By Mark Wright, OD, FCOVD,
and Carole Burns, OD, FCOVD
ROB Professional Editors
Oct. 11, 2017
What does the future of optometry look like over the next five years? Answers to that question were provided at the Essilor sponsored “Defining the Future of Optometry” presentation at the 2017 Vision Expo West meeting.
Mark Wright, OD, FCOVD, and Richard Edlow, OD, presented analysis of a vast amount of information available from the U.S. Census Bureau, Bureau of Labor Statistics, National Eye Institute, Vision Council surveys, Centers for Medicare and Medicaid, Jobson Optical Group, Vision Watch, AOA Workforce Study, combined with original Jobson research. Then, Gina Wesley, OD, and Michael Kling, OD, interpreted the data from the perspective of optometrists working daily in the trenches.
The presentation, which was the first step in building a major new resource for practice planning and growth, focused on four areas: demand, supply, mega-trends and opportunities. Let’s review each of these important areas.
Eyecare demand falls into two categories – (1) demand for optical services and products, and (2) demand for medical services and treatment, including surgery. The first category has been the traditional stronghold of optometry and the latter has been the main focus of ophthalmology. That landscape is rapidly changing with medical services looming larger in the optometric profession in the years ahead.
Eyecare is a large business. More than three quarters of the adult population wears vision correction devices. An estimated $33.5 billion is spent annually by American adults for refractive eye exams, eyewear and contact lenses with an additional $28.6 billion spent for medical and surgical eyecare.
Demand for eyecare is higher among older people — both because a higher proportion of people over age 40 need vision correction and because the prevalence of chronic ocular diseases is higher among older people. Growth in demand for eyecare has been steady and predictable, driven by population growth, the aging population, rising incomes and new technology.
The eyecare market weathers economic downturns better than most businesses because the foundation of eyecare demand is functional vision need, not discretionary desire. Technical innovation is continuous and transformative in the eyecare market. New and improved corrective devices are constantly being introduced and new diagnostic and treatment technologies steadily appear. Innovation is a significant contributor to demand growth, as it has been in other healthcare sectors.
As in all healthcare, insurers and the government exert increasing influence on eyecare demand as the proportion of the population covered with vision insurance, medical insurance, Medicare and Medicaid expands.
Over the past 10 years, the compounded annual revenue increase for optical corrective products and services has been about 4 percent in current dollars. While not spectacular growth, this rate of increase is nearly twice that of GDP growth, and is one percentage point higher than compound annual growth of total consumer expenditures for all goods and services. The two most important eyecare demand drivers have been price/fee inflation and upgrading the product mix with new technology.
There is no reason to believe that the eyecare market growth rate will either accelerate or decline through 2025. Fundamental demographic shifts are improbable and the pace of technological innovation is likely to resemble recent history.
Within both professions, the proportion of women in practice will rise substantially. Our optometry schools are two-thirds women today; soon women will comprise a majority of practicing optometrists in America.
Many optometrists are not operating at full capacity. This was demonstrated in a 2014 workforce study sponsored by the AOA which showed that average ODs conducted 62 patient visits per week, but there was room for more. The study estimated that 20 additional patient encounters weekly were possible.
The AOA workforce study goes on to estimate the supply of ECPs, adjusted for excess OD capacity, and to estimate total eyecare demand adjusted for the effects of the Affordable Care Act. Based on this analysis, it was estimated that there is a current excess supply of full time ECPs of 12 percent, which will shrink to a 4 percent over-supply by 2025. This indicates that the eyecare market will remain highly competitive and that ODs will need to satisfy much of the increasing demand for medical eyecare services in the future, as the supply of MDs remains relatively flat.
Clearly, the growth in eyecare is on our side in optometry–the only question now is how to make the most of it.
Review of Optometric Business will be publishing more from the Defining the Future of Optometry event in the coming weeks.