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Remember the Boy Scout motto…
EDITOR’S PERSPECTIVE Paul B. Freeman, O.D.
Remember the Boy Scout motto...
I
n May 2000, the issue highlight of Optometry was an article titled ‘‘Workforce projections for optometry.’’ The authors of the article collected data to get a picture of both the supply of optometrists, based on a number of variables such as ‘‘work hours, retirement rates, new entrants,’’1 and the demand, based on variables such as ‘‘patient encounters and associated time requirements.’’1 The results of the study ‘‘suggest[ed] an excess supply of optometrists is likely over the next 20 years.’’1 The resolution to this potential oversupply of optometrists as pointed out by the authors could be that ‘‘a gradual convergence between the need for eye care services and actual utilization, which might occur in response to changes in the nation’s health care system, educational programs or increases in the proportion of the population cover by vision benefits, could reduce or eliminate the excess supply.’’1 Moreover, according to the authors, if there were simply ‘‘a one percent annual increase in per-capita routine eye health and vision assessment examinations,’’1 the projected reversal of supply and demand would occur in 2015. How serendipitous is it then that most of the change in overall health care due to the new health reform law is scheduled to take place in 2014? As I and others have pointed out, not only will the change offer health care coverage to many Americans who did not previously have coverage, but also with the non-discriminatory health care provision, it will open (with coverage) access to any provider that the public now wishes to see, without restriction. This is a great start to the 1% increase in patient demand that will absorb the
anticipated excess supply of optometrists. To further bolster these demand numbers, the public is becoming acutely aware of the need for clear and comfortable vision to view different visual venues. As an example, although 3D is not a new viewing concept (many of us should remember stereoscopic viewing through devices like the View-Master), based on the recent releases of 3D movies and now televisions with stereo viewing potential, the concept of comfortable vision has jumped to the forefront. And with the help of organized optometry’s explanation of the need for good and complete eye care to resolve visual discomfort (stressing binocular function), more consumers who are seeing clearly (and thus not feeling the need for ‘‘preventive maintenance’’) might now seek an evaluation from someone who emphasizes clarity and comfort .and who best to do that? There is also the ever increasing need, as has been highlighted by both the professional and lay media, concerning the many eye-related eye conditions that can result in a decrease in sight, and, in many situations, function and quality of life. Again, patients will benefit from the access to optometric services, based on not only the numbers, but the geographic distribution of the profession. And finally, because of the overall increase in patient care, and because optometry is indeed a primary care profession, there will be many more opportunities to detect (possibly for the first time) systemic conditions such as hypertension and diabetes, to name but 2 of the more common and obvious sight- and life-threatening conditions. It is this group of patients that should concern health care professionals: where are we going to send
1529-1839/$ -see front matter Ó 2010 American Optometric Association. All rights reserved. doi:10.1016/j.optm.2010.05.008
Paul B. Freeman, O.D. these patients for care? One only has to go to the Internet and type in ‘‘doctor shortage in the United States’’ or ‘‘physician shortage in the United States’’ to become extremely concerned about where we are going to send the patients we diagnose with a systemic (or any other of the myriad conditions that an optometrist can diagnose, but not treat) condition. One article2 points to baby boomers as the primary reason for both the decrease in supply (retirement of boomer physicians) and the increase in demand (boomers in general). Added to that, the uneven geographical distribution of medical health care practitioners (e.g., the dearth of practitioners in some states due to malpractice insurance rates), as well as the change in workplace expectations (e.g., hours of service), and it is evident that the problem will be not in the supply of optometrists, rather the lack of supply of physicians who will be able to treat those patients
332 whom we diagnose. This decrease in supply is projected, in part, because of a decrease in the numbers of primary care physicians (as well as some specialty providers) that will ultimately lead to a decrease in overall quality of care.3 From where I sit, the public and many of the ‘‘para medical professions’’ are in a quandary. The public should be pleased that they will soon have (covered) access to health care services that they did not have before, including a better awareness of why they should avail themselves of these services. The ‘‘non-medical’’ professions who now find themselves
Editorial supplying the services that they are licensed to perform will also find conditions that should be treated by medical physicians, but who may not be (readily) accessible. So, rather than dissipating energy in interprofessional confrontation, now is the time for all of the health care professions to come to the table to figure out how best to resolve the workforce shortage of those health care professions who may not have looked at predictive models of supply and demand and, while there, to figure out how to better integrate all health care services for the betterment of the patients we all serve. And, as I’ve said before, each
one of us (regardless of our position in life) will someday be someone else’s patient, and when that occurs, we would hope that the proper health care provider is there to care for us.
References 1. White AJ, Doksum T, White C. Workforce projections for optometry. Optometry JAOA 2000;71:284-300. 2. Lapidos J. Where have all the doctors gone? Available at: http://www.slate.com/id/2217146. Last accessed May 14, 2010. 3. The physician shortage and healthcare reform. Available at: http://www.aamc.org/workforce/. Last accessed May 14, 2010.
Remember the Boy Scout motto...
I
n May 2000, the issue highlight of Optometry was an article titled ‘‘Workforce projections for optometry.’’ The authors of the article collected data to get a picture of both the supply of optometrists, based on a number of variables such as ‘‘work hours, retirement rates, new entrants,’’1 and the demand, based on variables such as ‘‘patient encounters and associated time requirements.’’1 The results of the study ‘‘suggest[ed] an excess supply of optometrists is likely over the next 20 years.’’1 The resolution to this potential oversupply of optometrists as pointed out by the authors could be that ‘‘a gradual convergence between the need for eye care services and actual utilization, which might occur in response to changes in the nation’s health care system, educational programs or increases in the proportion of the population cover by vision benefits, could reduce or eliminate the excess supply.’’1 Moreover, according to the authors, if there were simply ‘‘a one percent annual increase in per-capita routine eye health and vision assessment examinations,’’1 the projected reversal of supply and demand would occur in 2015. How serendipitous is it then that most of the change in overall health care due to the new health reform law is scheduled to take place in 2014? As I and others have pointed out, not only will the change offer health care coverage to many Americans who did not previously have coverage, but also with the non-discriminatory health care provision, it will open (with coverage) access to any provider that the public now wishes to see, without restriction. This is a great start to the 1% increase in patient demand that will absorb the
anticipated excess supply of optometrists. To further bolster these demand numbers, the public is becoming acutely aware of the need for clear and comfortable vision to view different visual venues. As an example, although 3D is not a new viewing concept (many of us should remember stereoscopic viewing through devices like the View-Master), based on the recent releases of 3D movies and now televisions with stereo viewing potential, the concept of comfortable vision has jumped to the forefront. And with the help of organized optometry’s explanation of the need for good and complete eye care to resolve visual discomfort (stressing binocular function), more consumers who are seeing clearly (and thus not feeling the need for ‘‘preventive maintenance’’) might now seek an evaluation from someone who emphasizes clarity and comfort .and who best to do that? There is also the ever increasing need, as has been highlighted by both the professional and lay media, concerning the many eye-related eye conditions that can result in a decrease in sight, and, in many situations, function and quality of life. Again, patients will benefit from the access to optometric services, based on not only the numbers, but the geographic distribution of the profession. And finally, because of the overall increase in patient care, and because optometry is indeed a primary care profession, there will be many more opportunities to detect (possibly for the first time) systemic conditions such as hypertension and diabetes, to name but 2 of the more common and obvious sight- and life-threatening conditions. It is this group of patients that should concern health care professionals: where are we going to send
1529-1839/$ -see front matter Ó 2010 American Optometric Association. All rights reserved. doi:10.1016/j.optm.2010.05.008
Paul B. Freeman, O.D. these patients for care? One only has to go to the Internet and type in ‘‘doctor shortage in the United States’’ or ‘‘physician shortage in the United States’’ to become extremely concerned about where we are going to send the patients we diagnose with a systemic (or any other of the myriad conditions that an optometrist can diagnose, but not treat) condition. One article2 points to baby boomers as the primary reason for both the decrease in supply (retirement of boomer physicians) and the increase in demand (boomers in general). Added to that, the uneven geographical distribution of medical health care practitioners (e.g., the dearth of practitioners in some states due to malpractice insurance rates), as well as the change in workplace expectations (e.g., hours of service), and it is evident that the problem will be not in the supply of optometrists, rather the lack of supply of physicians who will be able to treat those patients
332 whom we diagnose. This decrease in supply is projected, in part, because of a decrease in the numbers of primary care physicians (as well as some specialty providers) that will ultimately lead to a decrease in overall quality of care.3 From where I sit, the public and many of the ‘‘para medical professions’’ are in a quandary. The public should be pleased that they will soon have (covered) access to health care services that they did not have before, including a better awareness of why they should avail themselves of these services. The ‘‘non-medical’’ professions who now find themselves
Editorial supplying the services that they are licensed to perform will also find conditions that should be treated by medical physicians, but who may not be (readily) accessible. So, rather than dissipating energy in interprofessional confrontation, now is the time for all of the health care professions to come to the table to figure out how best to resolve the workforce shortage of those health care professions who may not have looked at predictive models of supply and demand and, while there, to figure out how to better integrate all health care services for the betterment of the patients we all serve. And, as I’ve said before, each
one of us (regardless of our position in life) will someday be someone else’s patient, and when that occurs, we would hope that the proper health care provider is there to care for us.
References 1. White AJ, Doksum T, White C. Workforce projections for optometry. Optometry JAOA 2000;71:284-300. 2. Lapidos J. Where have all the doctors gone? Available at: http://www.slate.com/id/2217146. Last accessed May 14, 2010. 3. The physician shortage and healthcare reform. Available at: http://www.aamc.org/workforce/. Last accessed May 14, 2010.