Professional Development

Telehealth: Where the Hockey Puck Is Going…

By Roger Mummert,
Content Director, Review of Optometric Business

May 2, 2018

“Skate to where the puck is going, not where it has been.” –Wayne Gretzky, NHL all-time scorer

Chances are, if you’ve been to a few optical meetings, as I have, you’ve heard a speaker employ these words of wisdom in predicting the future of eyecare.

Predicting the future of eyecare is like the search for the Holy Grail, of course. But that doesn’t deter optical meeting content organizers (and content creators like us here at Review of Optometric Business) from attempting the quest.

I recently spoke with third- and fourth-year optometry students attending the Seventh Career Symposium at SUNY College of Optometry, and asked them about that very subject of the future of eyecare and their role in it.

Overwhelmingly, the students said they hoped to practice in an independent setting where their clinical skills would be applied toward helping patients with a wide variety of conditions to see better and live better lives.

I was inspired by the clear sense of purpose expressed by these members of the future optometric workforce.

At the same time, I was haunted by a video by a company marketing remote eye exams. The video shows an “eyecare professional” sitting at a computer, viewing a patient’s test results and teleconferencing with that patient in an “eye exam” that, the video says, lasts “less than 5 minutes.”

How would the bright shining faces of these optometry students fit into that video, I wondered? How would they square their expectations of relating to patients face-to-face with a workaday reality of teleconferencing 10-20 patients per hour via a computer screen?

The Career Symposium also included a lively panel discussion with five ODs in various practice modes: independent, corporate, hospital, industry and academia. Panelists spoke of the pros and cons of their practice settings, most noting the freedom to make decisions, as well as the limitations of their organizational protocols and policies.

While telehealth was discussed as a present reality and future factor, nowhere did I see anyone talking about ODs sitting at a desk, viewing test results on a computer screen and conferencing with a new patient every five minutes for eight hours a day. And from anywhere in the country…or world?

Indeed, if the physical borders that determine licensure and scope of practice are dissolved, those teleconferences may be conducted by ODs in China, India, or in a developing nation where labor costs are a fraction of OD salaries here.

So, as we continually ask ourselves: Is this a threat or an opportunity? Or both?

Two realities provide perspective here: Telehealth is here now in many areas of medicine, and it inevitably will be a major factor in eyecare.

I recently spoke with a surgeon at the Mayo Clinic who conducts robotic surgery. “With robotics, the patient isn’t even in the room,” he told me. “They’re down the hall…but they could be in Europe.”

Take that thought a few years down the road: The surgeon removing an appendix could be directing the procedure from China or India. Our health plan may dictate that, based on cost and equivalent outcomes. And on the opportunity to expand care throughout the world.

By that time, will anyone be talking about whether someone needs to take or evaluate an acuity measurement in the same room as the patient?

Clearly, health care will go where it needs to go to achieve the primary goals of health-care reform: to expand access to care and to improve outcomes efficiently and economically.

I think back to the students I spoke with at the career fair, and how they have a lot on their plates. They need to develop clinical skills in the classroom, people skills in the clinic and business skills mostly while in practice. And along the way, they need to determine how they figure in the future of eyecare—and skate to where the hockey puck is going, hopefully, with the patient still in the center of that future.


Roger Mummert is Director of Content for Review of Optometric Business. Contact:


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