Think back to 1997 for a minute.

In Washington, we had peace, prosperity and a (somewhat) functional Congress. The cutting-edge gadget of the day, a Palm Pilot, allowed users to take notes and manage appointments on a low-res black-and-white screen. Amazon sold only books (a new British novel about a boy wizard was getting buzz but hadn’t yet reached these shores) and Google had just launched in September.

The only Kardashian anyone had heard of was family patriarch Robert. Apple had just rehired its old cofounder—some guy named Steve Jobs. He had lots of crazy ideas about new technology that seemed fanciful at the time.

While the era’s peace, prosperity and far fewer Kardashians looks enviable today, in most other ways we’ve advanced radically since then. But not, apparently, in the productivity of a typical optometric practice.

The average number of exams performed per OD per hour hasn’t budged since then: it was 1.1 patients per hour in 1997 and exactly the same in 2012. Since 1997 the US population has grown, and grown older. Eye care professionals haven’t kept pace with the increased demand for their services. That’s just one of the many sobering statistics John Rumpakis, OD, MBA, points to this month in his call to arms for optometrists to defeat the “economics of apathy” (see page 65). Dr. Rumpakis offers a wealth of data to detail many new opportunities to improve your practice.

Next, imagine a patient is in your exam chair, with vague complaints of subpar vision—and none of your instruments are working. No photopter to measure visual acuity, no tonometry to record the intraocular pressure, no slit lamp to examine the anterior segment, no ophthalmoscope or OCT to evaluate the retina. Could you make an accurate diagnosis? Not likely.

And yet, when you make business decisions without measuring the practice’s vital signs, that’s what you’re doing. To bring some rigor to the process, Gary Gerber, OD, offers his insights on critical metrics of practice performance in this month’s Optometric Study Center exam on page 74.

As someone who has seen many practices struggle, Dr. Gerber explains 15 key stats that you should be measuring and acting upon. Might these two notions be connected? If practice owners lack the tools to evaluate business decisions systematically, they won’t make the right ones, or any at all. That sounds like a recipe for stagnation.

This issue has lots of terrific ideas to boost practice performance. But if you do nothing else except improve on that patients-per-hour figure, it’ll have a ripple effect throughout the practice, allowing you to take on new opportunities. You’ll feel like you’ve traded a Palm Pilot for an iPhone.

The Best is Yet to Come

This is an excellent time to be an optometrist. There, I said it. Not many people do these days. Too often, doom and gloom talk dominates the conversation. Yes, the field of optometry currently faces loads of challenges. Can you name a profession that doesn’t? Especially in health care, which is currently roiling with uncertainty about the impact of the Affordable Care Act, enacted this month despite the Shakespearean drama in Washington that accompanied its birth.

No matter what happens on that front, optometry is sitting pretty. The emphasis on preventive and routine care will bring more patients in to optometric practices, and will raise your clout in the delivery of health care. Recognizing the importance of optometrists in the conversation about surgical options, well-known industry players are beginning to educate ODs about their surgical products. Would you have expected that even just a few years ago? Ophthalmology (as a whole and on the individual level) has been making overtures to optometry. Expect more—a lot more. We’re approaching a tipping point at which ODs will begin to drive the discussion.

Surgical comanagement isn’t for you? No problem. How about a greater emphasis on optometric specialty services, like VT, pediatrics, low vision or dry eye? Respondents to our income survey (see page 46) related successes in those pursuits—and, encouragingly, 66% reported satisfaction with their income, a slight increase from last year. From retail dispensing to essential vision care services to medical and surgical comanagement, the options are yours for the taking.

Hopefully, this month’s special issue on practice management can help you to open the door when opportunity knocks.