There is the old fable about the three blind men and the elephant. The blind men were asked to feel the creature and report what they thought it was. The first blind person examined and manipulated the tail, noting ts size and frayed end. It is a rope, he exclaimed! The second blind person concentrated on the leg, noting the knobby skin andits huge size. He concluded it was the trunk of a tree, and a large one that.
The third blind person handled the elephant’s trunk the best he could because it wiggled and waggled. He reported that what was in front of him was a snake and it was pretty spry.
You can not determine if an elephant is an elephant by feeling just one partof it. And you can not prophesize the future of the ophthalmic market or the profession of optometry without a great deal of data.
For example, if one were to analyze the results of the Workforce Study recently commissioned by the American Optometric Association, he or she might conclude that there is a definite overabundance of optometrists in this nation.
Yet, if the unmet vision needs in this country were only partially filled, one could justifiably conclude that there is an insufficient number of ODs to handle the demand. Just image what would happen if it became standard operating procedure for all infants to be examined in their first year of birth! And they should be if we are to treat conditions like amblyopia,
strabismus and major refractive abnormalities when they should be treated.
The same case can be made for the millions of motor vehicle operators who get licenses to drive with no determination that they can see properly to drive. Or the huge percent (like 70%) of computer operators who have symptoms that can be alleviated with properly focused eyewear.
From what we see today, filling all or most of the unmet vision needs in the
immediate future is highly unlikely. Change comes slowly. With no substantial change in sight (no pun intended), here, in my opinion, are some glimpses of the future as I see them:
* Data reveal that optometric income continues to rise in spite of the economic impact of managed care. True, more patients are being examined more often. However, it is because of the good economy that patients are buying eyewear, with sophisticated lenses and frames, and this, more than the numbers being examined, is what is propelling the economics of the practitioners. As long as the national economy is vibrant, optometric income will be good. In my view, sad to say, the general economy is beginning to show signs of slowing.
* Enhancements of state laws that regulate optometry remain as a priority for state optometric associations. But TPA enhancements will soon reach their end and other legislative initiatives will begin. The Kentucky law to require eye examinations for entering school children will be a model for other states. The first decade of the millenium will show a shift in optometric legislative efforts toward expanding the marketplace with laws required more frequent examinations for school children and motor vehicle operators.
* Ophthalmology as a competitor for primary care patients will not fade into the sunset. The profession of ophthalmology is already divided into two unequal parts - the smaller one doing the lion’s share of cataract andrefractive surgery and the larger part competing with optometry for primary care patients. This division and this competition, both not in the public’s interest, will continue and become more intense.
* The applicant pool for entrance into schools and colleges of optometry is shrinking. The independent colleges can not survive with reduced enrollments and you will see many of them developing affiliations with established universities.
* The demise of private optometric practice, particularly solo optometric practice, has been forecast for the past three decades; yet, this segment of the professional community remains vigorous. Three-fourths of all optometrists describe themselves as self-employed and more than half of those practice solo. The future appears clear: there will be substantial numbers of group private optometric practices and more “networking” among those practices. Concurrently, a significant number of ODs will continue to go it alone in a solo environment.
* Ophthalmology and third party payers, for no other reason than economics, will vigorously challenge the co-management of cataract and refractive surgical patients with optometrists.
* Refractive surgery is an established entity and we can now settle back fully knowing that there will be between one and one-half million and two million procedures done each year for at least a couple of decades. The fear that this will impact upon the sale of conventional eyewear is misplaced. Refractive surgery and eyeglasses can co-exist comfortably as did, and does, contact lenses and conventional eyewear.
* The retail segment of the industry, that is the corporate world that sells eyewear to the public and uses in-house and side-by-side professionals for the examinations, will not go away; however, as far as market share is concerned, it has reached its zenith. Reports over the past couple of years have shown diminished profits and this more than anything will result in mergers, consolidations and fewer companies.
* The number of contact lens wearers has been between 25 and 30 million for the past several years. There is no reason to see much change, up or down, with these numbers. Products, particularly for the correction of presbyopia, can and will make a difference and a breakthrough in this area is in the foreseeable future.
* The manufacturing of optical products, particularly ophthalmic frames, in the United States is a thing of the past. New and different manufacturing of ophthalmic lenses, that include higher indices of refraction, patient friendly progressive lens designs, and lenses with improved photochromic properties, have been, and will continue to be, the fuel that propels the industry at all levels. These products have “saved” the optical lab system. Don’t look for this to change soon.
* Managed care. Never thought you would ask. In spite of the public’s disillusionment with HMOs and managed care plans, eye care and eyewear discounting is here to stay. The “high profit margins” in eyeglasses and contact lenses, so evident to non-optical companies and managed care benefit administrators, calls for lower prices and reimbursements. Our profession has failed to sell to the public that dispensing a pair of eyeglasses or contact lenses is a professional service completely different from the merchandising of a commodity. It appears too late to change these entrenched views and the future holds for more of the same.
So what does all this mean? Would I want, or should you want, our sons and daughters to matriculate into a college of optometry?
Well, I would. I strongly believe that the profession of optometry is properly positioned to fill a vital health care need. The pubic image of the profession is one of resect and competence. If ODs have the necessary people skills they will succeed in optometry and their success will be both personally satisfying and financially rewarding.
The third blind person handled the elephant’s trunk the best he could because it wiggled and waggled. He reported that what was in front of him was a snake and it was pretty spry.
You can not determine if an elephant is an elephant by feeling just one partof it. And you can not prophesize the future of the ophthalmic market or the profession of optometry without a great deal of data.
For example, if one were to analyze the results of the Workforce Study recently commissioned by the American Optometric Association, he or she might conclude that there is a definite overabundance of optometrists in this nation.
Yet, if the unmet vision needs in this country were only partially filled, one could justifiably conclude that there is an insufficient number of ODs to handle the demand. Just image what would happen if it became standard operating procedure for all infants to be examined in their first year of birth! And they should be if we are to treat conditions like amblyopia,
strabismus and major refractive abnormalities when they should be treated.
The same case can be made for the millions of motor vehicle operators who get licenses to drive with no determination that they can see properly to drive. Or the huge percent (like 70%) of computer operators who have symptoms that can be alleviated with properly focused eyewear.
From what we see today, filling all or most of the unmet vision needs in the
immediate future is highly unlikely. Change comes slowly. With no substantial change in sight (no pun intended), here, in my opinion, are some glimpses of the future as I see them:
* Data reveal that optometric income continues to rise in spite of the economic impact of managed care. True, more patients are being examined more often. However, it is because of the good economy that patients are buying eyewear, with sophisticated lenses and frames, and this, more than the numbers being examined, is what is propelling the economics of the practitioners. As long as the national economy is vibrant, optometric income will be good. In my view, sad to say, the general economy is beginning to show signs of slowing.
* Enhancements of state laws that regulate optometry remain as a priority for state optometric associations. But TPA enhancements will soon reach their end and other legislative initiatives will begin. The Kentucky law to require eye examinations for entering school children will be a model for other states. The first decade of the millenium will show a shift in optometric legislative efforts toward expanding the marketplace with laws required more frequent examinations for school children and motor vehicle operators.
* Ophthalmology as a competitor for primary care patients will not fade into the sunset. The profession of ophthalmology is already divided into two unequal parts - the smaller one doing the lion’s share of cataract andrefractive surgery and the larger part competing with optometry for primary care patients. This division and this competition, both not in the public’s interest, will continue and become more intense.
* The applicant pool for entrance into schools and colleges of optometry is shrinking. The independent colleges can not survive with reduced enrollments and you will see many of them developing affiliations with established universities.
* The demise of private optometric practice, particularly solo optometric practice, has been forecast for the past three decades; yet, this segment of the professional community remains vigorous. Three-fourths of all optometrists describe themselves as self-employed and more than half of those practice solo. The future appears clear: there will be substantial numbers of group private optometric practices and more “networking” among those practices. Concurrently, a significant number of ODs will continue to go it alone in a solo environment.
* Ophthalmology and third party payers, for no other reason than economics, will vigorously challenge the co-management of cataract and refractive surgical patients with optometrists.
* Refractive surgery is an established entity and we can now settle back fully knowing that there will be between one and one-half million and two million procedures done each year for at least a couple of decades. The fear that this will impact upon the sale of conventional eyewear is misplaced. Refractive surgery and eyeglasses can co-exist comfortably as did, and does, contact lenses and conventional eyewear.
* The retail segment of the industry, that is the corporate world that sells eyewear to the public and uses in-house and side-by-side professionals for the examinations, will not go away; however, as far as market share is concerned, it has reached its zenith. Reports over the past couple of years have shown diminished profits and this more than anything will result in mergers, consolidations and fewer companies.
* The number of contact lens wearers has been between 25 and 30 million for the past several years. There is no reason to see much change, up or down, with these numbers. Products, particularly for the correction of presbyopia, can and will make a difference and a breakthrough in this area is in the foreseeable future.
* The manufacturing of optical products, particularly ophthalmic frames, in the United States is a thing of the past. New and different manufacturing of ophthalmic lenses, that include higher indices of refraction, patient friendly progressive lens designs, and lenses with improved photochromic properties, have been, and will continue to be, the fuel that propels the industry at all levels. These products have “saved” the optical lab system. Don’t look for this to change soon.
* Managed care. Never thought you would ask. In spite of the public’s disillusionment with HMOs and managed care plans, eye care and eyewear discounting is here to stay. The “high profit margins” in eyeglasses and contact lenses, so evident to non-optical companies and managed care benefit administrators, calls for lower prices and reimbursements. Our profession has failed to sell to the public that dispensing a pair of eyeglasses or contact lenses is a professional service completely different from the merchandising of a commodity. It appears too late to change these entrenched views and the future holds for more of the same.
Well, I would. I strongly believe that the profession of optometry is properly positioned to fill a vital health care need. The pubic image of the profession is one of resect and competence. If ODs have the necessary people skills they will succeed in optometry and their success will be both personally satisfying and financially rewarding.
Last edited by a moderator:
