This past week, Ginger Baker, the fabled drummer of the 1960s supergroup Cream, passed away at 80 years of age. With Eric Clapton on guitar, Jack Bruce on Bass and Baker on drums, Cream created a veritable wall of sound unlike anything that came before it. I will never forget the first time I heard Cream. The music was different, the times were different and after listening to them, life was different.

One of my favorite Cream songs was Crossroads, a classic Blues song originally recorded by legendary bluesman Robert Johnson in the 1930s. Reflecting on Baker’s passing, and thinking about Cream and Crossroads led me to the subject of this week’s Off the Cuff.

Life is filled with crossroads. Sometimes we take the right road. Sometimes we don’t. Some choices are trivial. Some are life changing. As optometrists, I suspect we will soon find ourselves and the profession at a crossroads—an important one. Things are changing and changing fast. Much faster than most of us can grasp.

It has become increasingly obvious, not just to me, but to many, that what defined optometry for more than a century will soon largely fade into irrelevance. Some of the best minds in the eye care industry are already engaged in crisis management exercises, and more will soon recognize this existential threat to traditional optometric practice. VSP already figured it out and hedged their bets with their Visionworks acquisition. Look at what’s happening with equity capital. Look at what’s happening with our schools. None of this is by accident.

The combination of artificial intelligence and advanced technology will have the greatest impact on the things that we take most for granted. Don’t underestimate the effect. Grammarly, essentially a grammar and writing assistant, just raised an additional $90M and has over a billion-dollar valuation. Investors see the future and power in AI.

For most of its existence optometry was primarily a refractive profession, but with rare exception, in just a few very short years, virtually no refractions will be performed by human optometrists. If your practice is still mostly refractive, change will come like a sledgehammer and there will be no place to hide. The profession’s crossroads is coming up fast. What worries me is that we are not prepared for it. Much of the profession’s leadership still seems oblivious. Many of us are in denial.

Conventional optometric practices will either change proactively, be forced to change begrudgingly or cease to exist. Those of us who understand that change is coming and prepare for it are the ones most likely to take the right road when they arrive at the crossroads. The others? It won’t be pretty. Over the coming months I will share a project I am working on that will help point the profession in the right direction.

Arthur B. Epstein, OD, FAAO Chief Medical Editor artepstein@optometricphysician.com