Q. I was recently talking with a classmate about future plans, and we struck an interesting point that I am looking for reassurance on. In the past I understand that most primary care optometrists who owned private practices received a significant portion of their profits from the selling and dispensing of glasses and contacts. Where do optometrists fit in with online dispensaries offering a wide selection of frames and the ease of shopping in your own time, with automatic phoropters and laser vision correction sure to become more affordable and more accessible, with the changes coming with healthcare reform and the likelihood of diminished reimbursements for refractions and other procedures? Would a residency in pediatrics or binocular vision help establish a niche? What do YOU think the future of optometry will be and where do YOU think the most business will be, if you were in my shoes if you were in my shoes as a student?

A.

From OOA Trustee Dr. Dave Anderson…

Frankly, I could write for days on this topic, as I truly love what I do and love all the ways we can help our patients.  While I agree there are pressures that surround us from online glasses to kiosk refractions, the core of what we do is still very very valuable in our current and future health care system and in the eyes of our patients.  The future will be different, and not as much compensation will be from glasses (and this has begun years ago).  The future of compensation will be a mix of many things, from medical home payments to specialty contact lens fits to eye disease treatment.  The value that each of us in the profession possesses is the ability and willingness to help with so many different eye problems.  I think the training provided at the college of optometry allows each of us to provide a wide array of problems, from glaucoma care, diabetic eye exams, and low vision (all three will be ever more valuable with the increasing aging of our population – and difficult to replace with a kiosk or online).  I think our training in contact lenses allows us to fit those patients that are not LASIK candidates – like high refractive errors, corneal diseases like keratoconus and for those that need bifocals.  Every day, I am confronted with this type of patient – one that is not coming to me for a pair of glasses but coming to me because I am the only professional that has any answers and can provide options for their eyes.  Our ability to be the primary eye care provider for so many patients and care for all things from birth until old age will have us positioned to be flexible to the changes in our health system and allow us to manage all that comes our way and the issues related to eye care.  In our professions past, we have endured the advent of 1 hour optical, online contact lens ordering, managed care solutions (both good and bad), and we will endure what comes in the future.  The waters are muddy with exactly what our future holds within our health system, but I have confidence our services and often the products we provide will be of great value to patients and health care decision makers. I love what I do, I have an impact on patients on a daily basis, and I have never been more busy.  Stay positive, stay focused and be willing to consider something beyond the standard refraction for a nearsighted patient.

From OOA Trustee Dr. Beth Muckley…

Thanks for allowing me to take the opportunity to address your 1st year student’s concerns.  First, I’d like to commend them on engaging in optometric issues at such an early stage in their career.  I think they are the exact person I want helping to lead our profession in the years to come.

There are always going to be conflicts and strengths in every profession, no matter what the career path.  I chose Optometry because I wanted to help make a difference in other people’s lives, and I enjoyed the aspect of vision.  I did not like the mechanics and robotics of surgery, so traditional medical school did not appeal to me.  I also wanted a flexible lifestyle to enjoy time with family. As a woman, I also wanted to be financially independent and self-sufficient in case I ever had to raise a family alone.  I am happy to say that 15 years later, I have achieved these goals.

As an optometrist, I interact with people of all ages. I am rewarded every day when I am able to catch glaucoma before it steals someone’s vision or fit a preteen with their first pair of contact lenses, giving them confidence and self-esteem in adolescence.  I build relationships every day and patients confide in me regarding other health or personal concerns.  It is extremely satisfying and I feel this is one of my life’s purposes.

At my interview, I had to write an essay on 2 topics that I thought was facing optometry.  I remember writing about the turf war with ophthalmology and the turf war with others.  Looking back, those same issues still exist but we are still here seeing patients and making a good living.  Optometry has adapted and going forward, we are placing more emphasis on our services, not merchandise.  We are changing public perception that we aren’t just about glasses.  The most successful ophthalmologists are the ones who emphasize surgery in their practice and are skilled surgeons.  The successful ODs are those who excel in primary eye care and communicate with their patients, providing exceptional service.  You are learning all facets of primary eye care at school (disease management, contact lenses, low vision, binocular vision, etc.).  Your externships will prepare you for when you are graduated and on your own.  I highly recommend finding a facet of optometry you enjoy most and emphasizing that in your practice.  Finding a niche will separate you from the rest of the pack.  I also think it is a good idea to take some additional small business courses in accounting and marketing.

We all worry about the future but the best way to ensure you are shaping it rather than succumbing to it is to stay engaged and involved in optometry.  Join and support the OOA/AOA. They are protecting our interests, making sure optometry is leading the way in eye care.  Stay on top of new technology. Whether you become a Fellow in the Academy or participate in other educational groups, you never stop learning.  When reading blogs, keep in mind, there will always be pessimists who are never satisfied.  They tend to be the ”chicken littles” of the group.   Stay focused on the positive, stay ahead of the game, and you will be successful.  I get up every day glad to go to “work” and I am confident you will too.

From OOA Executive Director Rick Cornett…

If you came to optometry school because you want to sell glasses, you should run elsewhere – maybe get an MBA.  If you want a lifetime helping people see the world as good as possible, then look at the exciting challenges (such as patient noncompliance) you are going to experience everyday of your professional life.