit earlier,
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  S1: these are registered health professionals that we're talking about. They
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  S1: aren't just there as they are for, for many of us,
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  S1: when we go in, we think, okay, they're just here
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  S1: to help me choose spectacles. But actually they're trained to
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  S1: detect glaucoma. Sometimes they're even spotting tumours or impending strokes.
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  S1: But you've spoken to optometrists who've been so stressed out
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  S1: by working at some of these chains. From the pressure
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  S1: to sell and other practices, it's really impacting their health, right?
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  S2: These optometrists that were kind of worried with a story
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  S2: like this that would make them come off as these
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  S2: terrible health professionals, and they're really worried about that. But
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  S2: it is impacting them, too. I mean, they want to
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  S2: be delivering the best patient care they can. I mean,
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  S2: I don't think many people got into a five year
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  S2: optometry course to just sell glasses. I mean, there's meant
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  S2: to be a different role for that. It's called dispensers
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  S2: or retail stuff in these stores, but the lines are
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  S2: being blurred. So an optometrist that I spoke to, Helene Lai,
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  S2: who worked at both Opsm and Specsavers, and she actually
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  S2: quit at the recommendation of her psychologist because she was
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  S2: so stressed, she got this really bad reflux and she
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  S2: she couldn't eat normally. Another person mentioned that she was
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  S2: so stressed out that she was grinding her teeth at
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  S2: night as she slept, to the point where she cracked
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  S2: a tooth. And um, Matt, who you mentioned earlier spoke
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  S2: about when he was at Epsom, he started obsessively looking
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  S2: at his appointment books and would try and calculate if
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  S2: he would make enough sales like glasses sales to his
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  S2: KPI that day, even for patients who hadn't even seen yet.
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  S2: In terms of the ones coming in later that day,
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  S2: and he'd be worried about it. And he just kind
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  S2: of looking back, he just thought it was really unethical.
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  S2: And he kind of he didn't like it that he
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  S2: was doing that. And at the end of the day,
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  S2: the APA registrations, it's based on an individual optometrist. It's
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  S2: not the store chain or the store manager that's at risk.
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  S2: It is the individual optometrist that is at risk of
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  S2: losing their registration, of losing their career if something goes
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  S2: wrong in these cases.
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  S1: Okay. But what would you say to those who say, okay, yes,
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  S1: but these are businesses. They're in business to make a profit.
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  S1: And determining individual KPIs or Key Performance Index is central
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  S1: to to many for profit business models.
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  S2: I mean, definitely, I mean, cost of living is going up.
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  S2: A lot of these stores are in places like Westfields
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  S2: where we know that the the rents to have a,
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  S2: you know, a Specsavers in a Westfield is going to
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  S2: be very high and you need to make ends meet
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  S2: at some point. I don't believe the Medicare benefits have
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  S2: gone up very much in terms of payments. We've seen
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  S2: it across GPS as well, where they're not making that
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  S2: much with each consultation. And yeah. Luca Rundle, the chief
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  S2: clinical officer, Optometry Australia, who I also spoke with, kind
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  S2: of said this anecdotal evidence, these anecdotal stories, they don't
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  S2: prove that KPIs are harming patients, he said. They're a
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  S2: very safe profession. I mean, only 1% of of optometrists
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  S2: were the subject of an Acra, which is a regulator
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  S2: of an APA complaint in 2024 2025, compared with 1.7%
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  S2: across all registered health practitioners. So it is possible that
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  S2: the two don't connect, but optometrists are pretty concerned.
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  S1: And so you've mentioned a number of optometry chains that
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  S1: many of us would be familiar with in this interview
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  S1: just today. Opsm Bailey Nelson, Specsavers. So what did they
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  S1: say in response?
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  S2: Yeah, I didn't hear back from Opsm and Bailey Nelson, unfortunately,
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  S2: but Specsavers essentially said that their optometrists are empowered to
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  S2: make clinical decisions in the best interests of their patients
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  S2: and that their clinical benchmarking and practice standards, aka their KPIs,
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  S2: help practitioners learn from their peers, strengthen their professional development,
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  S2: and deliver consistently high standards of care for every patient.
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  S2: And I do understand they've sent out an all staff
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  S2: email since our report where they sent all of their
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  S2: optometrists their full statement, because I could only use a
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  S2: little in my story. And yeah, maybe they'll be changing
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  S2: some things. I guess we'll see.
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  S1: And one last question that I've got to ask you.
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  S1: You know, your story really hit a nerve. The last
• 10:20
  S1: time I checked, it had more than 350 comments. I mean,
• 10:23
  S1: that's the number of comments that we often get at
• 10:25
  S1: our mastheads on like the biggest global political stories. So
• 10:29
  S1: why do you think that this has connected with so
• 10:31
  S1: many readers and listeners?
• 10:33
  S3: I think as.
• 10:34
  S2: Everyone's had that experience of going to a health professional,
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  S2: whether it's an optometrist or a dentist or a physio
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  S2: and feeling like you're being ripped off, maybe they're saying
• 10:43
  S2: you need this test, you need this treatment. And you think,
• 10:46
  S2: do I really need it? Or are they just trying
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  S2: to get a bit more money out of me or
• 10:49
  S2: my health fund? And it's really hard to know as
• 10:52
  S2: a average consumer what you actually need in these instances.
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  S2: And I think seeing these corporate practices, which are essentially
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  S2: directing optometrists to someone, I think put it as pull
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  S2: the wool over the eyes of patients, it's really tough
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  S2: to hear. And it kind of confirms a lot of
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  S2: our suspicions, I think.
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  S1: And I guess a lot of a lot of Australians
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  S1: like myself, like Josh, my producer who's sitting next to
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  S1: me wear glasses. And so have you got much feedback,
• 11:18
  S1: you know, beyond the 350 comments, have you received emails
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  S1: from anybody that's saying, hey, this has happened to me
• 11:23
  S1: as well? Or what sort of feedback besides the comments
• 11:26
  S1: have you received?
• 11:27
  S2: Yeah, we put in a call out box for people
• 11:28
  S2: to get in touch if they've had similar experiences. I
• 11:31
  S2: just had a count before we chatted, and I've got
• 11:33
  S2: more than 60 responses to that, as well as separate emails.
• 11:36
  S2: And we've got comments on Instagram from a mix of
• 11:39
  S2: optometrists and patients and others inside and outside of the
• 11:43
  S2: industry on their experiences on this. So I think there's
• 11:46
  S2: definitely more to come in this space.
• 11:51
  S1: Well, thank you so much, Rachel, for your time.
• 11:54
  S2: Thank you.
• 12:10
  S1: In other news today, children should be monitored for high
• 12:13
  S1: blood pressure from the age of seven under new national
• 12:16
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• 12:21
  S1: later in life. Strong commodity prices and the nation's job
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• 12:29
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• 12:34
  S1: the war against Iran risks a fresh spike in petrol
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  S1: prices and inflation. And Christopher Nolan's The Odyssey has become
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• 12:52
  S1: more at the age.com.au or smh.com.au. Today's episode was produced
• 13:00
  S1: by Josh towers. Our executive producer is Tammy Mills, and
• 13:04
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