I think there is a conflence of trends that can be analyzed for the future of eye care delivery.
Before the trends, though, the fundamental facts:
1.) Money preceeds power (in the free market).
2.) Professionalism is one pole on a continuum, and capitalism is another pole on the continuum.
3.) It's all about ownership.
Trend One: Economic might
A.) "Outside" money continues to enter the health care delivery system. By "outside", I mean mass merchandizers, insurance companies, online entities, even lens manufacturers and frame manufacturers (who have been part of the eye care industry for awhile...). They have inheirent power because they have money.
B.) Individual professionals' only advantage is legislative power. To date, society has valued professionalism to a high degree--so much so that professionalism is ensured by goverment law.
What economic power that professionals had in the past is miniscule compared to the economic might of the "outsiders", if I may call them that.
Trend Two: Changing scope of practice amongst the players in eye care health delivery
A.) Ophthalmology is not "legislated into existence" like optometry and opticianry is. They're not limited in their scope.
Ophthalmology's issue is dealing with remibursment form third parties and how to offer non-covered services that are "fee for service". They love refractive surgery, the advances in IOL technology, and increasingly, opticals.
B.) Optometry's scope is going to continue to evolve: the laws are in effect, it's just a matter of "phasing out the old, and phasing in the new".
Optometry's issue is to move solidly forward as an alternative to general ophthalmology. If the insurer's don't block it, it will happen, guaranteed. Optometry is a "hot" profession right now, generally, and the market is going to be flooded with wave after wave of new graduated ODs.
C.) Opticianry has a great opportunity in front of it, IMO. First of all, opticianry is underrepresented and underfunded as a profession. This will not change, regardless of educational improvements.
You need economic power. After that, everything else will come: more money for better licensure legislation; better education, etc.
You must realize that it's really the professionals vs. the "outsiders". Realize that your profession may not be strong enough to stand alone in the face of the "maturization" of this industry.
Professional opticians (one at a time, not as a unified whole) must cut deals with optometry and ophthalmology: you want to be an independent professional service within another independent professional service. In other words, you have to approach ODs and MDs and set up arrangements where you have equity ownership of an optical service (without fee-splitting). That means you will run a business located within a business. Obviously, there will be an overhead fee to pay, and it will be very steep.
If it can be done in the reverse by bringing an optometry practice within your optical, even better for you.
As an analogy, chains hire "independent practices of optometry" to operate within their overhead framework. That concept would work in reverse: optometrists and OMDs could be enticed to allow an "independent practice of opticianry" within their overhead framework with access to the patient base.
In summary, professionals have to work together to counterbalance the business forces that are, quite frankly, outcompeting opticianry to a large degree, optometry to a substantial degree, and is mostly an income drain only on ophthalmology.
It's that, or employment like the pharmacists. While that's not bad, necessarily, overseeing Rx drugs is a lot more secure than overseeing Rx vision correcting devices.
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Why not take advantage.............
Originally Posted by drk
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