The Optometry Surplus: A Quantitative Determination of Excess Densities

In 1997, D was at 11.5 with 30,510 optometrists and it was believed demand equaled supply at that time. Since then, enrollments have increased faster than population growth. These increased enrollments will drive D to the range 15- 17. In the past 60 years D hovered between 10 to 12 and future demands are unlikely to require optometry densities much, if any, above the current 12.8 because there is already evidence of excess supply with this density. (About 30% of ODs have two or more part-time practice sites.)

Readers can reach their own conclusions by predicting the D required in future years to equal demand. A surplus is the difference between the numbers projected to be in practice and the numbers needed to achieve the D required to meet predicted demand.

The attached figures calculate surpluses by taking the projected supply in each year and subtracting from it the number of optometrists required to meet demand D’s of 11.5, 12.8 or 14.0.

The following figures and charts appear in the text.

#1 Optometry enrollments vs. population growth.
#2 Densities per 100,000 based on two future graduation rates.
#2a. Impact of GI Bill on past Density
#3 Surpluses per year with graduation rate of 1,700.
#4 Surpluses per year with graduation rate of 1,900.
#5 Abt. Associates surpluses with 1,127 graduation rate.

Numerical values of surpluses are shown below for years 2010 – 2060 and graduation rates of 1,700 to 1,900 per year.

The most uncertain part of any manpower study is predicting the future Densities (D) required to meet future demands. Because of the many pitfalls and uncertainties in trying to predict future demand, this study explores a range from D=11.5 to D=14 as needed to meet future demand. Linear interpolations can be made for other demand densities and graduation rates.

Future supply densities were determined using the projected supply of optometrists derived from graduation rates; population projections determined from the US Census Bureau, an average annual attrition rate of optometrists from practice due to death, disability or retirement of 2.5% per year, with supplementation from cross-matching past graduation rates with future graduation rates year-by-year.

Density D is the best indicator of supply and projected demand because, unlike counting numbers of optometrists, it includes the effect of population growth over time.

This study concludes a current surplus exists and, unless demand requires D’s higher than 13, ever larger surpluses will exist each year over the next 35 years.
A: Surpluses with a Graduation Rate of 1,700 in 2016 and constant thereafter.

_ If D = 11.5 is needed to meet demand (1) * If D = 12.8 is needed to meet demand If D= 14 is needed to meet demand
Year Surplus Numbers Surplus Numbers Surplus Numbers
2010 3,223 133 -4,502
2015 5,845 (4) 1,672 -2,180
2020 7,805 3,476 -520
2025 9,460 4,962 810
2030 11,195 6,541 2,245
2035 12,505 7,708 3,280
2040 13,740 8,800 4,240
2045 15,205 10,168 5,480
2050 16,555 11,368 6,580
2055 15,705 10,388 5,480
2060 14,590 9,130 4,000

B: Surpluses with a Graduation Rate of 1,900 reached in 2018 and constant thereafter.

_ If D = 11.5 is needed to meet demand (1) * If D = 12.8 is needed to meet demand If D= 14 is needed to meet demand
Year Surplus Numbers Surplus Numbers Surplus Numbers
2010 3,223 133 -4,502
2015 5,845 1,672 -2,180
2020 8,805 4,476 480
2025 11,460 6,962 2,810
2030 14,195 9,541 5,245
2035 16,505 11,708 7,280
2040 18,740 13,800 9,240
2045 21,205 16,168 11,480
2050 23,555 18,368 13,580
2055 24,905 19,588 14,680
2060 24,890 19,430 14,390

* D= 12.8 in 2012, D= 11.5 in 1997 at time of Abt. Associates study.
# Based on graduates from two additional schools beginning 2018
(1) In 1997, supply = demand at D=11.5 per Abt. and AOA.
(2) These are national averages. Local densities vary widely. The 1997 Project Hope Census of Optometrists found regional Ds ranging from 1.61 to 39.09. Similar variations exist for physicians, and other health providers.
(3) Graduation rate for 2014 is predicted to be 1,600.
(4) Abt., with D=11.5, and 1,127 grads/year, predicted a surplus of over 4,000 by 2015.

optometry manpower chart #1.jpg

Purpose of Study.

To estimate the amounts by which rising enrollments increase density (D) of optometrists per 100,000, above its 1997 value of 11.5 determined by the national optometry census (Project HOPE), at which time it was believed the supply of optometrists equaled the demand for their services. [Figure 1]

Density is the best indicator of supply and can be accurately tracked back in time to1930 and projected into the future, unlike demand, which is far more difficult to predict as it depends on many assumptions. For these reasons this study concentrates upon D and how it is affected by increases in optometry schools and numbers of graduates.

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