For employers: pay structures

Optometrist choosing spectacles with patient

Most retail businesses use incentives to encourage staff members to promote sales. However, most optometrists would consider themselves clinicians rather than salespeople. In reality, optics has a heavy degree of cross subsidy of clinical work by retail income. This can mean that optometrists are often presented with incentives that may encourage them to help  facilitate the patient to make a retail purchase. In our view a situation where a significant proportion of the wages of the optometrist are linked to retail sales poses a potential risk to clinical care, as it may pressure optometrists to recommend products that are not in the best interest of the patient.

Any incentive should not form a significant part of the total remuneration and should focus on aspects of delivering excellent clinical care. Examples of such incentives could be patient satisfaction scores, the “recommend a friend” test and right-first-time prescriptions as a proportion of the total. Any element linked to dispensing should be a ‘nice to have’ in terms of the optometrist’s reward. In other words, any such incentive should be a way of enabling the optometrist to benefit from a good day for dispensing but not a way of inducing the optometrist to dispense where the patient care rationale for doing so is borderline.