FEARS ASSOCIATED WITH THE PROFESSION - OPTOMETRY

[okdooky]

Hi there,


I am a third year university student (a Canadian citizen), willing to peruse Optometry as a profession.

I am well aware of the pros and cons of the profession as I have worked with lenscrafters and pearl vision for over 2 years now as a frame consultant.

I have monitored the optometrist working there very closely and have also shadowed some optometrist in a couple of different optical stores where they visit for a few hours per week.

Anyways, I want to share some of my fears with the group – and would really want all you helpful people to guide me through this :

My first fear is the Technologies coming up – specifically once that offer ONLINE REFRACTION – Big players taking over - selling ONLINE glasses and contacts may bring up Online refraction – Moreover, software’s such as eye NETRA, clarity from lenscrafters.

Secondly, I would want to know what would the market look like – if in near future anytime – if opticians are allowed to refract – that would take away a huge portion of chunk from the – optometrist platter.

Thirdly, (this relates more to optometrist practice in Canada) what if tomorrow government cuts off the free eye exams – that are being offered to the seniors and minors, once every year free – covered by government & seniors, minors and diabetics would have to pay out of pocket ????


All these are going to negatively affect the profession - & their income – saturation on top of it !!!

Would really want some views of all you intellectual and helpful people,

please !!!!!!!!!!

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[20DOC20]

I've been an OD for 20 years. I am currently working medical optometry in an OD/MD group. I worked commercial optometry, however, for most of my career.

The online refraction scares the living daylights out of me, too. It scared the AOA so much that they're suing Opternative in a last minute effort to make online refractions and exams illegal. Case pending. I saw a piece by John Stossel promoting Opternative and I thought, "We're done. It's finally over." Then, I felt a rush of panic as I realized that yes, indeed, I would have to find another career in the middle of my life!

I imagine the optometry school professors are scrambling right now for an explanation to give students. They'll say these technologies will only enhance what we do and that patients are well-educated enough to know they're not getting a real eye exam. What they won't tell you is that most young patients know it's not a real eye exam and that they DON'T CARE. They want the cheapest, fastest option to sitting for an hour in our offices getting dilated. The old people will be the only patients seeking a real exam and most of that generation prefers to see MDs because of medical issues. If the AOA fails to stop the online refraction, then this profession is doomed.

If opticians are allowed to refract then there's another chuck of our livelihood gone.

I work in the USA. If Medicare cut funding for annual diabetic eye exams, for example, those patient would not present for an exam every year and that would take out another chunk.

I see you've worked commercial and so you're aware of what you'll be getting into. Honestly, I just can't recommend this profession. My fear would be that you'll work really hard for 4 years for the degree, an additional year for a residency only to find yourself 250K in debt with no job prospects. That would be my biggest fear were I in your position.

Best wishes.

 

[20DOC20]

My advice would be to keep your options OPEN. Take the OAT, but also take the GRE and the MCAT and then see where it goes. Take the test for Dental school, too. Look into MS degree programs in the health professions. There are a lot of really interesting fields out there. Remember, all MS and PhD programs will require a GRE score and it's good for five years.

 

[okdooky]

I've been an OD for 20 years. I am currently working medical optometry in an OD/MD group. I worked commercial optometry, however, for most of my career.

The online refraction scares the living daylights out of me, too. It scared the AOA so much that they're suing Opternative in a last minute effort to make online refractions and exams illegal. Case pending. I saw a piece by John Stossel promoting Opternative and I thought, "We're done. It's finally over." Then, I felt a rush of panic as I realized that yes, indeed, I would have to find another career in the middle of my life!

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Thanks for sharing all that valuable info DOC 20.

Since you have shared such detailed information with me, which I really appreciate.

It would be great if you could guide me over a few other little things.

As mentioned, I have seen the profession very closely – I know the fact that – optometry practice can be different types, - such as OD/MD practice – or working as an associate with some already established optometrist – or working at different optical stores such as walmart/lenskrafters/generic store or your own practice.

I was trying to crunch some numbers – coz I realize the amount of debt I would be under, so would want your help

Wanted to know, in today’s time – which is highly competitive – practically with real world examples – how many patients does one optom see in a month on an average – I know the question is subjective – but to the best of your knowledge, not pointing towards anybody - taking some examples or your friends or a few other people in the same profession.

Some of the optometrists that I shadowed about 1.5 years back , use to see about more than 325-360 patients a month at any given time. Those are great nos.

I know that you have seen the market and this profession more than me – thus I would like to know that is this somewhat same (the no.s) with all optometrists or is it just few of them, that reaches that benchmark – and how few ?

These numbers would help me know – how the market is currently – and how much time would it take me to come off my debt.

I know that I am inquiring pretty in depth – that’s only because I am really considering this profession for myself. It has some IFFYS – but overall – not that bad.

 

[okdooky]

Thanks for sharing all that valuable info DOC 20.

Since you have shared such detailed information with me, which I really appreciate.

It would be great if you could guide me over a few other little things.

As mentioned, I have seen the profession very closely – I know the fact that – optometry practice can be different types, - such as OD/MD practice – or working as an associate with some already established optometrist – or working at different optical stores such as walmart/lenskrafters/generic store or your own practice.

I was trying to crunch some numbers – coz I realize the amount of debt I would be under, so would want your help

Wanted to know, in today’s time – which is highly competitive – practically with real world examples – how many patients does one optom see in a month on an average – I know the question is subjective – but to the best of your knowledge, not pointing towards anybody - taking some examples or your friends or a few other people in the same profession.

Some of the optometrists that I shadowed about 1.5 years back , use to see about more than 325-360 patients a month at any given time. Those are great nos.

I know that you have seen the market and this profession more than me – thus I would like to know that is this somewhat same (the no.s) with all optometrists or is it just few of them, that reaches that benchmark – and how few ?

These numbers would help me know – how the market is currently – and how much time would it take me to come off my debt.

I know that I am inquiring pretty in depth – that’s only because I am really considering this profession for myself. It has some IFFYS – but overall – not that bad.

 

[Optogal]

I saw a piece by John Stossel promoting Opternative and I thought, "We're done. It's finally over."

I had to look up John Stossel. Here he is:
John Stossel: A cheap internet prescription is not much of a threat to public health

And his two Youtube spiels, identical vids. Since their release a few months ago, a total view count of 37K views.
18.6K views
17.4K views

My take on this. I think refraction is at the mercy of technology eventually, but Opternative isn't it. Why? The cost. At $50, this DIY internet thing seems like an even worse value than a (say) $95 eye exam from an optometrist. Maybe I'm totally wrong on this but let me explain why and how I'd do things if I was this company.

Clearly Contacts got into the market because successfully because they knew they had a viable product/service that would eventually succeed, but they probably also realized that people had some reservations about getting glasses online. So the first year they were in the business, they gave away free glasses. All you had to do was pay shipping. At least that's how it was in Canada. What they realized they needed, was a large enough base of "pilot" individuals to try out their product, and be able to tell others that it works just as they expected it to. The way they got people to use their service was by providing it for free. Free sells. And the rest was history.

At $50, people using Opternative are simply using an app. Doesn't that seem like a rip off to you? Like - apps are "free", so it seems the people running Opternative are getting an even bigger "mark up" than optometrists at the store that charge $20 more. If the whole idea about an alternative is to cut out the big mark-up big made by unscrupulous "middle-men" (people in the middle of your money and your RX for glasses), then it seems Opternative is lining the pockets of the owners at an even greater percentage than the optometrist that is allegedly ripping you off.

Opternative should basically roll out their service "for free" in the initial stages so that a meaningful number of people get familiar and comfortable using their service, so they can start telling others to use it. Later, their fee should run like $10 - $15, and that's it. At $50, I can't see anyone thinking they are getting a "good" deal, if for $65, they can get the friendly optometrist they've been seeing since they were 5, to do their eye exam and eye health check etc. The price simply isn't competitive enough for people to try an "experimental" DIY cheapie iPhone app. It has to basically be free.

If anyone says, "Hey but people will pay $50 for a pair of online glasses instead of $95". But that's different. In both cases you are getting glasses. You may perceive the product to be essentially the same. But in this case, I don't see how people think using an expensive app (who pays to use apps??) is the same as seeing an eye doctor. As well, they all know friends who got glasses online, during the free period, and it seemed to work out for them.

So basically, Opternative isn't the alternative. They are too greedy and no, their $50 eye exam isn't cheap. As a user, I'd probably wonder why it cost $50. Where did that money go? I provided the internet connection, the iPhone. So I don't see anything but a big mark-up. So I wouldn't necessarily feel I was doing anything but lining their pockets by using this service.

 

[Optogal]

More on Opternative.

Opternative sues Warby Parker for allegedly stealing its online eye exam

On Warby Parker.

Warby Parker’s Prescription Check app lets you skip the eye doctor

Actually, if an online retailer of glasses (e.g. Clearly) provided this Rx thing for free, THAT would be a potential game changer. In fact, the irony is, Opternative would be the first to go. Actually - I'm going to make this prediction right now. Opternative will fail before the average optometrist does. Because a "free" opternative (which will happen eventually) will render Opternative obsolete before it makes an optometrist obsolete.

Dumb are the people who invest money in building up a $50 online DIY eye examination. Because a free alternative would obviously be around the corner. They would simply be doing the same service, but cheaper. As well, the irony is that Opternative's entire business model is predicated around the eye exam not being "good" value. Yet their service costs $50? If something is so worthless, then why is using their internet app so expensive?

Opternative will fail. $50? Give me a break.

 

[Optogal]

Ok - a bit more. Opternative clearly has some competitors. Here's one based in the Middle East.

6over6

Not to mention Warby Parker's free service. It appears to be offline (probably due to the lawsuit by Opternative).

Prescription Check app | Warby Parker
Prescription Check app | Warby Parker
Rating: 4 - ‎111 votes - ‎Free - ‎iOS - ‎Health
Prescription Check is a mobile refraction service that, if you are eligible, allows an eye doctor to assess your vision and provide an updated glasses prescription.

Opternative is going to go down so badly. Who are they expecting will pay $50 for something they can get for free? I'm sure they are trying to do a good job with this, and hence the cost, but if anyone is willing to do an online refraction to save money, they'll go all the way and get it done by a free app won't they? By charging $50, Opternative will never reach the critical mass required (i.e. market share) to become profitable. The most they can hope for is to have their service bought out by a major player, but since refraction is simply an algorithm, why would anyone pay them for their intellectual property if they can just develop an algorithm themselves? Further, if Opternative is "good" and has value added stuff, just look at their service and "copy" their ideas. Opternative should've tried to enter the market at around $5, maybe that would've worked. Instead, they're getting no business at $50, and probably paying lawyers etc. to fight copyright infringement lawsuits. Problem is, even if they win them, the internet is global. What stops someone from (say) the Middle East) from providing a cheaper service without any copyright concerns? Exactly who is financing this and why are they continuing to finance this?

What I'm not saying is that online refraction won't be a game changer, but a $50 online refraction will not be a game changer.

 

[okdooky]

Thanks for the info OPTOGAL,

I really appreciate that you shared all that info with all of us.
In fact, each word that you wrote is fact based and very practical.
Your post, knowledge and facts you shared reflect that you are from optical & eye care
industry as well. - optician/optometrist/ophtal

The info you gave about OPTERNATIVE really makes sense - does not make sense to me too-
to pay $50 for an app based test.

Optogal - you must have read my concern / query / question i posted above in this thread :

I would appreciate if you can add something to it !!

As mentioned, I have seen the profession very closely – I know the fact that – optometry practice can be different types, - such as OD/MD practice – or working as an associate with some already established optometrist – or working at different optical stores such as walmart/lenskrafters/generic store or your own practice.

I was trying to crunch some numbers – coz I realize the amount of debt I would be under, so would want your help

Wanted to know, in today’s time – which is highly competitive – practically with real world examples –

how many patients does one optom see in a month on an average working 5 days a week – I know the question is subjective – but to the best of your knowledge, not pointing towards anybody - taking some examples or your friends or a few other people in the same profession.

Some of the optometrists that I shadowed about 1.5 years back , use to see about more than 325-360 patients a month at any given time. Those are great nos. But these optoms have a 30 years old practice.
I know that optoms who graduated 5 years back - or for that matter 1 year back - would obviously have some different no.s to share - that's actually what I wanted to know - coz i would be going through the same heat / touch time in the initial years.

I know that you have seen the market and this profession more than me – thus I would like to know that is this somewhat same (the no.s) with all optometrists or is it just few of them, that reaches that benchmark – and how few ?

These numbers would help me know – how the market is currently – and how much time would it take me to come off my debt.

I know that I am inquiring pretty in depth – that’s only because I am really considering this profession for myself. Ithas some IFFYS – but overall – not that bad.

 

[Optogal]

how many patients does one optom see in a month on an average working 5 days a week – I know the question is subjective

Some of the optometrists that I shadowed about 1.5 years back , use to see about more than 325-360 patients a month at any given time. Those are great nos. But these optoms have a 30 years old practice.

There is no way anyone can give you a reliable "number" for an average. Not everyone wants to work "full time", not everyone works in saturated markets, not everyone works in unsaturated markets. I think a big factor is where in the US you want to work - since the US is so large, you can't meaningfully generalize how busy the avg optometrist is. In one place, the avg might be 400+ patients, and in another place, less than 250. And I'm just making up these numbers.

325-360 patients/month works out to about 85 patients/week. For a 5 day workweek, that's about 16-17 patients a day. That seems reasonable to me for someone basically fully employed with a full schedule. What is the likelihood you'll come out and be fully employed with a full schedule? If you're in a more competitive market, it'll take time to get to that stage. Probably a half year to a few years.

 

[bigred]

Here’s the math equation you actually need to consider. When you get a job you’ll make about 100k + 25-40k in benefits.

It really doesn’t matter where you practice in the US. Your total compensation package will likely be 125-140k. There’s probably some small pocket where this isn’t true but it will hold for the most part. This hasn’t changed much in the last 10 years and due to online glasses sales and DIY refraction it won’t go up anytime soon. If you consider inflation compensation is already on the way down.

I know those that practice mostly medical optometry may think refraction and glasses don’t matter. When there’s a few thousand residency trained new grads and unemployed highly experienced OD’s applying for the few medical optometry jobs it’s going to sink that ship as well.

 

[Dr. Dangerfield]

I remember being concerned when online refraction was first coming out. I actually emailed the AOA about it YEARS ago, complete with a link to Opternative's website, and never received a response. At any rate, I think the fear mongering is a little over the top about it. Will it affect Optometry's bottom line? Yes. Is it a death knell for the profession? No, I don't think so. (I should add, I'm somewhat of a negative nelly about optometry, so this post may surprise you.)

First of all, it's really hokey. I realize the technology will probably improve, but as it stands, the Rx results mysteriously match the prior Rx, you know the one you got last year from your "real" OD. Also, as was mentioned above, it's not particularly cheap, or super convenient. Yes you can do it in your pajamas, but it still takes 20-30 minutes to do. That's about 17-27 minutes longer than it takes most ODs to refract someone.

Second, it's actually limited to a certain age group. Can you lie about your age? Well, yeah. But that at least in and of itself may cause some people to think it might not be worth the $50 if the results aren't "accurate" for their age.

Third, Warby Parker, Zenni Optical, et al. have already been around a LONG time. Have they affected optometry's bottom line? Yes. Are they killing optometry? No. To put this in perspective, years ago ODs were screaming about how LASIK would kill us... Yeah. Not so much.

Fourth, think about the majority of the people who will be using these services. I would be willing to bet a LARGE portion of them would be the kind of patient most of us wouldn't want to waste our time with. You know, the patient that wears their daily lenses for 2 weeks at a time. The last time they filled that Rx was 2008. If they get glasses they buy the cheapest thing you sell and bring it back 100x for repairs/adjustments. With that said, I DO see these services being used as stop-gap measures for certain patients. "I just broke my glasses and I'm short on money. Need something quick and cheap!" However, I also see many of those patients coming back to get something "better" with you.

Fifth, in reference to fourth above, think about the patients you've had that got their glasses online over the years. I've had many. I can't tell you how many times I've heard "I got these online and they're awful" or "these were okay to get by with, but I need something else that's better" or something along those lines.

Finally, as much as we might hate to admit it, vision plans and health insurance will continue to drive patients to you.

So, with all of that said, is online refraction good for optometry? Heck no! However, I don't think it's going to sink the profession. To be quite honest, and I've been beating this drum for awhile, the problem is optometry is it's own worst enemy. But that's a whole other post on it's own.

 

[percyeye]

As of right now I don't fear online refractions in the slightest. If you've ever tried them and have half a brain you can tell it's a big joke. As someone said before me it actually takes a while and is very clunky (I've personally tried it). They actually can't fill any prescription without you sending in your old Rx, aka they are just reprinting your old RX. I did the online refraction and said I couldn't remember where I went for my last exam and had no way of getting my last RX, so as you would guess they said there was no way for them to get me a new RX and refunded my money. It's a total hoax.

 

[EyeU85]

Finally, as much as we might hate to admit it, vision plans and health insurance will continue to drive patients to you.

This is the biggest reason why the effect of the internet will likely always be capped. With 75% of patient having vision insurance, they are going to still do business offline. The thing that bothers me most about online refraction is that it seems like my Board is ok with that but for some reason isn't ok with online education. I can get my eyes checked online but I have to get my CE in person. Stupid.

To the OP, as for the numbers, I think it needs to be clarified. "Patients per day" are meaningless to me but "new exams per day" are not. If people are using them interchangeably, then the numbers in the above posts don't make much sense. As a private optometrist, I see about 200 new exams per month, gross a little over $300 per exam (on average), and make about 25% of that. With better financial management and a few better decisions in years past, I should be around 35%. If I saw 350 new exams per month, I'd be making 500k per year.

You obviously have to compare apples to apples and separate being employed versus being an owner. If you're employed, then perhaps making 125k on 350 exams per month is realistic. Just remember in that case, someone is making a lot on you.

 

[mkhuc]

I had to look up John Stossel. Here he is:
John Stossel: A cheap internet prescription is not much of a threat to public health

And his two Youtube spiels, identical vids. Since their release a few months ago, a total view count of 37K views.
18.6K views
17.4K views

My take on this. I think refraction is at the mercy of technology eventually, but Opternative isn't it. Why? The cost. At $50, this DIY internet thing seems like an even worse value than a (say) $95 eye exam from an optometrist. Maybe I'm totally wrong on this but let me explain why and how I'd do things if I was this company.

Clearly Contacts got into the market because successfully because they knew they had a viable product/service that would eventually succeed, but they probably also realized that people had some reservations about getting glasses online. So the first year they were in the business, they gave away free glasses. All you had to do was pay shipping. At least that's how it was in Canada. What they realized they needed, was a large enough base of "pilot" individuals to try out their product, and be able to tell others that it works just as they expected it to. The way they got people to use their service was by providing it for free. Free sells. And the rest was history.

At $50, people using Opternative are simply using an app. Doesn't that seem like a rip off to you? Like - apps are "free", so it seems the people running Opternative are getting an even bigger "mark up" than optometrists at the store that charge $20 more. If the whole idea about an alternative is to cut out the big mark-up big made by unscrupulous "middle-men" (people in the middle of your money and your RX for glasses), then it seems Opternative is lining the pockets of the owners at an even greater percentage than the optometrist that is allegedly ripping you off.

Opternative should basically roll out their service "for free" in the initial stages so that a meaningful number of people get familiar and comfortable using their service, so they can start telling others to use it. Later, their fee should run like $10 - $15, and that's it. At $50, I can't see anyone thinking they are getting a "good" deal, if for $65, they can get the friendly optometrist they've been seeing since they were 5, to do their eye exam and eye health check etc. The price simply isn't competitive enough for people to try an "experimental" DIY cheapie iPhone app. It has to basically be free.

If anyone says, "Hey but people will pay $50 for a pair of online glasses instead of $95". But that's different. In both cases you are getting glasses. You may perceive the product to be essentially the same. But in this case, I don't see how people think using an expensive app (who pays to use apps??) is the same as seeing an eye doctor. As well, they all know friends who got glasses online, during the free period, and it seemed to work out for them.

So basically, Opternative isn't the alternative. They are too greedy and no, their $50 eye exam isn't cheap. As a user, I'd probably wonder why it cost $50. Where did that money go? I provided the internet connection, the iPhone. So I don't see anything but a big mark-up. So I wouldn't necessarily feel I was doing anything but lining their pockets by using this service.

The trouble is that apps aren't "free." They take money to develop, troubleshoot, and maintain. There are developers constantly providing revisions and updates to ensure it gets better.

Charging $50/exam isn't greedy. It's a business model. If the market finds it too expensive, then they will have to change their business model in terms of their price point.

Similarly, a lay person who doesn't understand the nuance of optometry, can say something outrageous like, "why are you charging me $95 to pick between slides on a projector."

I hate to say it, but online computerized eye tests are very compelling as technology advances. The profession will have to do some soul searching. Simply saying "we do DM retinopathy screening" isn't going to cut it. Primary Care providers who have DM patients routinely refer their patients to OMD's for exams, because they can treat it at the same time.



Sent from my SM-G930T using SDN mobile

 

[Optogal]

The trouble is that apps aren't "free." They take money to develop, troubleshoot, and maintain. There are developers constantly providing revisions and updates to ensure it gets better.

Charging $50/exam isn't greedy. It's a business model. If the market finds it too expensive, then they will have to change their business model in terms of their price point.

Similarly, a lay person who doesn't understand the nuance of optometry, can say something outrageous like, "why are you charging me $95 to pick between slides on a projector."

I hate to say it, but online computerized eye tests are very compelling as technology advances. The profession will have to do some soul searching. Simply saying "we do DM retinopathy screening" isn't going to cut it. Primary Care providers who have DM patients routinely refer their patients to OMD's for exams, because they can treat it at the same time.



Sent from my SM-G930T using SDN mobile

I wrote this a few months ago. I'm not going to go and comb through what I wrote to refute your post here. Everything you say about what I say is taken out of context.

I didn't say online refraction won't succeed. I just said this $50 DIY won't, and I gave my reasons why.

Lots of apps are free to download. Clearly contacts gave out free glasses for their first year or so, just to develop market share and customer familiarity with online glass purchases. That doesn't mean I suggested anywhere that coding apps takes no money, or that producing glasses takes no money.

You're right they have a business model. "Most" business models fail. What is your reasoning behind this particular one succeeding?

You basically argued straw man. Must make you feel smart.

 

[Optogal]

$40
Lens.com: Online Vision Test

Free. (for a limited time)
https://www.1800contacts.com/online-contact-lens-prescription

Warby Parker's was free too, but their service is down because they are currently being sued by Opternative, with whom they evidently had signed a partnership agreement, before going alone on it.

 

[Optogal]

This is really entertaining.

It actually seems that Opternative is the provider of the vision test at 1-800. Not sure how that arrangement works since 1-800 is currently offering the test for free (regular apparently 19.99).

 

[Optogal]

More on online refraction.
Optometrists Counter Good Technology With Bad Legislation | HuffPost

Incredibly, there's even this lobby group. I wonder who is responsible for the finance behind this?
https://americansforvisioncareinnovation.org/

 

[PBEA]

how anyone could possibly confuse these watered down online visual acuity tests, with that of an actual examination of the eye...is beyond me. Maybe I'm overestimating the public's average IQ but I think you'd have to be pretty stupid to think that they were even remotely similar. 1800 et al, must think there are a lot of stupid people out there.

 

[percyeye]

FDA: Opternative in violation of federal law; AOA complaint validated

FDA just confirmed that these "online eye exams" should not be labeled as exams and said they do not meet FDA standards.

 

[REBK]

Interesting views, thanks for that, especially Optogal with the links. None of these concerned me when they were released, except for the Warby one, since that company has tremendous social cache right now, and of course, it is/was free.

That being said, alot of the fears with our profession's future are already playing out in a test bed known as Canada (specifically western Canada, specifically BC). Opticians can refract there, and a valid Rx isnt even required to fill a prescription. Lots of 20 and 30-year-olds I know are smart enough to figure out how the "sph" cyl" system works, and that BC and DIA are not so important, and have been making their own prescriptions for years! One guy told me he used to be a -2.00 but it was blurry, so he bumped himself up a quarter each time, and now he is happy as a -3.00. And of course, most towns have "Free Sight Testing", where you can go into an optical and get a machine to autoref you. So like I said, on paper, its the apocalypse of optometry. Yet... there are lots of optometrists in BC, and the ones I know are still doing very well for themselves.

Optometrist have to realize that every profession faces tremendous threats to its survival, that's the wonder of capitalism. If there is money to be made, innovation will follow. Not sure if anybody has had to replace a broken pipe or leaky faucet in the last few years, but you would be absolutely amazed at how easy it is now with push-on fittings. I can literally run a new water pipe across my whole house with a $3 tool and some rubber tubing and $10 push-it-on fitting in about 5minutes. This technology has been railed against by many plumbers (it's unsafe! it will fail! you will be sorry!) and in jurisdictions where there are strong plumbing unions, using these fittings are against code. But the secrets out of the bag, and the average DIY know that little fixes are possible on small budget. But are plumbers out of jobs? No, but they have adapted, and now need to concentrate on the big jobs, and less on the small ones. This is what optometry will do. We will lose some more low hanging fruit, but we will find even more fruit to replace it. If lasik never existed, and then all of sudden on the news tonight we hear of a new surgery to correct refractive error, we would all freak out. But lasik has been around for decades, and it hasnt killed our profession.

A bigger threat to our profression, and all professions, is AI and machine learning. Pattern recognition is the hallmark of these fields, and medicine (and optometry) is essentially that. So I have zero doubt that we will be replaced by AI in the next 20 years. If you doubt this, I suggest you take a course on machine learning through Coursea, and you will see how close they actually are.

 

[koonsaar]

A bigger threat to our profression, and all professions, is AI and machine learning. Pattern recognition is the hallmark of these fields, and medicine (and optometry) is essentially that. So I have zero doubt that we will be replaced by AI in the next 20 years. If you doubt this, I suggest you take a course on machine learning through Coursea, and you will see how close they actually are.

WillRobotsTakeMyJob.com gives Optometry a 14% probability of automation, so I wouldn't worry too much about that.
Will Robots Take My job?

 

[Optogal]

Pretty fun link. No surprises there with things like truck drivers and waitressing most likely to become automated.

I haven't read through the methodology of the site. Does 14% mean "me, personally" (i.e. 14% of optometrists will continue to work as optometrists, 86% will be unable to find work), or 14% chance that ALL optometrists will become unemployable? In any case, 14% might not seem high, but it is infinitely higher than Physicians and Dentists, and orders of magnitude higher than other doctoral professions like chiro and vets.

Again, it is just one site's opinion, but 14% is probably way higher than it "should" be for a post-doctoral professional degree that involves as much training as it does. So I think we shouldn't be happy with that number, given that comparable degrees are given much safer projections.

 

[Optogal]

That being said, alot of the fears with our profession's future are already playing out in a test bed known as Canada (specifically western Canada, specifically BC).

I think polyannas underestimate the significance of inertia. The current "manner" of getting glasses for most people involves getting their eyes checked and buying glasses/CLs in some sort of retail manner. For most people, the "routine" eye exam part costs say $80 +/- 20 or so, give or take. So that means some people are only paying 60 (I've heard of 45 in Florida). A $65 fee every 2-3 years isn't so exorbitant that people will need to find any means to circumvent that cost. Indeed some will, and have done so, but a sea-change will take years to take effect. Is it however, possible this profession is one big ponzi scheme, whereby established and near-retirement aged practitioners will get out, whereas those entering and early in their careers will be around when the doodoo hits the fan? I don't think we can outrule that, if we're talking a 25 year horizon.

 

[koonsaar]

Pretty fun link. No surprises there with things like truck drivers and waitressing most likely to become automated.

I haven't read through the methodology of the site. Does 14% mean "me, personally" (i.e. 14% of optometrists will continue to work as optometrists, 86% will be unable to find work), or 14% chance that ALL optometrists will become unemployable? In any case, 14% might not seem high, but it is infinitely higher than Physicians and Dentists, and orders of magnitude higher than other doctoral professions like chiro and vets.

Again, it is just one site's opinion, but 14% is probably way higher than it "should" be for a post-doctoral professional degree that involves as much training as it does. So I think we shouldn't be happy with that number, given that comparable degrees are given much safer projections.

From what I read the percentage is the probability that the occupation as a whole will be "lost to robots". The mathematics behind it are more complex than I want to spend time trying to understand, but it looks at the Probability of Computerization based off of categories such as Perception and Manipulation, Creative Intelligence, and Social Intelligence (each having its own "o∗net Variables") and converts all of that into a mathematical formula.

Also the website gives physicians and dentists a 0.42%-0.44% probability of automation, so those occupations are much safer but not infinitely higher. Eventually robots are probably going to take over every occupation so it's more a matter of when. I personally don't see that happening within the next 20-40 years though.

 

[Optogal]

Also the website gives physicians and dentists a 0.42%-0.44% probability of automation, so those occupations are much safer but not infinitely higher. Eventually robots are probably going to take over every occupation so it's more a matter of when. I personally don't see that happening within the next 20-40 years though.

"Infinitely higher" was a figure of speech, not a mathematical derivation. Fine, so (according to the website) optometry is 32 times, or 3100% more likely to be lost to robots than medicine. That is still pretty crap odds compared to medicine.

For a time horizon of 40 years, I think you are giving tech way too little credit. A.I. relevant to eyecare is not 40 years away.

 

[REBK]

Yes, fun link to play with, but I think the percentages are fairly useless. Tech innovations and market disruptions usually happen exponentially instead of linearly. There is no way that family physicians only have a 0.4% of being taken over by AI in the next 40 years. The site claims lawyers have a 3.5% chance, however, the MIT Technology Review has an article from Dec 2017 claiming pretty much the opposite. Sure, AI won't get rid of all lawyers, but will get rid of the vast majority of them.
Family GPs wont cease to exist, but is it that hard to imagine a world where a nurse takes your vitals and case history (or a computer), and inputs that data into a program which spits out a list of differential diagnosis, further testing, and or treatment plans? I'm pretty sure we almost already live in that world.

 

[Optogal]

OK. Didn't want to start a new doomsday thread, but THIS I think is inching towards what I would call a potential gamechanger. As I've mentioned above, I don't think much of DIY refraction, but this remote-OD thing approaches what I've always imagined was possible - an optometry "kiosk" of sorts, where a patient could get all their various eye-assessments done using automated machines in a one-stop shop. In this case, it's a remote-OD who assesses the results of various tests. Link below, and the intro by some OD front man for the company. It doesn't take very much imagination to see how this can get off the ground.

Digitaloptometrics I Learn more about Tele-Optometry Exams
I am a consultant with DigitalOptometrics, the first remote based optometric led eye exam. The company was founded by Howard Fried, OD and he wants optometrists to lead this new technology.

DigitalOptometrics provides basic primary care eye exams using a remote ophthalmic technician and remote OD. These exams include EOMs, CT, Conf VF, IOPs, retinal photos, ant seg videography, and incorporates Optos, OCT, and other technology you may want to integrate.

The clinic site is charged $45 per glasses exam and $60 per contact lens exam to DigitalOptometrics. The remote optometrist receives $10 per glasses exam and $15 per contact lens exam and they spend an average of 5 min per patient, but can spend more. ANY symptom experienced results in a referral to your own office or to an office in the area that provides services (glaucoma, dry eye, vision therapy, blepharitis-meibography, concussion rehab, etc). Any amount above those fees is retained by the clinic hosting DigitalOptometrics exams.

There are many possibilities for optometrists using this technology. You can open a satellite office and not have to hire another OD, but pay per exam to DigitalOptometrics. If you have 2 offices and you split time between them, you can always capture the walk in patients and grow your practice with expanded hours using DigitalOptometrics. You will also be able to capture more product sales because DigitalOptometrics ODs will be available all hours that you want.

If you are semi retired but prefer to still practice, you may do so remotely with DigitalOptometrics. If you are disabled or have other health issues, you may still be able to practice optometry with DigitalOptometrics. If your spouse takes a job in another country, you may still practice optometry with DigitalOptometrics. Many more options may help expand your optometric life by partnering with DO.

Remote ODs make $500 per day to start even if they are seeing only 2-3 patients. Once they begin seeing enough patients the pay switches to per patient.

So there are 2 growth challenges happening simultaneously and this is happening fast. We are recruiting ODs and signing up clinics to use the DigitalOptometrics system.

Howard launched this at Vision Expo East in March 2018 and it was very well received. He has already spoken with leaders in corporate optometry as well as large private OD networks. He has had favorable feedback from the AOA and we are now going to all state organizations because we want optometry to lead the way in telehealth exams. There are 5 clinics currently operating in New York, New Jersey, and Pennsylvania with over 800 live exams performed and only 2 eyeglass remakes. Our goal is to be in every state in 4 years. We have optometrists signing up for training every day from multiple states. We have many corporate test sites scheduled for install in coming weeks.

I believe there is a lot of opportunity for optometrists to use this to grow private practice, to travel and be a remote OD, or to have this as a better alternative to other "refractive exams" being heavily promoted through social media channels who are excluding optometrists from the process, and also providing inferior care.

Contact me if you want more info or have questions.
Follow "Telehealth for Optometry" FB page.


Chad Fellows,OD
[email protected]
802-777-2015
www.DigitalOptometrics.com

 

[Optogal]

A potential worst-case scenario for something like this is summed up by M.Ware on ODwire.

"Eventually most corporate locations almost assuredly would opt to go with remote ODs and put about 20,000 optometrists out of work. This would lead to even further corporate optical expansion thanks to the lower overhead, not to mention an even worse oversupply issue, which would then lead to the destruction of private practices that can't compete on cost or with the thousands of new private offices opened up by the displaced corporate ODs."

I don't know what the arrangement is between ODs and chains like WM/Costco/LC in the US, but I can imagine that if something like DO is (substantially) more cost effective than having an OD in house, then at least some of the chains will look into this. Unlike DIY refraction, I personally can envision chains adopting this or something similar to this.

Thinking further, I can also imagine a situation where OMDs use the technology and sub-contracted ODs to do exams, to try to take out the OD profession entirely. If these arrangements are able to see patients in large numbers, it would have a profound effect.