In our May issue, we opened our general elections on some of the larger issues facing the profession of optometry. We called for your vote and put the ballot on our Web site.
The polls closed at the end of October, with more than 500 optometrists casting their votes.

Some of the responses might be predictable. For example, 93% of O.D.s say no to opticians writing spectacle Rxs.
But, some of the responses may surprise you. Thirty percent of respondents say theyd return to school for two years to gain surgical privileges. About the same percentage say that more women in optometry will have a negative effect on the profession.

Other questions ask about the influence of company-sponsored continuing education. More hot topics: Will there be enough O.D.s to take care of retiring baby boomers, or do we need to graduate more O.D.s to handle them?

Read on to see what your colleagues think about these issues.


Does Optometry Need Board Certification?

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The Joint Board Certification Project Team (JBCPT) is currently working on a model for optometric board certification. Once developed, the model would then be put up for consideration by the profession.

Why be board certified? Optometry is the only prescribing doctoral level health care profession that does not have a board certification process available as an ongoing measure of advanced (beyond entry level) clinical competence, the JBCPT says.

The project team defines board certification as, a voluntary process that establishes standards that denotes that a doctor of optometry has exceeded the requirement(s) necessary for licensure. It provides the assurance that a doctor of optometry maintains the appropriate knowledge skills and experience needed to deliver quality patient care in optometry.

Meanwhile, more than 700 O.D.s signed an online petition, posted on, opposing board certification. Board Certification ... begs the question: Why are Optometrists, having undergone extensive education, performed supervised clinical rotations, graduated from accredited institutions, and passed national board examinations, not currently competent? the petition says.


Continuing Education Questions

Commercial support for accredited continuing medical education (CME) has increased dramatically in the past decade. Indeed, nearly half of the $3 billion spent annually on CME comes from industry, according to the American Medical Associations Accreditation Council on Continuing Medical Education (ACCME).1

The limited evidence that does exist shows that CME activities funded by commercial interests can be effective in changing physicians prescribing practices. This is consistent with the extensive literature showing that CME changes physician practice and improves patient care, the ACCME wrote in a June 2008 report.1

Improving patient care is good, but to what extent does industry influence have in changing prescribing habits simply to sell drugs or products? In a 2006 survey, as many as one-third of doctors thought that their own decision to prescribe a drug would probably be influenced by accepting drug samples. Moreover, respondents were more likely to think an average doctors prescribing would be influenced by acceptance of the items than theirs would be.2


1. Cervero RM, He J. The relationship between commercial support and bias in continuing medical education activities: A review of the literature. June 2008. Available at: doc_upload/aae6ecc3-ae64-40c0-99cb-4c4coc3b23ec-uploaddocument.pdf (Accessed November 4, 2008).

2. Morgan MA, Dana J, Loewenstein G, et al. Interactions of doctors with the pharmaceutical industry. J Med Ethics. 2006 Oct;32(10): 559-63.


Are Tuition Costs for Optometry Schools Out of Control?

How can tuition debt affect graduating optometrists?

Consider that the combined debt of the 90 graduating students of the 2008 class of Nova Southeastern University College of Optometry equals more than $13 million. Thats an average debt of $152,410, according to study author Michael Bacigalupi, O.D., M.S. (See O.D. Students in Big Time Debt.)

Students who graduated in 2008 may need as much as 20 or 30 years to pay their debt back comfortably, Dr. Bacigalupi says.
And, he adds, student debt is only growing.

So, are tuition costs for optometry schools out of control?

Optometry as a Workforce

The American Optometric Association commissioned a study, Workforce Projections for Optometry, published in May 2000. The study predicted an oversupply of O.D.s through 2020. Still, a 1% increase in demand for eye exams would eliminate the oversupply and result in a shortage of O.D.s by 2013, the study said.

But, these projections are almost 10 years old.

If anything, theres going to be a real crunch on the demand for eye-care services, says Richard Edlow, O.D., chair of the AOAs Information and Data Committee.

As the first baby boomers turn 65 in 2010, there will likely be a greater prevalence of age-related eye disease, he says.

Also, the AOAs workforce study did not consider a shift in demographics in the United States. Consider: Latest estimates from the Census Bureau show that the Hispanic population is projected to nearly triple from 46.7 million to 132.8 million between 2008 and 2050. The black population is projected to increase from 41.1 million to 65.7 million by 2050.

Thats going to have a dramatic impact on the demand for services, Dr. Edlow says. The reason I say that is with both glaucoma and diabetic retinopathy having a much higher prevalence in the Hispanic and African-American populations, the demand for services is going to increase at a much more rapid rate than the [workforce] study predicted.

Dr. Edlow estimates that the demand for services will likely increase anywhere from 4% to 10%.

So, we need to be very careful not to have this sense of complacency that we have too many optometrists, Dr. Edlow says.

Then again, 94% of respondents to our survey said there will be enough O.D.s to take care of the baby boomers.


Women Are Changing Optometry

Women outnumber men in optometry classes. Thats changing the face of the profession.  In 2005, nearly 24% more women graduated from optometry school than men, according to data from the Association of Schools and Colleges of Optometry (ASCO). And, in the 2005-2006 school year, women made up 42% of didactic and clinical faculty, according to ASCO.

Women are also catching up to men in the increasing numbers of practicing optometrists. In 2000, the American Optometric Association (AOA) Workforce Study estimated that 43% of O.D.s under age 40 were female.

But results of the 2007 AOA Economic Survey show that women optometrists earn less than men optometrists. In 2006, the mean net income for men O.D.s was $142,924, while women optometrists only took home $101,788.

Two issues may explain this discrepancy: One, the women O.D.s who responded to the survey were only in practice for a median of eight years, while the men O.D.s were in practice for a median of 20 years. And, women optometrists are more likely to be employed by others than to be self-employed.


AOA Economic SurveyNational Highlights. Available at: (Accessed November 4, 2008.)

Vol. No: 145:11Issue: 11/15/2008