eyeglob

Optometry is a wonderful profession, full of history, changes and diversity.

With market forces from changes and challenges in healthcare and a weak economy to online retailing and vision care plans, it is time for us as a profession to better take a look at the forces that are challenging optometrist to evolve.

Optometry evolved from primarily refractionist in the mid-1950s, has morphed to become the primary caretakers of the eye and vision system within the last 40 years. It is without question that optometry will change even more in the next 10 to 20 years.

I believe that market forces will shift the current retailing of optical goods model to be replaced with diagnostic and therapeutic abilities as the main means of income for the profession as a whole.

Let us examine two basic market shifts that are putting pressure on the profession and  one that signals the direction optometry will next evolve and develop. Number one is the growth and adoption by consumers of online optical-goods retail sales. Number two the effect created by vision care plans. The third item I believe gives us an idea of where optometry is heading and that is the increased trend of Optometrist to adopt the so called “medical model“.

Let us take a look at online retailing. In the month of May, Coastal Contacts, the world’s largest online retailer of eyeglasses and contact lenses announced their quarterly earnings. During their conference call to investors, they announced that for the second fiscal quarter ending April, their worldwide had increase of 117% over Q2 2010, and a sequential increase of 62% over Q1 2011. Just in North American, sales of individual frames grew to approximately 162,000 units in the second quarter of 2011. This dwarfs the 48,000 units in the same period in 2010,and represents an increase of 238% from year to year. Of the 162,000 units shipped, approximately 28,000 were to returning eyeglasses customers and 134,000 were to new eyeglasses customers.

This represents a big step (400% increase in new costumers) in the adoption of online retailing of eyewear. In the contact lens arena, 1800 grew sales year over year in the United States from 181 million to 204 million dollars. Growth numbers in bricks and mortar retailers like Luxoticca or private optical’s simply do not compare.

Like it or not, online retailing of eyeglasses will continue to increase at a rate that we have not seen, all chipping away at bottom line revenue for offices that rely on the retailing of eyewear.

My second market steering force is the competitive Vision Care Plan arena and the effect it has taken on their subscribers and providers. The inherent limitations by the vision benefits business model and competitive environment are percolating to the consumers and affecting the whole industry. First the limits on the number of visits per year and secondly the limitations in the replacement of optical hardware, vision care plans are in excess limiting the frequency by which the average OD can have an opportunity at either receiving “vision exam” fees or selling a pair of glasses or contacts.

Furthermore, to remain competitive in the Vision Benefits arena, over the last years most Vision Care plans have had to lower their premiums and reimbursements while limiting or decreasing the reimbursements on materials both in frequency and retail value. Vision Care Plans subscribers have knowledge of the limited visits that the plans will cover.

The result is that patients now feel that they can only see the OD once every two years because that is when the vision plan allows for an “eye exam”, eyeglasses or contacts. This has sent the message to consumers that the “yearly eye check up” is now an every other year event. A side casualty of this has been the steering of medical complaint visits such as red eyes and allergies to non OD providers because of the wrong perception that if the patient comes to the optometrist for treatment, the patient has exhausted all vision benefit. This is driving away potential revenue out of OD’s offices and into MD’s offices.

Vision care plans have also placed a bigger burden in OD’s with passing much of the cost to providers via lower reimbursements on materials and placing higher discounted rates at the independent OD expense in optical profits.

The bottom line being that Vision Plans patients are being seen less often by OD’s, their red eyes are taken care of by the family Doctors, and all this while providing lower overall reimbursements for materials and fees.

The third point I believe signals the shift in which optometry as a profession is expanding. Since the Medicare Parity Amendment of 1987, optometrists have been able to deliver care in a manner that reflects their scope of practice. With more recent participation in medical panels, some optometrists have actively moved away or have complimented the primary optical goods based model to a more primary medical eye care provider model.

This has been labeled the “medical model” of eye care delivery and makes use of the optometrist as a health professional. This model provides a premium on services and few restrictions on the services that can be provided while increasing the sources of revenue that can range from dry eye to glaucoma.

The fact are that Optometrist have increased their prescription writing for pharmacological agents, and this signals a shift in mentality. The prescription drug writing statistics from optometry show a double digits increase year to year. This makes light to the fact that optometrist are providing more medical care than before and I could speculate perhaps to supplement the lost income from office visits and lost retail sale opportunities.

I believe that the adoption by optometrist of the much talked about “comprehensive medical-based model” is just a response of market forces pressuring optometry and optometrist. As we have seen in optometry’s past, if we are to succeed in the future, optometry as a profession and optometrists as individuals have been very keen at evolving the profession, embracing challenges, and adopt changes.