One of my goals is to do whatever I can to elevate the profession of optometry. If I’m asked to be involved in something that doesn’t do this, I decline. And the reason is simple: we have a profession of kind, compassionate and striving individuals who do what is best for our patients. However, I worry that our only enemy is ourselves or, more specifically, fear, complacency and apathy. Helen Keller once said, “We may have found a cure for most evils; but we have found no remedy for the worst of them all, the apathy of human beings.”

Optometry is a great profession; we serve the public in medical, optical and contact lens needs and we are a trusted provider. But sometimes this success breeds complacency, or worse yet, apathy due to fear or disregard of the future. All of our efforts to advance the profession are futile if any of these negative elements are present. So it’s time to start thinking about how to best position ourselves for the opportunities at hand and take action today.
Sears, Toys“R”Us, Blockbuster and Lehman Brothers are all great examples. These companies became complacent in their accomplishments and disregarded the future—even when it was upon them. They believed what worked well now wouldn’t need to change. Jeff Bezos, the founder and CEO of Amazon, on the other hand, says he is driven by the fact that “what’s dangerous is not to evolve and grow.” Here’s how we can evolve for the future.


It’s probably time to have staff do more so you can focus on what’s most important in growing your practice and serving patient’s needs. The most valuable staff members will also want the opportunity to do more and contribute to patients’ vision and quality of life. 

Many ODs are afraid to delegate refraction. But a recent study from Southern College of Optometry showed that new autorefraction tools suitable for staff use, such as VMax Vision’s voice-activated subjective refractor (VASR), are just as accurate as an experienced eye doctor’s manual reaction, or possibly more so.

In this study, faculty members with more than 80 years of combined experience conducted the manual phoropter refraction, while a second-year student using the VASR system had never performed a manual refraction. Results showed 14% of patients had better acuity with the VASR (>1 line Snellen compared with the manual refraction), 3% of subjects had worse acuity with VASR (>1 line worse refraction) and 83% were essentially the same. 

Right now these systems are only available to optometry, but this level of accuracy may one day be open to anyone. Amazon has already moved into pharmacy delivery and other areas of healthcare—why not optical? This should make us think carefully of future threats and how to prepare for them. Even if this never happens, preparing for it will ensure your practice is better positioned for the future.

Go Medical

You need to determine what your primary patient type is going to be in the future. And it will likely be in the area of medical eye care. The current ophthalmology shortage has created a significant demand that will be even more apparent in the coming years. Some are becoming desperate, and one colleague attending a major hospital group’s meeting heard an executive propose a physician’s assistant with an autorefractor as a solution. 

Many, like this executive, still don’t know optometry’s role in medical eye care. We need to educate our patients better, and we must do more to seize the medical eye care opportunity. If the logistics of medical eye care seem daunting, consider outsourcing your management needs to companies, such as Optometric Medical Solutions, that handle the credentialing, insurance verification, medical logistics and training. Attend meetings and conferences that focus on workshops to enhance your ability to conduct medical eye exams and treat conditions ranging from blepharitis to age-related macular degeneration (AMD). 

By delegating, we can see 20% more patients with no additional time. Adding 20% more medical eye care appointments, especially in the areas of dry eye, diabetes, AMD and glaucoma, can position our practices for the future and help more patients in greater need.

Note: Dr. Karpecki consults for companies with products and services relevant to this topic.