Q&A: Joan Hansen, OD

Where did you grow up?

Well, I never really did grow up! I was born on a small farm north of Winnipeg and moved into Winnipeg when I was 12.

How did your career take you from Ontario all the way out west to Tsawwassen?

In Manitoba, I worked in an optometrist’s office called Transcona Optical for three years. They wanted me join their practice and be a partner. But their idea of partnership wasn’t my idea of partnership, and I chose to start looking elsewhere. This was in the early ‘80s. I had some friends who lived out here, and I had never been to the west coast. I came to visit in January. Winnipeg in January is a little cold. I came out here-it was green and above freezing, and it was kinda nice! I thought, “Why not give this a chance?” If I was ever going to do something, I had to do it then. Once I got my license, I was here in the fall of ’82, and the office was open in January ’83. I gave myself three years to either like it and fit into the community or go broke, then I could go back to Winnipeg. I got very involved in the community, and the office got very busy. I got know a bunch of people and it was like, “Why would I ever want to go back?”

Did the U.S. Affordable Care Act affect the number of cross-border patients you see?

We see a number of people who live down there in Point Roberts, WA. They have to go so far to find care; they don’t have anybody down there to do eye care for them. They have to drive into over the border, through Tsawwassen, drive through Canada, go back again through the border, down to Blaine or Bellingham to get eye care. They pay with cash; we can’t bill their insurance plans. Nor do we bill any in Canada; it’s no different for our Canadian patients. When we need to send somebody off for, say, cataract treatment, if he has Medicare we try to set them up with an ophthalmologist down on the Bellingham/Seattle side. Most will chose to use their Medicare benefits or whatever insurance plan it is with somebody down in the mainland of Washington.

Have you ever been tempted move into academia or industry?

No, academia doesn’t interest me, it’s not my forte, and there’s not a school close by, anyway. I like private practice, dealing with patients on a day-to-day basis, and the variety of patients from 2 years old to 102 years old all day long. They’re more fun to me than dealing with students. I like students, but I’d rather have that variety of different age groups and different conditions.

What are three major differences between practicing in Canada vs. the U.S.?

I don’t have to deal with the insurance companies, though they’re trying to make inroads. Obviously our patients have coverage. They pay us for services, and then they deal with the insurance companies. And it’s taken us longer with therapeutics. We’re all pretty new in the therapeutics game. Here in BC, we didn’t get them until 2009; Alberta and Saskatchewan got theirs in the late ‘90s, so they’re ahead of us in treating. Because we waited so long, or we were forced to wait so long here in BC, we probably ended up with the better range of treatment options in that we can treat glaucoma but they can’t in Alberta or Saskatchewan. The vast majority of older optometrists were all trained in one school-Waterloo, that’s changed over the last several years. Many of our new graduates were trained in the States as well.

What’s something your colleagues don’t know about you?

Before optometry school, I was a hairdresser. [Laughs] When I finished high school, I wasn’t ready to go to university. I needed to do something, and I took a hairdressing course for 10 months at our local community college. All I wanted to do was have something to do to make enough money so I could go traveling. I worked as the hairdresser for only a couple of years and saved up enough money to go to Europe. That started my travel bug. I knew it wasn’t going to be forever-it would be hard to make the kind of money for the independence and intellectual challenge that I wanted. I knew I was going to go to university, but I had to be ready to buckle down and study.

How did you begin offering CE yourself?

I had always liked running the continuing education seminars for the BC association. It was getting to know the speakers who came to speak to us. So I went to other seminars like AOA, SECO, or Academy and listened to the top speakers on the circuit and found people I would like to bring up to British Columbia. Once you tell them you’re in Vancouver, it’s not hard to get somebody to come here. Prior to that, I was very disappointed in what the BC association was giving us as education. It didn’t fill my niche of what I wanted to listen to, and I found myself not going. So I thought, “I can’t be the only one,” so I tried offering some CE on my own. I figured out how to put one together, found a venue, and have been doing it ever since.

Why are you a CE junkie?

I like to know what’s going on. Being a part of optometric politics, I always want to be at the table when something new is being discussed or a decision was being made. I feel the same way about CE. I want to know what’s new in the world. Maybe I can’t do it in my own clinic today with lasers or cataract surgery, but I want to know what’s new so that I can help my patients make the best decisions. When I was in university, I sat in the back of the classroom. Now I sit at the front and direct it.

After 32 years, is there anything you wish you could change?

I probably would have come out here straight out of university. I might change having a partner in the office-it would have been nice to have one earlier when I was going through the chair of the British Columbia Association and then the Canadian Association. I didn’t find anyone who worked within our group and worked with the staff and the community. It would have been nice to have a partner to share those responsibilities all the way through. That’s about it. I’m pretty happy doing what I’m doing.

Many of your staff have been with you for a long time. What's your secret?

I treat them like I would want to be treated if I was a staff person. I encourage them to be part of the decisionmaking in the office. There are many things within the office that I don’t know what they do because it’s their responsibility. I try to empower them so that they have an interest in how we’re doing. I have no qualms about sharing how much money is coming into the office, how it happens. I think this makes them feel that they are an important part of the team.

What’s the craziest thing you’ve ever done?

Trying to ride a hand-pump train car with a bunch of my friends when I was in high school. We weren’t even drunk. [Laughs] The part of Winnipeg where I lived was right along the main railway track. It was the railway yard where they repaired all the cars the railway. We went not quite half a mile. Somehow we made it back. I’m not even sure how we even got into the yard.