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Thread: Optometry in 2035. Does it exist?

  1. #51
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    Blue Jumper Look at the forecasts for 2050..................................

    Look at the forecasts for 2050..................................

    see at : https://www.linkedin.com/pulse/fate-...vitor-pamplona

  2. #52
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    I got something in the mail today. My sense is that this "invite" has been mailed to all ODs and OMDs across Canada. Given their target audience, some general MDs may have been targeted as well.

    E-eyecare
    https://www.e-eyecare.com/

    It says it was launched on Aug 15, 2018. There isn't a lot of info in the packet that was mailed to me, so I visited the website, and from what I gather, it is a "telemedicine", remote-ophthalmology platform. It seems the idea is that any patients I need an OMD consult for (they claim an ability to manage glaucoma, cataract, cornea, neuro, and retina), I can send to them. Now as of today, not all the links on the website are working, so I only see various pictures and some title-headers, but my sense of the platform is as such: I'll have some internet-connected computer in my exam room. It'll have a camera. If I get a patient I need a consult for, I'll be able to do a face-time thing with a live ophthalmologist somewhere. He/she will be able to view what I see from my slit-lamp (so my slit-lamp will have a digital-camera as well). Because there is some sign-up involved, and they claim rapid access to my clinical charts, then for my computer to participate in their platform, it will have to download certain software and I will have to use "their" charts.

    I have no idea if this will get off the ground. Is it futuristic? Yes. Is it conceivable that such a telemedicine platform can succeed? Yes. Is THIS particular group the one that will succeed in making such a telemedicine platform widespread? That I don't know. First, if they are going to announce a "launch" of their platform on Aug 15, and mail invites to professionals across the country, then they should at least ensure their website is up-to-date and working properly. The "Our Work", "Learn More", and "Join Us" links, and all links beginning halfway down the page aren't working. The "Medical Director", who signs the invite letter I got, a Dr. Mahta Rasouli, says in multiple online bios that she is the recipient of an "Outstanding Canadian Youth Medal". That particular bio is in several places online. When I Google "Outstanding Canadian Youth Medal" in order to see what it is, the only places on the web that reference such an award are links of the same biography. I think if you're going to feature a big award in a widely-circulated biographical profile, then you should at least get the name of it written correctly.

    Anyways - just nitpicking some stuff. But if you're going to try to revolutionize eyecare, that will require a LOT of work, and a LOT has to be done right. If whoever is in charge isn't looking after little details like this, my sense is that there'll be another company that will.

  3. #53
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    Blue Jumper e-eyecare is an innovative software that brings ophthalmic care to the 21st century


    e-eyecare is an innovative softwarethat brings ophthalmic care to the 21st century. This ophthalmology softwareconnects Referring optometrists/general medical practitioners orophthalmologists to other Consultant comprehensive/sub-specialized ophthalmologists,for further assessment and suggestions on diagnosis, treatment, and monitoring.




    No names, no physical address ..................................

    Looks like an idea that has no real backup at this stage, and they are looking for participants that will commit to the idea.

    Will take some time to build up.

  4. #54
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    We all have to be careful of the proper definition of telemedicine (or telehealth). In it's true definition, a telemedicine encounter must meet very strict inter-active guidelines in order to be able to bill it to medicare, medicaid, and commercial insurance.

    Virtually all of what is being sold over the internet is not telemedicine. It is opportunistic internet business. Oh,... they may say they are high quality, that they bring convenience to the patient, that they save money, that they are altruistic. Most of these vendors don't even accept insurance but are simply trying to get cash (credit card) payments. It may have a place. It may grow, or it may flop.

  5. #55
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    There may be even bigger issues stopping optometry from existing in 2035. Without exaggerating, "modern" society "as the locals know it" may not even exist at that point. You can argue it already doesn't exist in some places in the world today.

    There is a growing plethora of literature discussing the future of the world vis a vis climate change. The issue is, as the world warms, natural disasters increase in both frequency and intensity. This not also destroys communities, but a hotter world leads to droughts, famines, mass migrations, and war. You can argue the "apocalypse" already exists in some places in the world, e.g. hurricane-ravaged Puerto Rico and cyclone-ravaged Mozambique and Zimbabwe. I'm sure some of those living in fire-alley Australia today aren't feeling too well about their prospects. If your home is gone, it's hard to be thinking about other things other than survival. For kids growing up in such situations, it's probably hard to remain optimistic about one's future, or even to visualize it. And things will only get worst. It is very possible 2020 will be the coldest year of our remaining lifetimes.

    Modern society is incompatible with a healthy planet, and we are running headlong into an unknown future. That said, chances are the economy will collapse before climate change kills any of "us" (first worlders who aren't living on the eastern seaboard or on the Gulf of Mexico). The next economic downturn will truly be catastrophic, especially with interest rates already at historic lows and debt levels at all-time-highs. It is entirely possible there will be "no recovery" from the next economic downturn. And while we're here, let's mention that we are decades past the "due date" for a worldwide flu pandemic (unless the current SARS 2.0 is the one we've been waiting for).

    Hopefully we're all still around in 2035 to see how things have turned out.

  6. #56
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    You can't time the stock market they say, and you really can't. But with values at almost all-time-highs, why would anyone want to be even more greedy with the Dow at 29000++? It was clear last week that coronavirus is an existential threat. It almost certainly, probably won't be, but the possibility can't be ruled out. Given the downside risk, timing a "sell" was obvious - things were obviously going to get worse before they got better. I exited 50% of my holdings last Friday afternoon, right before the post I made above. Stocks fell (as expected) on Monday, recovered a bit mid-week, and have crashed again. The timing to get back in, however, will be difficult. It'll depend on your risk tolerance. I don't have the crystal ball on that one, but last week's sell was a no-brainer for anyone who did. (as an aside, do your investing yourself, not through some sales person like a Primerica thief, so that you can stay on top of opportunities like this)

    Getting back on-topic, the reality is that in the best-case 2035 scenario, the only thing we have to worry about is if online refraction (or robots or whatever) has threatened the livelihood of some optometrists. There are much bigger existential threats on the horizon.

    There are some concerns that the entire world equities market is heading for a cliff. The current value of fossil fuel corporations worldwide is estimated to be worth anywhere between 5 and 20 trillion dollars. If, in a moment's notice, the prevailing attitude decides that all that equity should undergo a heavy devaluation because of a worldwide move away from non-renewables, then those corporations will be instantly worth trillions of dollars less, erasing enormous value off of people's balance sheets worldwide. This will cause a financial collapse of almost complete totality, far exceeding anything the world has experienced before with no obvious catalyst for recovery. At a point where the world would need the natural resources of a healthy, sustainable earth (bountiful fish stocks, healthy forests, etc.) for recovery, would be the very time the world would be unable to provide it. There is a very obvious reason why Aramco decided to go public last fall.

    In addition to, preceeding, or perhaps compounding the above problem, is that interest rate policy, long used by central banks as their "Stormbreaker" for times of economic malaise, has not recovered anywhere near enough from 2008 to be an effective tool against the next downturn. So much of the market is based on greed and fear, and given that investors understand this (that further lowering already-depressed interest rates will not be enough to stimulate a distressed economy), people will head for the exists and fast. Possible "cures" such as MMT and QE are not going to work. With the world as indebted as it is, either of these "solutions" will cause some fixes in the system, but cause other problems elsewhere. A huge QE, for instance, could strengthen the US economy, but weaken foreign ones (like the Chinese). Given the interconnectedness of the world economy, it would be one step forward for one step back.

    And of course, climate change. This will profoundly affect each of our lives, and likely far sooner than 2035. It will make, and is already making parts of the world unliveable. It will cause massive re-assessment of value and much value (e.g. real estate in hurricane or fire-prone areas) will be lost. Not to mention, as species go extinct and animal numbers collapse, there will be threats to food supply, security, and politically stability. This is the future.

    It is my wish, that in 2035, all we have to concern ourselves with is online refraction and 1-800 Contacts.
    Last edited by optio; 01-31-2020 at 06:47 PM.

  7. #57
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    Back in April 2019, Mark Carney (the Canadian who was heading the Bank of England) along with 33 other Central Banks, wrote an open letter to the world about the risk a sudden devaluation of the fossil fuel economy. This is before Greta became a household-name, before the current Australia wildfires, and before the current zeitgeist that accepts that the world truly is on fire.

    https://www.bankofengland.co.uk/news...inancial-risks
    "If the financial community acts on these recommendations we will be two big steps closer to ensuring an orderly transition to a low-carbon economy. We recognise that the challenges we face are unprecedented, urgent and analytically difficult. The stakes are undoubtedly high, but the commitment of all actors in the financial system to act on these recommendations will help avoid a climate-driven “Minsky moment” – the term we use to refer to a sudden collapse in asset prices."

    No one knows when the pop will occur, but when it does, it will be catastrophic. 1929 will look like a mild recessionary bump. The world economy will be destroyed. And I believe it is reasonable to suppose this will probably happen before 2035.

  8. #58
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    So still a bit OT for this board, but I wanted to add to the idea I alluded to above. A collapse in the oil industry (and therefore the world economy) may not be caused by a shift to renewables - it could be by a far worse "reason": the future inability of the industry to be profitable. This is serious.

    Government Agency Warns Global Oil Industry Is on the Brink of a Meltdown (Feb 4 2020)
    https://www.vice.com/en_ca/article/8848g5/government-agency-warns-global-oil-industry-is-on-the-brink-of-a-meltdown

    We are not running out of oil, but it's becoming uneconomical to exploit it—another reason we need to move to renewables as quickly as possible.

    Bottom line is this. There is plenty of fossil fuels in the world. Problem is, we've mined all the "easy to get to" conventional stuff already. What remains, is ever-more-difficult and more-costly-to-access sources (deep offshore, oil sands, shale), so that the costs associated with extraction makes such ventures uneconomical - too little ROI and therefore a collapsing industry. This reminds me of the premise of some who say that the current world economy wasn't a product of democracy, capitalism, or economic policy, but from cheap energy. In the 1800s, all you had to do was stick a hole in the ground and out came liquid gold. It was, the argument goes, all that plentiful free energy (and not any particular financial policy) that powered the development of today's economies.

    But the world relies on (requires?) oil to remain below a certain cost in order to keep its economy functioning. It can at most afford oil at $100/barrel, but it is becoming increasingly impossible to extract and sell oil profitably at that price. Bottom line is that the cheap energy that powered the creation of our civilization is nearing its end. There will be massive consequences for this. To say the problem is existential is not an exaggeration. If there is no gas to buy, how does the economy function?

    “To phase out petroleum products (and fossil fuels in general), the entire global industrial ecosystem will need to be reengineered, retooled and fundamentally rebuilt," the report notes. "This will be perhaps the greatest industrial challenge the world has ever faced historically.”
    Last edited by optio; 02-07-2020 at 03:02 PM.

  9. #59
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    You may want to stock up on food.

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    Covid-19 will be very unhelpful for young optometrists of the future. Historically, economic crises are what have always led to the biggest structural changes in the marketplace. The panic of 1907 led to the creation of the Federal Reserve, the WW1 economy led to women having a role in the workforce (as well as universal suffrage) and trade unions, and WW2 resulted in the creation of a huge consumer economy and widespread access to education. (I could go on. 2008 resulted in the disappearance of full time work/benefits and the creation of the gig economy...)

    There will be an untold number of changes because of Covid-19, but one obvious change will be the growth and establishment of telemedicine. Actually, if I were in charge of one of those online refraction platforms today, I would be doing everything I could to leverage this pandemic to have as many people do at-home DIY "eye exams" as possible (one can easily conceive of some coronavirus-related "promotion" like a free trial, which would not only entice first-time users, but could also generate themselves lots of valuable publicity). A second thing I would do, is try to expand from refraction, by adding health elements of eye exams, since going forward, remote examination will have broad acceptance, so the only roadblock would be the mechanics of actually getting them done. Telemedicine will result in a decreased need for physical chair time, and as such, a decreased need for actual practitioners. I'd personally be very concerned if I was a Canadian optometry student who wasn't paying a Canadian tuition (e.g. a Canadian studying in the US) about my ability to make that financial investment pay off. It was already probably a very borderline investment to begin with and Covid just made it a lot worse. For Canadian students in the US right now, I imagine a delayed graduation is a distinct possibility, not to mention the uncertainty around arranging externships, board exams, etc. Not to mention the plummeting CAN/USD exchange rate.

    Covid, perhaps the biggest economic shock of our lifetimes (and this saying a lot since we lived through the GFC, though climate catastrophe will be worse) will be a net negative for optometry going forward. There will be a smaller need for optometrists (in terms of how many of us are required) by 2035.
    Last edited by optio; 03-31-2020 at 09:01 PM.

  11. #61
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    Is The Next Downturn Coming?
    - If its due to fear of environmental collapse, it will be very bad

    Predicting the exact timing of financial downturns is impossible, but there are times when the signs of a correction are ubiquitous. Years of ZIRP because of 2008 followed by even more liquidity due to Covid, has resulted in massive asset and even non-asset bubbles. When people are putting billions of dollars of real money into absolutely nothing (crypto, GME, AMC) and deli stores with 35K sales/year have a market cap of 100 million (look up Your Hometown deli in New Jersey), then it probably means we're closer to the top than to the bottom. No one is in cash these days because interest rates are zero. So equities are at maximum valuations, but not only that, people have been finding all sorts of ways to spend their money like investing in intrinsically valueless assets like digital NFTs and crypto currencies. If you look at historical bubbles, right before the pop there was always signs of excess. 2007 housing, 1999 dot-com, 1929 roaring twenties, etc. There is a future for blockchain technology but can anyone argue with a straight face that we can sustain all of Bitcoin, Dogecoin, poopcoin, Safemoon, Ethereum, Ethereum Junior, and Ethereum & Friends? People are just piling all their money into these things, yet there is literally nothing there. When sentiment craters, people will realize the emperor has no clothes. Who is going to buy all these worthless beanie babies? We're therefore at a top. So now what?

    I think it's worth thinking back to late 2019, early 2020, before Covid, and when I made a lot of the posts above. The Australia wildfires I think were a psychological turning point for many in a way that previous environmental disasters were not. The G7 country of Australia became ground zero symbolizing the new world we find ourselves in. For several months, the world saw those lush green forests on fire, and orange skies over the Sydney Opera House. I think for many, it was then that the climate problem became real. Then we had Covid, so everyone forgot again. But there will be another fire season this year. Reports everywhere are expecting it to be really bad.

    There will be a day when the world will realize there is no infinite future of infinite growth. We live on a non-infinite planet. If and when that realization occurs, when bankers and investors realize that we are long past our carrying capacity, that nature giveths but also takeths away, and that the primary assumption that undergirds our entire capitalist financial system is wrong, there will be a reckoning. One day people will realize we cannot keep cutting down trees and poisoning oceans into eternity, and that these actions will eventually result in business revenues and GDP to fall. An increasingly decimated ecosystem is a negative influencer for stock valuations. That will be reflected in the markets as fear. There will be a 1929, but with no recovery. The entire process will potentially take years, with fits and starts, but it will occur. We live beside a hen that lays golden eggs, but that hen has been neglected and abused, so one day there will be no more eggs, or at least they will be much smaller and fewer between. When people realize that not policy but the environment is the superstructure of the economy and that superstructure is failing, it will probably be THE inflection point of this short history of civilized humanity. When the economy crashes due to the fear of coming ecological collapse, there will be no return.

    I don't know when THE crash will occur due to a realization of a non-infinite-growth future but it will happen one day. This CNN article from 2 days ago reports the IMF says that climate change can cause a financial crisis.

    Climate change could ignite a financial crisis, IMF official says
    https://www.cnn.com/2021/06/03/inves...imf/index.html

    What's incredible to me is that a concept like this can actually be considered news. Is it not obvious that our economy is based on taking the living and turning it into the dead? What we define as GDP is actually taking forests and rivers and polluting them so that we can have money in our bank accounts. Production of "natural resources" is simply the destruction of nature. Every facet of our economy is about causing pollution. When I buy grapes from South Africa for $1.99/pound, it's because the cost of the pollution caused in packaging then shipping them to my local Walmart is borne by Mother Earth. How else can I get grapes from the other side of the world so cheap? It's because all that gas and plastic pollution went into the environment for free. No one had to pay for it. Except the environment.

    Getting back to the market bubble, we're somewhere near a market top. We're also coming into a drought/fire season that may result in months and months of seeing the world on fire in the way Australia was. In this case, it'll be the U.S. and in particular, California. I think, therefore, there'll be incoming reasons for financial pessimism. This most certainly will not be the final financial collapse, but I'm thinking there's a pullback coming.

    I would like to say that some people believe the already frothy markets will continue to stay on fire for the next two years due to re-opening. They argue the high P/E ratios now will correct themselves as companies see their growth rebound. I think these arguments are fine, but they don't preclude a near-term correction. So what I'm arguing is not necessarily a crash, but the circumstances exist for the possibility of a big correction. The final death-throe collapse, hopefully, is still a while away.

    Lastly, I read someone's financial opinion yesterday - he said he felt Bitcoin was a forward indicator of the market. BTC peaked in April. He felt markets lagged BTC by 2 months. So we're about there now. So if you're trying to time the markets, that's something to think about.

    Drought saps California reservoirs as dry summer looms
    https://apnews.com/article/californi...f46880ed6dab9c

    Shocking photos show impact of California drought
    https://www.independent.co.uk/climat...-b1859667.html

    California faces worst drought in decades: 'Economic disaster'
    https://www.foxnews.com/science/cali...nomic-disaster

    A severe drought is gripping the Western U.S. as wildfire season begins
    https://www.cnbc.com/2021/06/04/drou...on-begins.html

  12. #62
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    FWIW, I literally called a top. My post above occurred on Saturday June 5. End of day June 4 was a recent peak.
    Click image for larger version. 

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    I emptied a single account that June 4, going all cash, then this past Monday, I dumped it all into inverse Bitcoin (BITI) at 19.50. Up 10K this week.

    Click image for larger version. 

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  13. #63
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    Are we mispricing climate risks or not pricing them at all? (June 17, 2021)
    https://thehill.com/opinion/energy-e...ng-them-at-all
    "The IMF has recently warned equity investors that they are not sufficiently pricing climate change risks."

    Not sufficiently pricing climate change risk? I personally agree with the title that we're not pricing them at all.

    Climate change is an existential risk for civilization. For the markets to be ignoring it in its entirety, is truly mind-boggling. What this also means, is the moment the market DOES recognize it, the collapse in equity values will be catastrophic. Climate change is not going to be fixed in our lifetimes.

    Click image for larger version. 

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    40% of the worst California wildfires since 1930 occurred in 2020. This year is predicted to be worse.

    There will be a day when the markets realize the earth is no longer going to be "Business-As-Usual". As temperatures rise, so will droughts, so will wildfires. We'll be spending more and more GDP on fighting disasters, not growing the economy. As temperatures heat up, weather patterns slow, meaning areas with rain will be inundated and dry areas will become more parched. This will affect food growth and agriculture. The point is, things are on a downwards trajectory but the markets do not consider any of this. It's been a down week on the DJIA. Are people going to realize soon that dogecoin, AMC and digital NFTs really aren't worth a trillion dollars?

    There will be a day when the markets realize the world we are in now. It's hard to predict when that will happen but as I mentioned, this year's fire season is going to be very bad. When there's daily news in July and August of how California is being burned to the ground, that could wake people up.

    You may want to decide if you want to be in this market or not. I think it would be prudent to be defensive.

  14. #64
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    I am sure we have all seen those "dump your eye doctor" commercials advertising an online refraction/contact lens renewal service. It's a little scary to me. How can an app or an optometrist tell if you have corneal neovascularization from contact lens overwear/abuse when they aren't physically present to examine your eyes? Of course, the fine print is that you should still see an eye doctor but they over-estimate how much concern the public has for eye health. I had a room-mate once who was wearing daily contacts for three years, so he claimed. I doubt there was even anything left.

    There needs to be an industry push for the importance of seeing an eye doctor routinely. Our optometrist and ophthalmologist have predicted that patients are at risk of stroke or have already had a stroke long before the primary care doctors have. They have discovered patients were diabetic who had not been diagnosed by their PCPs. We can glean a great deal from a comprehensive dilated eye examination. It's crazy to me that we often see patients in their forties and fifties who have never had an eye exam outside of the very basic one done by the school nurse back in grade school.

    Also, yes, we are basically at the point of no return as far as climate change goes. Just this week there are reports of fire-nados. Yikes. Scientists are warning us that the moon's wobble combined with rising sea levels due to melting polar ice will cause extreme flooding. Business cannot continue as usual. Tinfoil hat though here, but part of me suspects the billionaire space race is really them planning their exit if and when the crap hits the fan. Maybe they'll bring some of us peasants along. They will still need eye exams, glasses, and eye surgery in space, right?
    Krystle

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