A quote often misattributed to Mahatma Gandhi nicely sums up the state of optometry right now: “First they ignore you, then they laugh at you, then they fight you, then you win.” That’s been the trajectory of the optometry profession within the larger healthcare system ever since it started to see a role for itself beyond the world of glasses. Much of this ambition was met with derision from members of the medical establishment at first. Then they stopped laughing and dug in for a protracted fight. 

But optometry has been in phase 4 a lot lately, with plenty of wins to tout. We’ve talked at length in these pages about the successes of the latest scope expansion effort, adding Virginia and Colorado to the roster of laser states this year alone, while California tees up its own potentially game-changing lasers-and-lesions bill. These successes become self-perpetuating over time: more states are sure to follow.

The public is taking notice, too. In a recent analysis that gave a nice little PR jolt to optometry, the profession was ranked #2 on a list of the top 20 careers of 2022 by the job board Indeed. The site ranked careers by the amount of job postings they’ve received for positions with salaries above $75,000; admittedly, a pretty narrow metric. Still, it’s interesting that four of the top 10 careers were in healthcare (registered nurse, optometrist, pharmacist, nurse practitioner)—and none required an MD degree. 

This embrace of healthcare beyond the walled garden of organized medicine will only continue. The next bit of good news will likely come from the Dept. of Veterans Affairs, which is about to announce a more robust role for optometry as part of something called the Federal Supremacy Project, an effort by the agency to improve delivery of care in the VA system by empowering its non-MD healthcare providers to take on more responsibility. The VA is going to propose granting rights to optometrists in its system that would supercede the laws of the state in which they practice. This will be yet more validation that properly trained ODs can and should work to the full extent of their training. Expect it to make waves and, if successful, become another peg in future arguments for legislative scope expansion.

The profession also continues to graduate record numbers of new ODs, a fact that brings with it some hand-wringing about declining admissions standards. While it’s true that the average OAT score among students accepted to optometry schools has declined a bit—from 324 in 2010 to 309 in 2021, according to ASCO—there hasn’t been a corresponding increase in the number of students who wash out. The percentage leaving their program has remained steady over the last 15 years: 1.6% of the student body in the 2006-07 school year and 1.5% in 2020-21. Further, poor academic performance as the reason for such departures actually declined over the same period, from 63% to 47% of cases. Finally, the NBEO ultimate pass rate was 92.5% in 2021, which speaks well of the academic resilience of today’s students.

Add it all up and you’ve got more ODs doing more things in more places. But as I’ve said before, now it’s time to deliver. No one wants these wins to become hollow victories.