Optometrists in Ontario must balance professional independence with modern business arrangements. Whether practicing independently, within a corporate retail setting, or through a professional corporation, optometrists must comply with strict rules governing corporate ownership, patient records, and ethical practice standards.
This article summarizes some key requirements set out by the College of Optometrists of Ontario (COO) under the Optometry Act, 1991, the Regulated Health Professions Act (RHPA), and related regulations. It also discusses how optometrists can structure their practices to maintain compliance and protect their professional and legal responsibilities.
1. Corporate Structure for Optometrists
Optometry Professional Corporations
As a regulated profession under the RHPA, registered optometrists may practice through a health profession corporation (HPC). An HPC practicing optometry is sometimes referred to as an Optometry Professional Corporation (OPC).
OPCs allow optometrists to benefit from tax planning opportunities, liability protection for business debts, and smoother succession planning. However, as a professional corporation, the OPC must comply with the COO’s strict professional ownership requirements.
Certificates of Authorization
An OPC must hold a valid Certificate of Authorization from the COO before it may provide optometric services to the public. Without this certificate, practicing through the corporation is considered unauthorized practice and may result in professional discipline.
In a 2018 decision by the Discipline Committee of the College of Optometrists of Ontario (DCCOO), found that an optometrist had committed professional misconduct by practicing through a corporation that was not an OPC with a valid Certificate of Authorization. This case illustrates the importance of ensuring that all required certificates are obtained.
The COO generally processes new and renewal applications within one to three weeks. A Certificate of Authorization must be renewed each year on or before its anniversary date. If a corporation is amalgamated, the original Certificate becomes invalid, and a new application must be made.
Shareholders and Directors
Only COO-registered optometrists may hold shares—voting or non-voting—in an OPC. This means that non-optometrist family members and holding companies cannot own shares in an OPC. Optometrists with non-practicing status may remain shareholders, but only active registrants may engage in the clinical practice of optometry.
All directors and officers must also be shareholders of the OPC. Consequently, only optometrists may be directors or officers of an OPC.
2. Notifying the COO of Practice Changes
Under the COO’s by-laws, optometrists must notify the COO within 14 days of any change to information previously provided, including changes to:
- Practice location or additional locations;
- Ownership or corporate structure; or
- Contact information.
All locations—whether permanent, temporary, or part-time—must be reported, including one-day fill-in work. Optometrists can log in to the COO’s member portal to update this information.
3. Patient Records Ownership and Custody
Maintaining accurate and complete records is a professional and legal requirement for optometrists. Failing to keep proper records constitutes professional misconduct. Every optometrist must create and maintain a patient health record for each individual under their care, documenting clinical findings, diagnoses, and treatments.
Patient health records are the property of the optometrist or the OPC, not a retail or optical business.
A non-optometrist or non-OPC (for example, an optical store or corporate retailer) cannot own, control, or have custody of optometric records. Even when practicing as an independent contractor in a retail optical environment, the optometrist must retain care, custody, and control of all clinical records.
Each optometrist is the Health Information Custodian (HIC) for their patients’ records. Records must be maintained separately from the store’s administrative or sales records.
Any independent contractor agreement should explicitly state that the optometrist owns and maintains the patient records and has ongoing access to them. This ensures that when an optometrist leaves an arrangement, the records remain with the optometrist, who must then inform patients of the new location.
4. Control and Access to Records
Optometrists must always have unfettered access to their patient records, even outside business hours or during emergencies.
If a corporate employer or optical business restricts access to patient files, this could create a conflict of interest or even professional misconduct. The COO emphasizes that clinical information must never be controlled by a non-optometrist.
It is also professional misconduct for an optometrist to:
- Allow an unauthorized person to view or copy a patient’s health record; or
- Release any patient information except as required by law or with proper consent.
5. Release of Prescriptions and Patient Rights
Once finalized, an optometrist must provide a copy of the prescription directly to the patient. The prescription belongs to the patient—not the clinic, not the optical store.
A non-optometrist, such as an optician or retail staff, cannot request or retain a copy of the prescription without the patient’s consent. Patients are free to choose where they fill their prescriptions, and optometrists must respect and facilitate that choice.
6. Transferring or Relocating Records
When an optometrist relocates, retires, or closes a practice, patients must be informed of how to access their records. Patients have a right to expect that information in their clinical records will be available to them and that they will be notified of any transfer.
The departing optometrist must provide patients with:
- The location of their records;
- Contact information for the new custodian or optometrist; and
- Instructions on how to obtain copies.
If patient records are transferred to another optometrist, the receiving practitioner must provide access to those records upon the request of the original optometrist.
7. Record Retention and Secure Storage
Optometrists must retain patient records for at least 10 years following the patient’s last visit. For patients under the age of 18, records must be kept until 10 years after the patient reaches 18 years of age.
Records must be securely stored, either physically or electronically, and safeguarded against unauthorized access or loss. Secure electronic backups and confidentiality protocols are essential, particularly for optometrists working in shared or retail environments.
8. Advertising and Professional Representation
Optometrists may now advertise jointly with non-members (such as optical stores) if the content complies with COO advertising guidelines.
Advertising must not:
- Contain testimonials or endorsements;
- Include superlatives or comparative statements; or
- Mislead or exploit patients.
Collaborative advertising can be useful for business development, but it must never compromise professional independence or patient trust.
9. Practical Legal and Compliance Considerations
Given the above legal and compliance considerations, optometrists should adopt the following practices:
- Clarify ownership in writing. Agreements with optical stores or corporations must specify that the optometrist owns and maintains patient records.
- Maintain full access. Always ensure access to patient records, including after business hours.
- Communicate with patients. Provide clear instructions on accessing records during transitions or retirement.
- Renew certificates promptly. Maintain an active Certificate of Authorization to practice through a corporation.
- Seek legal help before entering new business relationships or financial arrangements, especially involving the transfer of patient records.
Corporate structures and business arrangements can offer many advantages for optometrists, but they also carry regulatory responsibilities. By maintaining ownership and control of patient records, ensuring transparent contracts, and complying with COO and privacy standards, optometrists can protect their patients, their professional standing, and the goodwill of their practices.
Thank you to Ephraim Barrera for his contribution to this article. The contents of this article are not to be construed as legal advice. Contact Emerge Law’s lawyers for legal assistance.