Revealed: The optometrists punished for putting patients before sales

Optometrists are being pressured to hit sales targets, rush consults and turn away clinical appointments during peak spending periods at multimillion-dollar optometry chains that their employees say prioritise profits over health.

Internal documents and private messages reveal senior management at Specsavers and OPSM threatened pay cuts or performance reviews if optometrists failed to sell enough glasses to meet KPIs.

Optometrist Matt Trinh, who worked at OPSM in Sydney and Newcastle for more than a decade, said healthcare was being compromised by rapid corporatisation of the industry as optometrists were pressured to push patients to buy glasses and speed through eye exams.

“That potentially is something that could lead to blindness, or in rare cases, death,” said Trinh, who, with fellow optometrist Rory Dowdall and the Health Services Union (HSU), has formed a collective of about 2600 optometrists – more than one-third of Australia’s workforce – aiming to unionise the specialty.

This masthead has reviewed more than 80 internal reports and correspondence that expose the corporate business models of optometry brands selling out patients.

They reveal at optometry chains including OPSM, Specsavers and Bailey Nelson, a key performance measurement was conversions: the number of appointments that resulted in a same-day sale of glasses. Another metric was customers’ average spend, including on add-ons such as sunglasses or premium lenses.

In a private group chat of Specsavers staff across three stores in Victoria, a head office superior said they were “going to have to cut wages even further” if conversions did not improve.

A directive from senior staff at Bailey Nelson included conversion tips for when a patient didn’t need a prescription update, including a suggestion to point out scratches on their existing glasses to secure a sale.

At OPSM, a locum optometrist was told by his state’s director over email that “failure to improve individual KPIs to an acceptable level will lead to a reduction or discontinuation of future bookings”.

A Bailey Nelson optometrist said regional managers closely monitored their bookings and would question them if they scheduled multiple time-consuming clinical tests in a day.

At the end of a peak trade period – also referred to in the industry as a “black-out period” for clinical consults to maximise sales – the optometrist ignored these directives and chose to perform additional tests on a patient with several “red flag” symptoms.

“She had an unruptured brain aneurysm, and she had surgery on it the week after,” the optometrist said. “I was told that she would have died had that not been picked up.”

Luke Arundel, the chief clinical officer at Optometry Australia, the peak body representing practitioners and optometrist practice owners, said anecdotal evidence did not prove KPIs were harming patients.

“We’re a very safe profession,” he said. One per cent of optometrists were the subject of an Australian Healthcare Practitioners Regulation Agency (AHPRA) complaint in 2024-25, compared with 1.7 per cent across all registered health practitioners.

Optometrist Helene Ly worked at both OPSM and Specsavers until she quit at the recommendation of her psychologist when the stress of the corporate chains left her with “such bad reflux it got to the point where I couldn’t eat normally”.

She said when optometrists had to “constantly think about what we can do to keep our KPIs up to get management off our back, we don’t really have the best interests of the patient at heart”.

“We just want to get them glasses and get them out of our chair, and that’s really sad,” she said.

Optometrist Shereen Kassir said that when she did contract work at Specsavers, she was asked to provide an explanation each time a patient didn’t buy new glasses. If her explanation was that they didn’t need them, “I was told to try and push for sales”.

Kassir said optometrists at Specsavers were also expected to “fish for conditions that the patient didn’t complain about, just so you can claim the Medicare item”.

Specsavers did not address questions about this event in a written statement.

It said their optometrists are “empowered to make clinical decisions in the best interests of their patients,” and that their “clinical benchmarking and practice standards help practitioners learn from their peers, strengthen their professional development and deliver consistently high standards of care for every patient”.

OPSM and Bailey Nelson did not respond to requests for comment.

At OPSM, some optometrists were pressured to treat close to one in three patients with red light therapy for dry eyes at a cost of $200 per session out of pocket.

One patient received burns as a result, and a current OPSM employee who spoke on the condition of anonymity for fear of their losing job said the decision to offer the treatment should be based on a practitioner’s clinical judgment and individual patient need.

Optometrists at OPSM and Bailey Nelson were pressured not to book clinical consults – such as for eye infections, eye floaters or flashes, or diabetes eye checks – to maximise revenue during high sales periods, such as the end of the calendar year when health fund benefits expire.

HSU president Kate Marshall said: “As a health professional, your patient is your No.1 priority. However, these optometrists are being told: No, let’s ignore what you’ve learned, money comes first.”

Trinh said optometrists played an important role as the “front line” of eye health. “Obviously, we understand the company needs to make money, but there’s got to be more of a balance,” he said.

Arundel said clinical autonomy and patient care must be upheld under the regulator’s code of conduct.

“Optometrists must provide treatment that isn’t influenced by financial gain or incentives, must treat based on clinical need, and not deliver unnecessary services,” he said.

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