• Restructuring the American Optometric Association for the 21st century

    An editorial by Paul Farkas, MS, OD, FAAO, Administrator, ODwire.org

    To remain current an organization, corporation, a practice and even an individual must constantly reevaluate their operation. The American Optometric Association (AOA) is an organization that should seriously reconsider their operation.

    The AOA was organized in 1898. The structure and methods served optometrists well for over 100 years. Lately many feel the AOA leadership has lost its way. Optometry cannot afford to lose the AOA with a powerful infrasructuure in place to protect optometric interests.

    Improvements should be considered to make the AOA function for 21st century needs. Some can be accomplished easily and in a relatively short period of time. Other issues are more complex and will take longer.

    Let us consider important changes that could be accomplishd almost immediately.

    1. Rethink the AOA public relations initiative

    The Hill and Knowlton PR Agency was hired by the AOA with a mandate to to make the public understand modern optometry. After several years and a great deal of expense the average person still has little understanding of the ODs education, training and scope of practice. Making the AOA and optometry well known through social networking has not happened. Seek an OD or eye examination through Google and see the results...

    There is no mention of the AOA website or any way to find an AOA member.

    The time has come to shake up the AOA PR inititive looking for 21st century approaches using the internet and social networking as well as traditional advertising to inform the public of how an OD can benefit them. This can be accomplished during this year.

    2. Making the “Optometry:the Journal of the AOA” profitable.

    Every AOA member receives a copy of the AOA Journal as part of their membership. The articles are quality and refereed. Unfortunately when asked most recipients do not read them. Most have little to do with every day clinical practice; many are medically oriented. Some argue a professional association requires a prestigious publication whether well read or not.

    Compare the number of ads in the AMA journal to the AOA Journal. The AMA journal has advertisers the AOA not a single ad. This is an unnecessary needless drain on membership dues.

    The solution is to get advertisers to help fund the cost of printing and mailing. Most articles are about medical optometry. Pharmaceutical companies should be lined up wanting to place ads in the journal. This could be a reality during this year.

    3. Relocate the AOA headquarters to the Washington, DC Area

    During most of the 20th century having a central AOA Headquarters located in the St Louis made auto and train travel more convenient. With the advent of air travel and on line telecommunication the St Louis location is unnecessary.

    The AOA is optometry's national lobbying group. At present there is a satellite Washington, DC office. This a needless expense if the AOA headquarters relocates to where the legislative action happens. An effective AOA in Washington is essential.

    With membership prodding this could happen within five years. Resistance can be expected because few of the multitude of AOA employees would relish the idea of relocating to the Washington, DC area.

    4. Essential change that must accomplished during the next decade

    At present AOA members do not have a direct voice in electing the AOA officers or Trustees. In addition, in this age of online interconnection, there are few opinion polls and certainly no votes that directly affect the membership. Many feel the American Board of Optometry (ABO) would never had received AOA backing if the membership had their say.

    To make the AOA a 21st century organization, there must be a change in the basic bylaws. State organizations should not be required to have their members automatically become AOA members if they disagree with the national organization. Many feel this might weaken the AOA decision making ability.

    Change should discussed and a conclusion reached that would satisfy all, without the need for a splinter American Optometric Society (AOS). Former loyal AOA members would return to the AOA if there was an idication that reform is on the way.

    Optometry is a small vulnerable profession, if divided. Every responsible optometric leader should make every effort to heal the wounds caused by recent actions. Restructuring the AOA for the 21st century would go a long way in accomplishing the healing process."
    Comments 15 Comments
    1. Richard_Hom's Avatar
      Richard_Hom -
      Great article, Adam.

      From my mobile device,
    1. AdminWolf's Avatar
      AdminWolf -
      Actually Paul gets the credit, I just uploaded it for him
      I think he'd like to get people's feedback on it.
    1. James D. Sargent's Avatar
      James D. Sargent -
      Paul,even as a past president of the state association and past chair of the state licensing board, I was ridiculed and belittled on the local chat board when I had the audacity to question the official position on board certification. Not one person came to my defense. Not one, even though our group eventually voted against board certification by a slim margin. At this stage in my life and career, I don't need to put up with that. I have other more important things to do with my life than squabble with the cool aid drinkers. I think I am tired of the constant and ongoing political battles our profession has faced. I joined the AOS as a founding member, but for personal reasons I still feel the need to be a member of the AOA. Perhaps if the AOS continues to grow and develop a national presence, I could completely shift my support. Now, I just pretty much ignore the AOA as it ignores me.
    1. J Martin's Avatar
      J Martin -
      The AOA leadership, its selection process, and intellectual inbreeding (you won't be considered if you don't swear fealty to the established positions) prevents meaningful reform. Its a devastatingly effective method of assuring "one party" control of the AOA.

      If AOA membership and state association membership were de-linked, I think the AOA would be stunned at the exodus of disgruntled docs who just can't/won't leave their state association.

      The AOA knows this, and cynically requires this link. That they do so when our national health care system is being revamped and our continued scope of practice & participation is under attack, rather than pitch a big tent and try to develop position that unify ALL ODs is very telling. They are clearly fine with developing a class system in optometry, where one group is more "worthy" (hence the "ABOVE the CROWD" marketing fiasco).

      If NOT, and if BC of Optometry were the actual goal, then any program that provides this level of certification should be acceptable. This is clearly not what the ABOA/ABO wants - competition. Why? If their product is superior, it will win in the market. If not, isn't Optometry strengthened from within by internal competition?

      The AOA leadership would tell you NO! - only they are uniquely qualified (although they themselves are not Board Certified) to decide for the whole profession what class lines will be drawn. Colleagues, this is dangerous, when one small cadre of men and women self appoint them selves and their cronies to a body to control this entire issue (the ABO) while simultaneously designing it in such a way that that body is beyond oversight.

      The question isn't whether or not a practicing OD would be able to pass any test the ABO imposes - I am quite certain anyone could.

      Instead, I ask you:

      Have any of the dire predictions the AOA made when selling the ABO concept come to pass?

      Is the profession more unified, or more fractured?

      Does passing a ABO sanctioned test provide any real world benefit like TPAs, orals, or laser laws have?

      What if the November elections pan out with Republican control of the House (likely) and Senate (less likely but more possible now than ever considered plausible bank in January)? Many senior party members are already vowing a repeal of the Obama Health Care Plan.

      Would a responsible AOA/ABO withdraw BC, or will it muster up some other boogieman to insure its survival?

      With $2-3 million of your AOA member dues at stake, you had better decide IF you think the AOA is acting in the best interests of OUR profession.

      My Dad, whom we lost this summer, always said: "judge a man by his actions, not by his words".

      What judgment do you have for the actions, not words, of the AOA?
    1. Tammy Richert's Avatar
      Tammy Richert -
      Quote Originally Posted by J Martin View Post

      The AOA leadership would tell you NO! - only they are uniquely qualified (although they themselves are not Board Certified) to decide for the whole profession what class lines will be drawn. Colleagues, this is dangerous, when one small cadre of men and women self appoint them selves and their cronies to a body to control this entire issue (the ABO) while simultaneously designing it in such a way that that body is beyond oversight.


      Is the profession more unified, or more fractured?

      Does passing a ABO sanctioned test provide any real world benefit like TPAs, orals, or laser laws have?
      These are a couple of points that have been bothering me, as well. Even when "new" blood takes over, nothing seems to change. They don't seem to care/realize how divided the profession has become. And, I don't see this getting us to the point of portablity. Which, if we are all on the same "higher" level and certified by the same entity, we should be able to practice the same any where we choose.
    1. Paul Farkas's Avatar
      Paul Farkas -
      Should the AOS boosters become more active in changing the AOA?

      Why is there not a challenge when it comes to electing AOA board of Trustees? It seems to me that there is only a single person running.

      In 2009 and then again in 2010 there should have been a BC opponent running to become an AOA Trustee. Must an AOA trustee put time in climbing the AOA ladder to run for the position or is it open to anyone who wishes to serve?
    1. Jonathan Warner's Avatar
      Jonathan Warner -
      Quote Originally Posted by Paul Farkas View Post
      Should the AOS boosters become more active in changing the AOA?

      Why is there not a challenge when it comes to electing AOA board of Trustees? It seems to me that there is only a single person running.

      In 2009 and then again in 2010 there should have been a BC opponent running to become an AOA Trustee. Must an AOA trustee put time in climbing the AOA ladder to run for the position or is it open to anyone who wishes to serve?
      Paul,

      Only Kool aide drinkers will ever work there way up the AOA ranks. The AOA system is set up to screen out individual thinkers.
    1. Paul Farkas's Avatar
      Paul Farkas -
      Quote Originally Posted by Jonathan Warner View Post
      Paul,

      Only Kool aide drinkers will ever work there way up the AOA ranks. The AOA system is set up to screen out individual thinkers.
      Will no one challenge those running for AOA Trustee in an open election where issues can be debated? Who nominates potential AOA Trustees?
    1. Jonathan Warner's Avatar
      Jonathan Warner -
      Quote Originally Posted by Paul Farkas View Post
      Will no one challenge those running for AOA Trustee in an open election where issues can be debated? Who nominates potential AOA Trustees?
      Any body could run, but they would never be elected. The kool-aide drinkers control the machinery of the AOA.
    1. Mike Burley's Avatar
      Mike Burley -
      I asked my state association to allow me to stay a member of the state association without any of my dues going to AOA. I didn't receive a response, which told me that I did not have that option. So I quit both AOA and O(hio)OA because I was not offered that choice. If a huge number of you would do the same, it could really get AOA's attention and change the direction of AOA.
    1. Steven Nelson's Avatar
      Steven Nelson -
      Quote Originally Posted by Jonathan Warner View Post
      Kool aide drinkers
      I never tire of hearing this term. Can we start calling people who overall believe in the AOA Coke drinkers? Since I've given them up, it would at least bring back fond memories.

      By the way, it's already been used 3 times in 11 posts. Is there some contest I should know about?
    1. Paul Farkas's Avatar
      Paul Farkas -
      Will no one have an alternative platform to run for the AOA Board in June?

      Wouldn't having at least two different approaches be useful for ODs to consider? ODwire.org is ready,willing and very able to disseminate the arguments to a very large number of concerned ODs.

      Complaining is easy. Doing something to create change is the challenge.

      Who will step up?
    1. Dominick Maino's Avatar
      Dominick Maino -
      A couple of points:

      Public Relations
      : I've had a chance over the past several months to work with the AOA and the Hill and Knowlton PR Agency. Hill and Knowlton is a very professional group that has made remarkable inroads into media access for optometry in all areas. They've even set up a teleinterview from Florida (where I was attending a meeting) to New York with NBC...and they did this very quickly and efficiently....(I was suppose to be in Chicago at that time....so they had to find a studio near where I was in Florida to accommodate the NBC interviewers). I and many others are used by the AOA to get the word out on many topics of interest to our patients. If you are not aware of this you haven't been paying attention. I also serve on the 3D Classroom Project team...we are producing documents that will reach hundreds of thousands of teachers, principals, and other leaders in education....the AOA is doing a very good, very consistent job in this area.

      As far as the public still getting us confused with that other profession....well, I've read that it takes something like 7 media exposures before people act on the message. Obviously no optometric organization has the kind of resources that could do this just yet....the bottom line is the OD in his or her office. What have YOU done to get the word out about optometry? What have you done to show your patients who you are and what you can do? It really all starts and ends with you. The AOA is a resource.

      AOA Journal: As a member of the Journal Review Board of the AOA Optometry journal, I agree that it is an outstanding, high quality publication. Dr. Freeman (editor) is an awesome individual to work with....and the JRB represent the top content experts in optometry. As far as content goes....don't like it? Write an article yourself!!! I (and probably others on the JRB) would be more than happy to assist you in this endeavor. Dr. Freeman will often hold seminars on how to write articles for the journal at the AOA meeting. It seems that medicine has docs in practice who write articles frequently....why can't optometry do that as well? As far as the advertising goes....I thought it was advertiser supported to some extent....I certainly agree the more advertiser support we have the better. Read the journal. Submit an article.

      Relocate the AOA: We already have a Washington DC office...but maybe it should be relocated. I don't have enough facts to say one way or the other. I will say that the home of the AMA is where I make my home (Chicago) and they seem to have plenty of political clout from here!

      Essential changes: AOA members do have a voice in electing the AOA officers/Trustees through their state representatives. Tell these representatives who you want where.

      If state organizations do not be required their members to automatically become AOA members the AOA looses political and fiscal clout to represent you on the Hill. We are a legislated profession....we can be wiped out by a single stroke of the pen (Didn't they do that in Italy?) We need the AOA to watch....we need you to support the AOA watchers!

      The American Optometric Society (AOS) is made up of several fine optometrists, but the organization is misguided. You do not change an organization from the outside....you change it from the inside. AOS, while well meaning, is a waste of valuable resources both fiscal, political and personal. You make my point by noting:
      "Optometry is a small vulnerable profession, if divided."

      Of course I totally agree with you when you say that: "Every responsible optometric leader should make every effort to heal the wounds caused by recent actions. Restructuring the AOA for the 21st century would go a long way in accomplishing the healing process."

      I'd like your feedback on my comments. Thanks

      Dominick
    1. Kraig M. Stasney,O.D.'s Avatar
      Kraig M. Stasney,O.D. -
      I do appreciate your comments Dominick and think we are pretty much on the same page. I am in Ms. and have not seen promotions of optometry in any form. I am constantly educating my patients, yes I can treat your glaucoma, yes I can monitor your retinal health for diabetes,etc. Medicine in general is very anti-optometry(anti-non-MD. I have never heard of the 3D Classroom project, so I can't comment on it's effectiveness. It would be great if we had optometric representatives in the major cities in Ms. to go on TV and help with these initiatives.
      With regard to the AOA journal, it needs some serious updating. The only color pictures I remember are of the authors. I think advertising is a very good idea. Look to the Jobson publications as an example.
      Finally essential changes should be trying to reunite the profession by looking seriously at the BC issue. That is the serious issue that is fracturing our profession. My state association voted for BC and asked for absentee voting. I sent a letter of my disapproval. In their newsletter, they said the vote was "pretty much" 75 to 1 in favor of BC. I guess I was "pretty much" the only one to vote against it. Talking to my colleagues, very few are in favor of BC. A definite minority. Our state association does not represent a large percentage of our practitioners, and after that I know several people that said they are not renewing their membership.
      I understand what the initial statements were from the AOA leadership regarding BC. They said that eventually we would have to show we were maintaining our competence through BC. As we have all seen, that is not the case.
      My state board won't recognize it, so what's the purpose? If it is to aid in gaining increased scope of practice, should a new subspecialty such as an optometric surgeon be considered?
      Have a good one.
    1. Lombaerts Benoit's Avatar
      Lombaerts Benoit -
      Hello,

      I do apologize if my european-english is not so good as your american-english !

      I'm benoit lombaerts president of the SOE ( European Society of Optometrists ) www.soe-optometry.eu .
      The association exists since 1967.
      I'm in charge for the SOE since 2007.
      From the beginning I'm trying to get european optometrists all together.

      In europe, we have 27 countries with 22 different languages !
      As optometrist we should have only one language: optometry and we should share common value like respect, friendship, love,supporting each other...
      I pretend ,there are as many optometries than there are many optometrists !

      We are different, this differences make us so specific and we may have additional talents;

      But this make us also weak because of egos and short term vision...

      The visibility of optometry and as optometrists is very low:

      - I bought a book on autism , "complete guide" it said, more than 500 pages: in the references, there was more on michael jackson than on optometry ( 0 time !!! );

      - in the classical litterature, you do see a lot on visual therapy, vision,learning problems,... but not so much on optometry, optometrists;

      - in the book "Jillian's Story: how vision therapy changed my daughter 's life"
      page 68: "The opthalmologist gave her sight. The vision therapist gave her vision that changed her life"...
      where is the optometrist ?, where is optometry?
      During her presentation of about 45 min : she mentionned almost 40 times "visual therapist", "opthalmologist" 7 times and "optometrist" 5 times !

      I'm sure it was unvoluntary... it shows very well, optometry does not exist (even in the titel ) and only in our mind because we are optometrist ! even some colleagues looks friendly to you but behind you they don't care !

      Actions and solutions:
      even if we may have different political vision on our profession, on both side of the ocean ( and even further) we do share the same problems: let it know to others ! You are not alone !

      The only way to save optometry is taking action: speak to each others and pay our fees to other associations ! even if we may disagree on some points ! We have to support each others.

      Should we consider the creation of an optometric federation of optometric associations where each association should be considered as one regardless his size ?

      What do you think ?
      What do you suggest ?
      What is your experience ?

      By the way, if every optometrist is members of each association, every association should have the same number of members and each association could keep his own identity !

      I express my gratitude to Paul for the forum and his realistic and nice vision .

      I really appreciate you took some moments to read the document and hope to meet you somewhere in the real or virtual world !

      Thank you so much

      Benoît Lombaerts
      SOE President